Global cancer statistics, 2012

Role of m5C methylation in digestive system tumors (Review)

Currently, the incidence of digestive system tumors has been increasing annually, thus becoming a prevalent cause of cancer‑related mortalities. Although significant strides have been made in targeting the molecular mechanisms that underpin the development of these tumors, their treatment and prognosis still pose substantial challenges. This is primarily due to the ambiguity of early diagnostic indicators and the fact that most digestive system tumors are detected at an advanced stage. However, epigenetic modifications are capable of altering the expression of oncogenes and regulating biological processes in cancer. In recent years, the study of methylation in relation to tumor pathogenesis has become a focus of prominent research. Among the various types of methylation, 5‑methylcytosine (m5C) methylation plays a crucial role in the development of digestive system tumors and is anticipated to serve as a novel therapeutic target. However, to date, a comprehensive and systematic review concerning the role of m5C methylation in digestive system tumors is lacking. Consequently, the present study reviewed the role of m5C methylation in digestive system tumors such as esophageal cancer, gastric cancer and hepatocellular carcinoma, with the aim of providing a valuable reference for future research endeavors.

Cognitive remediation in breast cancer survivors: A study protocol

Cancer treatment-related cognitive impairment, also known as "Chemobrain," is frequently reported among cancer survivors. This condition can persist for months after the end of cancer treatment and can affect various aspects of a patients' quality of life. Despite growing evidence, research into effective treatments remains an emerging field. This project aims to assess the effectiveness of a cognitive remediation protocol called Oncogite in reducing cancer treatment-related cognitive impairment. The primary outcomes are self-reported functional and emotional well-being. The secondary outcomes include measures of executive function (working memory, inhibition, shifting), episodic memory, perceived cognitive function and perceived quality of life. One hundred sixty-four breast cancer survivors will be recruited from an existing cohort. Patients will be randomized to either a cognitive remediation group or a no intervention group. Participation in the workshops will be via videoconferencing, led by a neuropsychologist. Patients in the experimental group will also have access to an internet platform with the exercises practiced between the group workshops. The intervention will last four months at a rate of one workshop per week. The following data will be collected: emotional and functional well-being, neurocognitive performance, switching, inhibition, cognitive complaints, episodic memory, fatigue and depression. We will conclude that the intervention is effective if there is 4-month improvement in both emotional and functional well-being to find in the experimental group in their cognitive functioning. This research will contribute to the development of new clinical tools for cancer treatment-related cognitive impairment and facilitate the return to work in cancer survivors.

Histone crotonylation in tumors (Review)

Lysine crotonylation (Kcr) refers to a type of modification in which crotonyl groups are transferred to lysine residues by histone crotonyltransferase (HCT) using crotonyl-coenzyme A (CoA) as a substrate. Kcr is distributed in core histones and in some nonhistone proteins. Histone crotonylation is a newly discovered epigenetic modification with a significant ability to regulate gene expression. Crotonylation occurs on the ε-amino group of lysine residues and results in a modification of the histone charge. Similar to acetylation, the substrate for crotonylation is a donor molecule, crotonyl-CoA, which is linked to the sulfhydryl group of CoA by a thioester bond. Crotonylation is involved in regulating a wide range of biological processes and diseases. With advances in detection technologies, the impact of histone crotonylation on tumors has been revealed. The present review examines the recent discoveries of histone crotonylation, its function in tumors and its regulatory mechanism, which will aid in elucidating the mechanisms of malignant tumor development and provide a theoretical foundation for the development of new targeted cancer therapies.

Progress in research of glucose transporters in molecular imaging of colorectal tumors

Colorectal cancer is one of the most common digestive tract malignant tumors in China. Due to the difficulty in early diagnosis, its morbidity and mortality are increasing year by year. Molecular imaging can monitor biological processes at cellular and molecular levels in vivo, having potential clinical diagnosis and treatment value. The key of molecular imaging is to develop new imaging technology and construct targeted molecular probes. Glucose transporters (Glut) are proteins distributed on various cell membranes in the human body. At present, it is believed that the abnormal expression of Glut1 is closely related to colorectal cancer, playing an important role in the occurrence and development of this malignancy. Therefore, Glut1 is expected to become a specific target for molecular imaging of colorectal cancer.

68Ga-labeled prostate specific membrane antigen HBED-CC PET/MRI for staging and evaluating the clinicopathological characteristics in newly diagnosed prostate cancer

OBJECTIVE

The purpose of this study was to investigate the role of 68Ga-labeled prostate specific membrane antigen HBED-CC (68Ga-PSMA-11) PET/MRI in primary staging and to evaluate the relationship between PSMA-derived parameters and clinicopathological characteristics in newly diagnosed prostate cancer (PCa).

MATERIALS AND METHODS

This study reports the findings from 72 patients newly diagnosed with primary PCa, all of whom underwent 68Ga-PSMA-11 PET/MRI scans. Calculated the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 68Ga-PSMA-11 PET/MRI for T, N, M staging, respectively. The maximum standardized uptake value (SUVmax), PSMA-tumor volume (PSMA-TVp), and total lesion-PSMA (TL-PSMAp) of primary lesion, PSMA-TV of total lesions (PSMA-TVt), and TL-PSMA of total lesions (TL-PSMAt) were measured, and Spearman correlation analysis was performed to assess their correlation with baseline prostate-specific antigen (PSA). Non-parametric Mann-Whitney U test was conducted to assess the difference of PSMA-derived parameters among clinicopathological characteristics of PCa. Receiver operating characteristic (ROC) curve was used to evaluate the performance of PSMA-derived parameters in diagnosing the clinicopathological characteristics of PCa.

RESULTS

The overall accuracy of 68Ga-PSMA-11 PET/MRI in detecting T staging of PCa was 80.7%. Diagnostic accuracy for T2a, T2b, T2c, T3a, and T3b were 94.2%, 92.3%, 90.4%, 90.4%, and 94.2%, respectively. Diagnostic accuracy for N and M staging were 96.1% and 97.2% based on patients-level, respectively. There were significant correlation between the SUVmax, PSMA-TVp, TL-PSMAp, PSMA-TVt, TL-PSMAt and baseline PSA values. Significant differences were observed in SUVmax, PSMA-TVp, TL-PSMAp, PSMA-TVt, and TL-PSMAt between T3 and T2 staging. Statistical differences were observed in SUVmax, TL-PSMAp, PSMA-TVt, and TL-PSMAt between Gleason Score (GS) > 7 and GS ≤ 7, as well as positive and negative regional lymph node metastasis. TL-PSMAt show the highest value in assessing clinicopathological characteristics.

CONCLUSIONS

68Ga-PSMA-11 PET/MRI can provide accurate TNM staging for PCa, particularly in local staging. TL-PSMAt accurately evaluate overall tumor burden and aids in diagnosing clinicopathological characteristics in mid-to-late-stage patients, outperforming SUVmax.

Oncologic outcomes of surgically treated colorectal cancer in octogenarians: a comparative study using inverse probability of treatment weighting (IPTW)

PURPOSE

Octogenarians constitute a growing number of diagnoses for colorectal cancer. However, the optimal treatment for these increasingly vulnerable octogenarians with colorectal cancer remains a challenging issue. The aim of this study was to evaluate the oncologic outcomes of colorectal cancer, comparing octogenarians (> 80 years) and younger age (60-79 years).

METHODS

A total of 657 patients underwent surgery for colorectal cancer between January 2015 and December 2019 at Gangneung asan hospital. Among them, 444 patients over the age of 60 were enrolled. The exclusion criteria were as follows: only local resection, R1 and R2 resection, Stage IV, absence of data in follow-up, concurrent inflammatory bowel disease, concurrent malignancy, and prior history of malignancy. The patients were divided into two groups according to their age: Octogenarian group (OG, aged > 80 years, n = 83), and younger group (YG, aged 60 to 79 years, n = 361). Inverse probability of treatment weight (IPTW) was used to control for confounding factors.

RESULTS

We used Inverse Probability of Treatment Weighting (IPTW) to control confounding factors and ensure a balanced comparison between octogenarians (OG) and younger patients (YG). Before IPTW adjustment, the OG had significantly worse 3-year overall survival (90.0% vs. 78.6%, p = 0.045), while 3-year disease-free survival (DFS) was similar between YG and OG (87.8% vs. 83.6%, p = 0.349). Additionally, the OG had a higher rate of emergency surgery (21.7% vs. 11.4%, p = 0.020), higher ASA classification (≥ III in 66.3% vs. 48.8%, p = 0.006), higher overall mortality (43.4% vs. 21.9%, p < 0.001), and less frequent use of adjuvant chemotherapy (17.2% vs. 57.6%, p < 0.001). Multivariate analysis showed that older age (hazard ratio [HR] = 2.177, 95% confidence interval [CI]: 1.452-3.264, p < 0.001), emergency surgery (HR = 1.831, 95% CI: 1.157-2.897, p = 0.010), severe postoperative complications (Clavien-Dindo III-V. HR = 1.357, 95% CI: 1.035-1.779, p = 0.027), higher TNM stage (stage III, HR = 5.143, 95% CI: 2.009-13.167, p < 0.001), and presence of perineural invasion (HR = 1.588, 95% CI: 1.058-2.385, p = 0.026) were significant predictors of worse survival. Similarly, independent factors associated with recurrence included emergency surgery (HR = 2.653, 95% CI: 1.550-4.542, p < 0.001), poor tumor differentiation (HR = 2.842, 95% CI: 1.198-6.743, p = 0.018), higher TNM stage (stage III, HR = 7.826, 95% CI: 2.355-26.016, p < 0.001), and presence of perineural invasion (HR = 1.876, 95% CI: 1.152-3.055, p = 0.011). However, age was not an independent factor associated with recurrence. In the subgroup analysis, the OG group with no or mild complications (Clavien-Dindo classification I-II) had a significantly better 3-year OS compared to those with severe complications (87.7% vs. 37.5%, p = 0.002). After IPTW adjustment, there were no significant differences in OS (73.2% vs. 77.5%, p = 0.120) or DFS (87.2% vs. 87.5%, p = 0.863) between the two groups. These findings suggest that age alone is not a critical determinant of oncologic outcomes once confounding variables are controlled.

CONCLUSION

After IPTW adjustment, age was not an independent factor affecting oncologic outcomes. Instead, emergency surgery, severe complications, advanced stage, tumor differentiation, and perineural invasion were significant predictors of survival and recurrence. In the subgroup analysis, octogenarians with no or mild complications had significantly better 3-year OS than those with severe complications. These findings suggest that perioperative management and disease severity, rather than age alone, should guide treatment decisions.

