Plasma miR-151-3p as a Candidate Diagnostic Biomarker for Head and Neck Cancer: A Cross-sectional Study within the INHANCE Consortium

BACKGROUND

Identification of screening tests for the detection of head and neck cancer (HNC) at an early stage is an important strategy to improving prognosis. Our objective was to identify plasma circulating miRNAs for the diagnosis of HNC (oral and laryngeal subsites), within a multicenter International Head and Neck Cancer Epidemiology consortium.

METHODS

A high-throughput screening phase with 754 miRNAs was performed in plasma samples of 88 cases and 88 controls, followed by a validation phase of the differentially expressed miRNAs, identified in the screening, in samples of 396 cases and 396 controls. Comparison of the fold changes (FC) was carried out using the Wilcoxon rank-sum test and the Dunn multiple comparison test.

RESULTS

We identified miR-151-3p (FC = 1.73, P = 0.007) as differentially expressed miRNAs in the screening and validation phase. The miR-151-3p was the only overexpressed miRNA in validation sample of patients with HNC with early stage at diagnosis (FC = 1.81, P = 0.008) and it was confirmed upregulated both in smoker early-stage cases (FC = 3.52, P = 0.024) and in nonsmoker early-stage cases (FC = 1.60, P = 0.025) compared with controls.

CONCLUSIONS

We identified miR-151-3p as an early marker of HNC. This miRNA was the only upregulated in patients at early stages of the disease, independently of the smoking status.

IMPACT

The prognosis for HNC is still poor. The discovery of a new diagnostic biomarker could lead to an earlier tumor discovery and therefore to an improvement in patient prognosis.

Association of antiretroviral therapy with anal high-risk human papillomavirus, anal intraepithelial neoplasia, and anal cancer in people living with HIV: a systematic review and meta-analysis

BACKGROUND

The effect of antiretroviral therapy (ART) on the natural history of anal high-risk HPV and anal lesion progression is not well established. We reviewed the association of ART and other HIV-related factors on anal HPV infection, anal intraepithelial neoplasia (AIN), and anal cancer among people living with HIV.

METHODS

For this systematic review and meta-analysis, we searched MEDLINE and EMBASE for studies published between Jan 1, 1996, and Oct 30, 2019, that reported the association of HIV-related exposures (ART or highly active ART [HAART], HIV-RNA plasma viral load [PVL], and nadir or current CD4 cell count) with outcomes of anal high-risk HPV prevalence, incidence, and persistence; prevalence, incidence, progression, or regression of anal histological and cytological abnormalities; and anal cancer incidence. Effect estimates were extracted whenever available; otherwise, they were calculated from raw data. We assessed the risk of bias of included studies using the Newcastle-Ottawa scale, and random-effects meta-analyses were done to examine heterogeneity using the I² statistic. This study is registered on the PROSPERO database, CRD42018007271.

FINDINGS

We identified 6777 studies, of which 5377 were excluded before full-text review. 122 studies providing estimates for 130 distinct populations matched the inclusion criteria. The populations comprised 417 006 people living with HIV (women, men who have sex with men, and men who have sex with women). 41 (32%) population estimates were not stratified by sex or sexual orientation. People living with HIV receiving ART had 35% lower high-risk HPV prevalence than ART-naive people (crude odds ratio [OR] 0·65, 95% CI 0·54-0·79; I² 12·1%, p=0·31) in 18 studies, and prolonged ART use was associated with a 10% reduction per year in high-risk HPV prevalence in two studies (adjusted OR 0·90, 0·85-0·95; I² 0%, p=0·88). People living with HIV with undetectable PVL had lower HSIL-AIN2+ prevalence than those with detectable PVL (crude OR 0·84, 0·72-0·98; I² 0%, p=0·80) in 16 studies, particularly if sustained for more than 1 year (crude OR 0·62, 0·47-0·81; I² 0%, p=0·51). ART was not associated with anal cancer incidence when adjusted for years living with HIV in three studies (adjusted hazard ratio [HR] 1·11, 95% CI 0·68-1·80; I² 0%, p=0·57), but ART users with sustained undetectable HIV PVL had 44% lower risk of anal cancer than those without (adjusted HR 0·56, 0·44-0·70; I² 0%, p=0·94) and for each increase in nadir CD4 cell counts of 100 cells per μL, there was a 40% decrease in anal cancer incidence (crude HR 0·60, 0·46-0·78; I² 21·7%, p=0·26).

INTERPRETATION

Effective ART use and early initiation at high nadir CD4 counts might reduce anal high-risk HPV infection and anal cancer risk. Although most studies were cross-sectional in design and few adjusted for potential confounders, this analysis provides comprehensive estimates of the effect of ART and HIV-related factors on the natural history of anal HPV-related disease in people living with HIV.

FUNDING

EU Marie Skłodowska-Curie Actions programme.

