Background and Objective: Epidermal growth factor receptor (EGFR) gene mutation, especially in exons 18 to 21, is an important predictor of the response rate of lung adenocarcinoma to tyrosine kinase inhibitors. There are variable reports from Asian and European countries, as well as North America, about the frequency of the EGFR mutation in lung adenocarcinoma, yet molecular study about this incidence has been published from Iran. In this study, we investigated the frequency of this mutation in our center, which is the largest referral center in the south of country. This report will be the first published article about EGFR mutational analysis from Iran. Methods: During the study period (September 2011 till September 2016) i.e. 5 years, there have been 50 cases of pathologically-confirmed lung adenocarcinoma. These cases underwent mutational analysis for exons 18 to 21 of the EGFR gene by PCR and DNA sequencing. All demographic findings were also extracted from the patients’ charts and recorded. Results: There were 30 male and 20 female patients, with an average age of 58 years. The overall frequency of EGFR mutation was 28% (14 out of 50). The most common mutation was Del 19 (10 of 14, 71.4%), 3 mutations were found in exon 20 and one mutation was found in exon 21. EGFR mutations were more frequent in women than in men (30% versus 26.7%) and in nonsmokers than in smokers (37.9% versus 14.3%). Conclusion: Lung adenocarcinoma with EGFR mutation shows strong association with female non-smokers. Our results showed an intermediate frequency of this mutation, which was higher than results from Western countries and lower than most Asian countries.

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BACKGROUND Incidence of colorectal cancer is increasing in countries such as Iran. Molecular biomarkers play very important role in the diagnosis, treatment, and prognosis of this cancer. Mutation in the RAS family (including KRAS and NRAS) is one of these important molecular biomarkers, which should be tested before starting treatment with anti-EGRF (Epidermal growth factor) drugs. Objectives: There has been very few reports about the frequency of NRAS mutation from Iran and no study from south of the country. In this article we will describe our experience about the frequency of NRAS mutation in colorectal cancers from the largest referral center in the south of Iran. METHODS During 5 years (2011-2015), we had 52 cases of colorectal cancers with wild type KRAS and BRAF in the hospitals affiliated to Shiraz University of Medical Sciences with enough tissue for molecular studies. NRAS mutation analysis was performed on paraffin embedded formalin fixed tissue of these cases by polymerase chain reaction (PCR)-sequencing method. RESULTS Among these 52 cases of colorectal cancer with wild type KRAS and BRAF, there has been 3 (5.7%) cases with mutant NRAS. One of the mutations has been in codon 12 and two in codon 61. No mutation in codon 13 was found. All the three cases were women with stage IV and well differentiated histomorphology. CONCLUSION Our results showed that frequency of NRAS mutation in colorectal cancer is rare, which is very close to other studies from different geographic areas of the world.

Scan to discover onlineBackground & Objective: Pancreatobiliary system disorders commonly include inflammatory diseases and tumors. Diagnosis of pancreatic cancer is challenging and is mostly achieved when the disease has extensively progressed, and metastasis has occurred. Therefore, this study was performed to evaluate cytopathology in the diagnosis of Pancreatobiliary malignancies, which can improve diagnostic adequacy and accuracy.Methods: A total of 116 cytopathologic results of the Pancreatobiliary system, performed in the Pathology Department of Taleghani Hospital, Tehran, Iran during 2017-2018 were selected and examined in this observational study. The frequency of different results was determined and compared with other variables. Results:The most common location of the lesions was the pancreas (47%). The lesions were categorized as malignant, benign, negative, suspicious for malignancy (SFM), and atypical in 28%, 10%, 24%, 14%, and 9% of the cases, respectively. In other cases, lesions were considered non-diagnostic. Rapid on-site evaluation (ROSE) was conducted in 25% of patients. Compatibility of the initial and final diagnoses was 100%, 50%, and 60% in cases with "malignant", "benign", and "negative" diagnoses, respectively. The sensitivity, specificity, as well as positive and negative predictive values of cytopathology in the diagnosis of Pancreatobiliary lesions were 75.8%, 92.3%, 95.9%, and 61.5%, respectively. Conclusion:Our findings indicated that half of the lesions of the Pancreatobiliary system were positive, SFM, and atypical. Fine-needle aspiration (FNA) and endoscopic ultrasoundguided FNA (EUS-FNA) were effective modalities in diagnosing Pancreatobiliary malignancies. The most important point in our experience is the increase in diagnostic sensitivity in the presence of ROSE. Therefore, the simultaneous use of ROSE and EUS-FNA can reduce the need for re-sampling.

Scan to discover onlineBackground & Objective: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. In this study, we aimed to evaluate the clinicopathological and immunohistochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing.Methods: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable.Results: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration. Conclusion:Immunohistochemistry would be a specific method for diagnosis of MSI colorectal cancers but may be associated with high rate of false negative results and of low sensitivity. Therefore, we recommend performing molecular studies by DNA sequencing in those colon cancers with clinical suspicion for MSI and negative immunohistochemical findings.