Nicotine-driven enhancement of tumor malignancy in triple-negative breast cancer via additive regulation of CHRNA9 and IGF1R

Cigarette smoking is a significant risk factor for cancer development with complex mechanisms. This study aims to investigate the impact of nicotine exposure on the regulation of stemness- and metastasis-related properties via cholinergic receptor nicotinic alpha 9 subunit (CHRNA9) and insulin-like growth factor-1 receptor (IGF1R) and to evaluate their therapeutic potential in triple-negative breast cancer (TNBC). We performed Kaplan-Meier survival analysis of public databases and revealed that high expression of CHRNA9, IGF1R signaling molecules, and stemness genes was significantly associated with poor recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in TNBC samples. Additionally, we examined two patient cohorts to determine the clinical associations between the expression levels of different genes (n = 67) and proteins (n = 42) and showed a strong positive correlation between the expression levels of CHRNA9, IGF1R signaling molecules, and stemness markers POU5F1/NANOG in tumor tissues. We carried out nicotine treatment and knockdown of CHRNA9 and IGF1R in TNBC cells to identify the effects on stemness-related properties in vitro. Furthermore, primary and secondary metastatic in vivo animal models were examined using micro-computed tomography (μCT) screening and in situ hybridization with a human Alu probe to detect tumor cells. Nicotine was found to upregulate the expression of CHRNA9, POU5F1, and IGF1R, influencing stemness- and metastasis-related properties. Knockdown of CHRNA9 expression attenuated nicotine-induced stemness-related properties in a TNBC cell model. Furthermore, knockdown of IGF1R expression significantly alleviated nicotine/CHRNA9-induced stemness features and cancer cell metastasis in cell cultures and lung metastatic mouse models. These results demonstrate that nicotine triggers IGF1R signaling, thereby enhancing stemness-related properties, cell migration, invasion, and tumor metastasis, resulting in a poorer prognosis for patients with TNBC. These findings highlight IGF1R as a promising therapeutic target for reducing stemness and metastasis in TNBC patients exposed to environmental nicotine. © 2025 The Pathological Society of Great Britain and Ireland.

Interpretable model based on MRI radiomics to predict the expression of Ki-67 in breast cancer

This study aimed to develop an interpretable machine learning model that accurately predicts Ki-67 expression in breast cancer (BC) patients using a combination of dynamic-contrast enhanced magnetic resonance imaging (DCE-MRI) radiomics and clinical-imaging features. A total of 195 BC patients, including 201 lesions, were enrolled retrospectively. These lesions were randomized into training and testing set (7:3). The correlation between clinical-imaging features and Ki-67 expression was analyzed via univariate analysis and binary logistic regression, leading to the development of a Clinical-imaging model. Radiomics features were extracted based on the early and delayed phases of DCE-MRI. These features were screened by Pearson correlation coefficient and recursive feature elimination (RFE). The logistic regression classifier was used to develop the Radiomics model. The clinical imaging and radiomics features were combined to form a Combined model. The Shapley Additive Explanation (SHAP) algorithm was employed to explain the optimal model, and the AUC was used to assess the model's performance. Ki-67 expression was markedly different from the internal enhancement pattern and necrosis among the imaging features. Compared to the Clinical-imaging model (AUC = 0.682), the AUCs of the Radiomics and the Combined models in the training set were 0.797 and 0.821, respectively. Clinical-imaging, Radiomics, and Combined models had AUCs of 0.666, 0.796, and 0.802 in the test set. Based on the IDI results, the combined model outperformed the Clinical-imaging and Radiomics models in the training set by 11.8% and 2.1%, respectively. They increased by 11% and 1.74% in the test set. SHAP analysis showed that ph2-original-shape-surface volume ratio was the most important feature of the model. Based on clinical-imaging features and DCE-MRI radiomics, the interpretable machine learning model can accurately predict the expression of Ki-67 in BC. Combining the SHAP algorithm with the model improves its interpretability, which may assist clinicians in formulating more accurate treatment strategies.

Breath biomarkers for esophageal cancer: identification, quantification, and diagnostic modeling

Esophageal cancer is a major global health issue with a high mortality rate. Early diagnosis is crucial for improving patient outcomes, but traditional diagnostic methods are often invasive and costly. This study explores the potential of exhaled volatile organic compounds (VOCs) as a non-invasive diagnostic tool for esophageal cancer. Using gas chromatography-mass spectrometry (GC-MS), we analyzed the breath samples of 80 esophageal cancer patients and 60 healthy controls, identifying and quantifying over 100 VOCs. The results revealed significant differences in the concentrations of VOCs such as acetone, ethanol, and isoprene between the two groups. A multi-parameter regression diagnostic model based on a neural network algorithm achieved an accuracy of 90.3% in distinguishing esophageal cancer patients from healthy individuals. Further optimization incorporating physiological factors, including smoking, drinking, and dietary habits, improved the model's accuracy to 92.4%, with a specificity of 93.1%, representing a significant improvement over previous studies. These results suggest that VOCs analysis in exhaled breath holds great promise as a non-invasive, cost-effective, and accurate method for early detection of esophageal cancer.

Stomach cancer identification based on exhaled breath analysis: a review

Early prediction of cancer is crucial for effective treatment decisions. Stomach cancer is one of the worst malignancies in the world because it does not reveal the growth in symptoms. In recent years, non-invasive diagnostic methods, particularly exhaled breath analysis, have attracted interest in detecting stomach cancer. This review discusses invasive and non-invasive diagnostic methods for stomach cancer, with a special emphasis on breath analysis and electronic nose (e-nose) technology. Various analytical methods have been used to analyze volatile organic compounds (VOCs) associated with stomach cancer. Gas chromatography-mass Spectrometry is one of the most widely used techniques. These techniques enable the detection and analysis of VOCs, offering a promising route for early stomach cancer diagnosis. The e-nose system has been introduced as a cost-effective and portable alternative for VOC detection in stomach cancer to overcome the challenges associated with conventional methods. This review discusses the advantages and disadvantages of the e-nose system. This review recommends that e-nose sensors, combined with advanced pattern recognition techniques, be utilized to enable rapid and reliable diagnosis of stomach cancer.

Integrating Novel and Classical Prognostic Factors in Locally Advanced Cervical Cancer: A Machine Learning-Based Predictive Model (ESTHER Study)

Background/Objective: This study aimed to assess the prognostic significance of pretreatment nutritional and systemic inflammatory indices (IIs), and body composition parameters in patients with locally advanced cervical cancer (LACC) treated with chemoradiation and brachytherapy. The goal was to identify key predictors of clinical outcomes, such as local control (LC), metastasis-free survival (MFS), disease-free survival (DFS), and overall survival (OS), using machine learning techniques. Materials and methods: A retrospective analysis of 173 patients with LACC treated between 2007 and 2021 was conducted. The study utilized machine learning techniques, including LASSO regression and Classification and Regression Tree (CART) analysis, to identify significant predictors of outcomes. Clinical data, tumor-related parameters, and treatment factors, along with IIs and body composition metrics (e.g., sarcopenic obesity), were incorporated into the models. Model performance was evaluated using ROC curves and AUC values. Results: Among 173 patients, hemoglobin (Hb) levels, ECOG performance status, and total protein emerged as primary prognostic indicators across multiple endpoints. For 2-year LC, patients with Hb > 11.9 g/dL had a rate of 95.1% compared to 73.6% in those with lower levels, with further stratification by ECOG status, ANRI, and total protein refining predictions. For 5-year LC, rates were 83.1% for Hb > 11.5 g/dL and 43.3% for lower levels. For 2-year MFS, ECOG 0 patients had an 88.1% rate compared to 73.8% for ECOG ≥ 1. In 2-year OS, Hb > 11.9 g/dL predicted a 95.1% rate, while ≤11.9 g/dL correlated with 74.0%. IIs (ANRI, SIRI, MLR) demonstrated predictive value only within specific patient subgroups defined by the primary prognostic indicators. The model showed strong predictive accuracy, with AUCs ranging from 0.656 for 2-year MFS to 0.851 for 2-year OS. Conclusions: These findings underscore the value of integrating traditional prognostic factors with emerging markers to enhance risk stratification in LACC. The use of machine learning techniques like LASSO and CART demonstrated strong predictive capabilities, highlighting their potential to refine individualized treatment strategies. Prospective validation of these models is warranted to confirm their utility in clinical practice.

Study on the regulatory mechanism of luteolin inhibiting WDR72 on the proliferation and metastasis of non small cell lung cancer

Non-small cell lung cancer (NSCLC) is a major cause of cancer-related mortality worldwide. Understanding molecular mechanisms and identifying potential therapeutic targets are crucial for improving treatment outcomes. This study aims to explore the effect of luteolin on NSCLC progression by regulating WDR72 and to investigate the related molecular mechanisms using cellular and animal models. The study employed a comprehensive set of experiments to evaluate the impact of luteolin and WDR72 on NSCLC cell proliferation and metastasis. Techniques included the CCK- 8 assay, colony formation assay, scratch test, and Transwell assay. Molecular docking experiments were performed to validate the binding interaction between luteolin and WDR72. Experimental groups included OE-WDR72, OE-WDR72 + Luteolin, Control, Control + Luteolin, and sh-WDR72. Western blot analysis was used to examine protein expression related to apoptosis, epithelial-mesenchymal transition (EMT), AKT signaling, and other markers. Additionally, a nude mouse subcutaneous tumor model was established to assess the in vivo tumor-forming ability of NSCLC cells under different treatments. Luteolin significantly inhibited the proliferation, invasion, and migration of NSCLC cell lines (H1299 and A549) and reduced tumor formation in nude mice. Molecular docking demonstrated strong binding affinity between luteolin and WDR72. Overexpression of WDR72 promoted NSCLC cell proliferation and migration, while WDR72 silencing showed the opposite effects. Western blot analysis revealed that WDR72 overexpression increased phosphorylated AKT and Bcl- 2 levels while decreasing caspase- 3. In contrast, silencing WDR72 reduced these protein levels. Luteolin treatment in WDR72-overexpressing cells resulted in decreased phosphorylated AKT, increased apoptosis, and suppressed EMT. Tumor transplantation experiments indicated that tumors in the OE-WDR72 group exhibited the fastest growth, while the sh-WDR72 group showed the slowest growth. Luteolin treatment significantly reduced WDR72 expression, suggesting a regulatory role in NSCLC progression. Luteolin effectively inhibits EMT, invasion, and migration of NSCLC cells by modulating WDR72. WDR72 plays a pivotal role in stimulating the proliferation and metastasis of NSCLC cells. By downregulating WDR72, luteolin suppresses NSCLC progression, potentially through modulation of the PI3 K/AKT/EMT signaling pathway. These findings highlight luteolin as a promising therapeutic agent for NSCLC treatment.

