Iraqi Journal of Cancer and Medical Genetics
Iraqi national specialized and peer reviewed scientific journal in cancer and medical genetics published by the Iraqi Center for Cancer and Medical Genetics Research, Mustansiriyah University. The Journal of Cancer and Medical Genetics (IJCMG) is an international scholarly publication that focuses on original research in the fields of cancer and medical genetics. It encompasses peer-reviewed articles, as well as comprehensive reviews and expert opinions on the most recent advancements in these areas. The articles cover the molecular mechanisms of human diseases, which include the study of germline cancer genetics, the clinical manifestations of genetic abnormalities, the utilization of molecular and genetics in medical practice, and the comprehensive assessment of these applications on a global scale. In addition, the Cancer section features original, high-impact articles and content solicitations based on the most recent findings in both clinical and basic research. Every issue of the publication aims to achieve comprehensiveness by addressing a wide range of oncology disciplines and offering valuable content for all individuals engaged in cancer research, risk mitigation, treatment, and patient care.
Iraqi Center for Cancer and Medical Genetics Research / Mustansiriyah University
Bioactive Imine-Amoxicillin Hybrids: Dual Antibacterial and Anti-Breast Cancer Potentials Supported by Molecular Docking
Antimicrobial and anticancer drug resistance represent two of the main global challenges for public health and require immediate practical solutions. Drug-resistant cancer chemotherapy and the growing threat posed by antimicrobial-resistant infections represent additional biomedical challenges. Thus, one viable way forward to develop multifunctional candidates with improved biological value is by altering existing drugs through chemical modification. Three imine-amoxicillin hybrids, J1-J3, were synthesized from the condensation of amoxicillin trihydrate with 2,4-dihydroxy-3-propylbenzaldehyde, 3-ethyl-4-hydroxy-5-methylbenzaldehyde, and 2-(3-formyl-4-hydroxyphenyl)acetonitrile. All products were successfully obtained as yellow to yellowish-orange precipitates, and subsequent characterization of the products by FTIR demonstrated that azomethine C=N bands formed during the condensation reactions. FTIR data also revealed the formation of new azomethine bands corresponding to derivatives J1 at 1643, J2 at 1620, and J3 at 1644 cm-1, indicating that Schiff base synthesis occurred. Additionally, docking studies were performed against the 6IIO protein, and the results revealed that synthesized derivatives J1, J2, and J3 possessed favorable docking scores of -7.83371, -8.18972, and -8.1703 kcal/mol, respectively. Derivatives J2 and J3 demonstrated the strongest antibacterial activity against S. pyogenes and B. subtilis, producing inhibition zones of 35 mm and 26 mm, respectively, at 0.1 mg/mL within the study. Furthermore, compared with the synthesized derivative J1, the synthesized derivative J3 exhibited stronger cytotoxic activity against the MCF-7 cell line, with IC50 values of 123.8 and 160.3 μg/mL, respectively. Finally, on the basis of ADMET prediction data, the gastrointestinal absorption of all three molecules is expected to be low, and only derivatives J3 and J2 will comply with the proposed rules of Lipinski’s rule.
Amoxicillin; Breast cancer; Drug resistance; Imine; Molecular docking
Copyright (c) 2026 Iraqi Journal of Cancer and Medical Genetics https://creativecommons.org/licenses/by/4.0
Efflux Pumps, Biofilms, and Tumor Resistance: Converging Mechanisms in Microbial and Cancer Survival: A Narrative Review
Drug resistance is one of the greatest obstacles to pharmaceutical success in contemporary medicine and has greatly restricted both antimicrobial and therapeutic approaches to cancer. While microbial multidrug resistance and cancer chemoresistance have been traditionally considered discrete processes, there is growing evidence that they have a number of common survival mechanisms. This narrative analysis critiques and clarifies drug-resistant bacterial pathogens and cancer cell molecular, structural, and physiological processes, including efflux pumps, biofilm-associated protection, and tumour microenvironment-mediated resistance. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar for papers on multidrug resistance mechanisms in microbial and cancer systems. This review shows how bacterial resistance-nodulation-division (RND) and cancer-associated ATP-binding cassette (ABC) transporters reduce intracellular drug accumulation and favour treatment failure. Biofilms and solid tumours have remarkable parallels in their extracellular polymeric matrices, which hinder medication penetration and let resistant cell populations survive. Emerging efflux pump inhibitors, antimicrobial peptides, drug delivery systems based on nanocarriers coupled to microenvironmental surveillance and microenvironment targeting technologies are considered among promising mechanisms for combating multidrug resistance. With much advancement, clinical translation continues to be constrained by toxicity, low selectivity, and resistance network complexity. In general, we emphasize that microbial and cancer resistance have in common the adaptive strategies and underscore the critical need for multi-domain strategies to develop optimized therapies against multidrug resistance.
Efflux pumps; Multidrug resistance (MDR); ABC transporters (ABCB1, ABCG2); Cancer chemoresistance; Antimicrobial resistance; Biofilms; Tumor microenvironment; Efflux pump inhibitors (EPIs); Pharmacogenomics; Nanocarriers
Surface Mold Brachytherapy for Scalp Dermatofibrosarcoma Protuberans in a Patient with Down Syndrome: A Case Report
Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue sarcoma arising from the dermis, representing approximately 0.1% of all malignancies. Although surgical excision with wide margins remains the standard treatment, local recurrence is common, particularly in patients with close or positive margins. Adjuvant radiotherapy is therefore recommended for recurrent disease or inadequate surgical margins. We report a rare case of scalp DFSP in a patient with Down syndrome treated using high-dose-rate (HDR) surface mold brachytherapy with the aid of three-dimensional (3D) printing technology. A 25-year-old woman with Down syndrome presented with recurrent DFSP of the right parieto-occipital scalp following an unplanned excision. Wide local resection with an occipital transposition flap and skin graft reconstruction confirmed DFSP with a deep positive margin involving the skull (R1). Owing to the curved scalp anatomy and the patient’s limited cooperation related to cognitive impairment, adjuvant HDR surface mold brachytherapy was selected. Treatment planning was performed using CT simulation under sedation. A 3D-printed skull model allowed the optimization of catheter placement without the need for further resimulation. A total dose of 32.5 Gy in five fractions was delivered using an Ir-192 radioactive source. Treatment was well tolerated, with only mild grade 1 dermatitis and partial alopecia. The irradiated tumor bed showed an initial complete response. Approximately twenty-two months later, a marginal recurrence developed at the edge of the surgical scar in the right temporal region, while the rest of the irradiated field remained free of disease. This nodule was removed by wide local excision, the multidisciplinary tumor board recommended observation, and the patient remained clinically free of recurrence at the most recent follow-up. Mild late effects included localized alopecia, hyperpigmentation, fibrosis, and thinning of the skin graft.
