ABO blood groups and risk of cancer: a systematic review and meta-analysis

Association of long non-coding RNAs and ABO blood groups with acute lymphoblastic leukemia in Egyptian children

Acute lymphoblastic leukemia (ALL) is the most prevailing cancer among children. Despite extensive studies, ALL etiology is still an unsolved puzzle. Long non-coding RNAs (lncRNAs) emerged as key mediators in cancer etiology. Several lncRNAs are dysregulated in ALL, leading to oncogenic or tumor-suppressive activities. Additionally, a relation between ABO blood groups and hematological malignancies was proposed. The current study intended to explore the association of lncRNAs, ANRIL and LINC-PINT, and their downstream targets, CDKN2A and heme oxygenase-1 (HMOX1), with the incidence of ALL and treatment response, and to determine the distribution of blood groups across different childhood ALL phenotypes. Blood samples were taken from 66 ALL patients (at diagnosis and at the end of remission induction phase) and 39 healthy children. Whole blood was used for blood group typing. Expression of ANRIL, LINC-PINT and CDKN2A was analyzed in plasma by qRT-PCR. Serum HMOX1 was measured using ELISA. ANRIL and CDKN2A were upregulated, while LINC-PINT and HMOX1 were downregulated in newly diagnosed patients. All of which showed remarkable diagnostic performance, where HMOX1 was superior. HMOX1 was independent predictor of ALL as well. LINC-PINT and HMOX1 were significantly upregulated after treatment. Notably, ANRIL and LINC-PINT were associated with poor outcome. No significant difference in the distribution of ABO blood groups was observed between patients and controls. In conclusion, our results suggested an association of ANRIL and LINC-PINT with childhood ALL predisposition, at least in part, through altering CDKN2A and HMOX1 production. Furthermore, the impact of remission induction treatment was newly revealed.

Association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19

BACKGROUND

Previous studies have reported that the susceptibility to coronavirus disease 2019 (COVID-19) is related to ABO blood group, but the relationship with Rh phenotype and MN blood group is unknown. China had adopted a strict control policy on COVID-19 until December 5, 2022, when local communities were liberalized. Therefore, we aimed to explore the correlation between ABO blood group, Rh phenotype, MN blood group and susceptibility to COVID-19 based on the time sequence of infection during the pandemic.

METHODS

A total of 870 patients who were routinely hospitalized in Ningbo Medical Center Lihuili Hospital from March 1, 2023 to March 31, 2023 were randomly selected to enroll in this study. Patients were divided into susceptible group and non-susceptible group, according to the time of their previous infection. The demographics and clinical information of the enrolled participants were collected from electronic medical records. The association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19 was analyzed.

RESULTS

A total of 650 cases (74.7%) had been infected with COVID-19, with 157 cases (18.0%) in the second week and 252 cases (29.0%) in the third week, reaching the peak of infection. Compared with the non-susceptible group, the susceptible group had no statistically significant differences in ABO blood group and Rh phenotype, but the proportion of N+ was higher (75.6% vs 68.9%, P = 0.030) and the proportion of MM was lower (24.4% vs 31.1%, P = 0.030). Consistent with this, ABO blood group and Rh phenotype were not significantly associated with susceptibility to COVID-19 (P>0.05), while N+ and MM were associated with susceptibility to COVID-19 (OR: 1.432, 95% confidence interval [CI]: 1.049, 1.954, P = 0.024; OR: 0.698, 95% CI: 0.512, 0.953, P = 0.024, respectively), after adjusting for age, sex, BMI, basic disease, and vaccination status in multivariate logistic regression analysis.

CONCLUSION

Our study showed that ABO blood group and Rh phenotype may not be related to the susceptibility to COVID-19, but MN blood group may be associated with the susceptibility to COVID-19.

The secretor status of blood group antigens in the saliva in people with oral cancers: a systematic review

BACKGROUND

Human ABO blood group type and the antigenic secretor status are hypothesized to associate with oral diseases including oral cancer. Secretor status is the ability of individuals to secrete blood group antigens into body fluids. This study aimed to evaluate the secretor status of ABO antigens of saliva in patients with oral cancers or oral potentially malignant disorders (OPMDs) relative to healthy adults.

METHODS

A systematic and comprehensive online search from inception to April 28, 2022, was carried out in MEDLINE, Embase, PsycInfo, and Emcare. The language was limited to English. Yielded records were screened by two independent reviewers at the title and abstract phase and at full-text screening. Studies investigating adults (≥ 18 years) with oral cancers or oral potentially malignant disorders compared to adults free of oral cancer were included in this study. Data were extracted according to the planned objectives. Methodological quality was assessed, and the findings were analyzed narratively. Meta-analyses were conducted to pool the odds of the non-secretor status of oral cancers and OPMDs compared to healthy adults.

RESULTS

The search included a total of 34 studies from three databases. Nine duplicates were removed. During the title and abstract screening, 11 irrelevant studies were excluded. Twelve studies were screened during the full-text screening, and eight articles were eligible to be included in the final analysis. A pooled odds ratio (OR) of 3.80 (95%CI, 1.53-9.44) was estimated when pooled 1254 oral cancers and oral potentially malignant disorders patients compared to 666 healthy adults.

DISCUSSION AND CONCLUSION

The odds of being a non-secretor appear to be approximately 3.8 times higher in patients with oral cancers and oral potentially malignant disorders compared to healthy adults. The lack of ABO blood group antigens in body fluids of non-secretors is more exposed to exogenous antigens than secretors. The host-parasite interactions of secretors and non-secretors underlying oral cancer and other diseases may be evidence to support or refuse them. Clinicians may use the secretor status as a detection test during their regular oral check-ups for high-risk populations for oral cancers. Non-secretors can be given more attention considering them as high-risk groups, and in terms of prognosis, differences between these two groups may be expected.

Evaluation of ABO/Rh blood group distributions in papillary thyroid cancer patients

The study aimed to evaluate the ABO/Rh blood group distributions and their relationship with clinical-pathological features in papillary thyroid cancer patients. It was planned as a retrospective case-controlled study. The blood group distributions of the patients were contrasted with that of the general population. Additionally, the association between clinical-pathological variables and blood group distribution was assessed. Two hundred and ninety-three patients were involved in the study. The median age was 48 years, and the majority of patients were female (84.3%). The most common variants of papillary thyroid cancer were follicular, classical, and oncocytic. The majority of the patients had stage 1 (91.1%) disease at the time of diagnosis. ABO blood group distributions in the patient (47.4% A, 11.9% B, 8.2% AB, 32.4% O) and control (42% A, 16% B, 8% AB, 34% O) groups were found to be similar ( P = .8). In terms of Rh factor, there was a comparable distribution for the characteristics of the patient and healthy control group ( P = .6). There was no association between clinical and pathological variables and blood group distributions (gender, age, tumor stage, tumor location, and pathological tumor variant). Comparing patients with papillary thyroid carcinoma to the healthy control group, the prevalence of the A blood group numerically increased while the prevalence of the B blood group numerically decreased, but it was not statistically significant. In addition, ABO/Rh blood type and clinical and pathological variables did not relate.

Recent advances in the identification of related factors and preventive strategies of hip fracture

Hip fracture is the most devastating type of osteoporosis-related fracture, and is a major worldwide public health problem with a high socioeconomic burden, morbidity rate, and mortality rate. Thus, it is crucial to uncover the risk factors and protective factors to create a hip fracture prevention strategy. In addition to a briefly review of some well accepted risk and protective factors of hip fracture, this review mainly summarized the recent advances in the identification of emerging risk or protective factors for hip fracture, in terms of regional differences in medical services, diseases, drugs, mechanical load, neuromuscular mass, genes, blood types, cultural differences. This review provides a comprehensive review of the associated factors and effective prevention measures for hip fracture, and discusses issues that need further investigation. These issues include the determination of the influencing mechanism of risk factors triggering hip fracture and their interlinked correlation with other factors, as well as the confirmation or correction of emerging factors associated with hip fracture, particularly those that are still controversial. These recent findings will aid in optimizing the strategy for preventing hip fracture.

Blood Type and Outcomes in Pregnant Women with Placenta Previa

Background

Placenta previa increases the risks of obstetrical complications. Many studies have reported a link between various ABO blood types and pregnancy complications. This study is aimed at describing and comparing the characteristics and outcomes of women with placenta previa by ABO blood type.

Methods

Data for this study was obtained from a retrospective cohort study between January 1, 2014, and June 30, 2019, of all clinically confirmed placenta previa in a university-based tertiary medical center. Both types of A, B, O, AB, and combining O and non-O blood types were compared to the characteristics and outcomes.