Impacts of loading thymoquinone to gold or silver nanoparticles on the efficacy of anti-tumor treatments in breast cancer with or without chemotherapeutic cisplatin

BACKGROUND

Nanotechnology has been greatly examined for tumor medication, as nanoparticles (NPs) serve a crucial role in drug delivery mechanisms for cancer therapy. In contrast to traditional cancer therapies, NPs-based drug delivery offers several benefits, including increased stability and biocompatibility, improved retention capabilities and permeability, as well as precise targeting.

AIM

The objective of this study was to examine the tumor-targeting efficacy of Thymoquinone (TQ)-loaded gold NPs (AuNPs/TQ conjugate) or TQ-loaded silver NPs (AgNPs/TQ conjugate) in conjunction with the conventional chemotherapy agent cisplatin (CP) in Ehrlich ascites carcinoma (EAC)-bearing mice.

METHODS

The loading capacity of synthesized conjugates was characterized by UV-Vis spectra and transmission electron microscope (TEM). We used CD-1 mice with a peritoneal EAC tumor xenograft model that received oral administration of TQ, AuNPs, AgNPs, AuNPs/TQ conjugate, and AgNPs/TQ conjugate.

METHODS

EAC-bearing mice received daily oral administration of one of the following treatments for six consecutive days: TQ, AuNPs, AgNPs, AuNPs/TQ, AgNPs/TQ, AuNPs/TQ + CP, or AgNPs/TQ + CP conjugates. Eleven days after EAC inoculations, assessments were conducted to evaluate the total number of tumor cells, splenocytes, white blood cells (WBCs), C-reactive protein (CRP) levels, flow cytometric analysis of apoptosis in EAC cells, as well as the functionality of the kidney and liver.

RESULTS

EAC-bearing mice that received treatment with TQ, AuNPs, AgNPs, AuNPs/TQ, and AgNPs/TQ exhibited significantly enhanced anti-tumor activity and improved therapeutic efficacy. Our results further revealed that the combined synergistic approach of TQ's anti-tumor properties, along with the efficient penetration abilities of AuNPs or AgNPs, led to a significant inhibition of the growth of tumor cells in EAC tumor-bearing mice. Moreover, the incorporation of CP into the AuNPs/TQ or AgNPs/TQ conjugates substantially augmented the anti-proliferative effects against EAC tumor cells, effectively overcoming resistance to chemotherapeutic agents. Furthermore, our data revealed that this combination resulted in an elevation of leukocyte counts, along with an increase in the absolute quantities of lymphocytes, neutrophils, and monocytes, thereby activating the immune system and reducing the inflammatory marker CRP. However, the restoration of splenocyte levels, which had been reduced due to EAC cell inoculation, required an extended period to return to baseline. Furthermore, the results indicated moderate alterations in the functionality of both the liver and kidney.

CONCLUSION

To conclude, AuNPs, AgNPs, AuNPs/TQ, and AgNPs/TQ may hold great promise as potential nanoparticle-based therapies for cancer treatment. Additionally, provides numerous benefits compared to conventional cancer therapies, such as selectivity and minimal side effects. Additionally, AuNPs, AuNPs/TQ, AuNPs/TQ + CP, AgNPs, AgNPs/TQ, or AgNPs/TQ + CP can specifically target tumor tissues, suppress tumor growth, extend the lifespan of tumor-bearing mice, and minimize cytotoxic effects on normal tissues, relative to the administration of free CP alone. More research is needed to understand the mechanisms of these nanoparticle-based therapies in clinical and optimize their use as cancer therapies.

Combining spatial transcriptomics and ECM imaging in 3D for mapping cellular interactions in the tumor microenvironment

Tumors are complex ecosystems composed of malignant and non-malignant cells embedded in a dynamic extracellular matrix (ECM). In the tumor microenvironment, molecular phenotypes are controlled by cell-cell and ECM interactions in 3D cellular neighborhoods (CNs). While their inhibition can impede tumor progression, routine molecular tumor profiling fails to capture cellular interactions. Single-cell spatial transcriptomics (ST) maps receptor-ligand interactions but usually remains limited to 2D tissue sections and lacks ECM readouts. Here, we integrate 3D ST with ECM imaging in serial sections from one clinical lung carcinoma to systematically quantify molecular states, cell-cell interactions, and ECM remodeling in CN. Our integrative analysis pinpointed known immune escape and tumor invasion mechanisms, revealing several druggable drivers of tumor progression in the patient under study. This proof-of-principle study highlights the potential of in-depth CN profiling in routine clinical samples to inform microenvironment-directed therapies. A record of this paper's transparent peer review process is included in the supplemental information.

Radical cystectomy mortality in older patients: a systematic review and meta-analysis

OBJECTIVE

To perform a systematic review and meta-analysis of post-radical cystectomy (RC) mortality and complications in older people to aid decision-making pertinent to RC, as bladder cancer is typically a disease of older people, yet older people are less likely than their younger peers to undergo RC, predominantly due to concerns about morbidity and mortality of surgery.

MATERIALS AND METHODS

A systematic search of MEDLINE, Scopus and Ovid Emcare was performed in May 2023 for all studies in the past 20 years that reported mortality and/or complications in the 90-days following RC. All studies reporting mortality or complication outcomes in patient groups aged >75 years were included. Exclusion criteria included partial, or organ-sparing cystectomy, non-English language articles, and <20 patients aged >75 years.

RESULTS

A total of 76 studies were included, with data from 58 504 older patients across five continents and 19 countries. Post-RC 90-day mortality was 11% in studies reporting outcomes for patients aged ≥80 years, and 7% in studies of patients aged ≥75 years. The 90-day mortality was higher in patients aged ≥80 years compared to patients aged <80 years (odds ratio [OR] 3.42, 95% confidence interval [CI] 1.62-7.22). Older people were more likely to experience a minor (Clavien-Dindo Grade I-II) postoperative complication than younger patients (OR 1.17, 95% CI 1.01-1.36), whereas there was no difference for major complications (Clavien-Dindo Garde III-IV; OR 1.00, 95% CI 0.63-1.60). A higher co-morbid status was more strongly correlated with 90-day mortality in older patients than in younger patients.

CONCLUSIONS

Older patients face higher postoperative mortality following RC than younger patients. Postoperative outcomes should be weighed against the high risk of cancer-specific death if no curative treatment is offered. Older people must be monitored closely postoperatively to try and prevent death as a result of escalation from minor and major complications.

Stress and coping strategies of cancer among adult cancer patients in Hawassa University comprehensive specialized hospital cancer centre in 2024: patient, family and health professional perspective

BACKGROUND

Cancer causes stress that impairs overall health of clients, their family members and health providers regardless of its stage. Despite the presence of various types of coping strategies to improve quality of life of patients, their family members and health providers, little is explored about the issue in the study area.

OBJECTIVE

To explore the lived experience of stress and coping strategies of cancer among patients, their family members and health care providers at cancer treatment centre of Hawassa University comprehensive specialized hospital.

METHODS

Phenomenological study design was conducted to understand the lived experience of stress and coping strategies of people with cancer, their family members and health providers. Twenty patients with their respective family care giver were interviewed followed by two focus groups discussions of health professionals. Study participants were selected purposively. After verbatim transcription and coding, mixed thematic analysis was conducted using Microsoft word.

RESULTS

A total of three main themes have been emerged during analysis: stress, coping strategies and interaction. Each of the main themes was further categorized into patient, family member and health provider perspectives. From client perspective stress can be categorized into: emotional, physical, mental and behavioural stress. Emotional stress, financial hardship and behavioural stress are the dominant cause of stress among family members. Health providers describe emotional strain and lack of infrastructure is the key source of stress. Almost all patients adopted active coping strategies such as accepting the realities, seeking support, religious values, being creative. Providing support, being spiritual and strengthening bond with the families were clearly explained coping strategies among patients. In addition team work and physical care are among the coping mechanism of health providers. Regarding interaction and dynamism, Client-family interaction was manifested as hiding information, advocacy, decision making, role change and social and emotional support categories. On the other hand, client provider interaction manifested as showed communication, holistic care, cooperation and building trust.

CONCLUSION

Patients with cancer suffered from many different stress types. They applied multiple positive forms of coping strategies. The findings enrich the limited existing literature on this understudied population and provide direction for the future development of interventions to improve their psychological well-being.

Quality of prostate MRI in early diagnosis-a national survey and reading evaluation

OBJECTIVES

The reliability of image-based recommendations in the prostate cancer pathway is partially dependent on prostate MRI image quality. We evaluated the current compliance with PI-RADSv2.1 technical recommendations and the prostate MRI image quality in the Netherlands. To aid image quality improvement, we identified factors that possibly influence image quality.

MATERIALS AND METHODS

A survey was sent to 68 Dutch medical centres to acquire information on prostate MRI acquisition. The responding medical centres were requested to provide anonymised prostate MRI examinations of biopsy-naive men suspected of prostate cancer. The images were evaluated for quality by three expert prostate radiologists. The compliance with PI-RADSv2.1 technical recommendations and the PI-QUALv2 score was calculated. Relationships between hardware, education of personnel, technical parameters, and/or patient preparation and both compliance and image quality were analysed using Pearson correlation, Mann-Whitney U-test, or Student's t-test where appropriate.

RESULTS

Forty-four medical centres submitted their compliance with PI-RADSv2.1 technical recommendations, and 26 medical centres completed the full survey. Thirteen hospitals provided 252 usable images. The mean compliance with technical recommendations was 79%. Inadequate PI-QUALv2 scores were given in 30.9% and 50.6% of the mp-MRI and bp-MRI examinations, respectively. Multiple factors with a possible relationship with image quality were identified.

CONCLUSION

In the Netherlands, the average compliance with PI-RADSv2.1 technical recommendations is high. Prostate MRI image quality was inadequate in 30-50% of the provided examinations. Many factors not covered in the PI-RADSv2.1 technical recommendations can influence image quality. Improvement of prostate MRI image quality is needed.

CRITICAL RELEVANCE STATEMENT

It is essential to improve the image quality of prostate MRIs, which can be achieved by addressing factors not covered in the PI-RADSv2.1 technical recommendations.

KEY POINTS

Prostate MRI image quality influences the diagnostic accuracy of image-based decisions. Thirty to fifty percent of Dutch prostate MRI examinations were of inadequate image quality. We identified multiple factors with possible influence on image quality.

