がんの科学と治療

Introduction: A worldwide estimated annual case of cervical cancer is 493,000 and ends with 273,500 annual deaths. In developing countries, it accounts for about 85% of both its morbidity and mortality. According to the report from World health organization, globally in 2012, cervical cancer incidence was 7.9%, mortality 7.5% and five-year prevalence was 9%. In sub-Saharan Africa the incidence was 25.2%, mortality 23.2% and five-year prevalence was 27.6%. In Ethiopia the incidence was 17.3%, mortality 16.5% and five-year prevalence was 18.2%. Methods: Retrospective cross-sectional study was conducted between 10/08/08 up to 28/01/2009 E.C. Data was collected from August 17th, 2002 E.C to 2008 E.C all charts of cervical cancer patients diagnosed and screened between August 17th, 2002 E.C to 2008 E.C at Yirgalem General Hospital was retrieved from cervical cancer screening and diagnosis logbook. Univariate, bivariate and multivariate analysis were performed using SPSS version 20. Results: from the screened clients, 16.5% had cervical cancer. From the screened and diagnosed clients those with multiple sexual partners had 40 times higher odd of cervical than those with no multiple sexual partners. This study revealed that being Human immune deficiency virus positive (AOR=9.033: 95%: CI 4.537, 17.985), sexually transmitted infection history (AOR=8.364:95% CI: 5.639, 12.405) and early age at initiation of sexual intercourse (AOR=8.968:95%: CI 5.588, 14.393) have statistically significantly associated with cervical cancer in multivariate analysis Conclusion: Of screened clients, 16.5% were with acetone white lesion and the risk factors for cervical cancer were having multiple sexual partners, human immune deficiency virus positive, history of sexually transmitted infection and early age at initiation of sexual intercourse. Early screening on mass campaign and focus from the government and other stake holders by strengthening both cancer prevention and control program and implementation strategies through due attention on the associated risk factors of the study.

Carotid blowout syndrome is one of the most complex bleeding complications that may occur in head and neck cancers patients. The purpose of this paper is to report the clinical manifestations and endovascular management of a case of patient with neck malignancies and a history of radiotherapy. The patient underwent immediate covered stent deployment which resulted in the successful control of bleeding.

Cervical cancer is the fourth most common cancer that occurs in women worldwide. In 2012 there were about 530,000 new cases reported of which about 270,000 were fatal. The fraction of these deaths that could be attributed to Human Papilloma Virus (HPV) was estimated to be 100 percent. Since the high-risk HPV virus causes cervical cancer, it is necessary to screen the population and eventually vaccinate against HPV. This is a descriptive crosssectional study conducted on 355 eighteen-to-sixty-year-old married women with normal Pap smear who visited the OB/GYN clinics of Isfahan University of Medical Sciences. Specimens from cervix transformation zone and endocervical canal were obtained by cytobrush method; then cytology study was performed on them, DNA being extracted. The presence of HPV infection and its subtypes including HPV 16, 18, 6, and 11 were assessed by using polymerase chain reaction method. Ninety cases (25.35% of the cases) had positive HPV PCR. Among these positive samples, 15.56% were type 16; 13.33% were type 18; 21.11% were type 11 or 6, and 50% were of other types. Of all positive cases, 7.22% were carrying at least one of the high-risk type of the virus. Based on the high prevalence of this virus in this as well as other studies, it was specifically proven that types 16 and 18 are risk factors for premalignant and malignant lesions of cervix. Moreover, administration of Quadrivalent vaccine in prevention of cervical cancer is suggested for our population.

Purpose: Antibodies that target immune checkpoint molecules have demonstrated significant and durable clinical benefit through re-activation and proliferation of pre-existing tumor-infiltrating CD8+ T cells in a broad range of tumor types including lung cancer. Detailed characterization of T cell dynamics at clonal levels using nextgeneration T cell receptor (TCR) sequencing in large cohorts of lung cancer patients is yet reported.
Methods: We performed TCR sequencing of peripheral blood samples (and some tumors) obtained from 27 lung cancer patients undergoing single/combined immune checkpoint blockade therapies.
Results: In one responder, we found expansion of a single T cell clone (approximately 20% of the all TCR reads) in a metastatic subcutaneous lesion that showed pathologic complete response on day 17 of treatment. The same TCR CDR3 sequence was detected in 6.1% of TCR reads in the peripheral blood prior to treatment initiation and the expansion remained persistent in peripheral blood at 21.0% at week 10 and 24.3% at week 48. In other patients who showed durable response, we also found persistent oligoclonal T cell expansion in their peripheral blood which was not observed in non-responders even while they remained on therapy.
Conclusion: We found sustained expansion of oligoclonal T cell clones in lung cancer patients who had durable response to immune checkpoint blockade. This suggests possible use of longitudinal TCR sequencing to assist clinical decision-making, assess synergism with other agents, and most importantly facilitate rational development of alternative treatment strategies for non-responders.