Prognostic significance of VEGF and components of the plasminogen activator system in endometrial cancer

Nanotherapeutic Formulations for the Delivery of Cancer Antiangiogenics

Antiangiogenic medications for cancer treatment have generally failed in showing substantial benefits in terms of prolonging life on their own; their effects are noticeable only when combined with chemotherapy. Moreover, treatments based on prolonged antiangiogenics administration have demonstrated to be ineffective in stopping tumor progression. In this scenario, nanotherapeutics can address certain issues linked to existing antiangiogenic treatments. More specifically, they can provide the ability to target the tumor's blood vessels to enhance drug accumulation and manage release, ultimately decreasing undesired side effects. Additionally, they enable the administration of multiple angiogenesis inhibitors at the same time as chemotherapy. Key reports in this field include the design of polymeric nanoparticles, inorganic nanoparticles, vesicles, and hydrogels for loading antiangiogenic substances like endostatin and interleukin-12. Furthermore, nanoformulations have been proposed to efficiently control relevant pro-angiogenic pathways such as VEGF, Tie2/Angiopoietin-1, HIF-1α/HIF-2α, and TGF-β, providing powerful approaches to block tumor growth and metastasis. In this article, we outline a selection of nanoformulations for antiangiogenic treatments for cancer that have been developed in the past ten years.

Cervicovaginal lavages uncover growth factors as key biomarkers for early diagnosis and prognosis of endometrial cancer

Endometrial cancer (EC) rates are continuing to rise and it remains the most common gynecologic cancer in the US. Existing diagnostic methods are invasive and can cause pain and anxiety. Hence, there is a need for less invasive diagnostics for early EC detection. The study objective was to evaluate the utility of growth factors collected through minimally invasive cervicovaginal lavage (CVL) sampling as diagnostic and prognostic biomarkers for EC. CVL samples from 192 individuals undergoing hysterectomy for benign or malignant conditions were collected and used to quantify the concentrations of 19 growth and angiogenic factors using multiplex immunoassays. Patients were categorized based on disease groups: benign conditions (n = 108), endometrial hyperplasia (n = 18), and EC (n = 66). EC group was stratified into grade 1/2 endometrial endometrioid cancer (n = 53) and other EC subtypes (n = 13). Statistical associations were assessed using receiver operating characteristics, Spearman correlations and hierarchical clustering. Growth and angiogenic factors: angiopoietin-2, endoglin, fibroblast activation protein (FAP), melanoma inhibitory activity, and vascular endothelial growth factor-A (VEGF-A) were significantly (p < 0.0001) elevated in EC patients. A multivariate model combining 11 proteins with patient age and body mass index exhibited excellent discriminatory potential (area under curve = 0.918) for EC, with a specificity of 90.7% and a sensitivity of 87.8%. Moreover, angiopoietin-2, FAP and VEGF-A significantly (p < 0.05-0.001) associated with tumor grade, size, myometrial invasion, and mismatch repair status. Our results highlight the innovative use of growth and angiogenic factors collected through CVL sampling for the detecting endometrial cancer, showcasing not only their diagnostic potential but also their prognostic value.

Evaluation of lymphovascular space invasion in endometrial carcinoma by APTw and mDixon-Quant

BACKGROUND

Lymphovascular space invasion (LVSI) is a strong and independent risk factor that increases the probability of endometrial carcinoma (EC) recurrence and reduces the survival rate of patients.

PURPOSE

To investigate the value of amide proton transfer weighted (APTw) and mDixon-Quant techniques in evaluating EC lymphovascular space invasion (LVSI).

MATERIAL AND METHODS

Data of 50 EC patients (18 LVSI+ and 32 LVSI-) confirmed by surgery and pathology were retrospectively analyzed. Preoperative magnetic resonance imaging (MRI) scans included APTw and mDixon-Quant imaging. APT, transverse relaxation rate (R2*), and fat fraction (FF) plots were obtained by postprocessing. The APT, R2*, and FF values of the two groups of cases were measured by two observers.

RESULTS

The agreement between the two observers was good. The mean APT, R2*, and FF values of LVSI+ EC were 2.947% ± 0.399%, 20.605 /s (range = 18.525-27.953), and 2.234% ± 1.047%, respectively, while the parameters of LVSI- EC were 2.628% ± 0.307%, 18.968 /s (range = 16.225-20.544), and 2.103% ± 1.070%, respectively. The APT and R2* values of LVSI+ EC were higher than those of LVSI- EC (P < 0.05). There was no significant difference in FF value between the two groups. The AUC values of APT, R2*, and APT + R2* for LVSI were 0.751, 0.713, and 0.781, respectively (all P > 0.05). APT value was moderately correlated with R2* value (r = 0.528, P < 0.001) and weakly correlated with FF value (r = 0.312, P = 0.027).

CONCLUSION

APTw and mDixon-Quant techniques could evaluate the LVSI status of EC, and their combined application could improve diagnostic efficiency.

