Cancer Research and Practice

REVIEW ARTICLE
	The roles of microRNA-331 Family in Cancers	p. 1
	Stefanie Mei En Shee, Rhun Yian Koh, Kenny Gah Leong Voon, Soi Moi Chye, Iekhsan Othman, Khuen Yen Ng DOI:10.4103/JCRP.JCRP_6_18   MicroRNAs (miRNAs) are single-stranded noncoding RNA strands that are involved in various pathological and physiological processes. Even though they do not code for any gene, they regulate gene expression by posttranscriptional modification through cleavage or translational repression of messenger RNA. Many miRNAs (for example, lethal-7 and miRNA-21) have been found to be involved in the pathogeneses of many diseases including cancers. The miRNA-331 family includes three miRNAs, namely, miRNA-331, miRNA-331-3p, and miRNA-331-5p. Recent studies have revealed that the miRNA-331 family is associated with the pathology of some cancers, including colorectal cancer, leukemia, hepatocellular carcinoma, prostate cancer, pancreatic cancer, breast cancer, melanoma, and lung cancer. Therefore, it is important to have a good understanding about how the miRNA-331 family regulates the pathogeneses of these cancers. In this review, we discuss the pathological and physiological roles of the miRNA-331 family. Understanding how these miRNAs regulate the gene expression levels of their targets and their involvement in cancers may lead to better therapeutic strategies to treat cancers.
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ORIGINAL ARTICLES
	Perceived benefits and barriers toward cervical cancer screening among women ≥15 years in Arsi Zone, Southeastern Ethiopia: Application of the health belief model in a community-based cross-sectional study	p. 7
	Gemechu Chemeda Feyisa, Haftom Temesgen DOI:10.4103/JCRP.JCRP_1_18   Introduction: The rate of cancer mortality is18.4/100,000 in Ethiopia, and cancer of the cervix is the second-most common cancer, with an incidence of 16.4/100,000. Cancer of the cervix is easily prevented through vaccinations against human papilloma virus, regular screening, and treatment. Assessing the perception of women with regard to the benefits and barriers of cervical cancer screening among women is important to decrease the barriers and increase the screening rate for early detection. The aim of this study was to describe women's perceived benefits and barriers to cervical cancer screening and their associated factors in Arsi zone, Southeastern Ethiopia. Materials and Methods: This community-based cross-sectional study design was conducted in Arsi zone, Southeastern Ethiopia among 906 women aged >15 years using a multi-stage sampling technique. After data had been coded and entered into Epi info, it was exported into SPSS for analysis. A binary logistic regression model was used to determine associations between sociodemographic characteristics and reproductive variables on the knowledge of cervical cancer and perception of screening at a value of P < 0.05. Results: Most of the participants had higher perceptions of the benefits and barriers to screening (567 [62.6%] and 487 [53.8%], respectively). The women who would like to undergo cervical cancer screening in the future when the service was available were 2.6 times more likely to believe in the benefits of undergoing screening than those who did not wish to undergo screening (adjusted odds ratio [AOR] = 2.3, 95% confidence interval [CI]: [1.2–4.6]). Women living in rural areas were four times more likely to perceive the benefits of cervical cancer screening than those living in semi-urban areas (AOR = 3.9, 95% CI: [1.9–7.7]). Women who started sexual intercourse at age <16 years were two times more likely to perceive barriers to cervical cancer screening than those who started sexual intercourse at age >16 years (AOR = 2.2, 95% CI: [1.5–3.3]). Moreover, the women who had >3 children were 1.5 times more likely to perceive barriers to cervical cancer screening than those who had <3 children (AOR = 1.5, 95% CI: [1.1–2.0]). Conclusion and Recommendation: There were high perceived benefits and barriers to screening in the community. We recommend decreasing the perceived barriers toward screening through education intervention and expanding screening services, as this can increase the uptake of screening in the community.
