Global cancer statistics, 2012

An Assessment of Young Adults' Awareness and Knowledge Related to the Human Papillomavirus (HPV), Oropharyngeal Cancer, and the HPV Vaccine

BACKGROUND/OBJECTIVES

The human papillomavirus (HPV) is a prevalent sexually transmitted infection that is a known cause of morbidities such as genital warts and cancers of the cervix, anus, and oropharynx. Non-cervical HPV-related cancers have been a developing problem in North America, increasing in incidence by up to 225% in some instances over a span of two decades.

METHODS

This study investigated levels of awareness and knowledge of HPV, oropharyngeal cancer (OPC), and the HPV vaccine using a self-administered web-based survey designed specifically for this research. University students (n = 1005) aged 18-30 completed a 42-item questionnaire that included demographic information, awareness questions, and a series of "true/false/I don't know" knowledge questions.

RESULTS

The data gathered revealed that participants had relatively high levels of awareness. However, many respondents had significant gaps in their knowledge of HPV, OPC, and the HPV vaccine. Collectively, the data indicate that awareness and knowledge of HPV and the value of vaccination may place younger individuals at risk for HPV-related infections.

CONCLUSIONS

Although a relatively high level of awareness concerning HPV was observed, the gaps in knowledge suggest that further efforts are necessary to educate young adults. While all risk factors cannot be reduced, the present data may guide future efforts directed toward better education on HPV and related health concerns and associated risks.

Global, regional, and national burden of early-onset colorectal cancer from 1990 to 2021: a systematic analysis based on the global burden of disease study 2021

BACKGROUND

To provide estimates and trends for burdens of early-onset colorectal cancer (EOCRC) from 1990 to 2021 at the global, regional, and national levels, and to provide projections of EOCRC burden through 2030.

METHODS

A trend analysis based on the Global Burden of Diseases 2021. The joinpoint regression model was used to analyze the temporal trends on EOCRC burden by calculating the corresponding average annual percent changes (AAPCs). A decomposition analysis was used to understand the drivers of the changes in EOCRC burden. The relationship between socio-demographic index (SDI) and disease burden was assessed by the concentration index of inequality. In addition, we constructed a Bayesian age-period-cohort model to predict the burden of EOCRC worldwide from 2022 to 2030.

RESULTS

Globally, the burden of EOCRC increased significantly between 1990 and 2021, with the incidence rising from 5.43/100000 to 6.13/100000 (AAPC = 0.39), and the prevalence increasing from 29.65/100000 to 38.86/100000 (AAPC = 0.87). Over the same period, the death rate decreased from 2.98/100000 to 2.30/100000 (AAPC = - 0.84), whereas the disability-adjusted life-year (DALY) decreased from 148.46/100000 to 115.42/100000 (AAPC = - 0.82). In 2021, East Asia and China had the highest burden of EOCRC regionally and nationally. Decomposition analysis indicated the increase in EOCRC burden was mainly driven by population growth. The concentration index revealed that high-SDI countries had a greater burden of EOCRC than low-SDI countries. The global incidence and prevalence of EOCRC will rise continuously from 2022 to 2030.

CONCLUSIONS

Between 1990 and 2021, the incidence and prevalence of EOCRC have escalated, whereas the death rate and DALY rate have declined. The burden varied with sex, SDI, and geographical locations. Given the rising trend of EOCRC burden, coordinated efforts are needed to reduce the burden posed by this malignancy.

Assessing the Colorectal Cancer Landscape: A Comprehensive Exploration of Future Trends in 216 Countries and Territories from 2021 to 2040

BACKGROUND

Colorectal cancer (CRC) has become a significant global concern, presenting formidable challenges to healthcare systems and leading to substantial healthcare expenses. This study examines the projected prevalence and trends of CRC worldwide, encompassing 21 regions and 195 nations.

METHODS

We employed an illness-death model (IDM) in order to forecast the anticipated prevalence of CRC by the year 2040. To accomplish this, we utilized data retrieved from the Global Health Data Exchange (GHDx) query tool spanning from 1990 to 2021. The primary objective of this study is to furnish sex-specific estimations encompassing various geographical regions.

RESULTS

By 2040, the global age-standardized prevalence rate (ASPR) of CRC among the total population is projected to rise, reaching 145.82 per 100,000, which reflects an increase of 8.15%. East Asia is forecasted to have the highest ASPR at 330.17 per 100,000, representing a substantial rise of 94.81%. Notably, the most rapid percentage increase is projected in Andean Latin America, with an anticipated rise of 106.2%. In contrast, many countries, particularly in developed nations, are expected to see a decline in ASPR during this period. The United Arab Emirates is projected to experience the most significant decrease in ASPR, at -86.51%, while Mauritius is anticipated to have the largest increase in CRC prevalence rate, at 226.26%. Globally and regionally, the ASPR among males is expected to remain higher than that among females over the next 21 years.

CONCLUSIONS

The global prevalence of CRC is increasing, particularly in developing countries, while developed countries are anticipated to observe a declining trend. This highlights the significance of appropriately allocating resources and implementing effective preventive measures, especially in developing nations.

Seeing beyond words: nanotechnology in hepatocellular carcinoma - a bibliometric study

Background

Nanotechnology has increasingly been applied in the diagnosis and treatment of hepatocellular carcinoma (HCC) over the past two decades. This study aims to explore the utilization of nanotechnology in HCC through a bibliometric analysis, identifying key themes, trends, and contributions in this field.

Methods

The study utilized VOSviewer and CiteSpace software to perform a bibliometric analysis, evaluating scholarly contributions related to nanotechnology in HCC. The analysis focused on co-occurrence network relationships, publications, citations, and contributions from various entities and authors.

Results

The analysis revealed a total of 2,968 articles, with China and the USA being the most prominent contributors in terms of publications and citations. Notable contributions were made by the Chinese Academy of Sciences and authors Gao Jie and Li Yan. LLOVET JM emerged as the most co-cited author, indicating a leadership role in the field. The "International Journal of Nanomedicine" was identified as the leading publisher, while "Biomaterials" ranked highest in citations. The research mainly focused on drug delivery systems and apoptosis, highlighting significant advancements in utilizing nanotechnology for HCC treatment.

Conclusion

This bibliometric study underscores the critical role of nanotechnology in advancing the diagnosis and treatment of hepatocellular carcinoma, with a particular emphasis on drug delivery and apoptosis. The findings highlight the contributions of key countries, institutions, and authors, reflecting the global effort and collaboration in this rapidly evolving field.

Incidence, trends and patterns of female breast, cervical, colorectal and prostate cancers in Antigua and Barbuda, 2017-2021: a retrospective study

BACKGROUND

Globally, estimates of cancer cases and deaths have increased since 2018, particularly in Latin America and Caribbean countries. In Antigua and Barbuda, understanding the burden of common cancers such as female breast, cervical, colorectal and prostate cancers is critical. This study aimed to assess the incidence, trends, and patterns of these four cancers from 2017 to 2021.

METHODS

Using a retrospective observational study design, information on these cancers was abstracted from medical records at four key study sites in Antigua and Barbuda. Estimates of age-specific and age-standardized incidence were determined using direct standardization. The KeyFitz method was used to derive standard errors and confidence intervals. Derived estimates were employed to analyze trends and Joinpoint regression modeling was used to determine annual percentage change.

RESULTS

Between 2017 and 2021, 391 cases of female breast (41.7%), cervical (10.2%), colorectal (20.2%) and prostate (27.9%) cancers were diagnosed. Overall mean age at presentation was 61.5 (± 12.9) years, ranging from 24 to 94 years, age-standardized incidence rate 65.2 (95% CI: 58.7-71.6) per 100,000 population. Age-standardized incidence rate for female breast cancer was 49.9 (95% CI: 42.2-57.8), annual percentage change in incidence a low of -0.2%. Prostate cancer had the second highest age-standardized incidence rate at 41.6 (95% CI: 33.8-49.4), annual percentage change showed a gradual but steady increase at 21.7%. Per cancer types, variations in age-standardized incidence rates were noted across age-groups, year-of-presentation, and parishes. Collectively, there was an 8.1% (95% CI: -14.9-37.6) annual percentage change increase in age-standardized incidence rates between 2017 and 2021. Incident cases, age-standardized incidence rates, and trends per cancer type are expected to gradually increase during 2022-2030 (average annual percentage increase is 3.4%).

CONCLUSIONS

This study is a first step in providing reasonable evidence on the incidence, trends, and patterns of four common cancers in Antigua and Barbuda. Female breast and prostate cancers were the dominant cancer types in terms of incidence, age-standardized incidence and predicted increasing incidence trends. Variableness in cancer-specific age-standardized rates across parishes and years of presentation were observed. Besides research, this study has importance for instituting cancer prevention and control measures, including surveillance and healthy lifestyles initiatives.

Metformin and the risk of malignant tumors of digestive system: a mendelian randomization study

BACKGROUND

Observational studies suggest that metformin may reduce the risk of malignant tumors of the digestive system (MTDS), but these findings are often confounded by bias and unmeasured variables. Recent meta-analyses have questioned these associations, emphasizing the need for robust causal inference.

METHODS

Mendelian randomization (MR) was used to evaluate the causal relationship between metformin and MTDS. Genetic variants associated with metformin's molecular targets were selected from GTEx, eQTLGen, and UK Biobank and validated using genetic colocalization to ensure instrument validity. GWAS summary statistics for MTDS, encompassing up to 314,193 controls and 6,847 colorectal cancer cases, were obtained from FinnGen and EBI. The primary analysis employed the inverse-variance weighted (IVW) method, supplemented by MR-Egger, weighted median, and weighted mode analyses. Bonferroni correction was applied to adjust for multiple testing across 14 cancer types.

RESULTS

Genetically proxied metformin use was associated with an increased risk of colorectal cancer (OR = 2.38, 95%CI = 1.38-4.09, P = 0.0018) and related subtypes. No causal relationship was found for hepatocellular carcinoma, gastric cancer, pancreatic cancer, or other digestive system cancers. The robustness of these findings was supported by sensitivity analyses, which indicated no significant pleiotropy, and leave-one-out tests.

