Frontiers in Oncology最新文献

Background: Cervical cancer is the 4^th most common cancer in women globally. Determining the prevalence of the high-risk human papillomavirus (HR-HPV) and low-risk (LR-HPV) genotypes and the distribution in abnormal cervical cytology will be essential in a future population-based cervical cancer prevention program.

Method: Primary studies with women with abnormal cervical cytology were systematically searched for in Medline, CINHAL, Google Scholar, African Journal Online, and the University of Antwerp repository from 19-30 May 2023. A weighted inverse-variance random effects model was used. Variations across the studies were checked using a forest plot, I² statistics, and Egger's test. Group analysis was performed for evidence of heterogeneity.

Results: The pooled prevalence of human papillomavirus (HPV) genotypes with abnormal cervical cytology of a precancerous cervical lesion was 38.74% (95% CI: 27.56-49.93). The leading pooled prevalence estimates by subgroup analysis were 18% (95% CI: 13-26), 14% (95% CI: 111-16), and 66% (51-79) for women with retroviral infection (RVI), DNA genotyping with amplification, and central parts of Ethiopia respectively. There were 25 HPV variants identified by genotyping techniques with the five most prevalent HPV genotypes being HPV-16 and HPV-18 coexisting at 54%; HPV-16 alone at 29%; HPV-51 at 16%; HPV-52 at 13%; and HPV-31 and HPV-33 each contributing approximately 12%.

Conclusion: The pooled prevalence of HPV genotypes was higher than in other countries. HPV-51, HPV-52, HPV-31, and HPV-33 are the most prevalent genotypes. Hence, the nonavalent vaccine type would be the one that includes all the most prevalent HPV genotypes, but HPV-51in Ethiopia. Additional data on similar DNA test techniques for comparisons with precancerous lesions and invasive cancer are needed. Cervical cancer prevention and control programs in Ethiopia should be aligned with the most prevalent genotypes.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023428955.

Introduction: The advent of bevacizumab has considerably transformed the therapeutic landscape for non-small cell lung cancer (NSCLC) patients devoid of specific genetic mutations. A pivotal milestone has been reached with the recent approval of a bevacizumab biosimilar, following rigorous phase III clinical investigations, poised to augment NSCLC therapeutic strategies.

Methods: This retrospective analysis encompasses a large-scale study conducted between January 2021 and December 2023, involving 1058 NSCLC patients (metastatic or locally advanced stages). The research design entailed a comparative assessment of the safety and efficacy profiles of combined therapies using the original bevacizumab and its biosimilar, adhering to RECIST v1.1 criteria. Adverse event grading was standardized using the National Cancer Institute's CTCAE v5.0.

Results: Notably, the biosimilar demonstrated an objective response rate (ORR) of 29.79% in 606 patients, closely paralleling the 27.41% ORR observed in 452 patients receiving the original drug, with insignificant risk differences (-0.03) and a risk ratio of 0.987, affirming equivalence. Progression-free survival (PFS) was influenced by radiation status, treatment lines, and regimen combinations, while dosage intensity and genetic factors had negligible impacts. The incidence of treatment-emergent adverse events (TEAEs) was slightly higher in the biosimilar group (75.11%) versus the original drug group (72.78%), with grade 3 or more severe TEAEs occurring in 23.6% and 18.5% of patients, respectively (Detailed criteria for the definition and assessment of TEAEs have been added to the Methods section, including the use of the National Cancer Institute's CTCAE v5.0 for grading).

Conclusions: The study affirms that bevacizumab biosimilars offer equivalent therapeutic efficacy and a similar safety profile to the originator product in the management of locally advanced or metastatic NSCLC. The tolerability of the toxicity profile, coupled with the absence of unforeseen adverse reactions, underscores the viability of biosimilar bevacizumab as a valuable addition to NSCLC treatment regimens. These findings also imply potential benefits for a broader patient population beyond clinical trial confines through the adoption of biosimilar beta-adrenergic blocking agents.

Endometrial carcinosarcoma is a tumor characterized by the coexistence of carcinoma and sarcoma. It almost only occurs in postmenopausal women, and the average five-year survival rate is less than 30%. Endometrial carcinosarcoma is very aggressive and usually has high tumor recurrence and mortality rates. Endometrial carcinosarcoma often metastasizes to the lymph nodes, lungs and peritoneum. Here, we report a rare case of duodenal metastasis of endometrial carcinosarcoma.

Objective: This study aims to investigate the clinical treatment effect of intelligent pressure-controlled ureteroscopy combined with thulium laser for patients with isolated kidney upper tract urothelial carcinoma (UTUC).