Results

1678 participants with placenta previa were included in this study. The highest participants were blood type O with 666 (39.7%), followed by type A with 508 (30.3%) and type B with 395 (23.5%), and the lowest participants were AB with 109 (6.5%). Blood type AB had a higher incidence of antepartum hemorrhage (p = 0.017), predelivery anemia (p = 0.036), and preterm birth (p = 0.015) in placenta previa women. Meanwhile, the incidence of rhesus D positive (97.9% vs. 95.8%, p = 0.012) and twins (5.0% vs. 2.7%, p = 0.011) was higher in the non-O group, and the incidence of neonatal asphyxia (5.9% vs. 9.2%, p = 0.016) was lower in the non-O group.

Conclusion

Type AB blood may be a potential risk factor for women with placenta previa. This finding may help provide any obstetrician to predict the risk of complication for placenta previa women by the ABO blood types.

Association of ABO blood groups with ovarian reserve: a retrospective cohort study in Chinese Han women younger than 40 years with infertility

BACKGROUND

Ovarian reserve reflects both the quantity and quality of oocytes available for procreation and is affected by many known and unknown factors. ABO blood type is related to several infertility processes, but it is unclear whether and how ABO blood type affects ovarian reserve.

OBJECTIVE

The purpose of the study was to explore the correlation between ABO blood types and ovarian reserve in infertile Chinese Han women under 40 years of age undergoing the in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI)-embryo transfer (IVF/ICSI-ET) treatment.

METHODS

Women aged < 40 years who underwent IVF/ICSI-ET at our institution and had a documented ABO blood type were eligible for this study. In this study, patients were divided into two groups according to the diminished ovarian reserve (DOR) group (AMH < 1.1 ng/mL, AFC < 6) and the non-diminished ovarian reserve (non-DOR) group (AMH ≥ 1.1 ng/mL, AFC ≥ 6). The relationship between ovarian reserve and ABO blood group was determined by correlation analysis.

RESULTS

In this retrospective cohort study, clinical data were collected from 1690 Chinese Han women treated with IVF/ ICSI-ET in hospital records between April 2019 and March 2020 in the affiliated hospital of Southwest Medical University, located in Luzhou, China. The differences in age, duration of infertility, BMI, FSH, FSH / LH, and p (DOR vs non-DOR) for each parameter (DOR vs non-DOR) were statistically significant, and the differences in LH and E2 were not statistically significant. ABO blood groups were most prevalent in the DOR group with O (143, 34.8%) and A (122, 29.7%) and in the non-DOR group with A (428, 33.5%) and O (419, 32.8%). ABO blood groups were most prevalent in the DOR group with O (n = 57, 30.5%) and A (n = 54, 28.9%) and in the non-DOR group with A (n = 335, 34.0%) and O (n = 323, 32.8%) were the most frequent in the non-DOR group.

CONCLUSIONS

In this retrospective cohort study, we confirmed the lack of a significant association between ABO blood type and ovarian reserve. Further studies are needed to clarify whether there is any prognostic correlation between ABO blood group and ovarian reserve in women undergoing IVF/ICSI-ET.

ABO blood groups and expression of blood group antigens of epithelial ovarian cancer in Chinese women

BACKGROUND

ABO blood groups has been associated with risk of several cancers; however, the results for an association with ovarian cancer are inconsistent and little is known about the expression of histo-blood group (ABH) antigens and ABO gene in ovarian tumor tissues.

METHODS

To assess the impact of genotype-derived ABO blood types on the risk of EOC, we conducted a case-control study in 1,870 EOC and 4,829 controls. Expression of A and B antigen in 70 pairs of ovarian tumor tissues and adjacent normal tissues were detected by immunohistochemistry. Gene expression and DNA methylation profiling was conducted in ovarian tumor tissues.

RESULTS

We identified that blood group A was associated with increased risk for EOC compared to blood group O (OR = 1.18, 95% CI = 1.03-1.36, p = 0.019). Increased frequency of aberrant expression of histo-blood group antigens was observed in patients with blood group A (76.5%) compared to patients with blood group O (21.1%) and B (5.0%) by immunohistochemistry (p < 0.001). ABO gene expression was down-regulated in ovarian tumor tissues compared with paired adjacent normal tissues (p = 0.027). In addition, ABO gene expression was positively correlated with NFYB (r = 0.38, p < 0.001) and inversely correlated with DNA methylation level of four CpG sites on ABO gene (cg11879188, r = - 0.3, p = 0.002; cg22535403, r = - 0.30, p = 0.002; cg13506600, r = - 0.22, p = 0.025; cg07241568, r = - 0.21, p = 0.049) in ovarian tumor tissues.

CONCLUSION

We identified blood group A was associated with increased EOC risk in Chinese women and provided the clues of the possible molecular mechanisms of blood group A related to ovarian cancer risk.

The frequency and prognostic significance of ABO/Rh blood groups in male breast cancer patients: A multicenter study

The study evaluated the distributions and prognostic significance of ABO and rhesus (D) groups in male breast cancer (MBC) patients. The data of 137 patients were retrospectively reviewed. Clinical, histopathological data and ABO/Rh blood groups of the patients were recorded. The ABO/Rh blood group distributions were compared to the healthy men control group (n = 120,160) by the chi-square test. Overall distributions of ABO blood groups were different between the patients (17.5% AB, 38% A, 19% B, and 25.5% O) and control group (7.88% AB, 42.06% A, 15.22% B, and 34.84% O) (P < .001). There were significant differences between the patients and control group with respect to AB vs non-AB blood group distributions (P < .001, odds ratio: 2.43, 95% CI) and O vs non-O blood group distributions (P = .016, odds ratio: 0.62, 95% CI). However, A vs non-A and B vs non-B blood group distributions were not significantly different. The distribution of the Rh factor was similar between patients and the control group (P = .93). In univariate analysis, ABO/Rh blood groups were not a prognostic factor on OS (P = .29). The frequency of the AB blood group in MBC patients is increased than in the healthy control group. AB blood group may be a risk factor for MBC, whereas O blood group may be a protective factor.

Association of ABO Blood Group Antigen and Neurological Tumors

Background Various risk factors for tumors such as smoking, alcohol consumption, diet, and radiation, etc., were already identified. ABO blood group antigens are also present on epithelia, endothelia, and neurons. Recent evidence suggested the role of ABO antigens in the pathogenesis of certain malignancies.

Materials and Methods A retrospective observational study was conducted in a tertiary care neurosurgical center in North India from January 2016 to December 2018. The hospital information system was used to obtain patient information while the blood center information system was used to collect blood group information. Brain tumors were majorly divided into cavernoma, glioma, meningioma, neuroma, pituitary adenoma, schwannoma, and others.

Results We found a total of 1,970 patients with brain tumors admitted during our study period. Most patients had glioma (33.55%), followed by pituitary adenoma (20.05%) and neuroma (2.23%). B blood group individuals had more prevalence of cavernoma, glioma, meningioma, pituitary adenoma, schwannoma, and others followed by O, A, and AB. Only association of O blood group with neuroma tumor was found statistically significant.

Conclusions Our patient population had blood group distribution similar to our general population and no significant association was observed by blood group antigens and brain tumors. Although neuroma was significantly associated with blood group O but the prevalence of neuroma in our patient population is very low hence large sample study is required to draw a firm conclusion regarding this association.

Association of ABO blood group with respiratory disease hospitalization and severe outcomes: a retrospective cohort study in blood donors

OBJECTIVES

Environmental, socioeconomic, and genetic factors all are associated with respiratory diseases. We aimed to investigate the association between the ABO blood group and the susceptibility to respiratory diseases.

METHODS

We constructed a retrospective cohort study of blood donors in Shaanxi, China between January 1, 2012, and December 31, 2018, to investigate the impacts of the ABO blood group on the risk of hospitalization due to respiratory diseases.

RESULTS

Of 1,686,263 enrolled participants (680,788 females), 26,597 were admitted to the hospital for respiratory diseases. Compared with blood group O, blood groups A, B, and AB all demonstrated a higher risk for diseases of the upper respiratory tract (International Classification of Diseases, Tenth Revision: J30-J39) (ARR (Adjusted relative risk) 1.139, 95% confidence interval [1.106-1.225]; 1.095 [1.019-1.177]; 1.178 [1.067-1.30], respectively). Conversely, blood group A was found to have a lower risk (0.86 [0.747-0.991]) for influenza (J09-J11) and blood group B had a lower risk for pneumonia (J12-J18) (0.911 [0.851-0.976]) than blood group O. The duration of hospitalization was significantly different across the blood groups in J09-J11 and J30-J39 (P <0.05).

CONCLUSION

The blood group appears to be a prognostic factor in differentiating the occurrence of specific respiratory diseases and duration.

