Evaluation of thromboembolic event, basic coagulation parameters, and associated factors in patients with colorectal cancer: a multicenter study

Comparison analysis of the burden and attributable risk factors of early-onset and late-onset colorectal cancer in China from 1990 to 2019

OBJECTIVES

The project intended to analyze the impact of burden and related risk factors of late-onset colorectal cancer (LOCRC) and early-onset colorectal cancer (EOCRC) in China, thus offering essential references for optimizing prevention and control strategies.

METHOD

Global Burden of Disease Study was employed to describe burden changes of EOCRC and LOCRC in China during 1990-2019, containing the numbers of incidence, deaths, prevalence, and disability-adjusted life years (DALYs), and to compare attributable deaths and DALYs risk factors in varying age and sex segments.

RESULTS

The numbers and corresponding crude rates of incidence, deaths, prevalence, and DALYs of EOCRC and LOCRC in China during 1990-2019 demonstrated an upward trend across all age categories, with males being dramatically predominant. Overall, over time, the impact of a low-calcium diet and a low-fiber diet on mortality and DALY rates decreased, while the impact of other risk factors increased. In terms of gender, the risk factors affecting males changed greatly, with smoking, inadequate milk intake, and the low whole-grain diet being the main factors in 2019, while in 1990, the main factors were the low-calcium diet, smoking, and inadequate milk intake.

CONCLUSION

The burden of colorectal cancer in China is concerning. Patients grouped by diagnostic age exhibit different characteristics, indicating the need for high-quality research in the future to achieve personalized medicine tailored to different population characteristics.

Magnitude of cancer-associated thrombosis in Africa: A systematic review and meta-analysis

Comprehensive data on the epidemiology of cancer-related thrombosis in Africa has been sparse until recently. Thus, this review was aimed to investigate the magnitude of cancer-related thrombosis in Africa. To obtain key articles, comprehensive search was conducted using various databases. A random-effects model was used to determine the pooled magnitude. Heterogeneity across the studies was checked, and publication bias was determined. The pooled magnitude of thrombosis among cancer patients in Africa is 11.65% (95% confidence interval [CI]: 9.02-14.28). Advanced age, comorbidity, and level of D-dimer were the factors associated with cancer-associated thrombosis. Cancer-related thrombosis has become a significant public health burden in Africa. About 3 out of 25 cancer patients are at increased risk of acquiring thrombosis. It is better to provide training and capacity-building programs for healthcare providers in Africa on the prevention, diagnosis, and management of cancer-related thrombosis and develop standardized evidence-based multidisciplinary approach care guidelines.

Preparation of a titanium-functionalized polymeric material rich in hydrophilic groups for phosphoproteome and glycoproteome analyses in serum

The analysis of protein phosphorylation and glycosylation is critical for investigating disease development. In this work, 1,2-epoxy-5-hexene and N,N-methylenebisacrylamide were polymerized with vinyl phosphate to produce a polymer (denoted as PVME), which contained a variety of hydrophilic groups. The material's hydrophilicity was further enhanced by a ring-opening reaction with cysteine (the product was denoted as Cys-PVEM). Finally, titanium sulfate was combined with Cys-PVME to form titanium-rich polymers (Cys-PVME-Ti4+) for the enrichment of phosphopeptides and glycopeptides. Cys-PVME-Ti4+ has a good sensitivity (0.02 fmol) and selectivity (1 : 1000) with a loading capacity of 62 mg g-1, recyclability (9 cycles), and a good recovery rate (101.6 ± 0.60%) for phosphopeptides, and good sensitivity (0.01 fmol μL-1), selectivity (1 : 2000), a loading capacity of 62.5 mg g-1, recyclability (9 cycles), and a good recovery rate (98.7 ± 1.2%) for glycopeptides. In addition, after enrichment with this material, 27 phosphopeptides with 14 phosphoproteins and 223 glycopeptides associated with 88 glycoproteins were captured from the serum of colorectal cancer patients, while 27 phosphopeptides associated with 14 phosphoproteins and 210 glycopeptides associated with 111 glycoproteins were also captured from the serum of a normal control. Gene ontology (GO) analysis revealed that complement activation, extracellular region, extracellular space, blood coagulation, the IgG immunoglobulin complex, and heparin binding were different between normal control and colorectal cancer, implying that related pathways are likely involved in colorectal cancer pathogenesis.