Therapeutic potential of microRNA-506 in cancer treatment: mechanisms and therapeutic implications

Cancer is a complex and highly lethal disease marked by unchecked cell proliferation, aggressive behavior, and a strong tendency to metastasize. Despite significant advancements in cancer diagnosis and treatment, challenges such as early detection difficulties, drug resistance, and adverse effects of radiotherapy or chemotherapy continue to threaten patient survival. MicroRNAs (miRNAs) have emerged as critical regulators in cancer biology, with miR-506 being extensively studied and recognized for its tumor-suppressive effects across multiple cancer types. This review examines the regulatory mechanisms of miR-506 in common cancers, focusing on its role in the competing endogenous RNA (ceRNA) network and its effects on cancer cell proliferation, apoptosis, and migration. We also discuss the potential of miR-506 as a therapeutic target and its role in overcoming drug resistance in cancer treatment. Overall, these insights underscore the therapeutic potential of miR-506 and its promise in developing novel cancer therapies.

Comparison of the diagnostic accuracy of enhanced-CT and double contrast-enhanced ultrasound for preoperative T-staging of gastric cancer: a meta-analysis

BACKGROUND

Accurate preoperative staging of gastric cancer (GC) depends on effective diagnostic methods. Enhanced computed tomography (enhanced-CT) is a widely used and reliable preoperative assessment tool for GC, Double Contrast-Enhanced Ultrasound (DCEUS) can display the structure and layers of the gastric wall more accurately, and has high sensitivity (SE) and specificity (SP).

OBJECTIVE

The present study aims to conduct a comprehensive meta-analysis comparing the preoperative T-staging accuracy of DCEUS and enhanced-CT.

METHODS

A systematic literature search was conducted across PubMed, Embase, Web of Science, and Cochrane Library to identify eligible articles from inception to February 19, 2024. The study included both prospective and retrospective studies involving patients with GC who underwent DCEUS or enhanced-CT. This encompassed studies utilizing comparative diagnostic test accuracy (CDTA) with both DCEUS and enhanced-CT, as well as studies employing single diagnostic test accuracy (SDTA) with either DCEUS or enhanced-CT alone. Risk of bias was assessed using the Quality Assessment Of Diagnostic Accuracy Studies-C (QUADAS-C) and Assessment Of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The quality of evidence for each outcome was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation).

RESULTS

A total of 39 studies involving 6,374 patients were included in this meta-analysis. Among these, 3 studies (319 patients) directly compared dynamic contrast-enhanced ultrasound (DCEUS) and enhanced computed tomography (CT), while 31 studies (5,180 patients) evaluated enhanced CT alone, and 5 studies (875 patients) assessed DCEUS alone. For the direct comparison studies (CDTA), DCEUS demonstrated higher sensitivity (SE) and specificity (SP) for T1-T4 staging compared to enhanced CT, with moderate to low certainty of evidence. Specifically, DCEUS showed superior performance in detecting early-stage (T1) and advanced-stage (T4) tumors. Enhanced CT, while effective, had lower sensitivity across all stages, particularly for T1 tumors. In the single-modality studies (SDTA), DCEUS consistently showed higher sensitivity for T2-T4 staging compared to enhanced CT, with comparable specificity. However, the certainty of evidence for indirect comparisons was very low, highlighting the need for further high-quality comparative studies. Overall, DCEUS appears to be a promising modality for gastric cancer T staging, particularly for early-stage detection, but the limited number of direct comparative studies underscores the need for more robust evidence.

CONCLUSION

Current evidence indicates that DCEUS significantly outperforms enhanced-CT in terms of SE and diagnostic accuracy for preoperative T-staging of GC, while maintaining comparable SP. However, these findings require further validation through rigorous studies with larger sample sizes and improved methodological quality.

Application of Fourier transform infrared spectroscopy on Breast cancer diagnosis combined with multiple algorithms: A systematic review

INTRODUCTION

Fourier transform infrared (FT-IR) spectroscopy is an innovative diagnostic technique for improving early detection and personalized care for breast cancer patients. It allows rapid and accurate analysis of biological samples. Therefore, the purpose of this study was to assess the diagnostic accuracy of FT-IR spectroscopy for breast cancer, based on a comprehensive literature review.

METHODS

An online electronic database systematic search was conducted using PubMed/Medline, Cochrane Library, and hand databases from March 28, 2024, to April 10, 2024. We included peer-reviewed journal articles in which FT-IR spectroscopy was used to acquire data on breast cancers and manuscripts published in English. All eligible studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.

RESULTS

Serum, breast biopsies, blood plasma, specimen, and saliva samples were included in this study. This study revealed that breast cancer diagnosis using FT-IR spectroscopy with diagnostic algorithms had a sensitivity and specificity of approximately 98 % and 100 %, respectively. Almost all studies have used more than one algorithm to analyze spectral data. This finding showed that the sensitivity of FT-IR spectroscopy reported in six included studies was greater than 90 %.

CONCLUSION

Employing multivariate analysis coupled with FT-IR spectroscopy has shown promise in differentiating between healthy and cancerous breast tissue. This review revealed that FT-IR spectroscopy will be the next gold standard for breast cancer diagnosis. However, to draw definitive conclusions, larger-scale studies, external validation, real-world clinical trials, legislative considerations, and alternative methods such as Raman spectroscopy should be considered.

Reasons for not undergoing cervical cancer screening: perspectives from women and health care providers in Addis Ababa: a qualitative study

Background

Cervical cancer is a major public health problem in low-income countries, including Ethiopia. Various pieces of evidence show that the uptake of cervical cancer screening is low in Ethiopia. The reasons for this low uptake of cervical cancer screening have not been well documented.

Objective

The aim of this study is to explore the reasons for not taking up cervical cancer screening and gather the perspectives of women and healthcare providers in Addis Ababa, Ethiopia.

Methods

Adult women and healthcare providers participated in the study. Eleven focus group discussions were conducted with women from the community. A total of 18 key Informant interviews were conducted with healthcare professionals who providing cervical cancer screening services and family health team leaders. Interviews and discussions were audio recorded, transcribed, and coded. We used MAXQDA software v.20 for data reduction to facilitate thematic analysis and interpretation.

Results

Eleven focus group discussions and 18 key informant interviews were conducted. In this study, individual-level barriers, such as low knowledge of cervical cancer and screening, feeling healthy, fear of the screening procedure and results, fear of not being cured, fear of divorce, stigma and discrimination, preference for female healthcare providers, and spousal disapproval or resistance, were identified as the main reasons for the low uptake of screening. Community-level barriers such as perceiving cervical cancer as a deadly disease; misconceptions, such as screening causing infertility, and the absence of open discussion, were also found to contribute to low screening uptake.

Conclusion and recommendations

Knowledge about cervical cancer and screening was found to be inadequate. Individual and community-level socio-cultural barriers were identified as reasons for the low uptake of screening. Therefore, it is crucial to conduct behavioral change and communication activities at both the individual and community levels to increase knowledge of cervical cancer and screening, reduce sociocultural barriers, and improve the uptake of cervical cancer screening.

Development of pyrazolo[1,5-a]pyrimidine-grafted coumarins as selective carbonic anhydrase inhibitors and tubulin polymerization inhibitors with potent anticancer activity

This study presents the design, synthesis, and evaluation of a novel series of coumarin-based compounds (9a-t) as potential anticancer agents. The compounds were strategically designed to inhibit cancer-related carbonic anhydrase (CA) isoforms IX and XII and tubulin polymerization. Two approaches were employed for CA inhibition: utilizing the coumarin motif to occlude the CA active site entrance and incorporating zinc-binding groups (sulfonamide, carboxylic acid, and thiol) to interact with the catalytic zinc ion. The target compounds were also designed to inhibit tubulin polymerization by combining the privileged coumarin and pyrazolo[1,5-a]pyrimidine scaffolds. Biological evaluation of the target compounds (9a-t) revealed that sulfonamide-containing derivatives 9h and 9r exhibited potent inhibitory activity in the low nanomolar range against CA IX (Ki = 23 and 14 nM, respectively) and CA XII (Ki = 6 and 17 nM, respectively). In NCI-60 human tumor cell line screening, compounds 9k, 9m, and 9q demonstrated broad-spectrum anti-proliferative activity in the five-dose assay with MG-MID values of 7.31 μM, 10.68 μM, and 5.92 μM, respectively. Compound 9m showed significant tubulin polymerization inhibition with an IC50 = 5.28 μM, surpassing the efficacy of colchicine. Cell cycle analysis in MDA-MB-231 breast cancer cells revealed G2/M phase arrest for 9m, which induced significant apoptosis and modulated apoptotic markers. Molecular docking studies provided insights into the binding modes of the compounds with CA IX, CA XII, and tubulin. ADMET and toxicity predictions were performed to assess the drug-like properties of the compounds. These findings pave the way for further optimization of the coumarin scaffold to develop dual inhibitors of carbonic anhydrase IX/XII and tubulin polymerization.

[Gender-specific differences in urological tumours]

Gender differences in medicine are playing an increasingly important role in diagnostic testing as well as therapy choices. Risk factors and mortality vary depending on gender. Diseases often manifest differently depending on gender. In diagnostic testing, gender-specific aspects need to be taken into consideration. For instance, bladder cancer diagnosis is often delayed in women compared to men as haematuria is frequently attributed to benign conditions like urinary tract infections. In therapy, decisive gender disparities should also be considered. To state an example, immune-checkpoint inhibitors have shown better response in men than in women when treating renal cell carcinoma. Furthermore, outcomes after treatment for urological tumours differ depending on gender.

Inhibition of proliferation, migration and invasion of RM-1 cells by roemerine: Insights from in vitro and in vivo studies

Prostate cancer is the second leading cause of cancer-related among men globally, with a rising incidence rate, particularly in developing countries. This highlights the urgent need to identify novel therapeutic agents. Roemerine, a naturally abundant alkaloid, has demonstrated antibacterial and antitumor properties, suggesting its potential utility in prostate cancer treatment. This study evaluates the effects of roemerine on RM-1 prostate cancer cells using in vitro assays and an in vivo nude mouse subcutaneous xenograft tumor model. Through Cell Counting Kit-8(CCK8), MTT, Wound-Healing, and Transwell assays, we assessed roemerine's impact on RM-1 cell proliferation, migration, and invasion. Additionally, the antitumor efficacy of roemerine was evaluated in nude mice bearing subcutaneous RM-1 tumors. Our findings reveal that roemerine significantly inhibits RM-1 cell activity, migration, invasion, and tumor growth. These results highlight the potential of roemerine as a novel antitumor agent for prostate cancer, providing a foundation for further mechanistic and pharmacological investigations.