ABO blood group and skin cancers

Beside the role of ABO group in immunohaematology, there is accumulating evidence that the ABO blood group also plays a key role in various human disorders. The interest in blood groups and their association with disease stems from the awareness that blood group antigens are incredibly important components in the process of cell maturation and control. Studies have indicated a link between cancer and the ABO blood group. The appearance or disappearance of blood type antigens is now considered a hallmark of malignancy in many common cancers. Several tumour markers are in fact known blood group antigens. The aim of this review is to describe the history and possible functions of the ABO group and then summarize the association between blood groups and skin cancers.

AB Blood Group Confers Higher Risk for Primary Brain Tumors in Pediatrics

Purpose

Our current study investigates the relationship between ABO blood groups and brain tumor incidence in the Jordanian pediatric population in a case-controlled manner.

Patients and Methods

This case-control study targeted pediatric primary brain tumor patients and tumor-free controls. Cases included patients younger than 18 when given a histologically confirmed diagnosis with a primary brain tumor, ascertained from two tertiary hospitals in Jordan. Controls were age- and gender-matched to cases and acquired from JUH pediatric clinics, with an exclusion for all patients with a personal history of tumors. Through using available records and calling guardians, our team obtained patients’ and controls’ blood groups.

Results

Our case control included 81 (35.4%) pediatric primary brain tumor patients and age- and gender-matched tumor-free controls 148 (64.6%). When compared to O blood group, patients with A and B blood groups were not at higher risk of developing pediatric primary brain tumors (P=0.742, P=1.000, respectively). However, Chi-square analysis revealed a 2.79-fold higher risk for pediatric primary brain tumors in AB blood group patients (P=0.024). Gender-specific analysis revealed a 3.42-fold higher risk for pediatric brain tumors in AB blood group males when compared to O blood group males.

Conclusion

This work represents the first published study on the association between blood groups and pediatric brain tumors. With future research with larger samples and control of confounding factors, AB blood group may become a more established risk factor for pediatric brain tumors, aiding in screening.

ABO Blood Group and the Risk of Esophageal Squamous Cell Carcinoma in Kashmir, a High Risk Region

BACKGROUND

ABO blood group has been linked with a number of diseases including cancer. Association of ABO blood type with esophageal squamous cell carcinoma (ESCC) has been sparsely reported and the results are inconsistent. We undertook this study to analyze if any association exists between the ABO and Rh blood groups and ESCC risk.

METHODS

We conducted a hospital-based case control study to analyze ABO and Rh blood groups in patients with histologically proven diagnosis of ESCC and compared them with healthy donors from the same population. ABO and Rh blood group status of general population was obtained from the blood bank at Sher-i-Kashmir Institute of Medical Sciences (SKIMS) and from original articles published from time to time. Chi-Square test was performed to look for statistical significance.

RESULTS

For this study, 206 patients were prospectively enrolled. Seventy-four (35.9%) patients had blood group O. Blood groups type A and type B was found each in 59 (28.6%) patients. In 108,014 healthy donors, 35.3% had blood type O followed by type B (33.66%). There was no significant difference in any of the blood types between patients with ESCC and donors (P = 0.31).

CONCLUSION

No association exists between ABO blood type and the risk of ESCC.

Impact of ABO Blood Group on the Development of Venous Thromboembolism in Children With Cancer: A Systematic Review and Meta-Analysis

BACKGROUND

Few studies have evaluated the impact of ABO blood group on the risk of venous thromboembolism (VTE) in pediatric populations. We performed a systematic review to determine whether children (0 to 18 y old) with non-O blood group have an increased risk of developing VTE compared with those with O blood group.

METHODS

We searched Ovid Medline, Embase, PubMed, Cochrane, Web of Science, and CINAHL online databases from inception to December 2018 to find studies involving blood grouping and VTE. Data was collected regarding patients' underlying diseases, sex, age, ABO blood group, and VTE frequency. A meta-analysis using the random effect model was performed, and heterogeneity was assessed with the I2 value.

RESULTS

Among 1280 unique articles identified, 7 studies (3 conference abstracts, 4 peer-reviewed journal articles) involving 609 VTE cases were included in the systematic review. Six studies were eligible for a meta-analysis; all involved patients with cancer. Blood group O was protective against VTE (odds ratio, 0.56; 95% confidence interval, 0.43-0.79). Findings were similar across sensitivity analyses.

CONCLUSIONS

This systematic review has documented that O blood group is protective against new-onset VTE in children with cancer. Larger studies across different ethnic backgrounds and disease categories are needed to confirm these findings.

Pancreatic adenocarcinoma: A review of recent paradigms and advances in epidemiology, clinical diagnosis and management

Pancreatic cancer is one of the dreaded malignancies for both the patient and the clinician. The five-year survival rate of pancreatic adenocarcinoma (PDA) is as low as 2% despite multimodality treatment even in the best hands. As per the Global Cancer Observatory of the International Agency for Research in Cancer estimates of pancreatic cancer, by 2040, a 61.7% increase is expected in the total number of cases globally. With the widespread availability of next-generation sequencing, the entire genome of the tumors is being sequenced regularly, providing insight into their pathogenesis. As invasive PDA arises from pancreatic intraepithelial neoplasia and mucinous neoplasm and intraductal papillary neoplasm, screening for them can be beneficial as the disease is curable with resection at an early stage. Routine preoperative biliary drainage has no role in patients suffering from PDA with obstructive jaundice. If performed, metallic stents are preferred over plastic ones. Minimally invasive procedures are preferred to open procedures as they have less morbidity. The duct-to-mucosa technique for pancreaticojejunostomy is presently widely practiced. The role of intraperitoneal drains after surgery for PDA is controversial. Neoadjuvant chemoradiotherapy has been proven to have a significant role both in locally advanced as well as in resectable PDA. Many new regimens and drugs have been added in the arsenal of chemoradiotherapy for metastatic disease. The roles of immunotherapy and gene therapy in PDA are being investigated. This review article is intended to improve the understanding of the readers with respect to the latest updates of PDA, which may help to trigger new research ideas and make better management decisions.

Genetic architecture of 11 organ traits derived from abdominal MRI using deep learning

Cardiometabolic diseases are an increasing global health burden. While socioeconomic, environmental, behavioural, and genetic risk factors have been identified, a better understanding of the underlying mechanisms is required to develop more effective interventions. Magnetic resonance imaging (MRI) has been used to assess organ health, but biobank-scale studies are still in their infancy. Using over 38,000 abdominal MRI scans in the UK Biobank, we used deep learning to quantify volume, fat, and iron in seven organs and tissues, and demonstrate that imaging-derived phenotypes reflect health status. We show that these traits have a substantial heritable component (8-44%) and identify 93 independent genome-wide significant associations, including four associations with liver traits that have not previously been reported. Our work demonstrates the tractability of deep learning to systematically quantify health parameters from high-throughput MRI across a range of organs and tissues, and use the largest-ever study of its kind to generate new insights into the genetic architecture of these traits.

Effect of intraoperative blood transfusion on Treg and FOXP3 in patients with digestive tract malignancies and different ABO blood types

Background

Blood transfusion can cause immunosuppression and lead to worse outcomes in patients with digestive tract malignancies; however, the specific mechanism behind this is not completely understood. One theory is that increased numbers of regulatory CD3⁺CD4⁺CD25⁺FOXP3⁺ T cells (Tregs) and forkhead box protein-3 mRNA (FOXP3) expression in the blood after transfusion contribute to these outcomes. The effect of blood transfusion on immune function in patients with different ABO blood types is variable. This study investigates the effect of intraoperative blood transfusion on the number of Tregs and the expression of FOXP3 in the blood of patients with different ABO blood types and digestive tract malignancies.

Methods

Patients with digestive tract malignancies who underwent radical resection and received intraoperative blood transfusion were divided into four groups according to their blood types:blood group A, blood group B, blood group O and blood group AB (n = 20 for each group). Blood was collected from all patients before surgery, immediately after transfusion, 1 day after transfusion, and 5 days after transfusion. The number of Tregs was measured by flow cytometry. The expression of FOXP3 was detected by real time reverse transcription polymerase chain reaction (RT-PCR).

Results

There was no significant difference in the number of Tregs or expression of FOXP3 mRNA among patients with different blood types before surgery. However, the number of Tregs and the expression of FOXP3 increased after blood transfusion in all blood type groups. This increase was especially evident and statistically significant on the first day after blood transfusion when compared with measures obtained before the surgery. Measures returned to the preoperative level five days after surgery. There were significant differences in the increase of Tregs and expression of FOXP3 among patients with different blood types. The greatest increase was seen in patients with blood group B and the least in blood group A.

Conclusions

Intraoperative blood transfusion can lead to an increase in blood Tregs and FOXP3 expression in patients with digestive tract malignancies. Increases were greatest on the first day after surgery and differed among patients with different blood types. Increases were greatest in blood type B and least in blood type A.