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	Perspectives of visual inspection of the cervix with acetic acid as an alternative to Pap smear test as a preventive measure of cervical cancer among female nurses in University College Hospital, Ibadan, Nigeria	p. 18
	Christene E Umukoro, Olufemi Y Makinde DOI:10.4103/JCRP.JCRP_10_18   Background: Visual inspection of the cervix with acetic acid (VIA) has been recommended by the World Health Organization as an alternative to the Pap smear test in preventing cervical cancer in low-resource healthcare settings. However, the level of awareness and uptake is still very low in Nigeria. In this study, the awareness and acceptance of VIA as a preventive measure against cervical cancer among female nurses at the University College Hospital (UCH), Ibadan was assessed. Materials and Methods: A pretested questionnaire on the knowledge of the risk factors of cervical cancer, uptake of the Pap smear test, and awareness and acceptance of VIA was administered to 301 female nurses at UCH, Ibadan. Results: The majority of the respondents (99%) knew about cervical cancer, but only 62.4% of them were aware that human papilloma virus is a causative agent. Early marriage (73.6%), high parity (64.0%), multiple sexual partners (91.1%), smoking (54.8%), and poor socioeconomic status (42.9%) were identified as risk factors for the disease. The proportion of those that had heard of VIA (43.6%) was low when compared with the Pap smear test (99%). However, 72.4% of them thought that female staff at the screening centers should promote VIA. Moreover, 61.5% believed that definitive treatment of cases could commence immediately after a VIA test. The age, duration of service, and educational qualification did not significantly (P > 0.05) influence the respondents' awareness of VIA as a cervical cancer screening technique. Conclusion: Adoption of VIA as part of routine checkups during postnatal visits and its integration into the nation l healthcare policy is recommended.
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SHORT COMMUNICATION
	Improving colorectal, oral, breast, and cervical cancer screening rates using an inreach approach	p. 26
	Lee-Kiat Ban, Ailun Heather Tseng, Hung-Chun Hsing, Henry Hsin-Chung Lee DOI:10.4103/JCRP.JCRP_5_18   The Taiwanese national cancer screening program was established in 1985 by providing Pap smear tests for women. At the same time, trial-based screening for colorectal, oral, and breast cancer screening was initiated. In 1999, outreach services for cancer screening were started and gradually scaled up to the national level. Our hospital is located in Hsinchu, Taiwan. Like many hospitals in Taiwan, we provide cancer screening services to the community. Our baseline screening rate was 96.6% in 2016. Aiming to increase the overall cancer (including colorectal, oral, breast, and cervical cancer) screening rates, we implemented two strategies. First, we modified the cancer screening workflow so that patients could receive screening counseling before the scheduled appointment. Second, we redesigned the clinic waiting room layout by moving check-in and cancer screening counters next to each other. By the end of 2017, the overall cancer screening rate increased from 96.6% to 105.4%. Our future efforts will be focused on collecting patient feedback, increasing coverage of hard-to-reach populations, and understanding barriers to cancer screening for specific groups of patients.
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CASE REPORTS
	Primary small-cell carcinoma of the glottic larynx: A case report from Northern Pakistan	p. 30
	Kanwal Awan, Humera Mahmood, Hadia Fatima, Sarosh Arif, Mohammad Faheem DOI:10.4103/JCRP.JCRP_2_18   Extrapulmonary neuroendocrine small-cell carcinoma is a rare tumor accounting for only 2.5%–4% of all small-cell carcinomas, and during the past 30 years, only 160 cases of primary small-cell carcinoma of the larynx have been reported worldwide. Most previously reported cases were metastatic small-cell carcinomas. Herein, we report the case of a 51-year-old male who was treated at the Atomic Energy Cancer Hospital, NORI, Islamabad, Pakistan for small-cell carcinoma of the larynx.
