Jehan Mohammed Abdel-Hasan Al-Musawi

Background: Lung cancer is a significant public health issue in the Middle Euphrates region of Iraq. Objective: To identify socio-epidemiologic and histopathologic patterns of lung cancer patients in this region. Methods: Medical records of lung cancer patients registered at the Middle Euphrates Cancer Center (January 2018 to December 2023) were analyzed. Demographic information and histopathologic classifications were reviewed. All confirmed lung cancer cases were included, while cases with incomplete data were excluded. Results: A total of 1,162 patients were included, with a mean age at diagnosis of 64.47 years. The majority (64.4%) were over 60 years of age, and those between 40 and 60 years of age (34%). Males accounted for 68% of cases, with a male-to-female ratio of approximately 2:1. Patients with low or no formal education comprised 87.9% of the study population. The most prevalent subtype was squamous cell carcinoma (SCC), with adenocarcinoma (AC) coming in second at 37% and small cell lung cancer (SCLC) coming in third at 10.5%. While SCC remained the predominant subtype, AC incidence increased over time (31.7% in 2018 vs. 41.4% in 2023), particularly among females, younger individuals, and those with higher education. The proportion of NSCLC-NOS diagnoses declined from 11.1% in 2018 to 3.2% in 2023. Conclusions: Lung cancer remains a major health concern, especially among older individuals. The rising incidence of AC underscores the need for enhanced screening strategies, targeted prevention programs, and tailored treatment approaches to address evolving risk factors.

Background: Diabetes is a chronic systemic disorder; it is a major cause of chronic kidney disease. Early diagnosis and timely intervention are crucial in preventing further progression. Objective: To evaluate renal changes in type 2 diabetes with normal renal function using ultrasonography compared to healthy controls. Methods: History, anthropometric measures, and laboratory investigations were performed for all participants. All participants were normotensive with normal renal function. For both groups, renal ultrasonography was used to evaluate renal length, parenchymal thickness, interlobar artery diameter, and renal resistive index of the kidneys. Correlation analysis was sought between renal parameters and clinical, anthropometric, and laboratory parameters for the diabetic group. Results:105 diabetic and 110 healthy controls were included. The mean age of the diabetic group was 53.5 years and 53.6 years in the non-diabetic group. The mean body mass index (BMI) for diabetics was 27.5 and 26.7 in non-diabetics (p>0.05). A significantly higher HbA1c, fasting blood sugar (FBS), and S. creatinine level in diabetics. There was a big difference in the kidney parameters of both groups. Diabetic patients had a significantly longer left kidney, more parenchymal thickness, a resistive index, and a decrease in interlobar artery diameter compared to the non-diabetics. The right kidney length was the same between the groups. Patient age, BMI, diabetes duration, HbA1c, and FBS levels may have predicted these differences. Conclusions: Renal ultrasound is valuable in early detection of structural and vascular changes in the diabetic population

Background & Objective: Ultrasound monitoring of fetal kidney length is of central importance for our assessment of intrauterine growth. It correlates strongly with gestational age and with weight and gender. Measurement according to gender is more accurate and aids early diagnosis of anomalies. The aim is to determine the relationship between fetal kidney length and gender during the second and third trimesters using ultrasonography. Materials & Methods: Kidney length measurements were obtained by ultrasound of 500 pregnant women in Baghdad in a cross-sectional study, associating kidney length with demographic and fetal growth parameters. The Amniotic Fluid Index (AFI) was also checked. Too low or too high levels (<5 cm or >24 cm) indicate possible problems that further testing is needed. Results: A study of 500 pregnant women established highly positive relationships between fetal kidney length and BPD, FL, AC, and fetal weight, which means that kidney growth is proportionate to the fetus. Female kidneys were relatively longer than male kidneys; the difference was statistically significant. The upper-normal AFI added to the length of the kidneys, which were the longest. This proves the fact that amniotic fluid is important to the development of the fetus. Conclusion: In the study, gender-based differences in fetal kidney lengths were statistically significant. However, significant differences were seen across the AFI groups, with the largest kidney lengths belonging to the upper normal AFI category. Kidney length also increased significantly with gestational age, being strongly correlated with BPD, FL, and AC