O-positive blood type is associated with prolonged recurrence-free survival following curative resection of pancreatic neuroendocrine tumors

BACKGROUND

The ABO blood group may influence the development and progression of cancer. In particular, the prognosis of patients with blood type O is better for pancreatic adenocarcinoma, although this has not been extensively explored in pancreatic neuroendocrine tumors (PanNET).

OBJECTIVE

To assess the influence of the ABO and Rhesus blood types on the risk of recurrence in patients who underwent curative intent PanNET surgical resection.

METHODS

All consecutive patients operated on for well-differentiated panNET in an expert center from 2003 to 2018 were retrospectively included. Blood group, Rhesus system, demographic and clinical data were collected. The primary endpoint was recurrence free survival (RFS). Factors associated with RFS were explored using Cox proportional hazard models.

RESULTS

Overall, 300 patients (male 43%) were included, median age 54 years old (IQR 45-64). The ABO blood group distribution was similar to that of the French population. There was no association between blood group and tumor features. The median postoperative follow-up was 43.9 months (17.0-77.8). The 5- and 10-year RFS rates were 85 ± 4% and 71 ± 13% in O RhD + patients, versus 72 ± 4% and 63 ± 6% otherwise, respectively (p = 0.035). The O RhD + blood group was associated with a decreased risk of recurrence (HR 0.34, 95% CI [0.15-0.75]), p = 0.007 in multivariable analysis adjusted for age, ki67, functioning syndrome, resection margins, tumor size, lymph node status, oncogenetic syndrome.

CONCLUSIONS

After curative-intent surgical resection for PanNET, patients with a non-O RhD + blood group may have an increased risk of recurrence and could benefit from closer follow-up.

A phenome-wide association study of ABO blood groups

BACKGROUND

ABO blood group is associated with differences in lifespan, cardiovascular disease, and some cancers, for reasons which are incompletely understood. To gain sex-specific additional insight about potential mechanisms driving these common conditions for future interventions, we characterized associations of ABO blood group antigen across the phenotype sex-specifically.

METHODS

We performed a phenome-wide association study (PheWAS) assessing the association of tag single nucleotide polymorphisms (SNPs) for ABO blood group antigens (O, B, A1, and A2) with 3873 phenotypes.

RESULTS

The tag SNP for the O antigen was inversely associated with diseases of the circulatory system (particularly deep vein thrombosis (DVT)), total cholesterol, low-density lipoprotein cholesterol (LDL-C), and ovarian cancer, and positively associated with erythrocyte traits, leukocyte counts, diastolic blood pressure (DBP), and healthy body composition; the tag SNP for the A1 antigen tended to have associations in reverse to O. Stronger associations were more apparent for men than women for DVT, DBP, leukocyte traits, and some body composition traits, whereas larger effect sizes were found for women than men for some erythrocyte and lipid traits.

CONCLUSION

Blood group has a complex association with cardiovascular diseases and its major risk factors, including blood pressure and lipids, as well as with blood cell traits and body composition, with some differences by sex. Lower LDL-C may underlie some of the benefits of blood group O, but the complexity of associations with blood group antigen suggests overlooked drivers of common chronic diseases.

Risk factors for gemcitabine plus nab-paclitaxel-induced interstitial lung disease in pancreatic cancer patients

BACKGROUND

Drug-induced interstitial lung disease (ILD) is one of the most serious adverse events with a high mortality rate and represents a serious clinical problem. However, gemcitabine plus nab-paclitaxel (GnP)-induced ILD in pancreatic cancer (PC) patients has not been thoroughly investigated. Therefore, we conducted this study to examine the clinical characteristics of GnP-induced ILD and identify risk factors for developing ILD.

METHODS

We retrospectively investigated consecutive patients with PC who received GnP between January 2015 and April 2020. We compared the clinical characteristics and overall survival (OS) according to ILD occurrence and explored risk factors including ABO blood type for developing ILD.

RESULTS

Of the 910 patients included in this study, ILD occurred in 20 patients (2.2%). PC patients who developed ILD had a significantly higher frequency of blood type B compared to those without ILD (42% vs. 22%, p ˂ 0.05). Other baseline characteristics including smoking history and current/previous lung disease were not different between the two groups. Median time from initiation of GnP to onset of ILD was 80 days. All patients recovered from ILD and OS was not significantly different according to ILD occurrence. Multivariate analysis revealed that blood type B was an independent risk factor for developing ILD.

CONCLUSIONS

We demonstrated that GnP-induced ILD occurred in 2.2% of PC patients with no mortality and OS did not differ according to ILD occurrence. Furthermore, we clarified that ABO blood type B was an independent risk factor for developing ILD in PC patients receiving GnP.

Association of ABO and Rh Blood Group Phenotypes with Type 2 Diabetes Mellitus at Felege Hiwot Comprehensive Referral Hospital Bahir Dar, Northwest Ethiopia

BACKGROUND

ABO and Rh blood group antigens are thought to be among genetic determinants of type 2 diabetes mellitus. Identification of blood group phenotypes are more associated with type 2 diabetes mellitus. It will be helpful for individuals who are susceptible blood groups to take care of themselves by avoiding other predisposing factors and taking preventive measures.

METHODS

Hospital-based comparative cross-sectional study was carried out from February to April 2019 at Felege Hiwot Comprehensive Referral Hospital. Sociodemographic and clinical data were collected with a semistructured pretested questionnaire. ABO and Rh Blood group were determined by slide and test tube methods. Biochemical parameters were determined with Mindray BS-200E fully automated clinical chemistry analyzer. Data were analyzed by IBM SPSS version 20 statistical software. Chi-square test and logistic regression analysis were employed for data analysis. A P value of < 0.05 was considered statistically significant.

RESULTS

From a total of 424 participants included for this study, blood group O was found higher in frequency with 74 (34.9%) and 97 (45.75%) for cases and healthy controls, respectively. ABO blood groups showed significant association with T2DM, a chi-square value of 12.163 and P value of 0.007. However, the Rh blood group was not associated with T2DM. Binary logistic regression analysis revealed that blood group B had a higher risk (OR: 2.12, 95% CI: 1.33-3.32) and blood group O had decreased risk (OR: 0.636, 95% CI: 0.43-0.94) of T2DM as compared to other blood groups.

CONCLUSION

ABO blood group antigens showed significant association with type 2 diabetes mellitus. Blood group B was associated with an increased risk and O blood group with decreased risk of type 2 diabetes mellitus.

A Medical Decision Support System to Assess Risk Factors for Gastric Cancer Based on Fuzzy Cognitive Map

Gastric cancer (GC), one of the most common cancers around the world, is a multifactorial disease and there are many risk factors for this disease. Assessing the risk of GC is essential for choosing an appropriate healthcare strategy. There have been very few studies conducted on the development of risk assessment systems for GC. This study is aimed at providing a medical decision support system based on soft computing using fuzzy cognitive maps (FCMs) which will help healthcare professionals to decide on an appropriate individual healthcare strategy based on the risk level of the disease. FCMs are considered as one of the strongest artificial intelligence techniques for complex system modeling. In this system, an FCM based on Nonlinear Hebbian Learning (NHL) algorithm is used. The data used in this study are collected from the medical records of 560 patients referring to Imam Reza Hospital in Tabriz City. 27 effective features in gastric cancer were selected using the opinions of three experts. The prediction accuracy of the proposed method is 95.83%. The results show that the proposed method is more accurate than other decision-making algorithms, such as decision trees, Naïve Bayes, and ANN. From the perspective of healthcare professionals, the proposed medical decision support system is simple, comprehensive, and more effective than previous models for assessing the risk of GC and can help them to predict the risk factors for GC in the clinical setting.

Causal associations of thyroid function and dysfunction with overall, breast and thyroid cancer: A two-sample Mendelian randomization study

Whether thyroid dysfunction plays a causal role in the development of cancer remains inconclusive. We conducted a two-sample Mendelian randomization study to investigate the associations between genetic predisposition to thyroid dysfunction and 22 site-specific cancers. Single-nucleotide polymorphisms associated with four traits of thyroid function were selected from a genome-wide association meta-analysis with up to 72,167 European-descent individuals. Summary-level data for breast cancer and 21 other cancers were extracted from the Breast Cancer Association Consortium (122,977 breast cancer cases and 105,974 controls) and UK Biobank (367,643 individuals). For breast cancer, a meta-analysis was performed using data from both sources. Genetically predicted thyroid dysfunction was associated with breast cancer, with similar patterns of associations in the Breast Cancer Association Consortium and UK Biobank. The combined odds ratios of breast cancer were 0.94 (0.91-0.98; p = 0.007) per genetically predicted one standard deviation increase in TSH levels, 0.96 (0.91-1.00; p = 0.053) for genetic predisposition to hypothyroidism, 1.04 (1.01-1.07; p = 0.005) for genetic predisposition to hyperthyroidism and 1.07 (1.02-1.12; p = 0.003) per genetically predicted one standard deviation increase in free thyroxine levels. Genetically predicted TSH levels and hypothyroidism were inversely with thyroid cancer; the odds ratios were 0.47 (0.30-0.73; p = 0.001) and 0.70 (0.51-0.98; p = 0.038), respectively. Our study provides evidence of a causal association between thyroid dysfunction and breast cancer (mainly ER-positive tumors) risk. The role of TSH and hypothyroidism for thyroid cancer and the associations between thyroid dysfunction and other cancers need further exploration.