The use of preoperative enteral immunonutrition in patients undergoing elective colorectal cancer surgery: A systematic review and meta-analysis

AIM

The present systematic review and meta-analysis aims to compare adult patients receiving enteral immunonutrition prior to elective colorectal surgery with those receiving conventional preoperative nutrition.

METHODS

MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched from database inception to March 2024. Articles were included if they were randomized controlled trials or cohort studies evaluating adult patients undergoing elective colorectal surgery comparing preoperative enteral immunonutrition with conventional preoperative nutrition protocols. Main outcomes of interest included surgical site infection, anastomotic leak, overall postoperative morbidity and postoperative length of stay. An inverse variance random effects meta-analysis was performed. Risk of bias was assessed with Cochrane risk of bias assessment tools. The GRADE approach was conducted to assess quality of evidence.

RESULTS

After reviewing 2508 relevant citations, 10 studies met inclusion criteria. Overall, 1521 patients (mean age 64.9 ± 10.0 years, 49.4% women) received preoperative immunonutrition and 1816 patients (mean age 64.1 ± 11.0 years, 52.1% women) received conventional preoperative nutrition. Across seven studies, there was a non-significant 30% relative risk reduction of surgical site infection (risk ratio 0.70, 95% CI 0.44-1.11, P = 0.13, I2 = 33%) and a non-significant 44% relative risk reduction of anastomotic leak (risk ratio 0.56, 95% CI 0.28-1.10, P = 0.09, I2 = 0%) in the immunonutrition group. Across eight studies, postoperative length of stay was 0.48 days shorter in the immunonutrition group (mean difference -0.48, 95% CI -0.84 to -0.12, P = 0.01, I2 = 53%). GRADE certainty of evidence was low or very low for all outcomes.

CONCLUSION

While point estimates suggest a likely benefit associated with preoperative enteral immunonutrition, wide corresponding 95% CIs suggest uncertainty remains. Further prospective study is warranted.

[Cancer of the cervix management in Reunion Island from 2016 to 2020]

INTRODUCTION

In Réunion Island, the standardized mortality rate for cervical cancer is 4.8/100,000 women, while it is 2.2/100,000 in France. A previous study, before 2016, showed that the absence of brachytherapy and non-compliance with recommendations could contribute to this increased mortality. The objective of the study was to analyze the management of invasive cervical cancers since 2016 in Reunion.

METHODS

Women diagnosed with invasive cervical cancer in one of our health centers in La Réunion, between January 1st, 2016, and December 31st, 2020. The recommendations of the French society of onco-gynecologists (SFOG) were considered as the reference to assess professional practices.

RESULTS

During the study period, 236 women were diagnosed with cervical cancer, 94% of whom underwent an MRI and 54.8% a PET scan during the initial assessment. Compared to previous years, there has been an improvement in the management of these patients with 99% of the files presented in multidisciplinary consultation meetings and more than 80% of the treatments administered which complied with the recommendations including with the use of brachytherapy.

CONCLUSION

Since the implementation of brachytherapy in Reunion in 2016, the treatment of invasive cervical cancer in Reunion has improved. Soon, a shared medical file should harmonize the transmission of information between the care centers of Reunion and contribute to improve our practices.

AKT activation participates in Fascin-1-induced EMT in hepatoma cells

High expression of Fascin-1 involves high metastasis, high recurrence, and poor prognosis of cancers. However, the related regulatory mechanism in hepatocellular carcinoma (HCC) remains elusive. In this study, Fascin-1 was highly expressed in HCC tissues and cell lines. Fastin-1 protein levels and p-Akt1/Akt1 rate were increased by Akt activator SC79 and were decreased by Akt inhibitor LY294002. Silenced Fascin-1 suppressed cell proliferation, promoted cell apoptosis, suppressed cell invasion and epithelial-mesenchymal transition (EMT) in HCC cell lines. Also, silenced Fascin-1 induced cell cycle arrest in the G1 phase. Moreover, silenced Fascin-1 repressed invasion of HCC cells by inhibiting EMT. Besides, interference with Fascin-1 inhibited HCC cell growth, reduced Vimentin expressions and p-Akt1/Akt1 rate in vivo, while these impacts were abolished after injection of SC79. In conclusion, silencing Fascin-1 reduced the malignant growth of HCC, and this process was closely related to AKT inactivation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10616-025-00707-9.

Safety assessment of cabozantinib in patients with renal cell carcinoma: retrospective pharmacovigilance study based on FAERS database

OBJECTIVE

This study was designed to conduct data mining through the Food and Drug Administration Adverse Event Reporting System (FAERS) to assess adverse events (AEs) associated with cabozantinib in the treatment of renal cell carcinoma.

METHODS

Reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) algorithms were used to detect drug-related AEs signals from reporting data in FAERS database from 2016 to 2024.

RESULTS

A total of 32,129 AE reports identifying cabozantinib as a 'primary suspect' were retrieved from the FAERS database. Among them, there were 21,549 reports of renal cell carcinoma as an indication. AEs induced by cabozantinib were observed in 23 system organ classes (SOCs). 215 AE signals were detected in 16 SOCs after four algorithms were simultaneously met. Among them, signals related to gastrointestinal disorders, general disorders and administration site conditions, and skin and subcutaneous tissue disorders were the most common. Of note, the median time to onset of AEs was 38 days (interquartile range (IQR) 14-116 days).

CONCLUSION

This study provides new insights into the monitoring, surveillance, and management of cabozantinib-related adverse drug reactions and provides a comprehensive long-term post-marketing safety assessment of cabozantinib.

TPPP3, a Good Prognostic Indicator, Suppresses Cell Proliferation and Migration in OSCC

INTRODUCTION AND AIMS

Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignancy of the head and neck. Early diagnosis of OSCC is difficult and the prognosis has not improved significantly. This study aims to explore the role of tubulin polymerisation promoting protein 3 (TPPP3) in the occurrence and development of OSCC and discover new diagnostic and prognostic markers for OSCC.

METHODS

Using UALCAN, GEPIA, western blot, and quantitative real-time polymerase chain reaction, we studied TPPP3 expression and its relationship with tumour stage. Then, we detected the effect of TPPP3 on OSCC biological functions by CCK-8 and cell scratch assays, as well as correlations between TPPP3 expression and survival of different kinds of head and neck squamous cell carcinoma (HNSC) patients through Kaplan-Meier plotter. Besides, we explored coexpressed genes associated with TPPP3 in HNSC using LinkedOmics and protein-protein interaction networks of TPPP3 using STRING and Cytoscape. Furthermore, we explored possible molecular mechanisms that TPPP3 functions in HNSC using UALCAN, Kaplan-Meier plotter, and TIMER. Finally, we analysed promoter methylation level by UALCAN and mutation by cBioPortal of TPPP3 in HNSC.

RESULTS

TPPP3 was less expressed in OSCC. The TPPP3 expression level was negatively correlated with tumour stage. Furthermore, TPPP3 significantly inhibited OSCC proliferation and migration. Besides, TPPP3 high expression was significantly associated with good prognosis in different kinds of HNSC patients. Additionally, TPPP3 may regulate the occurrence and development of OSCC through the PALMD/PI3K pathway. TPPP3 methylation level in HNSC decreased. Finally, we found that TPPP3 genetic alteration was involved in TPPP3 mRNA expression change in HNSC.

CONCLUSION

TPPP3 functions as a tumour suppressor in OSCC and is associated with good prognosis in HNSC patients. TPPP3 can be used as a potential biomarker for prognosis and diagnosis of OSCC.

CLINICAL RELEVANCE

TPPP3 can be used as a potential biomarker for prognosis and diagnosis of OSCC in clinical practice.

The multiple functions and mechanisms of long non-coding RNAs in regulating breast cancer progression

Breast cancer (BC) is a malignant tumor that has the highest morbidity and mortality rates in the female population, and its high tendency to metastasize is the main cause of poor clinical prognosis. Long non-coding RNAs (lncRNAs) have been extensively documented to exhibit aberrant expression in various cancers and influence tumor progression via multiple molecular pathways. These lncRNAs not only modulate numerous aspects of gene expression in cancer cells, such as transcription, translation, and post-translational modifications, but also play a crucial role in the reprogramming of energy metabolism by regulating metabolic regulators, which is particularly significant in advanced BC. This review examines the characteristics and mechanisms of lncRNAs in regulating BC cells, both intracellularly (e.g., cell cycle, autophagy) and extracellularly (e.g., tumor microenvironment). Furthermore, we explore the potential of specific lncRNAs and their regulatory factors as molecular markers and therapeutic targets. Lastly, we summarize the application of lncRNAs in the treatment of advanced BC, aiming to offer novel personalized therapeutic options for patients.

Comprehensive analysis of GDFs as therapeutic targets and prognosis biomarkers in gastric cancer

Growth/differentiation factors (GDFs, GDF1-3, GDF5-7, GDF9-11, and GDF15) belong to a subfamily of the transforming growth factor-β. GDFs play an important role in morphogenetic and developmental activities in many tissues. And many GDFs family numbers have been observed to be correlated with various types of tumors. However, the diverse expression patterns and prognostic values of ten GDFs in gastric cancer (GC) have yet to be analyzed. Herein we investigated the transcriptional and survival data of GDFs in patients with GC from the Gene Expression Profiling Interactive Analysis, The Cancer Genome Atlas, cBioPortal, Tumor Immune Estimation Resource, Tumor Immune Syngeneic Mouse, UALCAN, Human Protein Atlas Gene Expression Omnibus and The Database for Annotation, Visualization and Integrated Discovery databases. We found that multiple GDF family members are highly expressed in GC, which can prompt diagnosis and evaluate prognosis, and can be used as target points for GC immunotherapy.

