{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:10:42Z","timestamp":1789031442207,"version":"build-2803163510"},"update-to":[{"DOI":"10.12688\/f1000research.178233.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000}},{"DOI":"10.12688\/f1000research.178233.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000}}],"reference-count":37,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Cancer is one of the most significant global health challenges. Cytogenetic techniques are used as biomarkers of cancer risk to detect DNA damage and chromosomal abnormalities. Objective This study aimed to evaluate the influence of chemotherapy on genetic stability in cancer patients by applying Micronucleus and Comet assays as indicators of DNA and chromosomal alterations. It also aimed to determine the possible links between these genotoxic changes and variations in biochemical and hematological parameters, providing insight into the cellular responses to chemotherapy exposure. Methods Buccal epithelial cells were collected from 190 individuals (90 controls and 100 cancer patients) and stained for micronucleus analysis. To observe DNA breakdown, cells from blood were subjected to an alkaline comet assay. Biochemical (urea, creatinine, calcium, and bilirubin) and hematopoietic (Hb, WBC, Plt, and HCT) parameters were also assessed. Results Cancer patients showed elevated Binucleated cells (27.50\u00a0\u00b1\u00a03.62 per 1000 cells, ~6.8-fold), Condensed chromatin (10.50\u00a0\u00b1\u00a02.87 per 1000 cells, ~1.3-fold), pyknotic cells (2.65\u00a0\u00b1\u00a01.53 per 1000 cells, ~1.6-fold), basal cells (4.65\u00a0\u00b1\u00a01.98 per 1000 cells, ~2.4-fold), Karyorrhectic cells (9.45\u00a0\u00b1\u00a01.73 per 1000 cells, ~189-fold), Karyolytic cells (85.10\u00a0\u00b1\u00a02.69 per 1000 cells, ~8.9-fold), Monoonucleated cell with Micronucleus (12.50\u00a0\u00b1\u00a01.43 per 1000 cells, ~8.3-fold), and Percentage of nuclear anomalies in total (152.8\u00a0\u00b1\u00a04.75 per 1000 cells) compared with controls. The comet assay results revealed pronounced DNA fragmentation in cancer cells, with variable tail lengths indicating heterogeneous damage. The biochemical results showed a significant increase in the mean levels of urea (50.600\u00a0\u00b1\u00a08.259) and creatinine (1.073\u00a0\u00b1\u00a00.173), and no significant increase in TSB (0.917\u00a0\u00b1\u00a00.143) and HCT(38.080\u00a0\u00b1\u00a02.311) in cancer patients compared to the control. Calcium (9.010\u00a0\u00b1\u00a00.680), Hb (8.322\u00a0\u00b1\u00a01.247), Plt (91.300\u00a0\u00b1\u00a024.495), and WBC (11.920\u00a0\u00b1\u00a02.833) levels were lower in the patient group than in the control group. Conclusion The increased frequency of nuclear anomalies and DNA fragmentation in cancer patients highlights the potential of the buccal Micronucleus assay and comet assays as effective, non-invasive tools for early cancer detection and genotoxic monitoring. Alterations in the blood and biochemical parameters further support the systemic effects of malignancy.<\/ns3:p>","DOI":"10.12688\/f1000research.178233.3","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:19:06Z","timestamp":1786709946000},"page":"545","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Genotoxicity \u00a0effects in Cancer Patients: Evaluation by Micronucleus and Comet Assays and Correlation with Biochemical and Hematological Indices"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-2105","authenticated-orcid":false,"given":"Sarab","family":"Dalaf Khalaf","sequence":"first","affiliation":[{"name":"Biology Tikrit Saladin Governorate Tikrit University College of Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atyaf","family":"Talal Mahmood","sequence":"additional","affiliation":[{"name":"mosul university of Mosul college of pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyaa","family":"Fadhil Abbas","sequence":"additional","affiliation":[{"name":"Tikrit Salah ad-Din Education Directorate"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruwaida","family":"Watheq Neamah","sequence":"additional","affiliation":[{"name":"Tikrit Salahaddin oncology center (SOC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Nasser Abdul Hameed","sequence":"additional","affiliation":[{"name":"Tikrit Northern Technical University \/Institute Al-Dour Technical"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref1","article-title":"The Cancer: Types, The Mechanism of Caner Growth And Diagnosis: A.","volume":"3","author":"S Khalaf","year":"2024","journal-title":"World."