The relationship between circulating lipids and breast cancer risk: A Mendelian randomization study

BACKGROUND

A number of epidemiological and genetic studies have attempted to determine whether levels of circulating lipids are associated with risks of various cancers, including breast cancer (BC). However, it remains unclear whether a causal relationship exists between lipids and BC. If alteration of lipid levels also reduced risk of BC, this could present a target for disease prevention. This study aimed to assess a potential causal relationship between genetic variants associated with plasma lipid traits (high-density lipoprotein, HDL; low-density lipoprotein, LDL; triglycerides, TGs) with risk for BC using Mendelian randomization (MR).

METHODS AND FINDINGS

Data from genome-wide association studies in up to 215,551 participants from the Million Veteran Program (MVP) were used to construct genetic instruments for plasma lipid traits. The effect of these instruments on BC risk was evaluated using genetic data from the BCAC (Breast Cancer Association Consortium) based on 122,977 BC cases and 105,974 controls. Using MR, we observed that a 1-standard-deviation genetically determined increase in HDL levels is associated with an increased risk for all BCs (HDL: OR [odds ratio] = 1.08, 95% confidence interval [CI] = 1.04-1.13, P < 0.001). Multivariable MR analysis, which adjusted for the effects of LDL, TGs, body mass index (BMI), and age at menarche, corroborated this observation for HDL (OR = 1.06, 95% CI = 1.03-1.10, P = 4.9 × 10-4) and also found a relationship between LDL and BC risk (OR = 1.03, 95% CI = 1.01-1.07, P = 0.02). We did not observe a difference in these relationships when stratified by breast tumor estrogen receptor (ER) status. We repeated this analysis using genetic variants independent of the leading association at core HDL pathway genes and found that these variants were also associated with risk for BCs (OR = 1.11, 95% CI = 1.06-1.16, P = 1.5 × 10-6), including locus-specific associations at ABCA1 (ATP Binding Cassette Subfamily A Member 1), APOE-APOC1-APOC4-APOC2 (Apolipoproteins E, C1, C4, and C2), and CETP (Cholesteryl Ester Transfer Protein). In addition, we found evidence that genetic variation at the ABO locus is associated with both lipid levels and BC. Through multiple statistical approaches, we minimized and tested for the confounding effects of pleiotropy and population stratification on our analysis; however, the possible existence of residual pleiotropy and stratification remains a limitation of this study.

CONCLUSIONS

We observed that genetically elevated plasma HDL and LDL levels appear to be associated with increased BC risk. Future studies are required to understand the mechanism underlying this putative causal relationship, with the goal of developing potential therapeutic strategies aimed at altering the cholesterol-mediated effect on BC risk.

Relationship between ABO blood groups and preeclampsia

OBJECTIVE

To investigate the relationship between ABO blood group and preeclampsia.Methods: A case-control study was conducted, including 230 and 460 women with and without preeclampsia. ABO blood groups were compared and associated factors for preeclampsia were determined.Results: Blood group O was significantly more common in early-onset and less common in late-onset preeclampsia. Regression analysis showed that blood group O decreased the risk of late-onset preeclampsia (aOR 0.63, 95%CI 0.42-0.93) but increased the risk of early-onset preeclampsia (aOR 1.97 95%CI 1.05-3.69).Conclusion: Blood group O decreased the risk of late-onset preeclampsia while it increased the risk of early-onset preeclampsia.

Association of ABO polymorphisms and pancreatic Cancer/ Cardiocerebrovascular disease: a meta-analysis

Background

ABO gene polymorphisms have been reported to be associated with the risk of multiple cancers and cardiocerebrovascular diseases. However, the results remained controversial. In this study, we conducted a systematic review and meta-analysis to clarify the association between two SNPs (rs505922 and rs657152) in ABO gene and cancers/cardiocerebrovascular diseases.

Method

All eligible case-control studies come from PubMed, Embase and Web of Science up to Jan. 1, 2019. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the corresponding associations. Sensitivity analysis, publication bias assessment, and heterogeneity test were performed using STATA 12.0.

Results

A total of nineteen articles involving twenty-two case-control populations were included according to inclusion and exclusion criteria. Twelve populations (20,820 cases and 27,837 controls) were used to evaluate the relationship between rs505922 and overall cancers and nine populations (22,275 cases and 71,549 controls) were included to assess the association between rs505922 and cardiocerebrovascular diseases. The results showed a significant association between the rs505922 polymorphism and cancers (CvsT: OR = 1.13, 95%CI = 1.05–1.22, P = 0.001), and cardiocerebrovascular diseases (OR = 1.36, 95%CI = 1.19–1.57, P < 0.001). Five populations (8660 cases and 10,618 controls) were included to evaluate association between rs657152 and cancers and five populations (8105 cases and 6712 controls) were included to estimate the relationship between rs657152 and cardiocerebrovascular diseases. The result of meta-analysis reveals that rs657152 was significantly associated with cancers (OR = 1.18, 95%CI = 1.13–1.23, P < 0.001) and cardiocerebrovascular diseases (OR = 1.54, 95%CI = 1.24–1.92, P < 0.001).

Conclusion

Our study suggested that ABO polymorphisms might serve as a risk factor of pancreatic cancers and cardiocerebrovascular diseases.

ABO Blood Groups, Rh Factor, and Thyroid Cancer Risk: To 'B' or Not to 'B'

Purpose: In this study, we aimed to evaluate ABO blood groups and Rh factor in patients with thyroid cancer.Methods: Demographical and clinical features, cytological results, ABO blood groups, and Rh factor status of patients with benign and malignant thyroid disease were evaluated. Histopathological features of thyroid cancer were compared in Rh positive and negative patients, and patients with different ABO blood groups.Results: Histopathological diagnosis was benign in 1,299 (63.5%) and malignant in 744 (36.5%) patients. There was no significant difference between benign and malignant patients in terms of age, sex, thyroid autoantibody positivity, and ABO blood groups (p > .05 for each). A significantly higher rate of patients with malignant disease were Rh positive compared to patients with benign disease (91.8% vs. 88.1%, p = .046). In thyroid cancer patients, extrathyroidal extension and advanced stage (3-4) were observed more frequently in patients with B compared to non-B blood groups (p = .028 and 0.042, respectively). The likelihood of the extrathyroidal extension was 4.272 (95%: 1.816-10.049) times higher in B blood group compared to non-B blood groups in patients with multifocal disease (p < .001). Patients with O blood group had lower rate of capsular invasion than patients with non-O blood groups (p = .018).Conclusion: Patients with B blood group had higher risk of extrathyroidal extension and advanced stage compared to patients with non-B blood group.

The association between ABO blood group distribution and peptic ulcer disease: a cross-sectional study from Ethiopia

BACKGROUND

Studies have shown that ABO blood group antigens are associated with peptic ulcer disease (PUD). There are limited sources regarding the association of blood groups with PUD patients in Ethiopia. The aim of this study was to assess the association between ABO blood group distribution, non-steroidal anti-inflammatory drugs (NSAIDs), smoking, alcohol, coffee, and PUD at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

METHODS

A cross-sectional study was undertaken, and a total of 63 endoscopically confirmed PUD patients and 63 healthy controls were screened for ABO blood grouping using the standard slide agglutination reaction. Stool antigens were checked to determine Helicobacter pylori status of PUD patients. Chi-square and logistic regression were used for statistical analysis.

RESULTS

The ABO blood group distribution of PUD patients was 19.04% (12/63), 19.04% (12/63), 11.11% (7/63), 50.79% (32/63) for blood group A, B, AB, and O, respectively, while among control groups it was 25.39% (16/63), 23.80% (15/63), 12.69% (8/63), and 38.09% (24/63) for blood group A, B, AB, and O, respectively. 34.1% (22/63) of PUD patients had gastric ulcer and 65.9% (41/63) had duodenal ulcer. There was statistically a significant association between sex (p=0.001), use of NSAIDs (p=0.001), smoking cigarette (p=0.014), alcohol consumption (p=0.028), and PUD.

CONCLUSION

Although PUD trended as more prevalent among patients with blood group O than other blood group types their association was not statistically significant.