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	Brenner tumor of the ovary: Incidental finding with unusual combinations	p. 33
	Hema Udawat, Vandana Nunia, Natasha Agarwal, Arpita Jindal DOI:10.4103/JCRP.JCRP_3_18   The most common ovarian tumors are surface epithelial tumors, comprising 58% of all ovarian tumors. Among them, serous and mucinous cystadenomas are the most common (35%). A Brenner tumor is a rare, mostly benign type of ovarian epithelial neoplasm with an incidence of 1%–2%. Rarely, they occur in other locations, including the testis. The majority of Brenner tumors are benign; however, some can be malignant. These are most frequently found incidentally on pelvic examinations or during laparotomy. In the present case series, we report three cases of Brenner tumors diagnosed incidentally on histopathology. The first case was a rare combination of serous cystadenoma, with a focus showing a Brenner tumor in the wall of serous cystadenoma. The second case was a proliferating Brenner tumor in the wall of mucinous cystadenoma, and the third case had bilateral benign Brenner tumors.
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	Complete radiographic response of a rectal gastrointestinal stromal tumor to imatinib mesylate	p. 37
	Hsing-Yu Yang, Ming-Hung Lee DOI:10.4103/JCRP.JCRP_4_18   Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. These tumors occur rarely in the rectal region, with an incidence of <3%. In this case report, an 80-year-old man complained of abdominal fullness and difficulty in defecating during a visit to our outpatient department. A radiographic image survey showed an extraluminal lesion over the rectum, and the pathological diagnosis was GIST. Imatinib mesylate, a neoadjuvant agent, was administered. The patient then refused further surgical intervention and continued imatinib mesylate treatment. Subsequent magnetic resonance images revealed no obvious lesion occupying the pelvic cavity. In addition to this case, we also performed a literature review of rectal GIST treatment strategies.
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	Postmolar metastatic choriocarcinoma mimicking primary lung cancer	p. 41
	Chih-Chieh Yen, Hung-Wen Tsai, Chia-Jui Yen DOI:10.4103/JCRP.JCRP_7_18   Postmolar choriocarcinoma with delayed recurrence can be aggressive and has only been published in a few reports. We describe a postmenopausal woman with a molar pregnancy 10 years previously who presented with respiratory and neurological symptoms. Metastatic choriocarcinoma of the lungs with extensive metastases to various sites mimicking primary lung cancer was noted. She was successfully treated with systemic chemotherapy and had stable disease status 8 months after the diagnosis. Metastatic choriocarcinoma originating from an antecedent molar pregnancy can be overlooked given a prolonged latency. We review the published literature of postmolar choriocarcinoma and discuss the diagnosis and updates on treatment.
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	Paraneoplastic Systemic Sclerosis in a Patient with Metastatic Thymic Carcinoma	p. 45
	Hsing-Wu Chen, Ko-Jen Li, Hung-Yang Kuo DOI:10.4103/JCRP.JCRP_8_18   Thymic malignancies cause alterations in the immune system. Thymomas are known to be associated with paraneoplastic syndrome and autoimmunity, including myasthenia gravis, systemic lupus erythematosus, inappropriate antidiuretic hormone secretion, pure red cell aplasia, pernicious anemia, pemphigus, and autoimmune thyroid diseases. However, paraneoplastic syndrome has rarely been observed in patients with thymic carcinoma. The management of patients with paraneoplastic autoimmune disease is difficult, and treatment of the underlying malignancy is important. Herein, we present a case of thymic carcinoma who developed systemic sclerosis 3 years after the initial diagnosis during disease progression.
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	Hyperprogressive disease after nivolumab in a patient with microsatellite instability-high ampullary cancer	p. 50
	Yi-Hsuan Lai, Shih-Hung Yang DOI:10.4103/JCRP.JCRP_9_18   Ampullary cancer is a rare type of cancer with a limited choice of systemic therapy. Anti-programmed death-1 monoclonal antibodies have shown promising clinical benefits in multiple types of cancer, especially in tumors with microsatellite instability-high (MSI-H)/defective DNA mismatch repair and high tumor mutation burden. We report a case of a 61-year-old woman with MSI-H ampullary cancer who initially had slow progression without chemotherapy after recurrence. She experienced hyperprogressive disease with a dramatic deterioration of liver metastases following a short duration of nivolumab treatment.
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