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"761","DOI":"10.3390\/cancers13040761","article-title":"Tumor heterogeneity in glioblastomas: from light microscopy to molecular pathology.","volume":"13","author":"A Becker","year":"2021 Feb 12","journal-title":"Cancers."},{"key":"ref3","first-page":"2139-2164","article-title":"The American Society of Pain and Neuroscience (ASPN) best practices and guidelines for the interventional management of cancer-associated pain.","author":"M Aman","year":"2021 Jul 16","journal-title":"J. Pain Res."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"433-438","DOI":"10.4103\/0377-4929.107774","article-title":"Micronucleus assay of buccal mucosa cells in smokers with the history of smoking less and more than 10 years.","volume":"55","author":"N Naderi","year":"2012","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref5","first-page":"1-21","article-title":"Micronuclei formation: small nuclear packages with big genomic consequences.","author":"A Onoja","year":"2025 Feb 20","journal-title":"Nucleus."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1515-1531","DOI":"10.1016\/j.biochi.2006.07.004","article-title":"Chromosomal changes: induction, detection methods and applicability in human biomonitoring.","volume":"88","author":"R Mateuca","year":"2006","journal-title":"Biochimie."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"98-100","DOI":"10.22317\/imj.v5i3.1043","article-title":"Micronuclei and Other Nuclear Anomalies in Exfoliated Buccal Mucosa Cells in Breast Cancer.","volume":"5","author":"N Ismail","year":"2021 Sep 26","journal-title":"Iraq Medical Journal."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"5699","DOI":"10.3390\/ijms24065699","article-title":"High resolution and automatable cytogenetic biodosimetry using in situ telomere and centromere hybridization for the accurate detection of DNA damage: an overview.","volume":"24","author":"R M\u2019Kacher","year":"2023 Mar 16","journal-title":"Int. J. Mol. Sci."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2104","DOI":"10.3390\/cancers16112104","article-title":"When DNA mutations interplay with cellular proliferation: a narrative history of theories of carcinogenesis.","volume":"16","author":"L El Nachef","year":"2024 May 31","journal-title":"Cancers."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"503828","DOI":"10.1016\/j.mrgentox.2024.503828","article-title":"Investigation of genetic instability in patients with Diabetes Mellitus type I, II and LADA using buccal micronucleus cytome assay.","volume":"900","author":"G Parsadanyan","year":"2024 Nov 1","journal-title":"Mutation Research-Genetic Toxicology and Environmental Mutagenesis."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1186\/s12903-025-06522-0","article-title":"Oxidative genomic damage in pediatric patients exposed to mercury released by dental amalgam.","volume":"25","author":"G Mac\u00edas-Lamas","year":"2025 Jul 13","journal-title":"BMC Oral Health."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"88-97","DOI":"10.1016\/j.mrrev.2011.06.005","article-title":"The HUman MicroNucleus project on eXfoLiated buccal cells (HUMN (XL)): the role of life-style, host factors, occupational exposures, health status, and assay protocol.","volume":"728","author":"S Bonassi","year":"2011","journal-title":"Mutat. Res."},{"key":"ref13","first-page":"773-780","article-title":"Evaluation of cytogenic damage in the form of micronuclei in oral exfoliated buccal cells in tobacco users. ORIGINAL RESEARCH.","volume":"29","author":"K Gopal","year":"2018"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"473-479","DOI":"10.31018\/jans.v15i2.4329","article-title":"Genotoxicity and genomic instability in oral epithelial cells of agricultural workers exposed to pesticides using micronucleus and comet assay in Nineveh, Iraq.","volume":"15","author":"A Alhamadany","year":"2023","journal-title":"J Appl Nat Sci."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e37643","DOI":"10.1016\/j.heliyon.2024.e37643","article-title":"Cytome analysis (micronuclei and nuclear anomalies) in bioindication of environmental pollution in animals with nuclear erythrocytes.","volume":"10","author":"O Cherednichenko","year":"2024 Sep 30","journal-title":"Heliyon."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"214-226","DOI":"10.1158\/2159-8290.CD-23-1073. PMID: 38197599; PMCID: PMC11265298","article-title":"Micronuclei and Cancer.","volume":"14","author":"M Di Bona","year":"2024 Feb 8","journal-title":"Cancer Discov."