Relationship between ABO blood group and gestational diabetes mellitus

OBJECTIVE

To investigate the association between the ABO blood group and gestational diabetes mellitus (GDM).

METHODS

A case-control study was conducted in 600 pregnant women who received GDM screening with 50-g GCT and diagnosis by 100-g OGTT according to institutional guidelines. The cases included 200 women with GDM and another 400 normal pregnant women were randomly selected as controls. Various characteristics and ABO blood group were extracted from medical records and compared between cases and controls to determine their association with GDM. Logistic regression analysis was performed to determine independent associated factors for GDM adjusting for potential confounders.

RESULTS

Univariate analysis showed that significant factors associated with GDM were age ≥30 years, family history of DM, overweight, and obesity. Only blood group O significantly increased risk of GDM (OR 1.51, 95% CI 1.06-2.13, p = .020). Logistic regression analysis showed that blood group O independently increased the risk of GDM (adjusted OR 1.99, 95% CI 1.32-3.0, p = .001). The risk of GDM was enhanced in women with blood group O with family history of DM (adjusted OR 3.5, 95% CI 1.57-7.81, p = .002) while it was attenuated among those without (adjusted OR 1.6, 95% CI 0.97-2.64, p = .064).

CONCLUSION

Blood group O independently increased the risk of GDM.

ABO blood group in Malagasy patients with cancer: which group predominates?

The blood group of Malagasy patients with cancer have never been the subject of previous publications. Our objective was to determine the blood group of Malagasy patients with cancer followed in the Medical Oncology Unit of the Soavinandriana Teaching Hospital, Antananarivo. This was a one-year retrospective study (November 2012 to October 2013) in patients over the age of 15 with histological or pathological evidence of their cancer. One hundred and thirty of the 258 patients identified had an ABO blood group determination (50.39%). Among these 130 patients, 114 patients (87.69%) had solid tumors and 16 patients (12.31%) had hematologic malignancies. Thirty seven (28.49%) patients were transfused and 93 (71.54%) not transfused. There were 57 men and 73 women (sex ratio = 0.78), the average age was 55.11 +/- 14.76 years. With regard to their blood group, 52 patients (40%) were blood group B, 44 (33.84%) group O, 27 (20.76%) group A and 7 (5.38%) group AB. The order of blood group frequency of cancer patients in our series differs from other studies. This study has allowed us to know the proportion of each blood group in our Unit and thus help us in the management of stocks of labile blood products in our hospital.

AB0 Blood Group and Ovarian Cancer Survival

Background: Epithelial ovarian cancer is the most lethal gynecological malignancy because is usually diagnosed at advanced stage. New prognostic factors have been investigated but these biomarkers do not have a strong direct relationship with survival. Several studies investigated the association between AB0 blood group with ovarian cancer but with conflicting results. We investigated the association between AB0 blood group and epithelial ovarian cancer patients consecutively surgically treated at our department from 2004 to 2015.

Methods: Clinical charts of ovarian cancer patients treated and followed from 2004 to 2015 were checked for inclusion and exclusion criteria. Clinical and pathological data were recorded in an electronic separate, anonymous, password-protected database. All relevant data were extrapolated and used for final analysis.

Results: A population of 265 ovarian cancer patients was analyzed in this study. 121 (45.6%) patients presented blood type 0, 112 (42.3%) had blood type A, 23 (8.7%) B and 9 (3.4%) AB. A significantly lower percentage of death (8.7%) in patients with blood type B in comparison with patients presenting different genotypes (group 0: 34.7%, group A: 32.1%, group AB: 22.2%) was found. In invasive serous ovarian cancer patients the analysis showed a 5 fold significant reduction of the risk of death in patients with B genotype. However, postoperative residual tumor resulted the most important prognostic factor for overall survival.

Conclusions: AB0 blood group might be a preoperative prognostic factor in epithelial ovarian cancer patients. According to the literature, postoperative residual disease remain the most important prognostic factor also in our study.

Serum amylase activity altered by the ABO blood group system in Chinese subjects

Objective

The underlying interactions between ABO blood group antigens and pancreatic exocrine tissue have been demonstrated, and serum amylase was synthesized by pancreatic ductal cells. Thus, we investigated the link between ABO blood type and serum amylase activity in Chinese subjects.

Methods

Our study included 343 relatively healthy Chinese individuals, and the data were retrieved from electronic medical record database.

Results

A increased trend was observed for serum amylase activity in ABO blood type distribution, and we found that serum amylase activity was remarkable increased in subjects with O blood type compared to those with non‐O blood type (P = 0.013). Logistic regression analysis indicated that serum amylase was independently associated with individuals with O blood group (adjusted odds ratio 1.574; 95% CI, 1.022‐2.425, P = 0.039).

Conclusions

The present evidence suggests a significant link between serum amylase activity and ABO blood type in the study population, indicating ABO blood type may be associated with the susceptibility of pancreatic disease.

Validation of the Accuracy of Self-Reported ABO Blood Types in the Japan Nurses’ Health Study

Background: The associations between ABO blood type and risk of diseases including cancer have been reported from epidemiological studies. Self-reporting is one of the most widely used methods of collecting the ABO blood type information. Verifying the accuracy of self-reporting is important to consider measurement errors. We aimed to conduct validation of self-reported ABO blood types in the Japan Nurses’ Health Study (JNHS), which is a large prospective cohort study. Methods: The concordance rate between self-reported and serologically or genetically inferred ABO blood groups was investigated for a subsample of 41 subjects from the Gunma Nurses’ Health Study, which was a pilot cohort study that preceded the JNHS. The presence of antibodies to A or B antigens in serum (serological test) and allele types of the ABO gene (genotyping test) were determined by using frozen blood samples that were preserved for approximately 7 years. ABO blood types were determined from these tests and compared with self-reported data. Results: All of the nurses reported that their ABO blood groups were concordant with those determined by a serological and/or genotyping test. Self-reported ABO blood types of 35 of 38 (92.1%) participants were consistent with the results from serological typing, while the answers of three participants were not. In these three participants, ABO genotypes that were inferred from genotyping of three single nucleotide polymorphisms in ABO loci perfectly matched with their self-reported ABO types, and all of these were O-type. Conclusions: Japanese health professionals report their blood type with a high degree of accuracy. Special attention should be paid to the O-type group in serological analysis of blood samples that have been preserved for several years in longitudinal studies.

Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors

Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide. However, its toll is higher in more developed countries. Reasons for vast differences in mortality rates of pancreatic cancer are not completely clear yet, but it may be due to lack of appropriate diagnosis, treatment and cataloging of cancer cases. Because patients seldom exhibit symptoms until an advanced stage of the disease, pancreatic cancer remains one of the most lethal malignant neoplasms that caused 432,242 new deaths in 2018 (GLOBOCAN 2018 estimates). Globally, 458,918 new cases of pancreatic cancer have been reported in 2018, and 355,317 new cases are estimated to occur until 2040. Despite advancements in the detection and management of pancreatic cancer, the 5-year survival rate still stands at 9% only. To date, the causes of pancreatic carcinoma are still insufficiently known, although certain risk factors have been identified, such as tobacco smoking, diabetes mellitus, obesity, dietary factors, alcohol abuse, age, ethnicity, family history and genetic factors, Helicobacter pylori infection, non-O blood group and chronic pancreatitis. In general population, screening of large groups is not considered useful to detect the disease at its early stage, although newer techniques and the screening of tightly targeted groups (especially of those with family history), are being evaluated. Primary prevention is considered of utmost importance. Up-to-date statistics on pancreatic cancer occurrence and outcome along with a better understanding of the etiology and identifying the causative risk factors are essential for the primary prevention of this disease.

The role of ABO blood groups in glial neoplasms

INTRODUCTION

There are numerous diseases that are claimed to have a correlation with AB0 blood groups. Analysis on distribution of blood groups in primary brain tumors and clinical value has revealed conflicting results. The purpose of this study is to evaluate the association between AB0 blood groups and glial neoplasms (GN) and their effects on prognosis.

METHODS

A retrospective cross sectional study was performed. Patients admitted between 2000-2014 and had a diagnosis of GN were evaluated. Blood groups of patients were analyzed and compared with the National blood group data obtained from Turkish Red Crescent Society. The prognostic significance of AB0 blood groups was analyzed within glioblastoma multiforme (GBM), anaplastic astrocytoma and grade 1-2 astrocytoma.