Background: Magnetic resonance imaging (MRI) is highly sensitive to detect clinically suspected lesions that mammography and sonography may miss. However, routine postoperative MRI surveillance is not recommended unless there is concerning clinical or radiological evidence. Objective: To evaluate the role of MRI in assessing postoperative breast lesions and distinguishing benign changes from recurrence. Methods: This prospective cohort analysis was conducted at the National Center for Early Detection of Breast Cancer, Oncology Teaching Hospital, Medical City, from January 2022 to August 2022. The study enrolled breast cancer patients who had undergone breast-conserving surgery (BCS) or mastectomy within the past 24 months and were currently under radiological surveillance or presented with a new clinically detected mass. Results: A total of 42 lesions from 32 patients were analyzed; 21(65.7%) were under routine follow-up, while 11(34.3%) presented with a new mass. Mammography and/or ultrasound detected 36(85.7%) lesions, while MRI identified six (14.3%) additional lesions. Histopathology confirmed malignancy in 22(68.2%) patients. Five of six MRI-discovered lesions were malignant in histology, with a mean diameter of 7.5mm ranging from 6-11mm. Irregular shape, speculated margin, heterogeneous enhancement, and diffusion restrictions were significantly associated with malignancy. Using histopathology as the gold standard, MRI demonstrated 100% sensitivity, 55% specificity, and 78.6% accuracy. Conclusions: Dynamic contrast-enhanced MRI can improve the characterization of postoperative breast lesions. This method can help minimize benign lesion biopsies and detect recurring malignancies and multifocality when traditional imaging fails.

Background: The role of preoperative cancer antigen 125 (CA-125) levels in predicting the behaviour of the tumour, its relation with the prognostic indicators of the patients and the optimal cut-off values is still controversial. Objective: This study aims to explore the role of preoperative CA-125 in predicting the prognostic parameters and aggressiveness of endometrial cancers and to define the best cut-off values. Patients and methods: It is a retrospective study involved the data of 53 eligible patients with endometrial cancer, who were admitted to the oncology teaching hospital in Baghdad during the period between January, 2018 and October, 2020. The patients’ clinical characteristics and tumour pathologic characteristics were compared with the preoperative CA-125 values using non parametric Mann-Whitney, Kruskal-Wallis, One-way ANOVA and Bonferroni post hoc analysis. The Receiver Operating Characteristic (ROC) curve was used to find the usefulness of the CA-125 test and the optimal cut-off values. Results: Preoperative CA-125 values showed a significant relationship with the pathologic characteristics of the tumour; including the grade, stage, histotype, lymphovascular space invasion and the extent of invasion, while they did not show a meaningful association with the clinical characteristics of the patients. Preoperative CA-125 test showed to be useful in predicting advanced disease with a level of 30.25 U/ml being the optimal cut-off value for deep myometrial invasion and extra-uterine disease with a sensitivity of 63.2% and 75%, respectively, and a specificity of 85.3% and 86.5%, respectively. On the other hand, the value of 44.6 U/ml was the best cut-off for lymph nodes metastasis with a sensitivity of 66.7% and a specificity of 85.4%. Conclusions: Elevated preoperative CA-125 showed to be helpful in predicting aggressive pathologic behaviour and extra-uterine disease in patients with apparently early stage tumours and it would help determining the extent of surgical staging and pattern of follow up in those patients.

Dr. Jihan Mohammed Al-Mousawi, a faculty member at the College of Medicine, University of Kufa, participated as a member of the scientific committee and as an invited discussant in the sessions of the Best of ESMO Levant Conference, which was held by the Iraqi Society of Clinical Oncology (ISCO) in the city of Sulaymaniyah, Iraq, during the period of February 12-13, 2025, with the attendance of a select group of doctors and specialists in the field of oncology from Iraq and the Arab Levant countries.