The Microbial Conductor: Orchestrating Cancer Hallmarks through the Intratumoral Microbiome
The intratumoral microbiota, which consists of a variety of bacteria, fungi, and viruses living inside the tumor, is gaining recognition as a multifunctional factor that influences cancer development in multiple ways, similar to a “microbiological conductor.” The structure of the intratumoral microbiota is highly heterogeneous among different individuals and correlates closely with the immune response of the host, the tumor microenvironment (TME), and therapy effectiveness. Certain types of microbes can act as a conductor for tumor growth and progression through carcinogen production, inflammation disruption, or immune escape. In addition, the intratumor microbiome may affect the response to therapy by affecting the metabolism of drugs used during chemotherapy, as well as the effectivity of immuno-oncology drugs. The study of the intratumoral microbiome and its interaction with tumors thus has huge possibilities that may help us understand the basic mechanisms responsible for tumor formation and growth and at the same time provide new opportunities for personalized therapies in oncology. This review discusses the biological functions of the microbial community in regulating hallmarks of cancer, the current state of knowledge about its multidimensional interactions that lead to tumor growth, and the potential of microbiome-based approaches, considering recent developments. Further scientific efforts will be required to overcome methodological challenges, which include multi-omics studies combined with functional validation.
Association of TLR9 Gene Expression with Prior COVID-19 Infection in the Colorectal Cancer Tissues of Iraqi Patients
Background: It has recently been reported that colorectal cancer is among the most common types of cancer in Iraq. This cancer arises from genetic and hereditary changes in the epithelial cells of the colon or rectum and often progresses from benign adenomatous polyps to invasive cancer. Methods: A total of 30 Iraqi patients of both genders (11 males and 19 females) with colorectal cancer (CRC) and 15 healthy people (controls) were included in the study. Patients attended the Gastroenterology and Liver Diseases Teaching Hospital, Medical City, Baghdad, between January 2025 and November 2025. Participants underwent diagnosis. Results: Toll-like receptor (TLR9) gene expression levels were studied in all patient groups. Compared with that in the control group, TLR9 gene expression was significantly greater in colon cancer patients than in rectal cancer patients and control subjects (6.88 ± 0.77, 4.79 ± 0.90, and 1.04 ± 0.19, respectively). With respect to COVID-19, TLR9 gene expression was significantly higher in the colon cancer group than in the rectum and control groups, which were not infected with COVID-19. The values were 10.21±0.88, 6.15±3.24, and 1.08±0.23, respectively, with P < 0.001. There was also a significant difference between the two groups of COVID-19-infected and noninfected patients with colon cancer (P < 0.001). In tumor tissue, the size was less than 1 mm, and high TLR gene expression occurred in the patient group compared with that in the control group (P < 0.001). Compared with rectal cancer patients and controls, colon cancer patients were significantly more prevalent (7.75±1.11, 2.42±0.36, and 1.21±0.32, respectively), according to the group whose tumor tissue size was above 1 mm (P < 0.001). Conclusion: These findings indicate that TLR9 expression may represent a potential tissue biomarker in colorectal cancer. However, larger studies are needed to validate these findings.
Echinococcus granulosus Cyst Wall Antigens as Potential Anticancer Agents: Protein Characterization and Cytotoxic Effects on a Human Colorectal Cancer Cell Line
Colorectal cancer is among the most common cancers worldwide and is the second leading cause of cancer-related mortality. Early detection and screening are crucial for reducing both incidence and mortality. Parasitic diseases may induce anticancer effects through interactions between the parasite and its host. Accumulating scientific evidence has proven the validity of this concept, as some parasites have shown anticancer activity in vitro. This research aims to prepare and characterize hydatid cyst wall antigens by determining protein concentrations and analyzing them using electrophoresis, as well as evaluating their cytotoxic activity in a human colorectal adenocarcinoma cell line (HRT-18) compared with that in a normal human cell line (NHF). Methods: In this study, the Lowry method was used to measure protein concentration, and electrophoresis and MTT assays were used to determine the toxicity and IC50 values of the cyst wall antigens in both cancer and normal cell lines. The results revealed a dose-dependent cytotoxic effect that was significantly greater at the highest antigen concentration (100 µg) for colorectal cancer cells than for normal cells, while the effect was less pronounced on normal cells. The IC50 value of the cyst wall antigens on cancer cells was 24.0 µg/ml, whereas it was 100.8 µg/ml for normal cells, with a high selectivity index (SI) of 4.2, which indicated that the cyst wall antigens selectively target cancer cells while sparing normal cells. Conclusion: Antigens extracted from the cyst wall, including cyst wall antigens, are more cytotoxic to cancer cells than to normal cells; thus, these antigens are potential antitumor agents and warrant further investigation.
