The most important questions in cancer research and clinical oncology Question 2-5.Obesity-related cancers:more questions than answers

Obesity is recognized as the second highest risk factor for cancer. The pathogenic mechanisms underlying tobaccorelated cancers are well characterized and efective programs have led to a decline in smoking and related cancers, but there is a global epidemic of obesity without a clear understanding of how obesity causes cancer. Obesity is heterogeneous, and approximately 25% of obese individuals remain healthy(metabolically healthy obese, MHO), so which fat deposition(subcutaneous versus visceral, adipose versus ectopic) is "malignant"? What is the mechanism of carcinogenesis? Is it by metabolic dysregulation or chronic inflammation? Through which chemokines/genes/signaling pathways does adipose tissue influence carcinogenesis? Can selective inhibition of these pathways uncouple obesity from cancers? Do all obesity related cancers(ORCs) share a molecular signature? Are there common(overlapping) genetic loci that make individuals susceptible to obesity, metabolic syndrome, and cancers? Can we identify precursor lesions of ORCs and will early intervention of high risk individuals alter the natural history? It appears unlikely that the obesity epidemic will be controlled anytime soon; answers to these questions will help to reduce the adverse efect of obesity on human condition.

An international survey of classification and treatment choices for group D retinoblastoma

AIM： To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS： An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. RESULTS： The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children＇s Hospital of Los Angeles （CHLA） version, 33% used the Children＇s Oncology Group （COG） version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were： Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were： Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center （P〈0.0001）. CONCLUSION： Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.

Association of E-cadherin (CDH1) gene polymorphisms and gastric cancer risk

AIM:To investigate the associations between CDH1 gene polymorphisms and gastric cancer(GC) risk predisposition.METHODS:We analyzed four CDH1 polymorphisms(+54 T>C,-160 C>A,-616 G>C,-3159 T>C) in an Omani population,by extraction of genomic DNA from the peripheral blood of 192 patients with GC and 170 control participants and performed CDH1 genotyping using DNA sequencing.RESULTS:CDH1-160-AA genotype was associated with an increased risk of GC(OR = 3.6,95% CI:1.1-11.8)(P = 0.03).There was no significant association between the other polymorphisms and GC risk.The haplotype analysis of +54 T>C,-160 C>A,-616 G>C,-3159 T>C genotypes revealed that the OR of CCGC and CAGC haplotypes was 1.5(95% CI:0.7-3.5) and 1.5(95% CI:0.2-3.0),but did not reach statistical significance.CONCLUSION:The current study suggests that the-160 AA genotype was associated with an increased risk of GC in Oman.

LIGHT-INDUCED FLUORESCENCE SPECTROSCOPY AND OPTICAL COHERENCE TOMOGRAPHY OF BASAL CELL CARCINOMA

Many up-to-date optical techniques have been developed and applied recently in clinical practice for obtaining qualitatively and quantitatively new data from the investigated lesions.Due to their high sensitivity in detection of small changes,these techniques are widely used for detection of early changes in biological tissues.Light-induced fluorescence spectroscopy(LIFS)is one of the most promising techniques for early detection of cutaneous neoplasia.Increasing number of recent publications have suggested that optical coherence tomography(OCT)also has potential for non-invasive diagnosis of skin cancer.This recent work is a part of clinical trial procedure for introduction of LIFS technique into the common medical practice in National Oncological Medical Center in Bulgaria for diagnosis of non-melanoma skin cancer.We focus our attention here on basal cell carcinoma lesions and their specific features revealed by LIFS and OCT analysis.In this paper we prove the efficiency of using the combined LIFS-OCT method in skin lesions studies by integrating the complimentary qualities of each particular technique.For LIFS measurements several excitation sources,each emitting at 365,385 and 405 nm maxima are applied.An associated microspectrometer detects in vivo the fluorescence signals from human skin.The main spectral features of the lesions and normal skin are discussed and their possible origins are indicated.OCT images are used to evaluate the lesion thickness,structure and severity stage,when possible.The obtained results could be used to develop a more complete picture of optical properties of these widely spread skin disorders.At the same time,our studies show that the combined LIFS-OCT method could be introduced in clinical algorithms for early tumor detection and differentiation between normal/benign/malignant skin lesions.

Epidemiological Aspects and Anatomopathological of Ear Nose and Throat (ENT) and Cervico-Facial (CF) Cancers at the Military Hospital of Nouakchott

This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.

Peritoneal Histoplasmosis about a Case and Literature Review

Histoplasmosis is an opportunistic granulomatous fungal infection. Peritoneal histoplasmosis (PH) is a rare form. The first case of PH was described in 1970 but this is the first case reported in Mauritania. We report the case of a 60-year-old male patient with a history of pulmonary tuberculosis, treated and declared cured, and partial epileptic seizures treated with Carbamazepine. Contrast computed tomography of the abdomen showed a large mass with a large intraperitoneal fluid component with a finely calcified wall in places, for which laparoscopy and biopsy were performed, identifying Histoplasma capsulatum infection. The subject received treatment with amphotericin B deoxycholate with good evolution, and outpatient management with itraconazole. PH is a rare entity that requires high clinical suspicion, especially in immunocompetent patients. The patient was informed that non-identifying information from the case would be submitted for publication, and he provided consent.