CONCLUSION

This study provides robust genetic evidence that metformin use increases the risk of colorectal cancer, challenging its role as a preventive agent for digestive cancers. These findings emphasize the need for clinicians to carefully evaluate the risks and benefits of metformin, particularly in populations at higher risk for colorectal cancer. Future research should focus on delineating the mechanisms underlying this association to optimize the use of metformin in clinical practice.

Survival analysis of patients with hepatocellular carcinoma based on the ratio of platelet count to spleen diameter

Background

In China, 80% of Hepatocellular Carcinoma (HCC) is associated with cirrhosis. Portal hypertension, the most common outcome of cirrhosis progression, has a high incidence. Platelet count/spleen diameter ratio (PSL) with a cut-off value of 909 can predict the presence of esophagogastric varices and thus portal hypertension, which is also an independent risk factor for early recurrence and late recurrence of hepatocellular carcinoma after resection. Therefore, the effect of PSL on the overall survival (OS) of patients with HCC is necessary. The aim of this study was to apply a new method to establish and validate a model for predicting the prognosis of patients based on PSL with HCC.

Methods

A total of 1,104 patients with clinical diagnosed with HCC following non-surgical therapy randomly divided the patients into a primary cohort and a validation cohort in a ratio of 7:3, in which 772 HCC patients were in the primary cohort and a total of 332 HCC patients were in the validation cohort. Through Lasso-Cox analysis, the independent predictors of OS of training cohort were included in nomogram1, and the independent predictors of Cox regression analysis were included in nomogram2. Nomogram1 and nomogram2 used consistency index (C-index), AUC and time-dependent ROC curves in the training cohort, respectively, and the calibration curves were plotted. All suggest that nomogram1 is better than nomogram2. We get similar results in the validation cohort.

Results

The C-index of nomogram1was 0.792 (95%CI: 0.772-0.812), which was superior to nomogram2 (0.788) and traditional modes (0.631-0.712). The AUC of nomogram1 was 0.866 (95%CI: 0.840-0.889). In the validation cohort, the nomogram1 still gave good discrimination (C-index: 0.769, 95%CI: 0.740-0.798; AUC: 0.867, 95%CI: 0.826-0.902). Calibration plots for 3-year OS probabilities showed the good agreement between nomogram1 predictions and actual observations. In addition, we found that the decision curve analysis of nomogram1 and nomogram2 was also meaningful.

Conclusion

Novel nomogram containing PSL, based on LASSO Cox regression, had higher predictive efficacy for 3-year overall survival in patients with HCC.

From Blood to Therapy: The Revolutionary Application of Platelets in Cancer-Targeted Drug Delivery

Biomimetic nanodrug delivery systems based on cell membranes have emerged as a promising approach for targeted cancer therapy due to their biocompatibility and low immunogenicity. Among them, platelet-mediated systems are particularly noteworthy for their innate tumor-homing and cancer cell interaction capabilities. These systems utilize nanoparticles shielded and directed by platelet membrane coatings for efficient drug delivery. This review highlights the role of platelets in cancer therapy, summarizes the advancements in platelet-based drug delivery systems, and discusses their integration with other cancer treatments. Additionally, it addresses the limitations and challenges of platelet-mediated drug delivery, offering insights into future developments in this innovative field.

Nebulized Hybrid Nanoarchaeosomes: Anti-Inflammatory Activity, Anti-Microbial Activity and Cytotoxicity on A549 Cells

The properties of two hybrid nanoarchaeosomes (hybrid nanoARCs) made of archaeolipids extracted from the halophilic archaea Halorubrum tebenquichense and combining the properties of archaeolipid bilayers with metallic nanoparticles are explored here. BS-nanoARC, consisting of a nanoARC loaded with yerba mate (Ilex paraguariensis) extract (YME)-biogenic silver nanoparticles (BSs), and [BS + BS-nanoARC], consistent of a BS-nanoARC core covered by an outer shell of BSs, were structurally characterized and their therapeutic activities screened. By employing 109 ± 5 µg gallic acid equivalents (GAEs) and 73.4 µg chlorogenic acid/ YME mg as a silver reductive agent, spherical, heterogeneously sized (~80 nm diameter), -27 mV ζ potential, 90% Ag0 and λmax 420 nm BSs were obtained. We further prepared ~100-200 nm diameter, -57 mV ζ potential BS-nanoARC and ~300 nm diameter, -37 mV ζ potential [BS + BS-nanoARCs]. Freshly prepared and nebulized BS-nanoARCs reduced the release of TNF-α, IL-6 and IL-8 by LPS-irritated THP-1-macrophages and were highly anti-planktonic against S. aureus (MIC90: 13 ± 0.8 µg Ag/mL). While the nanoARCs and BS-nanoARCs were innocuous, freshly prepared [BS + BS-nanoARCs] magnified the cytotoxicity of BSs (IC50 12 µg Ag/mL vs. IC50 ~36 µg Ag/mL) on A549 cells. Such cytotoxicity remained after 30 days in the dark at 4 °C, while that of BSs was lost. Freshly prepared BSs also lost activity upon nebulization, whereas freshly prepared [BS + BS-nanoARCs] did not. However, the cytotoxicity of the [BS + BS-nanoARCs] was also lost when nebulized after 30 days of storage. Despite the harmful effects of storage and mechanical stress on the structure of the more active [BS + BS-nanoARCs], hybrid nanoARCs are promising examples of nanomedicines combining the properties of archaeolipids with antimicrobial silver nanoparticles and anti-inflammatory polyphenols that could complement oncologic therapies, reducing the usage of classical antitumoral agents, corticosteroids, and, importantly, of antibiotics, as well as their waste.

Signature of collagen alpha-1(x) gene expression in human cancers and their therapeutic implications

Cancers are a class of disorders that entail uncontrollably unwanted cell development with dissemination. One in six fatalities globally is attributed to cancer, a global health issue. The analysis of the entire DNA sequence and how it expresses itself in tumor cells is known as cancer genomics. The development of novel cancer treatments has been facilitated because of the genomics method. COL10A1 gene, a short chain collagen, and an interstitial matrix component, acts as a predictive biomarker for cancer prognosis. Recognizing the fundamental consequences of mutations in the COL10A1 gene and its expression in cancer is crucial. Analyzing the COL10A1 gene expression with a data set and gene expression patterns shows the level of display of the tumor. Examining the therapeutic techniques of COL10A1 gene expression leads to early detection, screening, radiation therapy, and advanced developments. This review highlights the value of the COL10A1 gene in breast, gastric, pancreatic, lung, and colorectal cancers, emphasizing its role in gene expression patterns and therapeutic techniques.

Distant Metastases of Breast Cancer Resemble Primary Tumors in Cancer Cell Composition but Differ in Immune Cell Phenotypes

Breast cancer is the most commonly diagnosed cancer in women, with distant metastasis being the main cause of breast cancer-related deaths. Elucidating the changes in the tumor and immune ecosystems that are associated with metastatic disease is essential to improve understanding and ultimately treatment of metastasis. Here, we developed an in-depth, spatially resolved single-cell atlas of the phenotypic diversity of tumor and immune cells in primary human breast tumors and matched distant metastases, using imaging mass cytometry to analyze a total of 75 unique antibody targets. Although the same tumor cell phenotypes were typically present in primary tumors and metastatic sites, suggesting a strong founder effect of the primary tumor, their proportions varied between matched samples. Notably, the metastatic site did not influence tumor phenotype composition, except for the brain. Metastatic sites exhibited a lower number of immune cells overall but had a higher proportion of myeloid cells as well as exhausted and cytotoxic T cells. Myeloid cells showed distinct tissue-specific compositional signatures and increased presence of potentially matrix remodeling phenotypes in metastatic sites. This analysis of tumor and immune cell phenotypic composition of metastatic breast cancer highlights the heterogeneity of the disease within patients and across distant metastatic sites, indicating myeloid cells as the predominant immune modulators that could potentially be targeted at these sites. Significance: Multiplex imaging analysis of matched primary and metastatic breast tumors provides a phenotypic and spatial map of tumor microenvironments, revealing similar compositions of cancer cells and divergent immunologic features between matched samples.

Predictive marker for response to trifluridine/tipiracil plus bevacizumab in metastatic colorectal cancer patients

OBJECTIVE

Trifluridine/tipiracil (FTD/TPI) is one of the options for late-line treatment of colorectal cancer (CRC). However, the specific patient populations that would particularly benefit from it remain unclear. This study attempted to identify predictive markers of chemotherapy efficacy with trifluridine/tipiracil (FTD/TPI), focusing on the RNA-editing enzyme adenosine deaminase acting on RNA 1 (ADAR1) expression and neutrophil-lymphocyte ratio (NLR).

METHODS

To assess the effectiveness of FTD/TPI in CRC patients, we retrospectively analyzed 72 CRC patients at Okayama University Hospital from 2014 to 2022.

RESULTS

Adding bevacizumab to FTD/TPI resulted in a more prolonged progression-free survival (PFS), consistent with the SUNLIGHT study findings (p = 0.0028). Among the participants, those with a high NLR had a shorter PFS (p = 0.0395). Moreover, high ADAR1 expression was associated with longer PFS (p = 0.0151). In multivariate analysis, low ADAR1 (HR = 3.43, p = 0.01) and absence of bevacizumab (HR = 4.25, p = 0.01) were identified as factors shortening PFS. The high ADAR1 group demonstrated fewer cases of progressive disease and a higher proportion of stable disease than the low ADAR1 group (p = 0.0288). Low NLR and high ADAR1 were predictive markers of prolonged PFS in the bevacizumab-treated group (p = 0.0036).

CONCLUSION

Low NLR and high ADAR1 were predictive markers for a positive response to the FTD/TPI plus bevacizumab regimen associated with prolonged PFS. The FTD/TPI plus bevacizumab regimen should be proactively implemented in the low NLR and high ADAR1 subgroups.