},{"key":"ref19","first-page":"59-71","article-title":"Premalignant and malignant oral mucosal lesions: Clinical and pathological findings.","volume":"81","author":"M Maymone","year":"2019 Jul 1","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref20","first-page":"227-231","article-title":"Comparison between micronucleated lymphocyte rates observed in healthy subjects and cancer patients.","volume":"12","author":"E Duffaund","year":"1997","journal-title":"Mutagenesis."},{"key":"ref22","first-page":"9-16","article-title":"Evaluation of micronuclei frequency in the cultured peripheral blood lymphocytes of cancer patients before and after radiation treatment.","volume":"491","author":"G Jagetia","year":"2001","journal-title":"Mutat. Res."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"22196","DOI":"10.1038\/s41598-020-78832-y","article-title":"Micronucleus frequency in buccal mucosa cells of patients with neurodegenerative diseases.","volume":"10","author":"H Reimann","year":"2020 Dec 17","journal-title":"Sci. Rep."},{"key":"ref24","article-title":"Evaluation of Micronuclei and Other Nuclear Anomalies in Buccal Cells of some Iraqi Women with Breast Cancer.","volume":"16","author":"F Shafi","year":"2017","journal-title":"Iraqi J Biotechnol."},{"key":"ref25","first-page":"115-120","article-title":"Micronucleus Score in the Buccal Mucosa of Women with Breast Cancer and the Relationship to Chemotherapy.","volume":"3","author":"M Kalender","year":"2015","journal-title":"Asian J Pharm Nurs Med Sci."},{"key":"ref26","article-title":"Radiosensitivity of peripheral blood lymphocytes obtained from patients with cancers of the breast, head and neck or cervix.","author":"S Ban"},{"key":"ref27","first-page":"895-899","article-title":"Micronuclei and other nuclear anomalies in exfoliated buccal mucosa cells of Mexican women with breast cancer.","volume":"19","author":"A Garc\u00eda","year":"2014","journal-title":"JBUON."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"347-349","DOI":"10.1002\/path.4205","article-title":"In brief: BRCA1 and BRCA2.","volume":"230","author":"W Foulkes","year":"2013","journal-title":"J. Pathol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"23-29","DOI":"10.1038\/nprot.2006.5","article-title":"The comet assay: a method to measure DNA damage in individual cells.","volume":"1","author":"P Olive","year":"2006","journal-title":"Nat. Protoc."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"249-261","DOI":"10.1385\/MB:26:3:249","article-title":"The comet assay for DNA damage and repair: principles, applications, and limitations.","volume":"26","author":"A Collins","year":"2004","journal-title":"Mol. Biotechnol."},{"key":"ref31","first-page":"1-15","article-title":"The use of the comet assay for the evaluation of genotoxicity.","volume":"764\u2013765","author":"A Azqueta","year":"2014","journal-title":"Mutat. Res. Genet. Toxicol. Environ. Mutagen."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"132-140","DOI":"10.22088\/cjim.16.1.132","article-title":"Chemotherapy on hematological and biochemical parameters in breast cancer patients.","volume":"16","author":"T Pullakanam","year":"2024","journal-title":"Caspian J. Intern. Med."},{"key":"ref33","first-page":"1071-8443","article-title":"CLINICAL CHARACTERISTICS, HEMATOLOGICAL VARIATIONS AND BIOACCUMULATION OF HEAVY METALS IN BLOOD, HAIR AND URINE OF BREAST CANCER PATIENTS.","volume":"19","author":"K Rimsha","year":"2024"},{"key":"ref34","article-title":"Study of some Hematological parameters as Biomarker for breast Cancer population of Sindh.","volume":"49","author":"S Khan","year":"2017","journal-title":"Sindh University Research Journal-SURJ (Science Series)."},{"key":"ref35","first-page":"574-579","article-title":"Full blood count pattern of pre-chemotherapy breast cancer patients in Lagos, Nigeria.","volume":"4","author":"A Akinbami","year":"2013","journal-title":"Caspian J. Intern. Med."},{"key":"ref36","first-page":"237-240","article-title":"Haematological parameters in pre chemotherapy breast cancer patients in a tertiary care centre, India.","volume":"3","author":"S Smita","year":"2018","journal-title":"IP Journal of Diagnostic Pathology and Oncology."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"235-240","DOI":"10.1016\/j.ctrv.2011.05.001","article-title":"Importance of monitoring renal function in patients with cancer.","volume":"38","author":"M Aapro","year":"2012","journal-title":"Cancer Treat. Rev."