ODAM: A Novel Tumor Suppressor Silenced in Breast Cancer
Background: The Odontogenic, Ameloblast-Associated gene (ODAM) encodes a matricellular protein that is involved in cell adhesion and odontogenesis. Emerging evidence suggests a role in tumor biology, with its expression documented in various epithelial malignancies, including breast cancer (BC). This study investigated the expression, clinical significance, and functional role of ODAM in BC, with a focus on its relationship with the AKT signaling pathway. Methods: ODAM expression in malignant, benign, and control groups (n=35 per group) was quantified via quantitative real-time PCR (qRT‒PCR) and normalized to that of the housekeeping gene GAPDH. Patient classification and dataset generation were based on oncologist evaluations and confirmed mammography findings. Serum AKT concentrations were measured by ELISA. Survival analysis was performed using a large public breast cancer dataset. Results: ODAM expression was significantly downregulated in malignant breast tissue samples than in benign and control tissue samples, with an approximately 66.6-fold downregulation in ODAM expression in BC patients (p<0.01). This loss of ODAM was inversely correlated with serum AKT levels, which were significantly elevated in malignant patients (3.173 ng/ml) versus controls (1.510 ng/ml; p<0.01). ODAM overexpression in aggressive BC cells suppressed tumorigenic properties by inhibiting growth, migration, and invasion while promoting cell adhesion and apoptosis. Mechanistically, ODAM may be associated with alterations in serum AKT and PI3K/AKT signaling and the upregulation of the expression of the tumor suppressors phosphatase and tensin PTEN. Critically, Kaplan-Meier survival analysis revealed that high ODAM expression is a favorable prognostic biomarker and is associated with significantly improved overall survival in BC patients (HR = 0.89; 95% CI = 0.80–0.98; p = 0.022).
Prognostic significance of CD34 expression and HbF level in childhood acute lymphoblastic leukemia
Background: Acute lymphoblastic leukemia is a heterogeneous malignancy characterized by variable biological and clinical behavior. Multiple diagnostic modalities, including morphological, immunophenotypic, cytogenetic, biochemical and molecular analyses, are essential for its diagnosis and classification. Both CD34 antigen expression and fetal hemoglobin levels have been linked to prognostic outcomes in pediatric acute lymphoblastic leukemia patients. Objectives: This study aimed to evaluate the prognostic significance of CD34 and hemoglobin F levels in childhood acute lymphoblastic leukemia patients and to explore their correlation with other hematological and clinical parameters. Method: A cross-sectional study was performed on 28 pediatric patients (<15 years) with a new diagnosis of ALL at the Oncology Department of the Central Teaching Hospital of Pediatrics from August 2017 to April 2018. Data were obtained from each patient using a questionnaire. Peripheral blood and bone marrow samples were analyzed by morphology, cytochemistry and flow cytometry. Hemoglobin F levels were determined using high-performance liquid chromatography. Results: CD34 expression was detected exclusively among B-lineage acute lymphoblastic leukemia patients and was detected more frequently in children with favorable clinical and hematological prognostic factors.. No associations were detected between HbF levels and any clinical or hematological prognostic factors. Conclusion: CD34 expression is a common event in childhood B-ALL and is associated with favorable prognostic factors. HbF levels were not associated with any clinical or hematological prognostic factors.
Cardiovascular disease and risk factors in Iraqi cancer patients: a cross-sectional study
Background: Cardiovascular diseases and cancer are major causes of mortality worldwide. Comorbidities among cancer patients significantly influence prognosis and quality of life. These comorbidities, including cardiovascular disease, may result from underlying pathology similar to that of noncancer patients, chemotherapy, or direct tumor extension. Our study aims to estimate the burden of cardiovascular diseases among cancer patients in our community. Methods: This was an observational cross-sectional study conducted at Basra Oncology Center and Basra Hematology Center. In this study, adult patients with different types of cancer, including solid and hematological malignancies, were included. The investigators extracted data from the medical records of the patients, including demographic data, past medical history, cancer type and stage, type of treatment (chemotherapy or radiotherapy), and history of cardiovascular diseases (ischemic heart disease, heart failure, valvular heart disease, pericardial disease, deep vein thrombosis, pulmonary embolism, cerebrovascular accidents, hypertension, hyperlipidemia, and diabetes mellitus). Results: We randomly enrolled 250 adult patients, including 173 females (average age 53.4 years, range 20-87). Breast cancer was the most common type, followed by gastrointestinal, genitourinary, lung, hematological, and brain tumors. Among the 250 patients, 51 (20.4%) had cardiovascular diseases, with ischemic heart disease being the most frequent, followed by venous thromboembolism, deep vein thrombosis, arrhythmia, heart failure, and valvular diseases. Additionally, 207 patients (82.8%) had cardiovascular risk factors, with hypertension being the most prevalent risk factor. Conclusion: The burden of cardiovascular disease and risk factors significantly present across all types of cancer. Early diagnosis and management of cardiovascular disease in cancer patients are needed to improve prognosis.
Matrix Metalloproteinases-3, -9, and Prolidase: A Promising Therapeutic Strategy Targeting Breast Cancer
Matrix metalloproteinases (MMPs) are tightly regulated enzymes that play a significant role in tissue remodeling. They are produced by normal and tumor cells and participate in extracellular matrix remodeling and degradation of basement membrane barriers. During tumor progression, cancer cells invade surrounding tissues, accompanied by numerous alterations, leading to microenvironmental stress and breakdown of the extracellular matrix, including loss of basement membrane integrity caused by dysfunction of metalloproteinase activity. This review summarizes the significant roles of MMP-3, -9, and prolidase in different stages of breast cancer progression to offer a comprehensive understanding of the main contributions of these enzymes in breast tumors. Studies have indicated that elevated expression and enzymatic activity correlate with tumor progression through the modulation of transcription factor activity and metastasis mechanisms. MMP-3 is involved in angiogenesis; inhibition of MMP-3 activity is considered a potential therapeutic strategy. In contrast, MMP-9 plays a restrictive role in angiogenesis. Numerous studies have shown that targeting tissue inhibitors of MMPs or silencing these enzymes represents a promising therapeutic strategy to suppress tumor growth and enhance apoptosis. MMP-3, MMP-9, and prolidase should not be considered independent regulators of extracellular matrix remodeling; they function through interconnected mechanisms that govern the dynamic remodeling of cancer progression. Few studies have investigated prolidase activity and its role in pathological processes, and its precise association with MMP-3 and MMP-9 in breast cancer remains poorly understood. Currently, no studies have directly discussed the relationship between MMP-3 and prolidase; however, few mechanistic studies have indicated that prolidase acts as an upstream regulator of MMP-3 and MMP-9 in breast cancer. Further experimental investigations are needed to clarify the interplay of these enzymes in extracellular matrix remodeling within the breast tumor microenvironment to support the development of a prospective therapeutic approach.