Diagnostic value of TAP, PIVKA-II, and AFP in hepatocellular carcinoma and their prognostic value for patients treated with transarterial chemoembolization

OBJECTIVE

The diagnosis and prognosis of hepatocellular carcinoma (HCC) present significant challenges in clinical practice. This study aimed to evaluate the clinical utility of tumor abnormal protein (TAP), Prothrombin induced by vitamin K absence-II (PIVKA-II), and alpha-fetoprotein (AFP) in diagnosing HCC as well as to investigate their prognostic significance in patients with HCC undergoing transarterial chemoembolization.

METHODS

A total of 93 HCC patients were enrolled and 101 healthy individuals served as controls. Fresh venous blood samples were collected, and TAP, PIVKA-II, and AFP levels were measured by chemiluminescence immunoassay.

RESULTS

Significant differences in TAP, PIVKA-II, and AFP levels were found between HCC patients and healthy individuals. The combined assay of TAP, AFP, and PIVKA-II showed better diagnostic performance for HCC. Patients who underwent transarterial chemoembolization and achieved complete response (CR) had lower levels of prechemotherapy serum TAP, AFP, and PIVKA-II. There are significant differences in levels of TAP, AFP, and PIVKA-II between CR and partial response (PR), CR and stable disease (SD), and CR and progressive disease (PD).

CONCLUSION

Combined detection of TAP, PIVKA-II, and AFP has better diagnostic performance for HCC. Higher levels of prechemotherapy serum TAP, AFP, and PIVKA-II are significantly associated with poor clinical chemoresponse.

Discovery and Synthesis of Conjugated Fatty Acids from Natural Products

Conjugated fatty acids are a promising ingredient for cancer prevention and treatment. Conjugated fatty acids are minor fatty acids that are rarely found in nature, although a wide variety of structures are known. In recent years, studies have been conducted to screen natural products containing conjugated fatty acids and to synthesize conjugated fatty acids using enzymes derived from natural products. As a result, it was found that the seed oils of Centranthus ruber and Valeriana officinalis, which belong to the Valerianaceae family, contain conjugated linolenic acid, which has a conjugated triene structure in the molecule. Furthermore, it was found that parinaric acid, a conjugated tetraenoic fatty acid, can be synthesized by adding α-linolenic acid to enzymes extracted from the brown alga Padina arborescens Holmes. These research results are expected to be useful in securing conjugated fatty acids in quantities that can withstand practical application. Recent studies have reported that the cytotoxic effect of conjugated fatty acids is due to a programmed cell death called "ferroptosis". Many anticancer drugs exhibit anticancer activity through DNA modification, cell cycle arrest, angiogenesis inhibition, and epidermal growth factor receptor inhibition. Conjugated fatty acids, however, induce cell death through a mechanism distinct from these mechanisms and are therefore expected to be effective against cancers resistant to currently used anticancer drugs. The results of these studies will help to promote research on the use of conjugated fatty acids to overcome intractable cancers in the future.

Miniaturization and characterization of patient derived hepatocellular carcinoma tumor organoid cultures for cancer drug discovery applications

Patient derived tumor organoid (PDTO) models retain the structural, morphological, genetic, and clonal heterogeneity of the original tumors. The ability to efficiently generate, expand, and biobank PDTOs has the potential to make the clinical diversity of cancer accessible for personalized medicine assay guided therapeutic drug selection and drug discovery. We describe the miniaturization and growth in 96- and 384-well formats of a single non-tumor liver and two Hepatocellular carcinoma (HCC) organoids derived from cryopreserved PDTO cells and the application of high content imaging (HCI) to characterize the models and enhance drug sensitivity testing. Non-invasive sequentially acquired transmitted light images showed that seeding cryopreserved cells from non-tumoral and HCC PDTOs into 96- or 384-well plates in reduced growth factor Matrigel (rgf-MG) that were fed with growth medium every 3 days supported organoid growth up to 15 days. The number and sizes of organoids increased with longer times in culture. HCC PDTO's had more heterogeneous morphologies than non-tumor organoids with respect to size, shape, and optical density. Organoids cultured in rgf-MG could be stained in situ with HCI reagents without mechanical, chemical or enzymatic disruption of the hydrogel matrices and quantitative data extracted by image analysis. Hoechst and live/dead reagents provided organoid numbers and viability comparisons. HCC PDTO's stained with phalloidin or immuno-stained with α-tubulin antibodies revealed F-actin and microtubule cytoskeleton organization. HCC PDTO's stained with antibodies to signaling pathway proteins and their phosphorylation status allowed comparisons of relative expression levels and inference of pathway activation. Images of HCC PDTO's exposed to ellipticine showed that drugs penetrate Matrigel hydrogels and accumulate in organoid cells. 9-day 384-well HCC organoid cultures exhibited robust and reproducible growth signals suitable for cancer drug testing. Complimenting cell viability readouts with multiple HCI parameters including morphological features and dead cell staining improved the analysis of drug impact and enhanced the value that could be extracted from these more physiologically relevant three-dimensional HCC organoid cultures.

LncRNA LINC00466 Promotes the Progression of Breast Cancer via miR-4731-5p/EPHA2 Pathway

BACKGROUND

Breast Cancer (BC) is a female malignancy with a high mortality rate. Novel diagnostic and prognostic biomarkers are valuable for reducing BC mortality. Our study is designed to undrape the precise role of the LINC00466/miR-4731-5p/EPHA2 axis in BC.

METHODS

The Cancer Genome Atlas (TCGA) sequencing dataset was utilized to compare the levels of LINC00466. The levels of LINC00466, miR-4731-5p, and EPHA2 were tested by qRTPCR. Cell proliferation and cycle were detected by CCK-8 assay and flow cytometer. In vivo role of LINC00466 was tested by Xenograft nude models. Binding sites were predicted by TargetScan and Starbase. The binding relationship was employed by Dual-luciferase reporter gene assay and RNA pull-down assay.

RESULTS

LINC00466 was increased in human breast cancer tissues. LINC00466 was negatively associated with miR-4731-5p and positively correlated with EPHA2 in human breast cancer tissues. Down-regulation of LINC00466 suppressed the proliferation and arrested the cell cycle of breast cancer cells, and inhibited tumor growth in vivo.

CONCLUSION

LINC00466 promoted BC development via mediating the miR-4731-5p/EPHA2 axis, which has the potential value as a promising therapeutic target in BC.

Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: A meta-analysis of tandem RCTs

BACKGROUND AND AIMS

One-fourth of colorectal neoplasia is missed at screening colonoscopy, representing the leading cause of interval colorectal cancer (I-CRC). This systematic review and meta-analysis summarizes the efficacy of computer-aided colonoscopy (CAC) compared to white-light colonoscopy (WLC) in reducing lesion miss rates.

METHODS

Major databases were systematically searched through May 2024 for tandem-design RCTs comparing lesion miss rates in CAC-first followed by WLC vs WLC-first followed by CAC. The primary outcomes were adenoma miss rate (AMR) and polyp miss rate (PMR). The secondary outcomes were advanced AMR (aAMR) and sessile serrated lesion miss rate (SMR).

RESULTS

Six RCTs (1718 patients) were included. AMR was significantly lower for CAC compared to WLC (RR = 0.46; 95 %CI [0.38-0.55]; P < 0.001). PMR was also lower for CAC compared to WLC (RR = 0.44; 95 %CI [0.33-0.60]; P < 0.001). No significant difference in aAMR (RR = 1.28; 95 %CI [0.34-4.83]; P = 0.71) and SMR (RR = 0.44; 95 %CI [0.15-1.28]; P = 0.13) were observed. Sensitivity analysis including only RCTs performed in CRC screening and surveillance setting confirmed lower AMR (RR = 0.48; 95 %CI [0.39-0.58]; P < 0.001) and PMR (RR = 0.50; 95 %CI [0.37-0.66]; P < 0.001), also showing significantly lower SMR (RR = 0.28; 95 %CI [0.11-0.70]; P = 0.007) for CAC compared to WLC.

CONCLUSIONS

CAC results in significantly lower AMR and PMR compared to WLC overall, and significantly lower AMR, PMR and SMR in the screening/surveillance setting, potentially reducing the incidence of I-CRC.

Clinical Characteristics and Risk Factors of Patients with Lung Cancer Complicated with Pulmonary Embolism: A Case Control Study

PURPOSE

The purpose of this study was to investigate the clinical characteristics and risk factors for patients with lung cancer complicated by pulmonary embolism and to provide a reference for the early clinical identification of these patients.

METHODS

Eighty patients with lung cancer complicated with pulmonary embolism who were treated at Bethune Hospital of Shanxi from October 2018 to October 2025 were compared with 80 patients with lung cancer without pulmonary embolism. The clinical data of the two groups of patients were collected and analysed.

RESULTS

Compared with that in patients in the LC group, the proportion of patients with pulmonary interstitial fibrosis in the LP group was significantly greater (p < 0.05). The incidence of dyspnoea in the LP group was significantly greater than that in the LC group (p < 0.05). Compared with that in the LC group, the proportion of pulmonary artery compression in the LP group was significantly greater, and the difference was statistically significant (p < 0.05). In terms of pathological type, the proportion of adenocarcinoma patients in the LP group was significantly greater than that in the LC group (p < 0.05). In terms of tumor stage, the proportion of patients with stage III/IV disease in the LP group was significantly greater than that in the LC group, while the proportion of patients with stage I/II disease was significantly lower than that in the LC group, and the difference was statistically significant (p < 0.05). The neutrophil [NEUT (%)], prothrombin time (PT), white blood cell (WBC), carcinoma embryonic antigen (CEA) and D-dimer (DD) levels were significantly greater in the LP group than in the LC group (p < 0.05). In terms of treatment, the proportion of patients receiving systemic chemotherapy in the LP group was significantly greater than that in the LC group (p < 0.05). Logistic regression analysis revealed that adenocarcinoma, systemic chemotherapy and tumor stage III-IV were independent risk factors for lung cancer complicated with pulmonary embolism.