RESULTS

759 patients with a diagnosis of glial neoplasia were evaluated. Distribution of AB0 blood groups in the different grades of Glial neoplasia was similar with the national blood group frequencies. There was not a statistically significant difference between grades of glial neoplasia and healthy control patients. Median overall survival (mOS) of GBM patients were 12.9 months in A (95% CI, 10.2-15.5), 13.4 months in B (95% CI, 7.3-19.5), 5.7 months in AB (95% CI, 0.8-10.6), 12.8 months in 0 blood groups (95% CI, 8.6-16.8) (p = .46). mOS of anaplastic astrocytoma patients were 24.4 months in A (95% CI, 15.2-33.6), 47.2 months in B (95% CI, 9.9-84.5), 37.8 months in AB (95% CI, 10.2-80.3), 29.2 months in 0 blood groups (95% CI, 21.2-33.4) (p = .96). mOS in grade 1-2 were 84.2, 90.6 and 144 months for A, AB and 0 blood groups respectively.

CONCLUSIONS

In our patient group, when compared with general population, there seems to be no association between frequencies of AB0 blood groups and Glial Neoplasia. In addition, the AB0 blood groups have no prognostic impact on glial neoplasms.

ABO phenotype-protected reproduction based on human specific α1,2 L-fucosylation as explained by the Bombay type formation

The metabolic relationship between the formation of the ABO(H) blood group phenotype and human fertility is evident in the case of the (Oh) or Bombay blood type, which Charles Darwin would have interpreted as resulting from reduced male fertility in consanguinities, based on the history of his own family, the Darwin/Wedgwood Dynasty. The classic Bombay type occurs with the extremely rare, human-specific genotype (h/h; se/se), which (due to point mutations) does not encode fucosyltransferases 1(FUT1) and 2 (FUT2). These enzymes are the basis for ABO(H) phenotype formation on the cell surfaces and fucosylation of plasma proteins, involving neonatal immunoglobulin M (IgM). In the normal human blood group O(H), which is not protected by clonal selection with regard to environmental A/B immunization, the plasma contains a mixture of non-immune and adaptive anti-A/B reactive isoagglutinins, which in the O(h) Bombay type show extremely elevated levels, associated with decreased levels of fucosylation-dependent functional plasma proteins, suchs as the van Willebrand factor (vWF) and clotting factor VIII. In fact, while the involvement of adaptive immunoglobulins remains unknown, poor fucosylation may explain the polyreactivity in the Bombay type plasma, which exhibits pronounced complement-binding cross-reactive anti-A/Tn and anti-B IgM levels, with additional anti-H reactivity, acting over a wide range of temperatures, with an amplitude at 37 °C. This aggressive anti-glycan-reactive IgM molecule suggests the induction of ADCC (antibody-dependent) and/or complement-mediated cytotoxicity via overexpressed glycosidic bond sites against the embryogenic stem cell-to-germ cell transformation, which is characterized by fleeting appearances of A-like, developmental trans-species GalNAcα1-O-Ser/Thr-R glycan, also referred to as the Tn (T "nouvelle") antigen.

ABO blood type and risk of hepatocellular carcinoma: a meta-analysis

BACKGROUND

ABO blood type is an invariant factor. There is a link between ABO blood type and some malignancies, such as gastric, pancreatic, and skin cancer. The role of ABO blood type in the pathogenesis of hepatocellular carcinoma (HCC) remains controversial. We performed a meta-analysis to explore the relationship between ABO blood type and risk of HCC.

METHODS

Literature search was conducted among the PubMed, EMBASE, and Cochrane Library databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Seven papers were included. They included 92,847 healthy subjects, 5,463 patients with hepatitis, 294 cirrhotic patients, and 3,322 HCC patients. The proportion of blood type O was significantly lower in HCC patients than healthy subjects (OR = 0.76, 95%CI = 0.66-0.87, P < 0.0001) without any significant heterogeneity (P = 0.55, I² = 0%). The proportions of blood types A, B, and AB were not significantly different between HCC patients and healthy subjects. The proportion of ABO blood type was not significantly different between patients with HCC and those with hepatitis or cirrhosis.

CONCLUSION

HCC patients might have a lower proportion of blood type O than healthy subjects. Among the patients with chronic liver diseases, ABO blood type might not be associated with the risk of HCC.

Clinical Associations with ABO Blood Group and Rhesus Blood Group Status in Patients with Breast Cancer: A Nationwide Retrospective Study of 3,944 Breast Cancer Patients in Turkey

Background

The aim of this study was to investigate the association between A, B, O, Rhesus (Rh)-positive and Rh-negative blood groups and breast cancer in a nationwide cohort of 3,944 patients in Turkey.

Material/Methods

A retrospective study included 3,944 patients diagnosed with breast cancer between 2004 and 2015 and with known blood type. Clinical and demographic patient data included age, sex, body mass index (BMI), menopausal status. The breast tumor type, size, grade, TNM stage, and the presence of lymph node and distant metastases were noted. Histopathology of the breast tumors had included routine detection of human epidermal growth factor receptor 2 (HER2) and estrogen receptor (ER) levels.

Results

The 3,944 patients with breast cancer were blood group, type A, B, O, and Rh-positive or Rh-negative; the median age was 47.9 years (range, 18.2–89.6 years); 99.5% (3923/3,844) were women, and 0.5% (21/3944) were men. Patients with blood type 0 had a significantly smaller tumor size compared with patients with blood types A or B. There were no significant differences between blood groups and patient age, BMI, menopausal status, tumor histology, ER status, HER2 status, lymph node and distant metastasis. However, there was a significant difference in the prevalence of lobular breast cancer, levels of ER-positive tumor cells, and prevalence of cases with tumor metastases in Rh-positive patients compared with Rh-negative patients.

Conclusions

The findings of this retrospective study showed that the type, grade, stage, and hormonal status of breast cancer showed no significant associations with ABO blood grouping.

Position of human blood group O(H) and phenotype-determining enzymes in growth and infectious disease

The human ABO(H) blood group phenotypes arise from the evolutionarily oldest genetic system found in primate populations. While the blood group antigen A is considered the ancestral primordial structure, under the selective pressure of life‐threatening diseases blood group O(H) came to dominate as the most frequently occurring blood group worldwide. Non‐O(H) phenotypes demonstrate impaired formation of adaptive and innate immunoglobulin specificities due to clonal selection and phenotype formation in plasma proteins. Compared with individuals with blood group O(H), blood group A individuals not only have a significantly higher risk of developing certain types of cancer but also exhibit high susceptibility to malaria tropica or infection by Plasmodium falciparum. The phenotype‐determining blood group A glycotransferase(s), which affect the levels of anti‐A/Tn cross‐reactive immunoglobulins in phenotypic glycosidic accommodation, might also mediate adhesion and entry of the parasite to host cells via trans‐species O‐GalNAc glycosylation of abundantly expressed serine residues that arise throughout the parasite's life cycle, while excluding the possibility of antibody formation against the resulting hybrid Tn antigen. In contrast, human blood group O(H), lacking this enzyme, is indicated to confer a survival advantage regarding the overall risk of developing cancer, and individuals with this blood group rarely develop life‐threatening infections involving evolutionarily selective malaria strains.

Risk of GERD-Related Disorders in Obese Patients on PPI Therapy: a Population Analysis

BACKGROUND

Increasing prevalence of obesity has shown an associated increase in gastroesophageal reflux disease (GERD)-related diseases. Proton pump inhibitor (PPI) therapy has been demonstrated to reduce the incidence of such diseases. The study's aim was to analyze the Clinical Practice Research Datalink (CPRD) to determine factors that increase the propensity of obese patients on PPIs to develop Barrett's esophagus (BE) and esophageal carcinoma.

METHOD

A case-control population study was carried out, including patients from the CPRD. Clinicopathological factors were extracted for each patient alongside clinical endpoints of GERD, BE, and esophageal carcinoma. Multivariate analysis was utilized to identify factors that increase the propensity to develop BE and esophageal carcinoma. Statistical significance was p < 0.050.

RESULTS

One hundred sixty five thousand nine hundred twenty nine obese patients on PPI treatment were identified up until July 2017. Median follow-up time was 119.0 months (range 11.3-1397.9 months). In patients with GERD, the following were associated with increased BE risk: age ≥ 60 years (OR = 1.197; p = 0.039), male (OR = 2.209; p < 0.001), H2 antagonists (OR = 1.377; p < 0.001), D2 antagonists (OR = 1.241; p = 0.008), and hiatus hernias (OR = 6.772; p = 0.017). The following were associated with increased risk of esophageal carcinoma: age (OR = 2.831; p = 0.031), male sex (OR = 3.954; p = 0.003), and hiatus hernias (OR = 12.170; p < 0.001). Only D2 antagonists (OR = 2.588; p = 0.002) were associated with increased risk of developing esophageal carcinoma in BE patients.

CONCLUSIONS

In obese patients on PPI therapy for reflux, higher BMIs were not associated with increased risk of BE or esophageal carcinoma. Males, older patients, and those with hiatus hernias are at increased risk of developing BE and carcinoma. Failure of PPI monotherapy is predictive of future metaplasia and dysplasia.