Copyright (c) 2025 Iraqi Journal of Cancer and Medical Genetics https://creativecommons.org/licenses/by/4.0
Anti-cancer effect of camptothecin and chloroquine on the inhibition of lung cancer and breast cancer cell proliferation
Background:This research aimed to evaluate the toxic effects of chloroquine alone and in combination with camptothecin on two human cancer cell lines, namely, MCF-7 breast cancer cells and A549 lung cancer cells. Objective: To determine the percentage inhibition of breast and lung cancer cells after 72 h of exposure to treatments utilizing (originally against C. trachomatis), chloroquine and camptothecin alone and in combination and to calculate the respective half-maximal inhibitory concentration (IC50) values. Methods: Exposure to varying amounts of chloroquine, camptothecin, and a mixture of these drugs was performed for 72 hours. The percentages of growth inhibition and IC₅₀ were obtained to investigate the cytotoxic effects. Results: Single treatment with chloroquine strongly reduced cell viability in both models; however, it moderately inhibited (57 - 63%) MCF-7 cells and strongly inhibited (72 - 77%) A549 cells, suggesting that lung cancer cells are more sensitive to chloroquine. Dual treatment with chloroquine and camptothecin resulted in dose-related cytotoxic activity. The inhibition was 17 - 35% at lower doses, whereas a greater percentage of cell death occurred (52 - 67%) at higher doses. Analysis using the IC₅₀ further confirmed the presence of an interaction between the two drugs. Conclusion: These findings indicate that chloroquine potentiates the antitumor effects of CPT, especially in A549 cells.
camptothecin, chloroquine, lung cancer cell line(A 549), Breast cancer Cell line (MCF7).
Predictive Power of Multiplex Serum Biomarkers in Breast Cancer: A Comprehensive ROC Curve Analysis
Introduction: Breast carcinoma is one of the most prevalent cancers in women, with its progression influenced by a complex interplay of genetic and environmental factors. This study aimed to investigate the association between resistin, mammaglobin, MUC1, CA15-3, CEA, and AKT pathway activation in breast cancer development. Methods: A cross-sectional study design was performed in Iraq/ Medical City at Baghdad/ Oncology Teaching Hospital. All samples (105 samples of blood) were classified into 3 groups; each one contains 35 samples. Results: A serological analysis was conducted using ELISA to measure serum levels of key biomarkers. Malignant samples exhibited elevated concentrations of mammaglobin (mean: 3.74 ng/ml), resistin (mean: 4.195 ng/ml), CA15-3 (mean: 36.15 ng/ml), CEA (mean: 41.983 ng/ml), mucin1 (mean: 33.45 ng/ml), and AKT (mean: 3.174 ng/ml). Conclusion: The findings suggest that a combined assessment of these tumor markers could enhance the prognosis, diagnosis, detection, and monitoring of breast cancer. Notably, CEA and MUC1 demonstrated superior sensitivity and specificity, positioning them as highly reliable biomarkers for clinical application.
Surgical Management of Skull Base and Spinal Chordomas: A Systematic Review and Meta-Analysis
Background: Chordomas are rare tumors originating from residual chordate tissues, predominantly affecting the base of the skull and the axial skeleton. Aim: This systematic review investigates the anatomical aspects and neurosurgical treatment modalities of skull base and spinal chordomas. Methods: We conducted a systematic literature review, adhering to PRISMA guidelines, by searching Databases including PubMed/Medline, Scopus, ScienceDirect, and EBSCO. Data was managed using Microsoft Excel and analysis was performed using SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). PROSPERO Registration Number; CRD420261322007. Results: In this study, we conducted a systematic review and meta-analysis, including a total of N=2,083 patients with clinical and neurological manifestations, as outlined between Table I and Table IV. The analysis results are summarized in Table 1. N=1,485, (71.5%) patients, N=636, Gross total resection (GTR), N=640, subtotal resection (STR), N=568, Radiotherapy, as detailed in Tables I and II and Figures 1, 2, and 3. Heterogeneity was assessed as follows: I² = [23%, 24%, 32%]. P = 0.21. Conclusion: The aggressive nature of chordomas necessitates personalized treatment strategies. Surgical approaches, particularly for elderly patients, proved promising in chordoma excision. Despite advancements, further research into disease management and etiopathogenesis is crucial for improved prevention, detection, and treatment strategies. Adjuvant therapies exhibited enhanced survival rates, highlighting their significance in prolonging patients' lives post-surgery.
Occurrence of hepatitis B and C infection in pediatric patients with cancer at Alhadbaa Hospital in Mosul/Iraq
Pediatric cancer patients face increased susceptibility to hepatitis B and C virus infection owing to immunosuppression resulting from the disease and its treatment, the frequent need for blood transfusions, and invasive procedures. This study sought to determine the prevalence of HBV and HCV infection within this community and identify correlated risk variables. Cohort research was performed in the oncology unit of Alhadbaa Teaching Hospital in Mosul from December 1, 2014, to December 1, 2024. The study included 153 children (under 15 years) with cancer selected randomly for routine checkup at the outpatient clinic who were initially negative for HBV and HCV at diagnosis, and screening was performed every 3 months for HBV and HCV. Demographic data, cancer type, vaccination status (both routine and postdiagnosis), and blood transfusion history were collected. Results: Over a follow-up duration of 10 years, all the children remained in follow-up, largely because of their families’ strong commitment to monitoring their health status, given the diagnosis of cancer. Twelve patients (7.8%) seroconverted to HBV-positive, and 2 patients (1.3%) acquired hepatitis C virus (HCV), culminating in a total incidence of hepatotropic viruses of 9.1%. Although higher proportions of HBV infection were observed among children who underwent blood transfusions and those who were unvaccinated or inadequately vaccinated, these associations did not reach statistical significance. The infection rate decreased relative to that reported in prior trials conducted in other countries. These results strongly support the stringent enforcement of universal blood product screening and meticulous aseptic procedures, importantly, at the time of cancer diagnosis for unvaccinated children. Conclusion: This study revealed that the prevalence of hepatitis B infection among pediatric cancer patients in Mosul was not significantly associated with frequent blood transfusions and insufficient immunization coverage.