CONCLUSION

(1) Tumor stage (III/IV), systemic chemotherapy, and adenocarcinoma were independent risk factors for pulmonary thromboembolism in patients with lung cancer. (2) In addition, patients with LP were more likely to have pulmonary interstitial fibrosis, dyspnoea, compression of the pulmonary artery by the tumor location, biological targeted therapy, and abnormal increases in D-dimer, WBC, NEUT (%), CEA and PT levels as laboratory indicators. (3) Pulmonary thromboembolism should be considered in lung cancer patients with a combination of the factors described above.

Advances in MiRNAs Involved in Endometrial Carcinoma

Endometrial carcinoma (EC) is a common malignancy worldwide. Existing evidence has revealed that EC could be associated with abnormal gene expression. Meantime, evidence supports that miRNAs act as critical regulators in gene expression through the binding to the 3'- untranslated region (3'-UTR). Accordingly, this review concludes some recent studies focusing on miRNAs that influence EC, aiming at understanding the association between miRNAs and EC more clearly and providing a reference for further studies on miRNA-related drugs treating EC.

Matrix Metalloproteinase-2 (MMP-2): As an Essential Factor in Cancer Progression

The development of cancer has been a multistep process involving mutation, proliferation, survival, invasion, and metastasis. Of all the characteristics of cancer, metastasis is believed to be the hallmark as it is responsible for the highest number of cancer-related deaths. In connection with this, Matrix metalloproteinases (MMPs), that has a role in metastasis, are one of the novel therapeutic targets. MMPs belong to the family of zinc-dependent endopeptidases and are capable of degrading the components of the extracellular matrix (ECM). The role of MMPs in ECM remodeling includes tissue morphogenesis, uterine cycling, growth, tissue repair, and angiogenesis. During pathological conditions, MMPs play a critical role in the excessive degradation of ECM which includes arthritis, tumour invasion, tumour metastasis, and several other autoimmune disorders. Moreover, they are believed to be involved in many physiological aspects of the cell, such as proliferation, migration, differentiation, angiogenesis, and apoptosis. It is reported that dysregulation of MMP in a variety of cancer subtypes have a dual role in tumour growth and metastasis processes. Further, multiple studies suggest the therapeutic potential of targeting MMP in invading cancer. The expression of MMP-2 correlates with the clinical characteristics of cancer patients, and its expression profile is a new diagnostic and prognostic biomarker for a variety of human diseases. Hence, manipulating the expression or function of MMP-2 may be a potential treatment strategy for different diseases, including cancers. Hence, the present review discusses the therapeutic potential of targeting MMP in various types of cancers and their recent patents.

Beyond endocrine resistance: estrogen receptor (ESR1) activating mutations mediate chemotherapy resistance through the JNK/c-Jun MDR1 pathway in breast cancer

PURPOSE

All patients with metastatic breast cancer (MBC) expressing estrogen receptor-α (ESR1) will eventually develop resistance to endocrine therapies. In up to 40% of patients, this resistance is caused by activating mutations in the ligand-binding domain (LBD) of ESR1. Accumulating clinical evidence indicate adverse outcomes for these patients, beyond that expected by resistance to endocrine therapy. Here we aimed to study the role of ESR1 mutations in conferring chemoresistance in BC cells.

METHODS

MCF-7 cells harboring Y537S and D538G ESR1 mutations (mut-ER) were employed to study the response to chemotherapy drugs, paclitaxel and doxorubicin, using viability and apoptotic assay in vitro, and tumor growth in vivo. JNK/c-Jun/MDR1 pathway was studied using qRT-PCR, western-blot, gene-reporter and ChIP assays. MDR1 expression was analyzed in clinical samples using IHC.

RESULTS

 Cell harboring ESR1 mutations displayed relative chemoresistance compared to WT-ER, evidenced by higher viability and reduced apoptosis as well as resistance to paclitaxel in vivo. To elucidate the underlying mechanism, MDR1 expression was examined and elevated levels were observed in mut-ER cells, and in clinical BC samples. MDR1 is regulated by the c-Jun pathway, and we showed high correlation between these two genes in BC using TCGA databases. Accordingly, we detected higher JNK/c-Jun expression and activity in ESR1-mutated cells, as well as increased occupancy of c-Jun in MDR1 promoter. Importantly, JNK inhibition decreased MDR1 expression and restored sensitivity to chemotherapy.

CONCLUSIONS

Taken together, these data indicate that ESR1 mutations confer chemoresistance through activation of the JNK/MDR1 axis. These finding suggest a novel treatment option for BC tumors expressing ESR1 mutations.

The Emerging Role of Herbal Medicines in Cancer by Interfering with Posttranslational Modifications

Significance: Herbal medicines have a long history of comprehensive cancer treatment through various posttranslational modifications (PTMs). Recently, emerging evidence revealed that dysregulation of reactive oxygen species (ROS) and ROS-regulated signaling pathways influence cancer initiation, growth, and progression in a paradoxical role with either low levels or increasing levels of basal ROS. However, ROS-triggered modifications of target proteins in the face of ROS-mediated signal transduction are not fully understood in the anticancer therapies of herbal medicines. In this review, we briefly introduce the PTM-dependent regulations of herbal medicines, and then focus on the current ideals that targeting ROS-dependent PTMs via antioxidant and redox signaling pathways can provide a promising strategy in herbal-based anticancer effects. Recent Advances: Advanced development in highly sensitive mass spectrometry-based techniques has helped utilize ROS-triggered protein modifications in numerous cancers. Accumulating evidence has been achieved in laboratory to extensively ascertain the biological mechanism of herbal medicines targeting ROS in cancer therapy. Two general mechanisms underlining ROS-induced cell signaling include redox state and oxidative modification of target protein, indicating a new perspective to comprehend the intricate dialogues between herbal medicines and cancer cellular contexts. Critical Issues: Complex components of herbal medicines limit the benefits of herbal-based cancer therapies. In this review, we address that ROS-dependent PTMs add a layer of proteomic complexity to the cancer through altering the protein structure, expression, function, and localization. Elaborating ROS-triggered PTMs implicated in cell signaling, apoptosis, and transcriptional regulation function, and the possible cellular signaling, has provided important information about the contribution of many ROS targeting herbal therapies in anticancer effects. Continued optimization of proteomic strategies for PTM analysis in herbal medicines is also briefly discussed. Future Directions: Rigorous evaluations of herbal medicines and proteomic strategies are necessary to explore the aberrant regulation of ROS-triggered antioxidant and redox signaling contributing to the novel protein targets and herbal-associated pharmacological issues. These efforts will eventually help develop more herbal drugs as modern therapeutic agents. Antioxid. Redox Signal. 42, 150-164.

Prostate cancer burden in major BRICS countries, 1990-2019: findings from the 2019 global burden of disease study

BACKGROUND

This study assessed prostate cancer burden and trends in major BRICS countries (Brazil, Russia, India, China, and South Africa) from 1990 to 2019.

METHODS

Utilizing Global Burden of Disease Study 2019 data, we calculated age-standardized rates for prostate cancer incidence, prevalence, mortality, and disability-adjusted life years (DALYs) with 95% uncertainty intervals (UIs). Joinpoint regression analysis determined the average annual percentage change (AAPC) for trend characterization.

RESULTS

Prostate cancer ranked highest in China for incidence, prevalence, mortality, and DALYs. In 2019, Brazil had the highest age-standardized incidence rate (ASIR) [55.029 (95% UI: 47.744-81.831)] and age-standardized prevalence rate (ASPR) [372.511 (95% UI: 327.549-549.128)], while South Africa recorded the highest age-standardized mortality rate (ASMR) [42.241 (95% UI: 32.146-47.933)], and age-standardized DALY rate (ASDR) [666.085 (95% UI: 522.626-764.612)]. ASIR and ASPR increased significantly over three decades (AAPC > 0), with varying ASMR and ASDR trends.

CONCLUSION

Prostate cancer poses a significant public health challenge. While incidence and prevalence rise, mortality declines in China, India, and Brazil. Tailored health policies are crucial to address diverse disease burden characteristics.

Gemcitabine and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy for stage III-IVA nasopharyngeal carcinoma: A real-world study

INTRODUCTION

This study aims to evaluate the efficacy of combining induction chemotherapy with concurrent chemoradiotherapy for patients with stage III-IVA nasopharyngeal carcinoma (NPC), particularly focusing on cases associated with Epstein-Barr virus infection. The primary focus is on treatment response and disease control.

METHODS

This retrospective cohort study analyzed data from 81 patients with stage III-IVA NPC (excluding T3N0M0) treated with gemcitabine and cisplatin as induction chemotherapy, followed by concurrent chemoradiotherapy at the Vietnam National Cancer Hospital. Patient data and follow-up information were collected between June 2021 and June 2024, focusing on disease-free survival (DFS) as the primary outcome and secondary outcomes including factors affecting DFS and treatment-related toxicity.

RESULTS

In the initial 3-month period, 76 out of 81 patients achieved a complete response, and five patients achieved a partial response. The follow-up period averaged 18.7 ± 5.3 months, with a 2-year DFS rate of 77.6%. Key factors influencing DFS included patient age, N stage, disease stage, and treatment interruptions. Grade 3 toxicities observed included neutropenia (17.3%) and mucositis (32.1%), while grade 4 toxicity was limited to nausea (2.4%). Additionally, 2.6% of patients experienced delayed grade I-II toxicities, with some presenting grade III anorexia.

CONCLUSION

Our findings suggest that gemcitabine and cisplatin induction chemotherapy, followed by chemoradiotherapy, may result in a high response rate and effective disease control with manageable toxicity. However, further research is needed to evaluate long-term outcomes and potential delayed adverse effects to confirm these initial observations.

Advancing Ki67 hotspot detection in breast cancer: a comparative analysis of automated digital image analysis algorithms

AIM

Manual detection and scoring of Ki67 hotspots is difficult and prone to variability, limiting its clinical utility. Automated hotspot detection and scoring by digital image analysis (DIA) could improve the assessment of the Ki67 hotspot proliferation index (PI). This study compared the clinical performance of Ki67 hotspot detection and scoring DIA algorithms based on virtual dual staining (VDS) and deep learning (DL) with manual Ki67 hotspot PI assessment.