MiR-146b overexpression promotes bladder cancer cell growth via the SMAD4/C-MYC/Cyclin D1 axis

MiR-146b has been identified as being overexpressed in human bladder cancer (BCa) and implicated in promoting cancer cell invasion. However, its specific involvement in BCa cell growth remains unclear. In this study, we demonstrate that the downregulation of miR-146b significantly suppresses tumorigenic growth of human BCa cells both in vitro and in vivo by inducing G0/G1 cell cycle arrest. Specifically, miR-146b inhibition resulted in a significant reduction in colony formation (p < 0.05) and anchorage-independent growth in both UMUC3 and T24T cells, as measured by soft agar assays, with three independent replicates for each experiment. Notably, Cyclin D1 protein plays a crucial role in miR-146b-induced BCa cell proliferation, as confirmed by Western blotting (p < 0.05), with each experiment performed in triplicate. Mechanistic investigations reveal that miR-146b reduces mothers against decapentaplegic homolog 4 (SMAD4) mRNA stability by directly binding to its 3' untranslated region (3'-UTR), leading to decreased SMAD4 expression. This reduction in SMAD4 levels promotes cellular myelocytomatosis (C-MYC) transcription, which in turn enhances Cyclin D1 transcription, ultimately facilitating BCa cell proliferation. The findings unveil a novel regulatory axis involving SMAD4/C-MYC/Cyclin D1 in mediating the oncogenic role of miR-146b in BCa cells. Statistical significance was determined using Student's t-test, with p-values <0.05 considered significant. Together with its previously established function in BCa invasion, the results highlight the potential for developing miR-146b-based therapeutic strategies for treating human BCa patients.

Metformin suppresses breast cancer cell proliferation and liver metastasis by up-regulating miR-34a

BACKGROUND

The incidence of breast cancer is on the rise, and metastasis remains a major challenge. Metformin has demonstrated anti-cancer effects, yet its mechanism remains unclear. miR-34a is a tumor-suppressing microRNA. This study explored the relationship between metformin and miR-34a in breast cancer, aiming to clarify the anti-cancer mechanism of metformin.

AIM

To study the effect of metformin on breast cancer cell proliferation and liver metastasis and to explore the possible mechanism involved.

METHODS

Breast cancer cells were transfected with pre-miR-34a or empty virus vector (negative control [NC] group) using the liposome transfection method. Real-time PCR was used to detect the expression of miR-34a in MDA-MB-231 and T-47-D cell lines, and the stably transfected cell lines were determined. Metformin (0, 5, 10, and 20 mM) was then administered. Breast cancer cell proliferation was detected by MTT assay. Apoptosis assay was used to determine the apoptosis in breast cancer cells. The invasive ability of cells was detected by scratch test and Transwell cell assay. Meanwhile, TA2 breast cancer cells were inoculated into the inguinal region of mice. On day 4 after tumor cell inoculation, mice were given metformin at 5 mM, 10 mM, and 20 mM by intragastric administration. The growth of tumors and liver and spleen metastases were observed at 18 and 30 days after tumor cell inoculation. Western blotting was used to detect the expression of miR-34a and the expression of E-cadherin and Vimentin in cell lines and tumor tissues.

RESULTS

Metformin significantly inhibited the proliferation, migration, and invasion of MDA-MB-231 and T-47-D cells (P < 0.05), and significantly promoted the expression of E-cadherin protein and inhibited the expression of Vimentin protein (P < 0.05). With the increase of metformin concentration, the expression of miR-34a increased (P < 0.05). Compared with the NC group, the expression of miR-34a was increased after transfection with pre-miR-34a (P < 0.05), and decreased after transfection with miR-34a inhibitor (P < 0.05). Compared with untreated breast cancer cells with low expression of miR-34A, the content of miR-34a was significantly increased after treatment with metformin at a concentration of 10 mM (P < 0.05). Compared with the NC group, cells with high expression of miR-34a grew slowest, while those with low expression of miR-34a grew fastest; the difference began to exhibit a statistically significant difference from day 3 (P < 0.05). The number of cells migrating and invading into the lower compartment in the high expression group was significantly decreased (P < 0.05), while that of the low expression group was significantly increased (P < 0.05). The number of cells migrating and invading into the lower compartment in the low expression group after metformin treatment was in the middle and significantly lower than that in the low expression group (P < 0.05). The expression of E-cadherin increased and Vimentin decreased in cells with high expression of miR-34a, but showed opposite trends in cells with low expression of miR-34a. After treatment with metformin at 10 mM, the expression of E-cadherin increased and Vimentin decreased in cells with low expression of miR-34a (P < 0.05). The tumor volume in the experimental group was significantly smaller than that in the control group (P < 0.05). There was a significant difference in the liver metastasis rate between the experimental group and the control group (P < 0.05), but there was no significant difference in the spleen metastasis rate (P > 0.05). The expression of miR-34a in tumor tissues of experimental mice was higher than that of the control group (P < 0.05). The expression of E-cadherin protein was increased and Vimentin protein was decreased in tumor tissues (P < 0.05).

CONCLUSION

Metformin may down-regulate the expression of miR-34a to inhibit the proliferation, invasion, and migration of breast cancer cells, as well as the liver and spleen metastasis of breast cancer in mice.

Assessing Cancer Presence in Prostate MRI Using Multi-Encoder Cross-Attention Networks

Prostate cancer (PCa) is currently the second most prevalent cancer among men. Accurate diagnosis of PCa can provide effective treatment for patients and reduce mortality. Previous works have merely focused on either lesion detection or lesion classification of PCa from magnetic resonance imaging (MRI). In this work we focus on a critical, yet underexplored task of the PCa clinical workflow: distinguishing cases with cancer presence (pathologically confirmed PCa patients) from conditions with no suspicious PCa findings (no cancer presence). To this end, we conduct large-scale experiments for this task for the first time by adopting and processing the multi-centric ProstateNET Imaging Archive which contains more than 6 million image representations of PCa from more than 11,000 PCa cases, representing the largest collection of PCa MR images. Bi-parametric MR (bpMRI) images of 4504 patients alongside their clinical variables are used for training, while the architectures are evaluated on two hold-out test sets of 975 retrospective and 435 prospective patients. Our proposed multi-encoder-cross-attention-fusion architecture achieved a promising area under the receiver operating characteristic curve (AUC) of 0.91. This demonstrates our method's capability of fusing complex bi-parametric imaging modalities and enhancing model robustness, paving the way towards the clinical adoption of deep learning models for accurately determining the presence of PCa across patient populations.

Transmembrane channel-like 5 drives hepatocellular carcinoma progression by regulating epithelial-mesenchymal transition

BACKGROUND

Hepatocellular carcinoma (HCC) is a difficult cancer to manage due to its highly invasive and metastatic nature.

AIM

To investigate the molecular function of transmembrane channel-like 5 (TMC5) in vitro and in vivo, with the objective of identifying novel diagnosis and treatment targets for HCC.

METHODS

The expression of TMC in cancer and normal tissues, along with its correlation with HCC prognosis, was analyzed using the GENT2, GEPIA database, and Human Protein Atlas. COX analysis was conducted to assess the relationship between TMC5 expression and overall survival in TCGA-LIHC patients. Further experiments were conducted to investigate the effect of TMC5 in cancer progression through loss- and gain-of-function assays in vitro and in vivo.

RESULTS

Bioinformatics revealed that TMC5 expression was generally higher in tumors than in normal tissues, and its expression was associated with poorer patient survival outcomes. TMC5 expression in HCC tissues and cells was consistent with the results of the bioinformatics analysis. Suppression of TMC5 expression reduced migration, invasion, and proliferation, while also decreasing the expression of epithelial-mesenchymal transition (EMT)-associated molecules in MHCC97-LM3 cells. Conversely, higher TMC5 expression significantly increased cell migration, invasion, proliferation, and EMT in MHCC97 L cells. TMC5 knockdown significantly decreased both the formation and spread of nodules in liver tissue, whereas TMC5 overexpression promoted them.

CONCLUSION

Our study provides compelling evidence that TMC5 is highly expressed in HCC and drives cancer progression through the activation of EMT-mediated invasion. TMC5 could represent a valuable molecular target for the diagnosis and treatment of HCC.

Prognostic Value of 18F-FDG PET/CT Metabolic Parameters in Resectable Non-small Cell Lung Cancer Treated With Neoadjuvant Immunotherapy Plus Chemotherapy

OBJECTIVE

This study investigates the predictive value of 18F-FDG PET/CT metabolic parameters in patients with non-small cell lung cancer (NSCLC) undergoing neoadjuvant immunotherapy plus chemotherapy.

METHODS

We conducted a retrospective analysis of clinical data from 131 patients with pathologically confirmed NSCLC who were deemed resectable after 3 cycles of neoadjuvant immunotherapy plus chemotherapy. Pretreatment and post-treatment PET metabolic parameters were evaluated. CT assessments based on immune response evaluation criteria in solid tumors (iRECIST) were compared with PET/CT assessments using the response criteria in solid tumors (PERCIST). ROC curve analysis and Kaplan-Meier survival analysis, including univariate and Cox multivariate analyses, were employed to assess the prognostic value of PET metabolic parameters after treatment.

RESULTS

The PET/CT assessment based on PERCIST showed high consistency with prognosis, while the CT assessment based on iRECIST demonstrated low consistency. Statistically significant differences were observed between the iRECIST and PERCIST criteria (P<0.001). ROC curve analysis revealed significant differences in post-treatment PET metabolic parameters (postSUVmax, postSUVmean, postSUVpeak, postMTV, and postTLG) as well as the percentage changes in metabolic parameters before and after treatment(Δ) (ΔSUVmax, ΔSUVmean, ΔSUVpeak, ΔMTV, and ΔTLG) (P<0.05). Optimal cutoff values enabled stratification into high-risk and low-risk groups. Univariate analysis showed significantly higher survival in the low-risk group for all parameters except ΔMTV (P=0.311), while Cox multivariate analysis identified ΔSUVmax as the most predictive.

CONCLUSIONS

The PERCIST is more accurate than iRECIST in evaluating prognosis for NSCLC neoadjuvant immunotherapy plus chemotherapy. PET metabolic parameters, particularly ΔSUVmax, effectively predict prognosis and support clinical decision-making.

A Geospatial Analysis of the Lung Cancer Burden in Philadelphia, Using Pennsylvania Cancer Registry Data from 2008-2017

(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to explore geospatial variations in the cancer burden and risk factors. Therefore, we used GIS to analyze the lung cancer burden in Philadelphia to assess which areas of the city have the highest morbidity and mortality, identify potential clusters, and determine which census tract-level characteristics were associated with higher tract-level cancer burden. (2) Methods: Using secondary data from the Pennsylvania Cancer Registry, age-adjusted standardized incidence and mortality ratios (SIR and SMR) were calculated by census tract, and choropleth maps were created to visualize geographic variations in the disease burden. Two geostatistical methods were used to determine the presence of lung cancer clusters. Multivariable regression analyses were performed to identify which census-tract level characteristics correlated with a higher lung cancer burden. (3) Results: Three distinct geographical lung cancer clusters were identified. After controlling for demographics and other covariates, adult smoking prevalence, prevalence of chronic obstructive pulmonary disease, and percentage of residential addresses vacant were positively associated with higher lung cancer SIR and SMR. (4) Conclusions: Our findings may inform cancer control efforts within the region and guide future municipal-level GIS analyses of the lung cancer burden.