The Role of Tumor-Associated Macrophages (TAMs) in Cancer Progression and Immunosuppression
Tumor-associated macrophages (TAMs) are important immunological components that influence the tumor microenvironment by inhibiting immune responses and encouraging tumor development and cellular proliferation. This study sought to assess the functional, morphological, and molecular functions of TAMs in solid tumor patients. This study used a number of methods, such as flow cytometry, quantitative polymerase chain reaction (qPCR), and immunohistochemistry. Blood samples were taken from 50 patients clinically diagnosed with solid tumors, as well as from 30 healthy individuals who served as controls. Cytological investigations revealed a considerable increase in the percentage of macrophages bearing the CD163 and CD204 markers, as well as a decrease in HLA-DR expression, indicating that the cells polarized toward the M2 immunophenotype with immunosuppressive features. Additional genetic analyses revealed elevated expression of IL-10, TGF-β, ARG1, CSF-1R, and MMP9, genes linked to the immunosuppressive tumor microenvironment (TME). Histological evaluations revealed distinct infiltration of macrophages toward tumor peripheral zones and increased PD-L1 expression by macrophages, suggesting that macrophages may participate in the regulation of immunological checkpoints in addition to the suppression of effector T lymphocytes. Statistical analyses showed an inverse correlation between PD-L1 and HLA-DR and a positive correlation with IL-10, supporting the notion of the pleiotropic immunosuppressive function of macrophages. These data underscore the importance of TAMs for tumor progression and suppression, thereby rendering them suitable targets for contemporary immunotherapeutic approaches. Research suggests that additional investigations on the potential for reprogramming or targeting these cells therapeutically to enhance the immunotherapy response in solid tumors are needed.
Assessment of Physical and Emotional Status and Fear among Women with Breast Cancer in Mosul City
Breast cancer is a significant health issue that affects patients› physical, emotional, and financial well-being as well as the health of their families. This study aimed to assess the physical, emotional, and fear of women with breast cancer. A descriptive cross-sectional study was carried out from November 2023 until July 2024. Ninety patients were selected from a purposive sample taken from the Nuclear Medicine Oncology Hospital in Mosul City. The study instrument includes questions about demographic and clinical data, physical and emotional health, and fear. Three response alternatives for each item (always, sometimes, never). Both descriptive and inferential statistics, such as chi-square tests, were used to examine the data, and the reliability estimate of the questionnaire was 0.89 breast cancer in women between the ages of 40 and 49 years. The affected women›s physical and emotional states were moderately impacted (46.7% and 51.5%, respectively). The responses from the participants indicated that their level of fear was between moderate and high. Additionally, there are worries about the disease›s potential to manifest and spread throughout the body. The study recommends that cancer patients benefit from good physical and emotional support to enhance their health, reduce their worry and fear through the use of coping strategies.
Highest Incidence Cancers Study: A Real Global Analysis
Background: According to World Health Organization publications, cancer arises from the transformation of normal cells into tumor cells in a multi-stage process that generally develops from a precancerous lesion to a malignant tumor. These changes result from the interaction between a person’s genetic factors and three categories of external factors: physical carcinogenic factors, chemical carcinogenic factors, and biological carcinogenic factors. The incidence of cancer increases sharply with age, and the accumulation of cancer risks is associated with the tendency for the effectiveness of cell repair mechanisms to decline as the person ages. This paper highlights the three main cancers that are most common in the world: female breast, prostate, and lung, accompanied by global statistical indicators by region. Material & Methods: Publications for the year 2024 on the incidence and mortality of the most common cancer diseases in global regions were used. A comparison was made by types of cancers by regions and finding their indicators, illustrated with graphs, for the three cancers. Results: The data analysis indicated that the mortality-to-incidence ratio (MIR) was lowest for female breast cancer (0.29), intermediate for prostate cancer (0.27), and highest for lung cancer (0.73). While Asia had the highest incidence of the three cancers, Africa demonstrated the highest mortality in relation to incidence. Conclusion: The results of the analysis of the data of the three most prevalent cancers showed that in the developed countries, despite the high number of cancer cases, their deaths were the least due to the sound health environment and the availability of diagnostic and treatment factors, unlike the continent of Africa, their death rate was the highest among other continents, despite the low prevalence.
Synthesis, characterization and cytotoxic effect of 2-((E)-((E)-2-(5-chloro-3,3-dimethylindolin-2-ylidene)-3-oxopropylidene) amino) benzoic acid on the MCF7 cancer cell line
Indole Schiff base derivatives have attracted considerable interest in the field of medicinal chemistry because of their broad range of biological activities. This study aimed to synthesize a new indole Schiff base derivative, and its cytotoxic activity was subsequently tested against the MCF7 breast cancer cell line and the REF normal cell line. The new compound 2-((E)-((E)-2-(5-chloro-3,3-dimethylindolin-2-ylidene)-3-oxopropylidene) amino) benzoic acid was synthesized via the condensation reaction of malonaldehyde with 2-aminobenzoic acid in methanol under acidic conditions, as shown in Figure (1). The chemical structure of the synthesized compound was characterized by TLC, FT-IR, 1H NMR and 13C NMR, and the absorption bands confirmed the chemical structure of this new compound. The cytotoxic activity of the new synthetic Schiff base compound was studied by using a breast cancer cell line (MCF7) and a normal cell line (REF). The results revealed a low inhibition rate at low concentration on normal cells with 11% and 12% for 48 hrs. and with (40, 60) µg/ml concentration showed 16% and 22% for the same time. The cytotoxic activity of this compound toward MCF7 showed a higher inhibition rate with 64% for the concentration (60 µg/ml), 63% for (40 µg/ml), 60% for (20 µg/ml), and 56% for (10 µg/ml) after 48 hrs. Therefore, this new compound has high potential to inhibit MCF7 breast cancer cell line.