METHODS

Tissue sections of 135 consecutive invasive breast carcinomas were immunohistochemically stained for Ki67. Two DIA algorithms, based on VDS and DL, automatically determined the Ki67 hotspot PI. For manual assessment; two independent observers detected hotspots and calculated scores using a validated scoring protocol.

RESULTS

Automated hotspot detection and assessment by VDS and DL could be performed in 73% and 100% of the cases, respectively. Automated hotspot detection by VDS and DL led to higher Ki67 hotspot PIs (mean 39.6% and 38.3%, respectively) compared to manual consensus Ki67 PIs (mean 28.8%). Comparing manual consensus Ki67 PIs with VDS Ki67 PIs revealed substantial correlation (r = 0.90), while manual consensus versus DL Ki67 PIs demonstrated high correlation (r = 0.95).

CONCLUSION

Automated Ki67 hotspot detection and analysis correlated strongly with manual Ki67 assessment and provided higher PIs compared to manual assessment. The DL-based algorithm outperformed the VDS-based algorithm in clinical applicability, because it did not depend on virtual alignment of slides and correlated stronger with manual scores. Use of a DL-based algorithm may allow clearer Ki67 PI cutoff values, thereby improving the clinical usability of Ki67.

Exploiting the role of O6-methylguanine-DNA-methyltransferase (MGMT) in gastrointestinal cancers

Gastrointestinal (GI) cancer is a prevalent disease and is recognized as the primary cause of cancer-related mortality globally. Therefore, there is an urgent need for novel diagnostic and treatment approaches for GC. The methylation of the O(6)-methylguanine DNA methyltransferase (MGMT) gene promoter is a significant factor in the development of colorectal cancer (CRC), namely in roughly 30-40% of cases where the cancer has spread. MGMT plays a role in the repair of DNA damage caused by methylating drugs like temozolomide (TMZ) and chloroethylating compounds like carmustine. As a result, it contributes to the resistance of chemotherapy when these agents are utilized. Although MGMT's role in the development of CRC is well established, its prognostic significance remains a subject of debate. Only a limited number of research have been conducted to examine the prognostic significance of MGMT methylation, yielding varying outcomes. This review explores the structural functions and repair processes of MGMT, focusing on the putative structural and functional significance of the N-terminal domain of MGMT. It also investigates the advancement of cancer treatment techniques that specifically target MGMT.

ADAR1 Promotes the Progression and Temozolomide Resistance of Glioma Through p62-Mediated Selective Autophagy

BACKGROUND

Resistance to temozolomide (TMZ) remains is an important cause of treatment failure in patients with glioblastoma multiforme (GBM). ADAR1, as a member of the ADAR family, plays an important role in cancer progression and chemotherapy resistance. However, the mechanism by which ADAR1 regulates GBM progression and TMZ resistance is still unclear.

METHODS

We first constructed stable transfected strains in which ADAR1 was knocked down and overexpressed to investigate the effect of ADAR1 on the first-line glioma chemotherapy drug TMZ. Subsequently, we validated that ADAR1 induces autophagy activation and used autophagy inhibitors to suppress autophagy, demonstrating that ADAR1 enhances TMZ resistance through autophagy. We further knocked down p62 (SQSTM1) based on the overexpression of ADAR1, and the results showed that ADAR1 regulates selective autophagy through the p62 regulation. Finally, we demonstrated through mutations at both edited and nonedited sites that ADAR1 regulates selective autophagy in an edited dependent way.

RESULTS

Further analysis showed that in the presence of TMZ, elevated ADAR1 promoted TMZ induced autophagy activation. Further research revealed that ADAR1 enhances TMZ resistance through p62-mediated selective autophagy. Further, ADAR1 regulates selective autophagy in an edited dependent way. Our results indicate a relationship between ADAR1 levels and the response of glioma patients to TMZ treatment.

CONCLUSIONS

We found that the expression of ADAR1 is upregulated in GBM and is associated with tumor grade and TMZ resistance. Elevated expression of ADAR1 predicts poor prognosis in GBM patients and promotes tumor growth in vivo or in vitro.

Health-related quality of life among adult patients with cancer in Uganda - a cross-sectional study

OBJECTIVES

The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda.

METHODS

This cross-sectional study surveyed 385 adult patients (95% response rate) with various cancers at a specialised oncology facility in Uganda. Health-related quality of life was measured using the EORTC QLQ-C30 in the Luganda and English languages. Predetermined validated clinical thresholds were applied to the instrument in order to identify patients with poor health-related quality of life, that is, functional impairments or symptoms warranting concern. Multivariable logistic regression was used to identify factors associated with poor health-related quality of life in six subscales: Physical Function, Role Function, Emotional Function, Social Function, Pain and Fatigue.

RESULTS

The mean age of the patients was 48 years. The majority self-reported poor functioning ranging between 61% (Emotional Function) to 79% (Physical Function) and symptoms (Fatigue 63%, Pain 80%) at clinically concerning levels. These patients were more likely to be older, without formal education and not currently working. Being an inpatient at the facility and being diagnosed with cervical cancer or leukaemia was a predictor of poor health-related quality of life.

CONCLUSION

Improvement of cancer care in East Africa requires a comprehensive and integrated approach that addresses various challenges specific to the region. Such strategies include investment in healthcare infrastructure, for example, clinical guidelines to improve pain management, and patient education and support services.

The antipsychotic drug pimozide promotes apoptosis through the RAF/ERK pathway and enhances autophagy in breast cancer cells

The antipsychotic drug pimozide has been demonstrated to inhibit cancer. However, the precise anti-cancer mechanism of pimozide remains unclear. The purpose of this study was to investigate the effects of pimozide on human MCF-7 and MDA-MB-231 breast cancer cell lines, and the potential involvement in the RAF/ERK signaling. The effects of pimozide on cells were examined by 4,5-dimethylthiazol-2-yl-3,5-diphenylformazan, wound healing, colony formation, transwell assays, and caspase activity assay. Flow cytometry and acridine orange and ethidium bromide staining were performed to assess changes in cells. Transmission electron microscopy and monodansylcadaverine staining were used to observe autophagosomes. The cyclic adenosine monophosphate was evaluated using the FRET system. Immunohistochemistry, immunofluorescence, RNA interference, and western blot investigated the expression of proteins. Mechanistically, we focus on the RAF1/ERK signaling. We detected pimozide was docked to RAF1 by Schrodinger software. Pimozide down-regulated the phosphorylation of RAF1, ERK 1/2, Bcl-2, and Bcl-xl, up-regulated Bax, and cleaved caspase-9 to induce apoptosis. Pimozide might promote autophagy by up-regulating cAMP. The enhancement of autophagy increased the conversion of LC3-I to LC3-II and down-regulated p62 expression. But mTOR signaling was not involved in promoting autophagy. The knockdown of RAF1 expression induced autophagy and apoptosis in breast cancer cells, consistent with the results of pimozide or sorafenib alone. Blocked autophagy by chloroquine resulted in the impairment of pimozide-induced apoptosis. These data showed that pimozide inhibits breast cancer by regulating the RAF/ERK signaling pathway and might activate cAMP-induced autophagy to promote apoptosis and it may be a potential drug for breast cancer treatment.

[18F]FDG PET/CT Radiomics in Cervical Cancer: A Systematic Review

Background/Objectives: Cervical cancer is a significant global health concern, with high incidence and mortality rates, especially in less-developed regions. [18F]FDG PET/CT is now indicated at various stages of management, but its analysis is essentially based on SUVmax, a measure of [18F]FDG uptake. Radiomics, by extracting a multitude of parameters, promises to improve the diagnostic and prognostic performance of the examination. However, studies remain heterogeneous, both in terms of patient numbers and methods, so a synthesis is needed. Methods: This systematic review was conducted following PRISMA-P guidelines and registered in PROSPERO (CRD42024584123). Eligible studies on PET/CT radiomics in cervical cancer were identified through PubMed and Scopus and assessed for quality using the Radiomics Quality Score (RQS v2.0), with data extraction focusing on study design, population characteristics, radiomic methods, and model performances. Results: The review identified 22 studies on radiomics in cervical cancer, 19 of which focused specifically on locally advanced cervical cancer (LACC) and assessed various clinical outcomes, such as survival, relapse, treatment response, and lymph node involvement prediction. They reported significant associations between prognostic indicators and radiomic features, indicating the potential of radiomics to improve the predictive accuracy for patient outcomes in LACC; however, the overall quality of the studies was relatively moderate, with a median RQS of 12/36. Conclusions: While radiomic analysis in cervical cancer presents promising opportunities for survival prediction and personalized care, further well-designed studies are essential to provide stronger evidence for its clinical utility.

Androgen receptor and osteoglycin gene expression predicting prognosis of metastatic prostate cancer

This study aimed to identify the predictive factors associated with the oncological outcomes of metastatic hormone-sensitive prostate cancer-related genes. A nomogram for predicting prostate cancer-specific survival (CSS) was constructed based on biopsy samples obtained from 103 patients with metastatic hormone-sensitive prostate cancer. We analyzed the association between clinical data and mRNA expression levels. The nomogram was externally validated in another cohort (n = 50) by using a concordance index. Based on the cutoff value, determined by a receiver operating characteristic analysis, longer CSS was observed in the high osteoglycin and androgen receptor expression level groups (> 1.133 and > 0.00; median CSS, 85.3 vs. 52.7 months, p = 0.045, and 69.1 vs. 32.1 months, p = 0.034, respectively), compared with that of the low expression level groups. The nomogram predicting CSS included hemoglobin (≥ 13.7 g/dL or < 13.7 g/dL), serum albumin (≥ 3.1 g/dL or < 3.1 g/dL), serum lactate dehydrogenase (≥ 222 IU/L or < 222 IU/L), total Japan Cancer of the Prostate Risk Assessment score, androgen receptor expression level, and osteoglycin expression level. The concordance indices for the internal and external validations were 0.664 and 0.798, respectively. In this study, a nomogram that integrated the expression levels of androgen receptors and osteoglycin to predict CSS in metastatic hormone-sensitive prostate cancer was established.