Venous thrombosis and obesity: from clinical needs to therapeutic challenges

Weight bias and stigma have limited the awareness of the systemic consequences related to obesity. As the narrative evolves, obesity is emerging as a driver and enhancer of many pathological conditions. Among these, the risk of venous thromboembolism (VTE) is a critical concern linked to obesity, ranking as the third most common cardiovascular condition. Obesity is recognized as a multifactorial risk factor for VTE, influenced by genetic, demographic, behavioral, and socio-economic conditions. Despite established links, the exact incidence of obesity related VTE in the general population remains largely unknown. The complexity of distinguishing between provoked and unprovoked VTE, coupled with gaps in obesity definition and assessment still complicates a tailored risk assessment of VTE risk. Obesity reactivity, hypercoagulability, and endothelial dysfunction are driven by the so-called 'adiposopathy'. This state of chronic inflammation and metabolic disturbance amplifies thrombin generation and alters endothelial function, promoting a pro-thrombotic environment. Additionally, the inflammation-induced clot formation-also referred to as 'immunothrombosis' further exacerbates VTE risk in people living with obesity. Furthermore, current evidence highlights significant gaps in the management of obesity related VTE, particularly concerning prophylaxis and treatment efficacy of anticoagulants in people living with obesity. This review underscores the need for tailored therapeutic approaches and well-designed clinical trials to address the unique challenges posed by obesity in VTE prevention and management. Advanced research and innovative strategies are imperative to improve outcomes and reduce the burden of VTE in people living with obesity.

Study of Coagulation Parameters in Gastrointestinal Malignancies

Introduction  Gastrointestinal (GI) malignancies represent a diverse group of cancers affecting various parts of the digestive system. These malignancies encompass an important burden of cancer incidence and mortality globally, contributing to substantial morbidity and mortality worldwide. Studying the coagulation parameters of patients having GI malignancies is crucial for several reasons. It allows to identify the patients at an increased risk of thrombotic complications, enabling clinicians to implement appropriate prophylactic measures, such as anticoagulant therapy or mechanical thromboprophylaxis. Aim  To study coagulation parameters in patients diagnosed with GI malignancies. Materials and methods The present study is a two-year prospective observational study, carried out in the Department of Pathology in our tertiary care institute from July 2022 to June 2024 to investigate the coagulation profile in patients diagnosed with GI malignancies. A total of 86 cases were studied. Results  A significant increase in the mean values of coagulation parameters was noted with an increase in the grade of malignancy. Conclusion  Early examination for the presence of coagulation abnormalities can help to prevent morbidity and mortality and other bleeding diathesis in GI malignancies as alterations in the coagulation pathway can lead to lethal complications.

The Potential of Integrative Cancer Treatment Using Melatonin and the Challenge of Heterogeneity in Population-Based Studies: A Case Report of Colon Cancer and a Literature Review

Melatonin is a multifunctional hormone regulator that maintains homeostasis through circadian rhythms, and desynchronization of these rhythms can lead to gastrointestinal disorders and increase the risk of cancer. Preliminary clinical studies have shown that exogenous melatonin alleviates the harmful effects of anticancer therapy and improves quality of life, but the results are still inconclusive due to the heterogeneity of the studies. A personalized approach to testing clinical parameters and response to integrative treatment with nontoxic and bioavailable melatonin in patient-centered N-of-1 studies deserves greater attention. This clinical case of colon cancer analyzes and discusses the tumor pathology, the adverse effects of chemotherapy, and the dynamics of markers of inflammation (NLR, LMR, and PLR ratios), tumors (CEA, CA 19-9, and PSA), and hemostasis (D-dimer and activated partial thromboplastin time). The patient took melatonin during and after chemotherapy, nutrients (zinc, selenium, vitamin D, green tea, and taxifolin), and aspirin after chemotherapy. The patient's PSA levels decreased during CT combined with melatonin (19 mg/day), and melatonin normalized inflammatory markers and alleviated symptoms of polyneuropathy but did not help with thrombocytopenia. The results are analyzed and discussed in the context of the literature on oncostatic and systemic effects, alleviating therapy-mediated adverse effects, association with survival, and N-of-1 studies.