Copyright (c) 2025 Iraqi Journal of Cancer and Medical Genetics https://creativecommons.org/licenses/by-nc/4.0
Anxiety levels among patients treated with chemotherapy at the Oncology Teaching Hospital in Baghdad city
Chemotherapy may cause psychological effects such as anxiety, and the level of anxiety varies from one person to another. Objective: This study aimed to assess the level of anxiety in patients treated with chemotherapy and to determine the relationships between anxiety levels and several variables, such as age and sex, level of education, and marital status. Method: A cross-sectional study was conducted from December 2022 to February 2023 at the Oncology Teaching Hospital in Baghdad city; the study involved 65 patients on the morning shift, and a questionnaire was used to measure anxiety levels (Anxiety Self-Rating Scale). The collected data were analyzed via SPSS V.23, which included descriptive statistical tests, frequencies, percentages, means, and chi-square tests for inferential analysis. Results: The results indicated that the majority of participants were women. (58.5%), aged between 39 and 48 years (30.8%) and diagnosed with breast cancer (41.5%). The highest percentages of anxiety (55.4%, 32.3%, and 12.3%) were moderate, mild, and extreme, respectively. Furthermore, the chi-square test revealed no statistically significant relationship between anxiety level and participants› demographic variables. Conclusion: This study revealed that patients had a moderate level of anxiety. There was no significant relationship between the level of anxiety of patients treated with chemotherapy and their demographic characteristics.
Investigation of CA15-3 and IgE in Iraqi lung cancer patients: A biochemical and immunological analysis
Introduction: Lung cancer (LC) is one of the leading causes of cancer death worldwide. A number of single nucleotide polymorphisms are associated with the risk of LC, which deserves to be studied further. Aim: The purpose of this study was to identify immunological and biochemical markers for Iraqi lung cancer patients. Method: Fifty LC Iraqi patients and 50 apparently healthy people, who composed the control group, were involved in the study. Blood samples were used for biochemical and immunological studies. DNA extraction and polymorphism of the EXO1 and CHRNA5 genes were carried out via polymerase chain reaction. Results: Lactate dehydrogenase (LDH), blood urea, and serum creatinine levels were significantly greater (P≤0.01) in LC patients compared with control. In contrast, adenosine deaminase (ADA), HbA1c, and Hb were significantly decreased. Moreover, the levels of immunoglobulin-E (IgE) and cancer antigen 15–3 (Ca-15-3) are increased in LC patients. Scanning the EXO1 gene revealed that the percentage of the mutant homozygous (AA) and (GA) genotypes is greater than that of the wild-type homozygous (GG) genotypes. Homozygous (GG) was highly significant in the control group than other genotypes (AA and GA). Conversely, the CHRNA5 gene revealed that, in comparison with other genotypes (GA, GG), the AA genotype was considerably greater in LC patients. However, the number of homozygous GG genotypes was more significant in the control group than in other groups. EXO1 and CHRNA5 were significantly higher in all the biochemical markers associated with the mutant (AA) genotype. While they were significantly normal in the GG genotype, they also decreased in ADA, HbA1c, and Hgb. IgE was significantly increased in all genotypes.
A Comprehensive Review of Lung Cancer: Epidemiology, Diagnosis, Treatment, and Risk Factors in Iraq
Lung cancer, which is characterized by uncontrolled cell division in the lungs, is the leading cause of cancer-related death worldwide, accounting for one-fifth of all cancer deaths. This review aims to provide a comprehensive analysis of lung cancer, focusing on its epidemiology, diagnosis, treatment, and risk factors, particularly non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). The objective is to explore recent advancements in diagnostic techniques, including low-dose computed tomography (LDCT), liquid biopsies, and biomarker-based approaches, which enhance early detection and monitoring. Additionally, the review examines treatment strategies, including surgical interventions, chemotherapy, radiation therapy, targeted therapies, and immunotherapy, with a focus on personalized treatment plans based on cancer type and stage. Emerging risk factors, such as genetic predispositions and environmental exposures, are also discussed to highlight their implications for prevention and early intervention. In conclusion, this review underscores the importance of integrating the latest research and clinical advancements to improve diagnostic accuracy, develop innovative treatments, and implement preventive measures. By doing so, it aims to contribute to reducing the global burden of lung cancer and improving patient outcomes.
The Impact of Obesity on Breast Cancer Development in Women: A Study from Kirkuk Governorate, Iraq
Objective: Breast cancer (BC) is a malignant tumor arising in breast tissue due to abnormal cell growth and has the ability to spread to other body parts. It is the second most prevalent cancer, and its incidence rate among women has significantly increased, prompting research into contributing factors. Obesity is recognized as a critical factor linked to the development and dissemination of this disease. This research aims to understand the potential impact of obesity on BC development in women. Methods: A statistical analysis was conducted with 130 women diagnosed with breast cancer to evaluate the relationship between obesity levels and the development and dissemination of BC among obese women in Iraq (Kirkuk governorate). Data were collected via a specifically designed questionnaire, which classified obesity levels as moderate or high. SPSS Statistics software was used for data processing and analysis. Relationships and differences among the variables were assessed via the chi-square test, t test, and standard deviation. Results: The analyses revealed a significant increase in obesity prevalence among women with BC. These findings indicate that obese women are at increased risk of developing BC, highlighting obesity as a potential risk factor for this disease. Conclusion: The findings of this study underscore that obesity is a considerable risk factor linked to an increased probability of BC development in women. Statistical analysis confirmed that obesity rates were significantly higher among women diagnosed with BC. These findings support the notion that excess weight may significantly contribute to the onset and progression of the disease. Evidence suggests that obesity influences various biological processes contributing to cancer, including chronic inflammation, hormonal changes, and elevated insulin levels. Emphasizing obesity as a risk factor for BC is crucial for developing effective prevention and treatment strategies.
Study of the Anticancer Activity of Annona squamosa Seeds
The whole world is still searching for natural sources in various fields, especially natural alternatives for treating diseases and various health disorders, most notably in the treatment of tumors and cancers. The current study included an in vitro anticancer estimation of Annona seed extract on two cell lines of breast cancer (MCF-7& MDA-231) and one normal cell line represented by REF. Active constituents in the seeds were extracted by maceration with 70% ethanol. General phytochemical tests were conducted to investigate the active constituents of the extracted seeds. The phenolic compounds and flavonoids in the extracted residue were estimated via HPLC in addition to the nonpolar substances in the seed residue. The three cell lines (MCF-7, MDA-231 & REF) were subjected to different concentrations of seed extract for the anticancer assay. Results showed that the ethanolic extract residue was 8.4 g from 90 g of powdered plant seeds, representing 9.34% W/W, and the seed residue contained many active constituents. The HPLC results indicated that the seed extract was rich in gallic acid, caffeic acid, pyrogaloll, cinnamic acid, p-coumaric acid and, to a lesser extent, chlorogenic acid, which are simple phenolic compounds. Luteolin, kaempferol, and apegnine and lower amounts of quercetin, rutin and catechin, which are flavonoids, were also detected in the residue extracted from the seeds. For the nonpolar seeds, the following components were detected at a decreasing level: β-myrcene, p-cymene, α-pinene, eugenol, and β-pinene. The anticancer activity of the seed extract at several concentrations differed across the three types of cell lines in the present study.