Integrating immune multi-omics and machine learning to improve prognosis, immune landscape, and sensitivity to first- and second-line treatments for head and neck squamous cell carcinoma

In recent years, immune checkpoint inhibitors (ICIs) has emerged as a fundamental component of the standard treatment regimen for patients with head and neck squamous cell carcinoma (HNSCC). However, accurately predicting the treatment effectiveness of ICIs for patients at the same TNM stage remains a challenge. In this study, we first combined multi-omics data (mRNA, lncRNA, miRNA, DNA methylation, and somatic mutations) and 10 clustering algorithms, successfully identifying two distinct cancer subtypes (CSs) (CS1 and CS2). Subsequently, immune-regulated genes (IRGs) and machine learning algorithms were utilized to construct a consensus machine learning-driven prediction immunotherapy signature (CMPIS). Further, the prognostic model was validated and compared across multiple datasets, including clinical characteristics, external datasets, and previously published models. Ultimately, the response of different CMPIS patients to immunotherapy, targeted therapy, radiotherapy and chemotherapy was also explored. First, Two distinct molecular subtypes were successfully identified by integrating immunomics data with machine learning techniques, and it was discovered that the CS1 subtype tended to be classified as "cold tumors" or "immunosuppressive tumors", whereas the CS2 subtype was more likely to represent "hot tumors" or "immune-activated tumors". Second, 303 different algorithms were employed to construct prognostic models and the average C-index value for each model was calculated across various cohorts. Ultimately, the StepCox [forward] + Ridge algorithm, which had the highest average C-index value of 0.666, was selected and this algorithm was used to construct the CMPIS predictive model comprising 16 key genes. Third, this predictive model was compared with patients' clinical features, such as age, gender, TNM stage, and grade stage. The findings indicated that this prognostic model exhibited the best performance in terms of C-index and AUC values. Additionally, it was compared with previously published models and it was found that the C-index of CMPIS ranked in the top 5 among 94 models across the TCGA, GSE27020, GSE41613, GSE42743, GSE65858, and META datasets. Lastly, the study revealed that patients with lower CMPIS were more sensitive to immunotherapy and chemotherapy, while those with higher CMPIS were more responsive to radiation therapy and EGFR-targeted treatments. In summary, our study identified two CSs (CS1 and CS2) of HNSCC using multi-omics data and predicted patient prognosis and treatment response by constructing the CMPIS model with IRGs and 303 machine learning algorithms, which underscores the importance of immunotherapy biomarkers in providing more targeted, precise, and personalized immunotherapy plans for HNSCC patients, significantly contributing to the optimization of clinical treatment outcomes.

Integrative analysis of ASXL family genes reveals ASXL2 as an immunoregulatory molecule in head and neck squamous cell carcinoma

Despite the progress in conventional treatments for head and neck squamous cell carcinoma (HNSCC), the 5-year survival rate remains below 70%. Enhancing immunotherapy outcomes through personalized treatment strategies, particularly by identifying immune-related biomarkers, is critical. The ASXL family are associated with malignancies, but their relationship with HNSCC has not been elucidated. In this study, we found that high expression of ASXL2 is associated with better prognosis in HNSCC patients. Analysis revealed a significant positive correlation between ASXL2 and immune infiltration. Functional analysis suggests that ASXL2 co-expressed genes in HNSCC patients are enriched in the JAK-STAT signaling pathway, and patients with high expression show an even greater enrichment in T cell and B cell receptor signaling pathways. Utilizing the NPC single-cell dataset, ASXL2's widespread expression in the tumor microenvironment was confirmed, and its co-expressed genes were found to be highly associated with immune cell function. Experimental validation showed a correlation between ASXL2 expression and T cell secretion of interferon-γ (IFNγ), confirming that high ASXL2 expression facilitates T cell activation. Overall, our findings underscore the important role of ASXL2 in immune activation, suggesting its potential as a promising biomarker for tailoring immunotherapy strategies in HNSCC patients.

Validation of novel grading schemes and refinement of the Leibovich risk groups for chromophobe renal cell carcinoma

BACKGROUND

Traditional grading systems have proven inadequate in stratifying chRCC patients based on recurrence risk. Recently, several novel grading schemes, including three-tiered, two-tiered, and four-tiered systems, have been proposed, but their prognostic value remains controversial and lacks external validation.

MATERIALS AND METHODS

We included 528 patients with pathologically proven chRCC (chromophobe renal cell carcinoma) from multiple medical institutions and the Cancer Genome Atlas-Kidney Chromophobe cohort. Three experienced pathologists independently reassessed the slides based on the three novel grading schemes. Survival outcomes, including disease-specific survival (DSS), recurrence-free survival (RFS), were analyzed using Kaplan-Meier methods and Cox proportional hazards regression models. The prognostic value of the original and adjusted Leibovich risk groups was compared using Harrell's C-index.

RESULTS

All grading systems demonstrated significant survival differences among their respective groups (p < 0.001 for all). However, within the four-tiered system, no significant survival disparity was observed between grade 1 and grade 2 tumors (GTG2 without necrosis) (p = 0.619 for DSS). When patients with necrosis were excluded, no survival difference was detected between CTG1 and CTG2 tumors in the three-tiered system (p = 0.870 for DSS), challenging the prognostic utility of distinguishing between these two grades. The adjusted Leibovich risk stratification (C-index = 0.840 for DSS), incorporating necrosis and tumor thrombus, demonstrated superior prognostic value compared to the original model (C-index = 0.762 for DSS), with more pronounced survival distinctions and improved predictive performance.

CONCLUSION

Our study validates the prognostic significance of recently developed grading systems for chRCC. The observed survival difference between CTG1 and CTG2 in the three-tiered system may be attributed to varying percentages of coagulative necrosis. By integrating necrosis and tumor thrombus into the Leibovich risk groups, we enhanced the model's ability to distinguish between patients and improved its predictive performance.

Roles and Mechanisms of Ferroptosis in Sorafenib Resistance for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most prevalent malignant tumor, characterized by a poor prognosis. In recent decades, both the incidence and mortality rates of HCC have risen sharply. Sorafenib has emerged as the first conventional drug approved by the US Food and Drug Administration for first-line treatment in advanced HCC patients due to its favorable safety profile. However, its effectiveness is severely hindered by acquired drug resistance, which leads to only approximately 30% of HCC patients benefited from sorafenib therapy. Sorafenib resistance involves various mechanisms that inhibit cellular uptake of iron and reactive oxygen species (ROS). Consequently, ferroptosis a novel form of cell death contingent upon the accumulation of intracellular iron and ROS plays a critical role in mediating sorafenib resistance through the Hippo YAP pathway or Keap1-Nrf2 system. This review aimed to comprehensively elucidate the mechanisms underlying sorafenib resistance in HCC, particularly focusing on ferroptosis and its pathways, to provide valuable insights into targeting ferroptosis or its pathways for sorafenib-resistant HCC treatment.

Furopyridine Derivatives as Potent Inhibitors of the Wild Type, L858R/T790M, and L858R/T790M/C797S EGFR

The treatment of patients with nonsmall cell lung cancer (NSCLC) using epidermal growth factor receptor (EGFR) inhibitors is complicated by drug-sensitive activating L858R/T790M and L858R/T790M/C797S mutations. To overcome drug resistance, a series of furopyridine (PD) compounds were virtually screened to identify potent EGFR inhibitors using molecular docking and molecular dynamics (MD) simulations based on the solvated interaction energy (SIE) method. Several PD compounds identified from virtual screening demonstrated the potential to suppress both wild-type and mutant forms of EGFR, with IC50 values in the nanomolar range. Among these, PD18 and PD56 exhibited highly potent inhibitory activity against both wild-type and mutant forms of EGFR, surpassing the efficacy of known drugs. Additionally, both PD compounds were cytotoxic to NSCLC cell lines (A549 and H1975) while being nontoxic to normal cell lines (Vero). The interaction mechanisms of both PD compounds complexed with wild-type and mutant forms of EGFR were elucidated through 500 ns molecular dynamics simulations. The predicted binding affinity from molecular mechanics/Poisson-Boltzmann surface area (MM/PBSA) correlated well with the experimental binding affinity derived from IC50 values. Furthermore, it was observed that van der Waals interactions, rather than electrostatic interactions, played a significant role in interacting with EGFR's active site. The strong inhibitory activity against EGFR was attributed to two key residues, M793 and S797, via hydrogen bonding, corresponding with lower solvent accessibility and a higher number of atomic contacts. Therefore, these potent compounds could be developed as promising drugs targeting both wild-type and mutant EGFR for the treatment of NSCLC.

The Intersection of Psoriasis and Neoplasia: Risk Factors, Therapeutic Approaches, and Management Strategies

The association between psoriasis and increased cancer risk is gaining recognition as studies reveal shared inflammatory and immune pathways. This review examines the relationship between psoriasis and neoplasia, focusing on cancer risk factors in psoriasis patients, the biological pathways underlying this connection, and the impact of various psoriasis treatments on cancer development. Psoriasis patients have a heightened incidence of certain cancers, such as lymphomas, skin cancers, and urological malignancies, potentially linked to immune dysregulation and chronic inflammation. Immunomodulatory treatments for psoriasis, including conventional systemic therapies and biologics, present varied cancer risks, with others, such as phototherapy, associated with an elevated risk of skin cancers. For oncologic patients with psoriasis, management necessitates a tailored approach, balancing effective psoriasis control with minimizing cancer progression risks. The emergence of IL-17 inhibitors, IL-23 inhibitors, and small-molecule therapies offers promising therapeutic alternatives with favorable safety profiles for these patients. This review underscores the need for interdisciplinary collaboration to optimize care for patients managing both psoriasis and malignancy.