[Drug related problems and hospital admissions]

OBJECTIVE

Drug related problems (DRP) are health problems associated with the pharmacological treatment of patients and interfere or can interfere with the expected results on their health. The aim of this study is to determine the prevalence of DRP in patients from an urban health centre that lead to hospitalisation, and its prevention.

DESIGN

It is a retrospective, observational and descriptive study.

SETTING

Les Corts Health Centre (HC), which is an urban health and teaching centre with a reference population of 32,318 inhabitants.

PARTICIPANTS

Users of the les Corts HC admitted to the Barcelona Hospital Clinic from August 2005 to January 2006. RESULTS AND MAIN OUTCOME MEASUREMENTS: A pharmacist and a family doctor analysed the clinical histories and determined whether or not there was a DRP. A DRP was present in 13.4% of all hospital discharges, and 12% were implicated in the hospital admission. It was considered that 57.3% of all the discharges with a DRP as the causing factor in the hospital admission were avoidable. Admissions due to DRP were mainly in internal medicine, cardiology and pneumology. The health problems that lead to hospital admission due to DRP are mainly circulatory (38.5%) and respiratory (11.5%).

CONCLUSIONS

The number of hospital admissions due to drug related problems is avoidably high.

[Osteopenia in primary health care patients: ¿do we need to be more rigorous?]

AIM

To describe the treatment prescribed to osteopenic women seen at an urban primary health care centre and the treatment compliance of those patients with a prescription of calcium and/or vitamin D.

MATERIALS AND METHOD

Cross-sectional study, osteopenic women diagnosed by bone densitometry between February 2005 and January 2006 (n=121). Clinical history review: demographic information; previous clinical history of bone fracture, type of fracture; parental history of fractures; tobacco use; osteoporosis-related medication or disease; dietary and sun exposure assessment; calcium, vitamin D and raloxiphene/bisphosphonates prescription; mean daily dose of calcium and vitamin D supplements collected at the pharmacy by patients. Analysis of treatment prescription and compliance according to the information collected was performed.

RESULTS

Mean age, 61.9±9.1 years; 90.7% post-menopausic. The dietary assessment was performed in 30.5% of the women included in the study. The drug prescription was as follows: calcium 74.6%, vitamin D 68.6% and raloxiphene/bisphosphonates 16.1%. All drug prescriptions were associated with lower T-score values. The patient's compliance of calcium supplements has been calculated as mean of 423.8±321.7 mg/day, and 343.1±225.9 IU of vitamin D; with no association with any of the studied variables.

CONCLUSIONS

We identified greater drug prescription in those patients with a lower T-score. The clinical history of previous fracture did not show association with drug prescription nor a better compliance. There was a lack of information about relevant issues in the clinical history of the osteopenic women included in the study. The patient's compliance of calcium and vitamin-D supplements is very variable.

[Risk of Suffering from Cardiovascular Diseases because of the Clustering of the Modifiable Cardiovascular Risk Factors in the Population Older than 15 years of a Health Care Center in Barcelona]

OBJECTIVE

Over recent decades, the death rate due to cardiovascular diseases has shown a downward trend in developed countries, as has also been the case in Spain. However, are still the leading cause of death. This study is aimed at studying the relationship between cardiovascular diseases and different modifiable cardiovascular risk factors related to their clustering.

METHODS

Descriptive cross-sectional study conducted at an urban healthcare center, which included 2248 individuals ages 15 and above selected by simple random sampling of the medical record files. The risk of having some cardiovascular disease (ischemic cardiopathy, cerebrovascular disease or peripheral arteriopathy of lower limbs) was calculated in the form of an odds ration (OR) in relation to the clustering of the risk factors of smoking, high blood pressure,hypercholesterolemia, hypertriglyceridemia and diabetes mellitus,adjusted by age, sex and risk factors.

RESULTS

The individuals studied had 224 cardiovascular diseases.For smoking, the OR as an isolated risk factor was 1.5 (95% CI:1.0-2.2) and 1.6 (95% CI: 0.9-2.5) with the clustering with the other four risk factors; with high blood pressure, respectively of 2.1 (95% CI: 1.5-2.9) and 1.7 (95% CI: 1.1-2.6); with hypercholesterolemia, respectively of 1.7 (95% CI: 1.2-2.4) and 1.6 (95% CI: 1.1-2.4); and with hypertriglyceridemia, respectively of 1.8(95% CI: 1.2-2.8) and 1.3 (95% CI: 0.8-2.1). The OR's showed a similar behavior on layering by each cardiovascular disease, although the highest OR's (2.4 - 3.1 range) corresponded to the clustering of diabetes mellitus and smoking.

CONCLUSIONS

The risk of having cardiovascular diseasesremains high with the clustering of cardiovascular risk factors,although differences among them are found to exist.