Exploring Dietary Patterns and Breast Cancer Risk: Epidemiological Insight from Sulaymaniyah City, Iraq
Objective: An increasing number of women are being diagnosed with breast cancer, which ranks as one of the most common cancers in women globally, particularly in developed nations. Although genetic environmental factors and lifestyle choices are all contributors to breast cancer risk, dietary habits are known to play a modifiable role in both the disease›s prevalence and prognosis; therefore, the aim of this study was to correlate dietary habits with the prevalence of breast cancer in Sulaymaniyah city, Iraq. Methods: Hiwa Oncological Hospital in Iraq›s Sulaymaniyah City was the site of the research. In all, 301 individuals who received a breast cancer diagnosis between June 2023 and January 2024 were included in the sample size. Patient demographics, medical history, eating habits, and other crucial details related to daily dietary regimens were among the data obtained. Once collected, the data were processed via IBM SPSS Statistics. Results: Among 301 breast cancer patients, 43.5% were aged 40--49 years, and 85.6% were married. Invasive ductal carcinoma (IDC) is the most prevalent subtype. Most patients (82.7%) followed a balanced diet, with IDC being the predominant subtype (73.9%). The majority (63.5%) consumed fruits and vegetables 1–2 times daily, while only 1% exceeded five servings. Additionally, 58.1% had no dietary restrictions, whereas 29.6% avoided sugar, meat, or fatty foods. It was observed that patients with uncontrolled dietary habits and lower fruit and vegetable intake were more likely to develop invasive breast cancer subtypes. Conclusion: These results emphasize the necessity of advocating for healthier lifestyles through nutritional habits and screening in order to decrease the increasing breast cancer burden in the region. In order to lower the incidence of breast cancer and improve outcomes, it may be essential to implement dietary interventions and early screening techniques within the population.
The MTHFR A1298C polymorphism and Breast Cancer Susceptibility
Background:Breast cancer (BC) is still a worldwide health problem with a high mortality rate in Iraq and other countries. reductase gene (MTHFR) controls cell DNA methylation, and any defect in this gene may lead to cancer development. Aim: The goal of this study was to investigate the associations of SNP (rs1801131) A1298C genetic polymorphism of MTHFR gene as well as its haplotypes with breast cancer risk among Iraqi females. Materials and Methods: The study included fifty individuals diagnosed with breast cancer and fifty healthy controls. The ages of the patients ranged between 25 and 67 years. For DNA extraction, 1 ml of peripheral blood from each individual was used. The A1298C polymorphism was detected with a previously prepared kit according to the manufacturer’s instructions. Taq-Man allelic discrimination assay was used for genotype identification. Then, p values were calculated via a chi-square test for statistical analysis. Results: DNA was successfully extracted from all the samples. The breast cancer patients and control groups all had frequency genotypes consistent with Hardy-Weinberg equilibrium (HWE) expectations. Logistic regression was used to assess the etiological risk of A1298C polymorphism in breast cancer cases. Breast cancer cases were more common in people with the heterozygous mutant AC genotype, which was significantly associated (p = 0.016; OR = 2.88; 95% CI: 1.29–6.4). The risk factor of the mutant AC genotype increased 2.88 times more than that for the wild type. Conclusions: According to the study results, there is a variation in the distribution of the genetic frequency of the MTHFR polymorphism between patients and control individuals, which is associated with increased etiological risk of the A1298C SNP (rs1801131) in breast cancer patients.
Origins of Glioblastoma: Initiation and Molecular Signatures of Extreme Aggressiveness
Compared with other malignancies, brain tumors rank among the most fatal types of cancer affecting humans, with the lowest survival rates. The overall 5-year survival rate for all primary brain tumors is approximately 5%, although this figure varies significantly on the basis of factors such as tumor type, location, size, patient age, and overall health. Glioblastoma, in particular, is among the most aggressive lethal cancers, making it one of the most devastating brain tumors. Its molecular pathogenesis is highly complex and involves genetic mutations in key regulatory genes, such as IDH1/2, EGFR, PDGFRA, the hTERT promoter, and NF1, along with epigenetic alterations and contributions from the tumor microenvironment, all of which drive tumor progression and invasion. Addressing the extremely poor survival rate of glioblastoma requires a deeper understanding of its origins and the cells responsible for its initiation. Various cancer initiation theories—such as the two-hit hypothesis, random mutation model, and clonal selection hypothesis—have proven experimentally effective in explaining its development. However, the cancer stem cell hypothesis stands out, as it successfully accounts for glioblastoma’s unmanageable aggressiveness and recurrence. Glioblastoma cancer stem cells (GSCs) can self-renew, differentiate into multiple tumor cell types, resist conventional therapies, and contribute to tumor heterogeneity, metastasis, and infiltration into surrounding brain tissue. These characteristics significantly impact patient prognosis and mortality. The exact cellular origin of glioblastoma remains a subject of ongoing research. However, studies suggest that glioblastoma may arise from neural stem cells (NSCs) or glial precursor cells, which undergo oncogenic mutations that drive uncontrolled proliferation. The molecular subtype of a tumor is often influenced by the lineage of its originating cells, with mesenchymal stromal cells emerging as potential glioblastoma-initiating cells, particularly in tumors with mesenchymal molecular features.