Cost Analysis Related to Diagnosis, Treatment and Management of Cervical Cancer in Antigua and Barbuda: A Prevalence-Based Cost-of-Illness Study

Cervical cancer remains a significant public health issue globally. In Antigua and Barbuda, cervical cancer is ranked among the top five most common cancers in terms of incidence and mortality among females. There is no evidence that the costs of diagnosing, treating, and managing this cancer have been studied before in Antigua and Barbuda. From the providers' perspective, this study aimed to estimate costs associated with cervical cancer in Antigua and Barbuda. The prevalence-based cost-of-illness methodology was used to assess patient data abstracted from four study sites for the period 2017-2021, and to derive the annual prevalence. Top-down and bottom-up costing approaches were used to estimate direct medical costs. Costs were computed using the 2021 price level and converted to United States Dollars (USD). Total annual direct medical costs of cervical cancer were estimated at USD 0.24 million (ranging between USD 0.19 million and USD 0.30 million). Major cost drivers were treatment (USD 112,863.76), post-treatment side-effects care (USD 67,406.57), and the diagnostic process (USD 26,238.58). The overall direct medical unit costs for managing a case were estimated at USD 115,822.09. Our study reflects the current estimates for managing cervical cancer and provides evidence to complement cervical cancer prevention and cost containment measures in Antigua and Barbuda.

Comprehensive review of drug resistance in mammalian cancer stem cells: implications for cancer therapy

Cancer remains a significant global challenge, and despite the numerous strategies developed to advance cancer therapy, an effective cure for metastatic cancer remains elusive. A major hurdle in treatment success is the ability of cancer cells, particularly cancer stem cells (CSCs), to resist therapy. These CSCs possess unique abilities, including self-renewal, differentiation, and repair, which drive tumor progression and chemotherapy resistance. The resilience of CSCs is linked to certain signaling pathways. Tumors with pathway-dependent CSCs often develop genetic resistance, whereas those with pathway-independent CSCs undergo epigenetic changes that affect gene regulation. CSCs can evade cytotoxic drugs, radiation, and apoptosis by increasing drug efflux transporter activity and activating survival mechanisms. Future research should prioritize the identification of new biomarkers and signaling molecules to better understand drug resistance. The use of cutting-edge approaches, such as bioinformatics, genomics, proteomics, and nanotechnology, offers potential solutions to this challenge. Key strategies include developing targeted therapies, employing nanocarriers for precise drug delivery, and focusing on CSC-targeted pathways such as the Wnt, Notch, and Hedgehog pathways. Additionally, investigating multitarget inhibitors, immunotherapy, and nanodrug delivery systems is critical for overcoming drug resistance in cancer cells.

Pan-cancer analysis of B3GNT5 with potential implications for cancer immunotherapy and cancer stem cell stemness

B3GNT5, a critical member of the β-1,3-N-acetylglucosaminyl transferase gene family involved in lactose and glycosphingolipids biosynthesis, has been documented to promote tumor-infiltrating T-cell responses. Our research utilized the Pan-Cancer dataset from The Cancer Genome Atlas (TCGA) to explore the functional role of B3GNT5. Our study demonstrated that the antibody-driven inhibition of B3GNT5 diminished T cell-mediated anti-tumor responses in both in vitro and in vivo settings. By analyzing RNA-seq data from Genotype-Tissue Expression (GTEx) and TCGA databases, we observed differential expression levels of B3GNT5 across various tumor types accompanied by an unfavorable prognostic correlation. We further utilized integrated clinical survival data from TCGA and immune cell infiltration scoring patterns to identify significant associations between B3GNT5 expression and immune checkpoints, cancer stemness, chemokines, chemokine receptors, and immune-activating genes. B3GNT5's expression was highly correlated with different immunoregulatory factors, including T cell infiltration, chemokine receptors, and activation genes. Subsequent experiments discovered that suppressing B3GNT5 expression in pancreatic adenocarcinoma cells significantly reduced their tumorigenicity by limiting sphere-forming ability and self-renewal capacity, thus underscoring B3GNT5's vital role as a prognostic factor in immune regulation across pan-cancer. Our findings suggest that B3GNT5 presents a viable target for cancer immunotherapy by enabling effective communication between cancer stem cells and immune cells during tumor treatment.

Uptake and determinants of HPV vaccination in South Asia: a systematic review and meta-analysis

Background

Cervical cancer burden in South Asia is among the highest globally. Due to the lack of national immunization programs, the prevalence of human papillomavirus (HPV) infection and vaccine uptake remains unknown. This systematic review and meta-analysis aim to determine the prevalence of HPV vaccine uptake in South Asia.

Methods

We conducted a comprehensive search of MEDLINE (via PubMed), Embase, the Cochrane Library, and the Web of Science, covering the period from inception to May 20, 2024. We included observational studies reporting HPV vaccine uptake in South Asia, without any language filters or restrictions. The search strategy involved MeSH terms and relevant keywords related to "Papillomavirus Infections," "Vaccination," and "Uptake." MetaXL and STATA were used to perform a proportional meta-analysis and meta-regression analysis.

Results

Out of 3,913 articles identified, 17 articles (10,585 participants) were included in the systematic review. The pooled prevalence of vaccine uptake was 8% (95% CI 1-21). There was high heterogeneity between studies (I 2 = 100%). The pooled prevalence of adequate knowledge of the HPV vaccine was 41% (95% CI 28-55, I 2 = 99%). The pooled prevalence of a favorable attitude toward the HPV vaccine was 56% (95% CI 47-66, I 2 = 98%). In the univariate meta-regression model, good knowledge significantly predicted HPV vaccine uptake (p = 0.003), while no covariates were found to be significant predictors of attitudes toward HPV vaccine uptake.

Conclusion

The findings of this meta-analysis indicate a low pooled prevalence of HPV vaccine uptake (8%) in South Asian countries. The pooled prevalence of adequate knowledge and a favorable attitude toward the vaccine were 41 and 56%, respectively. In the univariate meta-regression model, knowledge of the HPV vaccine uptake was the only significant predictor of vaccine uptake.

Systematic review registration

Systematic review is registered at Prospero through the link https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024547393.

Magnetic Resonance Imaging Liver Segmentation Protocol Enables More Consistent and Robust Annotations, Paving the Way for Advanced Computer-Assisted Analysis

BACKGROUND/OBJECTIVES

Recent advancements in artificial intelligence (AI) have spurred interest in developing computer-assisted analysis for imaging examinations. However, the lack of high-quality datasets remains a significant bottleneck. Labeling instructions are critical for improving dataset quality but are often lacking. This study aimed to establish a liver MRI segmentation protocol and assess its impact on annotation quality and inter-reader agreement.

METHODS

This retrospective study included 20 patients with chronic liver disease. Manual liver segmentations were performed by a radiologist in training and a radiology technician on T2-weighted imaging (wi) and T1wi at the portal venous phase. Based on the inter-reader discrepancies identified after the first segmentation round, a segmentation protocol was established, guiding the second round of segmentation, resulting in a total of 160 segmentations. The Dice Similarity Coefficient (DSC) assessed inter-reader agreement pre- and post-protocol, with a Wilcoxon signed-rank test for per-volume analysis and an Aligned-Rank Transform (ART) for repeated measures analyses of variance (ANOVA) for per-slice analysis. Slice selection at extreme cranial or caudal liver positions was evaluated using the McNemar test.

RESULTS

The per-volume DSC significantly increased after protocol implementation for both T2wi (p < 0.001) and T1wi (p = 0.03). Per-slice DSC also improved significantly for both T2wi and T1wi (p < 0.001). The protocol reduced the number of liver segmentations with a non-annotated slice on T1wi (p = 0.04), but the change was not significant on T2wi (p = 0.16).

CONCLUSIONS

Establishing a liver MRI segmentation protocol improves annotation robustness and reproducibility, paving the way for advanced computer-assisted analysis. Moreover, segmentation protocols could be extended to other organs and lesions and incorporated into guidelines, thereby expanding the potential applications of AI in daily clinical practice.

Applying machine learning techniques to predict the risk of distant metastasis from gastric cancer: a real world retrospective study

Background

Distant metastasis of gastric cancer can seriously affect the treatment strategy of gastric cancer patients, so it is essential to identify patients at high risk of distant metastasis of gastric cancer earlier.

Method

In this study, we retrospectively collected research data from 18,472 gastric cancer patients from the SEER database. We applied six machine learning algorithms to construct a model that can predict distant metastasis of gastric cancer. We constructed the machine learning model using 10-fold cross-validation. We evaluated the model using the area under the receiver operating characteristic curves (AUC), the area under the precision-recall curve (AUPRC), decision curve analysis, and calibration curves. In addition, we used Shapley's addition interpretation (SHAP) to interpret the machine learning model. We used data from 1595 gastric cancer patients in the First Hospital of Jilin University for external validation. We plotted the correlation heat maps of the predictor variables. We selected an optimal model and constructed a web-based online calculator for predicting the risk of distant metastasis of gastric cancer.

Result

The study included 18,472 patients with gastric cancer from the SEER database, including 4,202 (22.75%) patients with distant metastases. The results of multivariate logistic regression analysis showed that age, race, grade of differentiation, tumor size, T stage, radiotherapy, and chemotherapy were independent risk factors for distant metastasis of gastric cancer. In the ten-fold cross-validation of the training set, the average AUC value of the random forest (RF) model was 0.80. The RF model performed best in the internal test set and external validation set. The RF model had an AUC of 0.80, an AUPRC of 0.555, an accuracy of 0.81, and a precision of 0.78 in the internal test set. The RF model had a metric AUC of 0.76 in the external validation set, an AUPRC of 0.496, an accuracy of 0.82, and a precision of 0.81. Finally, we constructed a network calculator for distant metastasis of gastric cancer using the RF model.

Conclusion

With the help of pathological and clinical indicators, we constructed a well-performing RF model for predicting the risk of distant metastasis in gastric cancer patients to help clinicians make clinical decisions.