Evaluation of immunotherapy efficacy in gynecologic cancer

Various immunotherapies have demonstrated remarkable success over the past few decades, and have been approved for the treatment of different cancer types. However, patient responses to immunotherapy are variable, and approximately 50% of cases are refractory to these agents. Tumor biomarker-based stratification of cases may therefore help identify subpopulations that are sensitive/resistant to immunotherapy; it may also improve prediction of response in various cancers including gynecologic cancer. These biomarkers include the tumor mutational burden, microsatellite instability, mismatch repair deficiency, T cell-inflamed gene expression profile, programmed cell death protein 1 ligand 1, tumor-infiltrating lymphocytes, and numerous other genomic alterations. Future directions in the treatment of gynecologic cancer include the utilization of these biomarkers to select ideal candidates. This review focused on recent advances in the predictive ability of molecular biomarkers in patients with gynecologic cancer who undergo immunotherapy. The most recent developments in combined immunotherapy and targeted therapy strategies and novel immune interventions against gynecologic cancers have also been discussed.

Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer

We aimed to study the function and mechanism of endothelial cell-specific molecule 1 (ESM1) in endometrial cancer (EC). The binding relationship between SPI1 and ESM1 was predicted by bioinformatics analysis and verified by the dual-luciferase reporter assay. The expressions and effects of SPI1 and ESM1 were determined using quantitative real-time PCR, immunohistochemistry, Western blot, and functional experiments. ESM1 was highly expressed in EC and was associated with the poor prognosis of patients. ESM1 silencing suppressed the viability, proliferation, invasion, and angiogenesis of EC cells, down-regulated expressions of PCNA, N-cadherin, Vimentin, VEGFR-1, VEGFR2, and EGFR, but upregulated E-cadherin level, while ESM1 overexpression did oppositely. Moreover, SPI1 bound to ESM1. Overexpressed SPI1 promoted the expression of ESM1 and induced malignant phenotype (viability, proliferation, and invasion), which were countervailed by ESM1 silencing. Collectively, ESM1 induced by SPI1 promotes the malignant phenotype of EC.

Neural plasticity of the uterus: New targets for endometrial cancer?

Endometrial carcinoma is the most common gynecological malignancy in Western countries and is expected to increase in the following years because of the high index of obesity in the population. Recently, neural signaling has been recognized as part of the tumor microenvironment, playing an active role in tumor progression and invasion of different solid tumor types. The uterus stands out for the physiological plasticity of its peripheral nerves due to cyclic remodeling brought on by estrogen and progesterone hormones throughout the reproductive cycle. Therefore, a precise understanding of nerve-cancer crosstalk and the contribution of the organ-intrinsic neuroplasticity, mediated by estrogen and progesterone, of the uterine is urgently needed. The development of new and innovative medicines for patients with endometrial cancer would increase their quality of life and health. This review compiles information on the architecture and function of autonomous uterine neural innervations and the influence of hormone-dependent nerves in normal uterus and tumor progression. It also explores new therapeutic possibilities for endometrial cancer using these endocrine and neural advantages.

A highly sensitive electrochemical aptasensor for vascular endothelial growth factor detection based on toehold-mediated strand displacement reaction

An electrochemical aptasensor with high sensitivity, specificity, and good intra-day reproducibility is reported to meet the detection needs of vascular endothelial growth factor (VEGF). The toehold-mediated strand displacement recycling amplification and VEGF aptamer are integrated in the biosensor. The probe A is hybridized with the VEGF aptamer to form the probe A-aptamer complex. When VEGF is introduced, the aptamer specifically binds with VEGF, and probe A can be liberated. Then, the free probe A captures the toehold region of the Hp1, leading the exposure of the toehold region on the other end of Hp1. Similarly, Hp2 and Hp3 are also immobilized on the surface of the electrode; thus, the methylene blue labelled on Hp2 and Hp3 causes the current response. With the signal transduction mechanism, the expression level of VEGF can be detected quantitatively. With a series of optimizations of sensor parameters, high sensitivity and specificity of the VEGF detection sensor can be achieved with a detection limit as low as 10 pg mL^-1. This significant performance has good intra-day reproducibility, and it can be applied to human biological samples such as serum, urine, and saliva to detect the VEGF content.

Simultaneous Detection of VEGF and CEA by Time-Resolved Chemiluminescence Enzyme-Linked Aptamer Assay

BACKGROUND

As two important tumor markers, vascular endothelial growth factor (VEGF) and carcinoembryonic antigen (CEA) have a great value for clinical application in the early diagnosis of cancer. Due to the complex composition of biological samples, the results from combined detection of CEA and VEGF are often taken as a comprehensive indicator in order to make an accurate judgment on a disease. However, most of the current methods can only be used to detect the content of one biomarker. Therefore, it is necessary to explore a simple, rapid, low-cost, and highly sensitive method for the simultaneous detection of CEA and VEGF.

METHODS

Based on specific aptamers and magnetic separation, a time-resolved chemiluminescence enzyme-linked aptamer assay was developed for the simultaneous detections of CEA and VEGF in serum samples.

RESULTS

Under the optimal conditions, the linear range of the calibration curve for VEGF was from 0.5 to 80 ng mL-1, and the limit of detection was 0.1 ng mL-1. The linear range of the calibration curve for CEA was 0.5 to 160 ng mL-1, and the limit of detection was 0.1 ng mL-1. The established method was applied to detect VEGF and CEA in serum samples. The results were consistent with those of commercial kits.

CONCLUSION

The method has high sensitivity and can quickly obtain accurate results, which could greatly improve the measurement efficiency, reduce the cost, and also reduce the volume of sample consumed. It can be seen that the method established in this study has important application value and broad application prospect in clinical diagnosis.