},{"key":"ref38","first-page":"214-217","article-title":"Kidney functions and electrolyte disturbance among Iraqi patients with bladder cancer.","volume":"64","author":"N Ibraheem","year":"2022","journal-title":"J Fac Med Baghdad."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"S23-S33","DOI":"10.1053\/j.ajkd.2009.09.035","article-title":"Prevalence of CKD and comorbid illness in elderly patients in the United States: results from the Kidney Early Evaluation Program (KEEP).","volume":"55","author":"L Stevens","year":"2010","journal-title":"Am. J. Kidney Dis."},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.18889026","author":"S Khalaf","year":"2023","journal-title":"Zenodo."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/15-545\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-545\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-545\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:44:08Z","timestamp":1789029848000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/15-545\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":37,"URL":"https:\/\/doi.org\/10.12688\/f1000research.178233.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.178233.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.178233.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.208301.r512004","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.208301.r512004","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/15-545\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.205608.r502246, Ayse Gul Zamani, Nihan Somuncu, Medical Genetics, Necmettin Erbakan University Meram Faculty of Medicine (Ringgold ID: 427826), Meram, Konya, 25 Jul 2026, version 2, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/15-545\/v2#referee-response-502246","order":0,"name":"referee-response-502246","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.205608.r503793, Adi Baumgartner, York St John University, York, 06 Aug 2026, version 2, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/15-545\/v2#referee-response-503793","order":1,"name":"referee-response-503793","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>sarab dalaf<\/b>; \n<i>Posted: 08 Aug 2026<\/i>; Response to Reviewer 2  Dear Reviewer,  We sincerely thank you for your valuable and detailed comments. We have carefully revised the manuscript based on all your suggestions. Below is a summary of our responses:  1. Language and terminology: All incorrect terms (e.g., issue, excised, surveillance, relaxation, miniature) have been corrected to proper scientific terminology. 2. Nuclear abnormalities: We have changed broken eggs to pyknotic cells, corrected plural forms, and clarified that values are expressed per 1000 cells in the abstract, tables, and discussion. 3. Abstract: We added fold increases for all significant parameters (e.g., binucleated cells ~6.8-fold, karyorrhectic cells ~189-fold) alongside p-values. 4. Methods: We corrected the staining dye name to Giemsa, clarified the mouth-rinsing procedure, added the electrophoresis field strength (V\/cm), and confirmed double-blinding and anonymization. 5. Discussion: We corrected karyolitic to karyolytic, replaced malignant epithelial cells with exfoliated buccal cells, revised the statement about binucleated cells to indicate defective cytokinesis (not aneuploidy), changed ruptured micronuclei to disrupted micronuclei, mitochondria to micronuclei, and DNA destruction to DNA damage. 6. References: We moved reference 37 to its correct place in the kidney function paragraph and added reference 41 (Olive &amp; Ban&aacute;th, 2006) to the Comet assay discussion. 7. Figures: We added a scale bar = 10 &micro;m to Figure 2 and clarified the axes in Figure 3 with appropriate units and labels. 8. Section title: We changed Inclusion to Conclusion.  We believe the manuscript is now significantly improved and hope it meets your expectations.  Kind regards, Sarab Dalaf Khalaf (Corresponding Author) Department of Biology, College of Science, Tikrit University Email: sarab.dalaf@tu.edu.iq","URL":"https:\/\/f1000research.com\/articles\/15-545\/v3#referee-comment-16882","order":2,"name":"referee-comment-16882","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.208301.r512004, Paolo Baldo, Valeria Martinello, Centro Riferimento Oncologico CRO-Aviano\u2014IRCCS, Aviano, 10 Sep 2026, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/15-545\/v3#referee-response-512004","order":3,"name":"referee-response-512004","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}