Mitophagy in gynecological malignancies: roles, advances, and therapeutic potential

Mitophagy is a process in which impaired or dysfunctional mitochondria are selectively eliminated through the autophagy mechanism to maintain mitochondrial quality control and cellular homeostasis. Based on specific target signals, several mitophagy processes have been identified. Defects in mitophagy are associated with various pathological conditions, including neurodegenerative disorders, cardiovascular diseases, metabolic diseases, and cancer. Mitophagy has been shown to play a critical role in the pathogenesis of gynecological malignancies and the development of drug resistance. In this review, we have summarized and discussed the role and recent advances in understanding the therapeutic potential of mitophagy in the development of gynecological malignancies. Therefore, the valuable insights provided in this review may serve as a basis for further studies that contribute to the development of novel treatment strategies and improved patient outcomes.

Gr-1 blockade remodels the immunosuppressive microenvironment induced by incomplete microwave ablation of hepatocellular carcinoma

BACKGROUND

Ablation is one of the main methods for local treatment of hepatocellular carcinoma (HCC). Different from radiofrequency ablation (RFA), microwave ablation (MWA) is not limited by tissue conductivity, and can use multiple electrodes at the same time to improve ablation efficiency. In addition, MWA can form a larger ablation area, which makes it possible to completely ablate large HCC. However, MWA may be incomplete due to factors such as larger tumors or tumors in high-risk areas. The mechanism by which the cellular and tumor immune microenvironment (TIME) is involved in the in vitro effects of incomplete microwave ablation (iMWA) needs to be further elucidated.

METHODS

H22 tumor-bearing C57BL/6 mice were treated with iMWA with several combinations of ablation power and time duration. The effects of iMWA on the genes of HCC cancer cells and the TIME were investigated by RNA sequencing, mass cytometry, immunohistochemistry, and immunofluorescence. The effect of iMWA in combination with anti-Gr-1 on HCC tumor growth was also evaluated.

RESULTS

Thermal stress generated by iMWA induced coagulative necrosis and apoptosis in the region of the ablation center of HCC. RNA sequencing analysis showed that iMWA can boost chemokine CXCL5, which was further confirmed by quantitative real time polymerase chain reaction (qRT-PCR). Mass cytometry results showed that relative to Ctrl group, iMWA-treated led to decreased CD4+ T, CD8+ T, Natural killer (NK), macrophages including both M1 and M2 types but increased monocytes and bone marrow-derived suppressor cells (MDSC). Therefore, inhibiting MDSC is the main target in the later stage of iMWA. In vivo results showed that the tumor volume and weight of iMWA+ anti-Gr-1 group were significantly reduced compared with iMWA+ anti-IgG group. In addition, the merged expressions of CD11b and Gr-1 proteins were found reduced in the iMWA+ anti-Gr-1 group compared with the iMWA+ anti-IgG group by immunofluorescence staining. Immunohistochemistry suggested that CD8 was enriched in the iMWA+ anti-Gr-1 group but not in the iMWA+ anti-IgG group.

CONCLUSION

Our data suggests that iMWA and Gr-1 blocking combined therapy can further inhibit HCC growth and significantly improve the CD8+ T cells in the mouse subcutaneous tumor model, which brings good news to HCC patients.

Development and validation of a prediction model for the prognosis of renal cell carcinoma with liver metastases: a population-based cohort study

Background

Current studies on the establishment of prognostic model for renal cell carcinoma (RCC) with liver metastases (LM) were scarce. This study aimed to develop nomograms to predict the prognosis of RCC with LM.

Methods

Patients diagnosed with RCC between 2010 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) database were selected. The eXtreme Gradient Boosting (XGBoost) and Random Forest (RF) machine learning algorithms were used to screen for the most influential factors affecting prognosis, and the Venn diagram method was employed for further refinement. Subsequently, a nomogram related to brain metastases was constructed. The performance of the nomograms was evaluated through receiver operating characteristics (ROC) curves, calibration plots, C-index, time-dependent C-index, and decision curve analysis (DCA). Kaplan-Meier (K-M) survival curves were used to provide additional verification of the clinical efficacy of the nomogram.

Results

This research comprised 2,395 RCC patients with LM. The Venn diagram demonstrated that age, histological type, grade, AJCC T stage, AJCC N stage, surgery, chemotherapy, marital status, and lung metastasis were highly relevant variables to patients with LM. The AUC, C-index, calibration curves, and DCA curves showed excellent performance of the nomogram. Additionally, the prognostic nomogram accurately classified RCC with LM patients into low- and high-risk groups for mortality.

Conclusion

This study developed a novel nomogram to predict the prognostic factors of RCC with LM, providing a valuable reference for making accurate clinical decisions.

Prevalence of mental disorders and their associations with age at diagnosis and time since diagnosis of nasopharyngeal cancer

Background

Despite advancements in cancer treatment, understanding the long-term mental health implications for nasopharyngeal carcinoma (NPC) survivors remains an underexplored area. This study aims to examine the prevalence of mental disorders and their correlations with age at diagnosis and time since diagnosis among NPC survivors.

Methods

A total of 1872 NPC patients were surveyed from September 2020 to June 2021 in this cross-sectional survey. Logistic regression models were used to analyze the associations of age at diagnosis and time since NPC diagnosis with the risk of mental disorders. Additionally, the potential nonlinear trend between these factors was examined using restricted cubic splines. Analyses were conducted both overall and stratified by gender. Gender interaction was also examined.

Results

The prevalences of depression, anxiety, and sleep disorders were 32.4, 33.2, and 61.5%, respectively. Age at NPC diagnosis was significantly associated with an elevated risk of depression (adjusted OR (aOR): 1.75 for 30-39 years old; 2.33 for 50-59 years old; 2.59 for ≥60 years old) and sleep disorders (aOR: 2.41 for 40-49 years old; 1.95 for 50-59 years old; 2.26, for ≥60 years old), compared to patients diagnosed with NPC at age < 30 years. Conversely, the risk of depression, anxiety, and sleep disorders exhibited negative associations with the time since diagnosis, compared to patients <3 months. Notably, significant nonlinear associations were observed between time since diagnosis and the risk of depression, anxiety, and sleep disorders, which showed an initial increase, with the highest risk occurring at approximately 3.0 (ORmax: 2.7), 1.5 (ORmax: 2.1), and 4.0 (ORmax: 1.9) months since NPC diagnosis, followed by a gradual recovery to a lower risk level at around 12 months. No gender interactions were observed.

Conclusion

The prevalence of mental disorders is notable among NPC survivors, showing a positive correlation with age at diagnosis while displaying a negative correlation with time since diagnosis, thus indicating the need for psychological support, especially within the initial several months following NPC diagnosis.

Advancements in lung cancer: a comprehensive perspective on diagnosis, staging, therapy and follow-up from the SAKK Working Group on Imaging in Diagnosis and Therapy Monitoring

In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics. Treatment aspects, such as preoperative assessment and the implementation of immune response evaluation criteria in solid tumours (iRECIST), have also seen advancements. For those undergoing curative treatment for lung cancer, guidelines propose follow-up with computed tomography (CT) scans within a specific timeframe. However, discrepancies exist in published guidelines, and there is a lack of universally accepted recommendations for follow-up procedures. This white paper aims to provide a certain standard regarding the use of imaging on the diagnosis, staging, treatment and follow-up of patients with lung cancer.

Gene expression alterations in hypoxic A549 lung cancer cell line

Human non-small cell lung cancer (NSCLC)is a very common disease with limited treatment options. Hypoxia is a characteristic feature of solid tumors associated with the resistance of cancer cells to radiotherapy and chemotherapy. Therefore, the expression changes in cancer-resistance genes may be biomarkers of hypoxia with value in targeted therapy. The aim of the present study was to examine the effect of hypoxia on gene expression and the changes that occur in relation to drug resistance in a human NSCLC cell line (A549). A549 cells were exposed to 72-h hypoxic episodes (<1% oxygen) for a total of 10 episodes (acute). The alterations in gene expression were examined using PCR array technology after 10 episodes of acute hypoxia and compared with normoxic cells. The chemoresistance of hypoxic cells toward doxorubicin was measured using a MTT cell proliferation assay. A549 cells were affected by acute hypoxia leading to induced doxorubicin chemoresistance. Evident changes in the gene expression level were identified following episodes of acute hypoxia. The most important changes occurred in the estrogen receptor 1 (ESR1) and Finkel-Biskis-Jinkins osteosarcoma (FOS) pathways and in different nucleic transcription factors such as aryl hydrocarbon receptor and cyclin-dependent kinase inhibitor. The present study showed that exposing cells to prolonged periods of hypoxia results in different gene expression changes. There was induction of chemo-resistance due to acute hypoxia. ESR1 and c-FOS are proposed as a potential hypoxia genes in lung cancer.

The risk and distribution of second primary cancers according to subsite of primary stomach cancer: a retrospective cohort population-based study

Background

The development of second primary cancers (SPCs) following a diagnosis of stomach cancer presents a significant clinical challenge, with varying risks depending on the anatomic subsite of the primary tumor, patient demographics, and treatment modalities. This study aims to assess the risk of SPCs in stomach cancer survivors, focusing on differences across anatomic subsites, sex, age, and treatment periods.

Methods

The authors conducted a retrospective cohort study using data from stomach cancer patients, analyzing the incidence of SPCs based on the anatomic location of the primary tumor, with stratifications by sex, age, latency period, and year of diagnosis. Standardized incidence ratios (SIRs) were calculated to compare the observed SPC rates with those expected in the general population.

Results

Elevated stomach SPC risk was observed across most anatomic subsites, particularly in the body (SIR 8.84) and fundus (SIR 7.34). Females exhibited higher SIRs compared to males, especially in the fundus (SIR 13.33 for females vs. 4.55 for males). Younger patients (<50 years) had significantly higher SPC risks, particularly for cancers originating in the fundus (SIR 49.56). Notably, patients diagnosed after 2010 showed the highest SIRs, indicating a potential impact of advances in diagnostic and therapeutic modalities. Nonstomach SPCs, including colorectal, lung, and thyroid cancers, were significantly elevated, with distinct patterns based on the primary tumor site.

Conclusions

The study highlights the critical role of primary tumor location, sex, age, and treatment era in determining SPC risk in stomach cancer survivors. These findings underscore the need for tailored surveillance strategies to manage long-term cancer risks in this population.