Synergistic Effects of Oncolytic Newcastle Disease Virus AMHA1 and Chemotherapy in Treating Breast Cancer cells
Breast cancer is a significant health concern, necessitating innovative therapeutic approaches beyond traditional treatments. This study investigates the synergistic effects of combining virotherapy and chemotherapy using the mouse mammary adenocarcinoma model. Combination cytotoxicity assays were performed using NDV at different hemagglutination units (HAU) and chemotherapy drugs, including Cisplatin, Methotrexate, Etoposide, Mitomycin C, Vindesine, and Cyclophosphamide, at different concentrations. Cell viability was assessed using the MTT assay, and synergistic interactions were determined through isobologram analysis. The AMN3 cell line, representing mammary adenocarcinoma, was cultured under standard conditions. NDV was propagated, purified, and quantified using embryonated chicken eggs and a hemagglutination assay. Our findings demonstrate that the combined application of NDV and chemotherapy significantly enhances the therapeutic outcomes compared to either modality alone. Mitochondrial permeability transition assays confirmed enhanced apoptosis rates in combination treatments, particularly with NDV plus Cisplatin, Methotrexate, Vindesine, and Cyclophosphamide. Additionally, NDV replication remained stable across all treatment conditions, suggesting that chemotherapy agents did not significantly impact NDV’s oncolytic activity. In conclusion, the findings highlight the potential of NDV as an adjunct to chemotherapy, enhancing cytotoxicity and apoptosis in mammary adenocarcinoma. The observed dose-dependent synergy suggests that optimal dosing strategies should be considered to maximize therapeutic efficacy while minimizing antagonistic effects. Further in vivo studies are warranted to explore the translational potential of NDV-chemotherapy combinations in breast cancer treatment.
Copyright (c) 2024 Iraqi Journal of Cancer and Medical Genetics https://creativecommons.org/licenses/by-nc/4.0
10-Year Survival and Voice Preservation after Definitive Radiotherapy for T1--T2 Glottic Laryngeal Squamous Cell Carcinoma in a Region of Conflict: A Single Institution Retrospective Report
Background and purpose: Early-stage laryngeal cancer represents a large proportion of cancer patients treated with definitive radiotherapy (RT). This study aimed to evaluate the outcomes of radical RT for patients with T1-T2 cN0 laryngeal cancer at an institution in a developing country without adequate infrastructure and to address overall survival and voice preservation. Research has shown that radical RT should be performed as soon as possible after the diagnosis of early-stage laryngeal cancer if RT is selected as the main treatment. We evaluated the efficacy of this type of treatment despite the delay in its initiation. Methods: We reviewed the medical records of patients who had cT1-cT2/cN0 squamous cell carcinoma of the larynx treated with definitive RT from June 2009 to June 2020 and who had not undergone previous surgical treatment or chemotherapy. Results: The median age of the study population was 63 years, with a male predominance (94%). Histologically, all laryngeal cancers were confirmed to be squamous cell carcinomas, and 86% were glottic squamous cell carcinomas. The mean time from diagnosis until initiation of RT was 120 days (4 months). The median follow-up period was six years. Among the 53 patients enrolled, the 2-, 3- and 5-year survival rates were 83%, 71% and 66%, respectively, during the follow-up period. The majority of the surviving population (97%) had good voice preservation. Conclusion: Despite these challenges, the results are promising. Definitive RT achieved an acceptable cure rate and voice preservation in patients with cT1-2 laryngeal carcinomas.
Chromosome 7 Deletion and Its Role in Nephrocalcinosis: A Study in an Iraqi Family
Background: Nephrocalcinosis refers to medulla calcium phosphate deposition in the kidney. It can occur as a result of some diseases, drugs, or physiological or genetic effects. Genetic effects can involve either genes or chromosomal disorders. Nephrocalcinosis was thought to be not inherited condition. Objective: A family of six members who were suffering from nephrocalcinosis were referred to the Iraqi Center for Cancer and Medical Genetics for chromosomal analysis. Methods: G-banding chromosomal analysis was performed according to the ICCMGR protocol, karyotype analysis was performed via CytoVision (Leica Microsystems Crop), and chromosomal nomenclature was designated according to ISCN 2020. The aim of this study was to report the role of the deletion of region 7p22 associated with nephrocalcinosis. Results: The relatives exhibited breaks at the common fragile site 7p22, some of which were chromatid breaks and others chromosomal deletions. Few cells within adult samples presented chromosomal abnormalities extending to the 7p21 band. To our knowledge, the correlation between fragile site 7p22 and nephrocalcinosis has not been previously reported, as we have shown in our present study. Only two previous studies mentioned the role of the association between aldosterone and 7p22, and the other study mentioned the association between aldosterone and nephrocalcinosis; thus, our current study clarifies a new relationship between 7p22 and nephrocalcinosis, especially when we know that the region holds some genes involved in renal genesis and kidney function. Our conclusion is that the region 7p22-ter holds effective genes involved in kidney function, and its deletion may lead to the appearance of nephrocalcinosis, and the fragile site 7p22 may play a role in nephrocalcinosis.
Evaluate the utility of Iraqi Ephedra Transitoria methyl extract on the proliferation of cervical cancer cell line
Objective: This study aimed to assess the inhibitory effect of a methanolic extract of Iraqi Ephedra transitoria on the proliferation of cervical cancer cells. Materials and methods: To assess the anticancer properties of Ephedra transitoria, a HeLa cell line (derived from cervical cancer) was utilized. The concentration of the evaluated agent was varied between 0.1 and 1000 µg/ml, and the cells were incubated for 24 and 72 hours. The IC50 value was used to identify the potency of the examined substance. Results: The study results demonstrated that the extraction ratio of E. transitoria was 8%. Additionally, a cytotoxicity study revealed that the plant extract can potentially inhibit the proliferation of human cervical cancer cells in a concentration- and time-dependent manner. The extract at a concentration of 1000 µg/ml inhibited growth by 88% after 72 hours. The comparison between the cytotoxicity of a plant extract and traditional anticancer chemotherapy (cisplatin) revealed that the plant extract exhibited higher cytotoxicity than cisplatin in the HeLa cancer cell line after two incubation periods. Additionally, the IC50 value of the extract was lower than that of cisplatin. Conclusion: Ephedra transitoria inhibits the proliferation of cervical cancer cells via cell cycle-specific and cell cycle-nonspecific mechanisms, thus demonstrating its anticancer properties. The study also revealed that, compared with cisplatin, the plant extract exhibited superior efficacy and potency in cancer treatment.