A randomized phase II/III trial of rosuvastatin with neoadjuvant chemo-radiation in patients with locally advanced rectal cancer

Aim

Statins have been shown to improve the possibility of a pathological complete response (pCR) in patients with locally advanced rectal cancer when given in combination with neo-adjuvant chemo-radiation (NACTRT) in observational studies. The primary objective of this phase II randomized controlled trial (RCT) is to determine the impact of rosuvastatin in improving pCR rates in patients with locally advanced rectal cancer who are undergoing NACTRT. The secondary objectives are to compare adverse events, postoperative morbidity and mortality, disease-free survival (DFS), and overall survival in the two arms and to identify potential prognostic and predictive factors determining outcomes. If the study is positive, we plan to proceed to a phase III RCT with 3-year DFS as the primary endpoint.

Methods

This is a prospective, randomized, open-label phase II/III study. The phase II study has a sample size of 316 patients (158 in each arm) to be accrued over 3 years to have 288 evaluable patients. The standard arm will receive NACTRT while the intervention group will receive 20 mg rosuvastatin orally once daily along with NACTRT for 6 weeks followed by rosuvastatin alone for 6-10 weeks until surgery. All patients will be reviewed after repeat imaging by a multidisciplinary tumor board at 12-16 weeks after starting NACTRT and operable patients will be planned for surgery. The pathological response rate, tumor regression grade (TRG), and post-surgical complications will be recorded.

Conclusion

The addition of rosuvastatin to NACTRT may improve the oncological outcomes by increasing the likelihood of pCR in patients with locally advanced rectal cancer undergoing NACTRT. This would be a low-cost, low-risk intervention that could potentially lead to the refinement of strategies, such as "watch and wait", in a select subgroup of patients.

Clinical trial registration

Clinical Trials Registry of India, identifier CTRI/2018/11/016459.

Chemosensitizer Loaded NIR-Responsive Nanostructured Lipid Carriers: A Tool for Drug-Resistant Breast Cancer Synergistic Therapy

Although numerous technical advances have been made in cancer treatment, chemotherapy is still a viable treatment option. However, it is more effective when used in combination with photothermal therapy for resistant breast cancer cells. This study introduces a smart drug delivery system, (DOX-OA+VERA+AuNRs)@NLC, which is designed for dual chemo/photothermal therapy of multiple-drug-resistant breast cancer. Type-III nanostructured lipid carriers (NLCs) were used as drug delivery systems, where nano-in-nano structures offer several advantages. Doxorubicin (DOX) was used as the antitumor agent by ion-pairing it with oleic acid (OA) to increase the DOX loading capacity, as well as to reduce the burst release of the drug. Verapamil (VERA), which was used as a chemosensitizer to overcome the multiple-drug resistance, was co-loaded with DOX-OA. Gold nanorods (AuNRs) were exploited as the photothermal therapy agent in photothermal therapy (PTT) application, which would have a synergistic relation with chemotherapy. The release of DOX-OA and VERA from NLCs was studied in vitro by triggering with NIR laser irradiation. Thus, an all-in-one drug delivery system was designed to release the active pharmaceutical ingredients (APIs) at higher concentrations in the desired region and provide both chemo/PTT. Besides, the application of a folic acid-chitosan (FA-CS) coating to NLCs has facilitated the development of systems capable of targeting and specifically releasing their cargo within cancerous tissues while preserving their surrounding environment.

Transmembrane protein 176B promotes epithelial-mesenchymal transition in colorectal cancer through inflammasome inhibition

BACKGROUND

Activation of the epithelial-mesenchymal transition (EMT), a pivotal process in tumor metastasis and evasion, as well as the NLRP3 inflammasome, both promote colorectal cancer (CRC) progression. Recent studies have shown that Transmembrane protein 176B (TMEM176B) regulates NLRP3 and promotes CRC malignant phenotypes.

AIM

To investigate the role of TMEM176B in modulating NLRP3 inflammasome and its implications on EMT and tumor progression in CRC.

METHODS

CRC in situ mouse and co-cultured cell models were established using CT26 cells, BALB/c mice, and primary cultured mouse natural killer (NK) cells. Short hairpin RNA knocked down TMEM176B and NLRP3 expression in CT26 cells. Fluorescence imaging, Terminal deoxynucleotidyl transferase dUTP nick end labeling assays, immunohistochemistry staining, flow cytometry, and molecular assays were used to investigate the effects of TMEM176B knockdown on the NLRP3 inflammasome in NK cells to assess tumor metastasis, apoptosis, and EMT indicators.

RESULTS

Silencing TMEM176B in CRC mice significantly reduced tumor metastasis, proliferation, and EMT, while activating apoptosis, NLRP3 inflammasome, and NK cell activity. Furthermore, silencing TMEM176B in co-cultured cell models inhibited cell migration and invasion, and promoted apoptosis. The interference of NLRP3 reversed these effects by modulating key proteins such as phosphorylated nuclear factor kappa B subunit 1 p65, matrix metallopeptidase 9, and transforming growth factor-β.

CONCLUSION

This study highlights the critical role of TMEM176B/NLRP3 in CRC progression and provides a basis for targeting this axis as a novel therapeutic approach to manage CRC progression and metastasis.

Doxorubicin prodrug for γ-glutamyl transpeptidase imaging and on-demand cancer therapy

The γ-glutamyl transpeptidase (γ-GGT) is an important tumor marker, which has been reported to be firmly associated with the developmental stage of liver cancer. Therefore, it makes sense to image and monitor γ-GGT level and design γ-GGT-responsive prodrug for integrated diagnosis and treatment of liver cancer. Herein, we prepare a doxorubicin (Dox) prodrug for imaging γ-GGT and on-demand treating liver cancer. When γ-GGT exists, the γ-glutamyl group will be cut off to liberate free Dox for monitoring cancer progression and killing tumor cells. Fortunately, little Dox is released due to the low level of γ-GGT in normal cells, which improves the safety and efficiency of chemotherapy. To further improve the tumor targeted ability, Dox prodrug is loaded in hyaluronic acid modified liposome nanoparticles to form the nano-prodrug. Then nano-prodrug is enriched in the tumor by binding to the high expressed CD44 on cancer cells. With the assistance of anti-PD-L1, nano-prodrug effectively inhibits the growth of proximal and distal tumors.

Brachytherapy as a Cancer Therapy Tool

Brachytherapy (BT) is a core cancer treatment modality that delivers targeted radiotherapy through the placement of radioactive sources inside or near the area to be treated. This provides a very conformal distribution of dose that minimizes radiation exposure to normal organs. This review introduces healthcare professionals (nurses, nurse navigators, public health practitioners, family physicians, and others) to the principles, applications, and future directions of BT. It covers the intent of treatment in oncology, the different types of BT, conditions that are treated with BT and the characteristics of common BT radioactive isotopes. BT's unique characteristics allow physicians to use it in curative and palliative settings for a wide range of malignant and benign indications. Despite its importance, there are still challenges in terms of accessibility and awareness, highlighting the need for comprehensive education and specialized training in this area. In view of the rising incidence of cancer, the demand for qualified brachytherapists is expected to rise accordingly, given its essential role in cancer care. Furthermore, emerging areas in BT such as the implementation of artificial intelligence and 3-dimensional (3D) printing technology hold promise for improving the accuracy and efficiency of this modality.

Next-Gen Cancer Treatment: Nanotechnology-Driven siRNA Delivery Solutions

RNA interference through small interfering RNA (siRNA) has shown great promise as a potential cancer treatment strategy in recent years. However, the delivery of siRNA to target cancer cells efficiently remains a significant challenge. This review aims to highlight the recent advances in nanotechnology-enabled siRNA delivery for cancer treatment, bridging the gap between bench research and clinical application. A comprehensive literature search was conducted to identify recent studies focused on the utilization of nanotechnology for siRNA delivery in cancer treatment. Key databases, including PubMed, Scopus, and Web of Science, were used, and relevant articles were screened. Several nanotechnology-based platforms for siRNA delivery have emerged in recent years, providing enhanced selectivity, improved stability, and controlled release profiles. The primary types of nanocarriers discussed include lipid-based nanoparticles, inorganic nanoparticles, polymeric nanoparticles, and exosomes. Nanotechnology-based siRNA delivery systems represent a promising avenue for cancer treatment. Although significant progress has been made in preclinical studies, translating these findings to clinical applications poses several challenges, including scale-up production, safety, and targeted delivery. Nevertheless, the recent developments in this field hold great promise in revolutionizing cancer therapy, providing hope for more effective and personalized treatment options in the future.

Breast cancer characteristics in low- and middle-income countries: An umbrella review

Breast cancer presents significant challenges in low- and middle-income countries (LMICs) due to disparities in healthcare access and outcomes. This umbrella review synthesizes data on breast cancer characteristics-age at diagnosis, staging, and molecular subtypes-to guide targeted healthcare strategies in LMICs. Our umbrella review was conducted following PRISMA 2020 and JBI guidelines. Systematic reviews from 2009 to 2024 were sourced from PubMed, Google Scholar, and Cochrane. Reviews were assessed with AMSTAR 2, and only those rated moderate or higher were included. Data synthesis and meta-analyses were performed using R. From 1165 records, 35 systematic reviews met initial criteria; nine were included in the final synthesis, representing 305 primary studies (195 relevant to LMICs). Of those, 50 % were hospital-based and 22 % population-based, limiting the generalizability of the data and the importance of promoting more population-based studies. The overall quality of systematic reviews was variable, with only a few meeting high standards. Geographic analysis revealed a significant underrepresentation of high-quality reviews in sub-Saharan Africa and Latin America. Age at diagnosis varied: sub-Saharan Africa (45-52 years), Middle East (36-56 years), and Latin America (∼49-53 years). Advanced-stage diagnoses (stages III and IV) were common, worsening prognostic outcomes. Molecular subtype analysis indicated a predominance of luminal A but highlighted treatment challenges due to limited targeted therapy access. The results emphasize a pressing need to enhance the availability and quality of primary data, including both hospital-based and population-based studies, particularly in underrepresented regions like sub-Saharan Africa and Latin America. Addressing these gaps with rigorous, locally focused studies is essential for improving breast cancer prevention, diagnosis, and treatment. Enhancing methodological standards and expanding research in these areas will be crucial to bridging global breast cancer outcomes disparities.