AB0 blood groups and rhesus factor expression as prognostic parameters in patients with epithelial ovarian cancer - a retrospective multi-centre study

BACKGROUND

AB0 blood groups and Rhesus factor expression have been associated with carcinogenesis, response to treatment and tumor progression in several malignancies. The aim of the present study was to test the hypothesis that AB0 blood groups and Rhesus factor expression are associated with clinical outcome in patients with epithelial ovarian cancer (EOC).

METHODS

AB0 blood groups and Rhesus factor expression were evaluated in a retrospective multicenter study including 518 patients with EOC. Their association with patients' survival was assessed using univariate and multivariable analyses.

RESULTS

Neither AB0 blood groups nor Rhesus factor expression were associated with clinico-pathological parameters, recurrence-free, cancer-specific, or overall survival. In a subgroup of patients with high-grade serous adenocarcinoma, however, blood groups B and AB were associated with a better 5-year cancer-specific survival rate compared to blood groups A and 0 (60.3 ± 8.6% vs. 43.8 ± 3.6%, p = 0.04). Yet, this was not significant in multivariable analysis.

CONCLUSIONS

AB0 blood groups and Rhesus factor expression are both neither associated with features of biologically aggressive disease nor clinical outcome in patients with EOC. Further investigation of the role of the blood group B antigen on cancer-specific survival in the subgroup of high-grade serous should be considered.

ABO blood groups as a prognostic factor for recurrence in ovarian and vulvar cancer

The relationship between ABO blood groups (BG) and risk of incidence in cancers including gynecological cancers has been widely studied, showing increased incidence risk for BG A patients. As available data are inconsistent we investigated whether BG and their anti-glycan antibodies (anti-A and anti-B) have prognostic values in gynecological cancers. We retrospectively evaluated 974 patients with gynecological cancers in three cancer centers (Switzerland and Australia) between 1974 and 2014 regarding the relationships between clinico-pathological findings and the BG. Time to disease recurrence was significantly influenced by BG in patients with ovarian (n = 282) and vulvar (n = 67) cancer. BG O or B patients showed a significantly increased risk for ovarian cancer relapse compared to A, 59% and 82%, respectively (p = 0.045; HR O vs A = 1.59 (CI 1.01-2.51) and (p = 0.036; HR A vs B = 0.55 (CI 0.32-0.96). Median time to relapse for advanced stage (n = 126) ovarian cancer patients was 18.2 months for BG O and 32.2 for A (p = 0.031; HR O vs A = 2.07 (CI 1.07-4.02)). BG also significantly influenced relapse-free survival in patients with vulvar cancer (p = 0.002), with BG O tending to have increased relapse risk compared to A (p = 0.089). Blood groups hence associate with recurrence in ovarian and vulvar cancer: women with BG O seem to have a lower ovarian cancer incidence, however are more likely to relapse earlier. The significance of the BG status as a prognostic value is evident and may be helpful to oncologists in prognosticating disease outcome and selecting the appropriate therapy.

ABO blood group and ovarian reserve: a meta-analysis and systematic review

Ovarian reserve reflects a woman's fertility potential. The ABO blood group system is a very stable genetic marker. Although many recent studies have explored the relationship between ABO blood group and ovarian reserve, a consensus has not yet been reached. This paper is the first meta-analysis and systematic review of the relationship between ABO blood type and ovarian reserve. We analyzed seven cross-sectional studies evaluating follicle stimulating hormone (FSH) or anti-Mullerian hormone (AMH) levels in 55,113 participants to determine ovarian reserve. This study found no relationship between ABO blood type and ovarian reserve when FSH was used as an indicator of ovarian reserve (A vs non-A:OR=1.03, 95% CI:0.96-1.11; B vs non-B: OR=0.98, 95% CI:0.75-1.29; AB vs non-AB:OR=0.96, 95% CI:0.71-1.30; O vs non-O:OR=1.03, 95%CI:0.74-1.43).There was also no relationship between ABO blood type and ovarian reserve when AMH was used as an indicator (A vs non-A:OR=0.89, 95% CI:0.76-1.03; B vs non-B:OR=1.02, 95% CI:0.80-1.30; AB vs non-AB:OR=1.14, 95% CI:0.80-1.64, O vs non-O:OR=1.07, 95% CI:0.86-1.34). Overall, the current study found no relationship between ABO blood group and ovarian reserve. However, additional rigorous, high-quality and multi-indicator studies with large sample sizes are required for further verification.

Gastroduodenal Ulcers and ABO Blood Group: the Japan Nurses' Health Study (JNHS)

Background

Although several studies have shown that blood type O is associated with increased risk of peptic ulcer, few studies have investigated these associations in Japan. We sought to investigate the association between the ABO blood group and risk of gastroduodenal ulcers (GDU) using combined analysis of both retrospective and prospective data from a large cohort study of Japanese women, the Japan Nurses’ Health Study (JNHS; n = 15,019).

Methods

The impact of the ABO blood group on GDU risk was examined using Cox regression analysis to estimate hazard ratios (HRs) and 95% confidence intervals (CI), with adjustment for potential confounders.

Results

Compared with women with non-O blood types (A, B, and AB), women with blood type O had a significantly increased risk of GDU from birth (multivariable-adjusted HR 1.18; 95% CI, 1.04–1.34). Moreover, the highest cumulative incidence of GDU was observed in women born pre-1956 with blood type O. In a subgroup analysis stratified by birth year (pre-1956 or post-1955), the multivariable-adjusted HR of women with blood type O was 1.22 (95% CI, 1.00–1.49) and 1.15 (95% CI, 0.98–1.35) in the pre-1956 and post-1955 groups, respectively.

Conclusion

In this large, combined, ambispective cohort study of Japanese women, older women with blood type O had a higher risk of developing GDU than those with other blood types.

Glioblastoma and ABO blood groups: further evidence of an association between the distribution of blood group antigens and brain tumours

BACKGROUND

Glioblastoma is a highly malignant brain tumour that usually leads to death. Several studies have reported a link between the distribution of ABO blood group antigens and a risk of developing specific types of cancer, although no consensus has been reached. This study aims to investigate the relationship between the distribution of ABO blood group antigens and the incidence of glioblastoma.

MATERIALS AND METHODS

The study cohort consisted of 115 glioblastoma patients who were diagnosed at King Abdullah University Hospital, Jordan, between 2004 and 2015. Three different patient populations made up three control groups and these were selected from among patients at the same institution between 2014 and 2015 as follows: 3,847 healthy blood donors, 654 accidental trauma patients admitted to the Departments of Neurosurgery and Orthopaedics, and 230 age- and sex-matched control subjects recruited blindly from the Departments of Paediatrics and Internal Medicine.

RESULTS

There was a significant association between the distribution of ABO blood group antigens and the incidence of glioblastoma. Post hoc residual analysis revealed that individuals with group A had a higher than expected chance of developing glioblastoma, while individuals with group O had a lower than expected chance. Furthermore, individuals with group A were found to be at a 1.62- to 2.28-fold increased risk of developing glioblastoma compared to individuals with group O.

DISCUSSION

In the present study, we demonstrate that, in Jordan, individuals with group A have an increased risk of developing glioblastoma, while individuals with group O have a reduced risk. These findings suggest that the distribution of ABO blood group antigens is associated with a risk of brain tumours and may play an important role in their development. However, further clinical and experimental investigations are required to confirm this association.

ABO blood groups: A risk factor for left atrial and left atrial appendage thrombogenic milieu in patients with non-valvular atrial fibrillation

BACKGROUND

Previous studies have identified ABO blood groups as predictors of thromboembolic diseases. In patients with atrial fibrillation (AF), however, potential association between ABO blood groups and the risk of left atrial (LA) and/or left atrial appendage (LAA) thrombogenic milieu (TM) has not been established.

METHODS

This is a retrospective case-control study that included 125 consecutive patients with non-valvular atrial fibrillation (NVAF) plus TM, as evidenced by transesophageal echocardiography (TEE) during a period from1 January 2010 to 31 December 2016. The controls were selected randomly from 1072 NVAF without TM at a 1:2 ratio. Potential association between ABO blood groups and TM was analyzed using multivariate logistic regression analysis.

RESULTS

The risk of TM was higher in patients with blood group A (33.6% vs. 20.2% in non-A blood groups, P=0.005). After adjusting for age, sex, oral anticoagulant use, AF type and duration, and relevant functional measures (e.g., NT-pro BNP level, left atrium diameter, and left ventricular ejection fraction), blood group A remained associated with an increased risk of TM (OR=2.99, 95% CI 1.4-6.388, P=0.005).

CONCLUSION

Blood group A is an independent risk factor for TM in NVAF patients.