Effect of Helicobacter pylori eradication on gastric cancer risk in patients with intestinal metaplasia or dysplasia: a meta-analysis of randomized controlled trials

BACKGROUND

Observational studies suggest that Helicobacter pylori (H. pylori) is associated with an increased risk of gastric cancer, yet the effect of H. pylori eradication on gastric cancer risk in patients with intestinal metaplasia (IM) or dysplasia remains controversial. The purpose of this study was to summarize the evidence from randomized controlled trials (RCTs) investigating H. pylori eradication on gastric cancer risk in patients with IM or dysplasia to determine the evidence base.

METHODS

PubMed, Embase, Cochrane Library, Web of science and China National Knowledge Internet database were searched for RCTs published through May 2024 in adults with IM or dysplasia comparing the risk of gastric cancer following H. pylori eradication versus no eradication therapy. Relative risk (RR) with its 95% confidence interval (CI) using random-effects model were employed for the effect estimate. Sensitivity, meta-regression, and subgroup analyses were also calculated.

RESULTS

Sixteen RCTs involving 15,027 patients with IM or dysplasia met the inclusion criteria. In a pooled analysis, H. pylori eradication resulted in a 45% reduction in RR for gastric cancer risk relative to no eradication (RR: 0.55; 95% CI: 0.46-0.67; p < 0.001). H. pylori eradication significantly reduced the risk of gastric cancer in patients with dysplasia (RR: 0.51; 95% CI: 0.32-0.82; p = 0.005), and IM (RR: 0.61; 95% CI: 0.40-0.93; p = 0.022). Further, if the study conducted in countries other than those in Asia, sample size <500, percentage of male <50.0%, follow-up duration <5.0 years, and low study quality, then there was no significant association between H. pylori eradication and a decreased risk of gastric cancer.

CONCLUSION

H. pylori eradication is protective against gastric cancer in patients with IM or dysplasia.

SYSTEMATIC REVIEW REGISTRATION

INPLASY202530010, https://inplasy.com/.

Breast cancer awareness, knowledge and self-screening intention among females in Northern Border of Saudi Arabia, Arar City

BACKGROUND

Breast cancer is the most common cancer among females, and early detection plays a crucial role in disease management. This study aimed to assess the knowledge, practices, and barriers related to breast self-examination (BSE) and mammography among Saudi women in Arar City, Saudi Arabia.

METHOD

A cross-sectional observational study was conducted using an online Google Form distributed to women in Arar City. The survey collected sociodemographic data and assessed knowledge, practices, and barriers related to BSE and mammography. Statistical analyses were performed using IBM SPSS Statistics version 27.0.1, with significance set at p < 0.05.

RESULTS

The study included 385 females, with women aged 19-25 constituting nearly one-third of the population (n = 118; 30.6%). Most participants were married (n = 217; 56.4%) and held a bachelor's degree (n = 281; 73%). While 84.2% (n = 324) had heard of BSE and 80% (n = 308) demonstrated good knowledge, only 33.5% (n = 129) reported performing BSE. Regarding mammography, only 19.5% (n = 75) reported undergoing screening, despite 65.1% (n = 247) recognizing it as a safe procedure. Educational level (p = 0.018), prior knowledge of BSE (p = 0.009), and history of breast problems (p = 0.027) were significantly associated with higher knowledge scores.

CONCLUSION

While women demonstrated good awareness and knowledge of BSE, its practice remains low, with many unaware of proper techniques, timing, and frequency. Mammography awareness and utilization were also limited, emphasizing the need for targeted educational campaigns to promote early detection and improve screening behaviours.

Tumor protein 53 gene polymorphism, demographic attributes and associated risk factors among liver cancer patients in Calabar, Nigeria

Mutations in the TP53 gene had been attributed to the development of liver cancer. Hepatocellular carcinoma (HCC) and liver tumour are liver diseases having high mortality rates in several populations. There is no information on the TP53 gene polymorphism among liver diseases patients in Calabar, Nigeria. This study investigated the genetic polymorphism of TP53 among HCC and liver tumour in Calabar. This research was carried out in the University of Calabar Teaching Hospital, Calabar. Blood samples were collected from 35 clinically diagnosed hepatocellular carcinoma and 10 tumour patients and 10 healthy controls. DNA was extracted from all blood samples and Polymerase Chain Reaction (PCR) was performed using specific primers. The PCR amplicons were digested using Hae III restriction enzyme and the genotypic and allelic frequencies was determined. Demographic data among participants showed that males were 68.9% (31), females (31.1%; 14), sex ratio (2.2: 0.5), mean age was 41.51 ± 2.13 years with an odds ratio of 1.25. The distribution of participants according to marital status were 33(73.3%), 10(22.2%), and 2(4.4%) for married, single, and widowed respectively. The participants were from different extractions with varied representations of Yakurr (22.2%, 10), Efik (20%, 9), Boki (13.3%, 6), Ogoja (13.3%, 6), Annang (8.8%, 4), Ibibio (2.2%, 1) and Igbo (2.2%, 1) and respectively. Approximately, 64.7% (30) of the chronic liver diseases were from the Central and Northern part of Cross River State. The risk factors were HCV infection, HBsAg+, alcoholism, smoking, consumption of groundnuts that may have been contaminated with aflatoxin and family history of the disease. PCR product yielded 254 bp and digested PCR product showed homozygous TT mutation (27), heterozygous GT mutation (17) and homozygous GG wild type (1) in cases. The overall TP53 gene mutation frequency was 46.32% (44). The frequency of G allele, T allele, GG, GT and TT were 0.21, 0.79, 0.04, 0.33 and 0.62 respectively among cases, while GG (wild type) was only detected among controls in the study population. The genotypic and allelic frequencies conform to Hardy-Weinberg equilibrium meaning that the forces of evolution were not acting on the locus. There were significant differences in the genotypic proportions of the TP53 gene polymorphism among patients and controls. This study on the TP53 gene polymorphism will serve as baseline information on the molecular etiology of hepatocellular carcinoma and liver tumour in Cross River State.

Perioperative versus adjuvant chemotherapy for resectable gastric cancer: a meta-analysis of randomized controlled trials

Objectives

To report the latest systematic review and meta-analysis of randomized controlled trials (RCT) to compare perioperative versus adjuvant chemotherapy for resectable gastric cancer.

Methods

We conducted a systematic literature retrieval via PubMed, Embase, Web of Science, and Cochrane until April, 2024 for RCT which compared perioperative versus adjuvant chemotherapy for resectable gastric cancer. Outcomes measured were overall survival (OS) and progression-free survival (PFS).

Results

5 RCTs including 2,735 patients were included for meta-analysis. Meta-analysis revealed a significant longer PFS in the neoadjuvant chemotherapy (NAC) group (HR: 0.77; 95% CI: 0.69, 0.85; P<0.00001) compared with adjuvant chemotherapy (AC) group. Subgroup analysis found that there was still a significant superiority of NAC in female (HR: 0.53; 95% CI: 0.40, 0.70; P<0.0001) and cN+ (HR: 0.77; 95% CI: 0.67, 0.89; P=0.0005) patients, while the superiority disappeared in male (HR: 0.87; 95% CI: 0.74, 1.01; P=0.07) and cN- patients (HR: 0.91; 95% CI: 0.46, 1.78; P=0.77). In addition, meta-analysis observed a trend towards improved OS with NAC (HR: 0.86; 95% CI: 0.70, 1.07; P = 0.17), and sensitivity analysis demonstrated instability in OS.

Conclusions

NAC can significantly prolong PFS in patients with resectable gastric cancer compared to AC, and the benefit is more significant in women and cN+ patients. Besides, our analysis indicated that NAC has a potential to improve OS compared with AC.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024546165.

Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections?

Obesity (BMI > 30 kg/m2) is rapidly increasing worldwide with 26% of the UK population being obese and 38% being overweight. Obesity is intimately related to several life-limiting conditions including colorectal cancer (CRC). Obese patients have a higher degree of perioperative systemic inflammatory response (SIR) and an increased risk of perioperative complications. The aim of this current study was to investigate whether robotic-assisted surgery mitigates the effects of obesity in left sided CRC resections on the SIR and clinical outcomes. All patients undergoing left-sided colorectal cancer resections from May 2021 to May 2023 were, prospectively, entered into a database with patient characteristics and perioperative short-term outcomes recorded. CRP was considered a surrogate for SIR. The relationship between obesity and complications were examined using Chi Square for linear association, Kruskal-Wallis for continuous data and multivariate binary logistic regression model. 221 patients who underwent RAS for left-sided CRC were analysed. Obesity was associated with more comorbidity (ASA, p < 0.01) and SSI (p < 0.05) but not with age, sex, procedure or pathology. POD3 CRP < 150 mg/l was also associated with obesity (p < 0.01). In turn, greater comorbidity was associated with age (p < 0.001), site of resection (p < 0.05), SSI (p < 0.05), postoperative blood transfusion (p < 0.01) and LOS (p < 0.001). On multivariate analysis, only greater ASA (p < 0.05) and surgical procedure (p < 0.01) were associated with the development of an SSI independently. Greater comorbidity but not obesity was independently associated with postoperative SIR and clinical outcomes in patients undergoing RAS. These results support the use of RAS for left sided CRC resections, particularly in the obese.

Bioinspired Materials for Controlling Mineral Adhesion: From Innovation Design to Diverse Applications

The advancement of controllable mineral adhesion materials has significantly impacted various sectors, including industrial production, energy utilization, biomedicine, construction engineering, food safety, and environmental management. Natural biological materials exhibit distinctive and controllable adhesion properties that inspire the design of artificial systems for controlling mineral adhesion. In recent decades, researchers have sought to create bioinspired materials that effectively regulate mineral adhesion, significantly accelerating the development of functional materials across various emerging fields. Herein, we review recent advances in bioinspired materials for controlling mineral adhesion, including bioinspired mineralized materials and bioinspired antiscaling materials. First, a systematic overview of biological materials that exhibit controllable mineral adhesion in nature is provided. Then, the mechanism of mineral adhesion and the latest adhesion characterization between minerals and material surfaces are introduced. Later, the latest advances in bioinspired materials designed for controlling mineral adhesion are presented, ranging from the molecular level to micro/nanostructures, including bioinspired mineralized materials and bioinspired antiscaling materials. Additionally, recent applications of these bioinspired materials in emerging fields are discussed, such as industrial production, energy utilization, biomedicine, construction engineering, and environmental management, highlighting their roles in promoting or inhibiting aspects. Finally, we summarize the ongoing challenges and offer a perspective on the future of this charming field.