Methods: This study employed a retrospective analysis approach and focused on six patients with isolated kidney UTUC admitted to our hospital from June 2018 to May 2023, who underwent tumor resection surgery using intelligent pressure-controlled ureteroscopy combined with thulium laser. We collected the perioperative clinical data of these six patients and conducted statistical analysis of the treatment effects.

Results: The surgeries of all six patients were completed smoothly, without incidents of surgery termination due to significant bleeding. Postoperative pathology revealed that four patients had low-grade non-invasive papillary urothelial carcinoma, while the other two patients had high-grade invasive urothelial carcinoma. During follow-up period, one patient had a renal pelvis recurrence three months after the surgery, and subsequently underwent thulium laser resection. Additionally, another patient experienced bladder recurrence eight months after the surgery and received transurethral resection of bladder tumor (TURBT) for treatment. The remaining four patients did not experience tumor recurrence during the follow-up.

Conclusion: For patients with isolated kidney associated with UTUC, intelligent pressure-controlled ureteroscopy combined with thulium laser represents a feasible treatment option, with good therapeutic effects for low-risk upper tract urothelial carcinoma.

Objective: This study aims to investigate the regulation of host gene transcription and microbial changes during the development of oral squamous cell carcinoma (OSCC) associated with smoking.

Methods: The OSCC mouse model and smoking mouse model were established using 200 μg/mL 4-nitroquinoline-1-oxide (4NQO) in drinking water and exposure to cigarette smoke (four cigarettes per session, once a day, 5 days a week). Tongue tissues were harvested at 4 weeks and 16 weeks. Histopathological changes were evaluated using hematoxylin and eosin staining and Ki67 staining. RNA sequencing was performed on the mouse tongue tissues to identify differentially expressed genes (DEGs), and the results were validated by RT-PCR and immunohistochemistry. 16S rDNA sequencing was used to analyze changes in the oral microbiota during the early development of OSCC, identifying differentially abundant taxa associated with smoking. Finally, associations between the relative abundances of the oral microbiome and host gene expression were modeled using the Origin software.

Results: DEGs associated with smoking during the development of OSCC were identified. There were 12 upregulated genes, including NR4A3 and PPP1R3C, and 23 downregulated genes, including CD74 and ANKRD1. These genes were enriched in functions related to the signal transduction of cellular processes such as inflammation, differentiation, immunity, and PI3K/AKT, NF-κB signaling pathways. 4NQO and smoking treatment decreased oral microbial diversity and reduced the abundance of Bacteroidetes, Proteobacteria, and Lactobacillus but increased the abundance of Staphylococcus. Integrative analysis showed that the expression of CD74 was positively correlated with the relative abundance of Lactobacillus, while PPP1R3C was negatively correlated with Bacteroidota.

Conclusion: In addition to characterizing host gene expression and the oral microbiome, our study explored the potential role of host-microbiome interactions in the development of OSCC. These findings enhance our understanding of smoking-related OSCC occurrence and development, providing new insights for its prevention.

Protein tyrosine kinase 7 (PTK7) is an evolutionarily conserved transmembrane receptor and a specialized tyrosine kinase protein lacking kinase activity. PTK7 has been found to be strongly associated with a variety of diseases, including cancer. In this review, we will provide a comprehensive overview of the involvement of PTK7 in human cancer, focusing on the changing research landscape of PTK7 in cancer research, the molecular mechanisms of PTK7 involved in cancer progression, the targetability of PTK7 in cancer therapy, and the potential application of PTK7 in cancer management, thus demonstrating that PTK7 may be an underestimated contributor to human cancer.

The present situation of neuropathology practice in the Central American region has not been addressed in the past. These are low middle-income countries, and therefore, many do not have a basic immunohistochemistry panel. Cytogenetics and molecular studies are not available in most of Central America. Pediatric brain tumors are diagnosed either by anatomical pathologists or by pediatric pathologists. Access to a weakly Latin American Tumor Board is available to consult cases, but most countries do not participate in these expert meetings. The most recent World Health Organization brain tumor book has a very broad molecular classification of pediatric brain tumors. All these factors make it very difficult to properly diagnose pediatric brain tumors in the region, and this impacts the treatment and overall survival of children with brain tumors.

Objective: Radical hysterectomy has been established as the standard treatment for early stage cervical cancers. Despite numerous efforts to standardize the technique for radical hysterectomy across varying extents of tumor invasion, success has been inconsistent. Total Müllerian Compartment Resection (TMCR), an ontogenetic compartment-based oncologic surgery initially developed for open procedures by Professor Höckel, offers a standardized approach applicable to all patients with locally confined tumors. This method holds promise for achieving thorough oncologic clearance while maintaining acceptable complication rates. Moreover, robotic-assisted surgery may further reduce morbidity compared to open surgery. In this context, we provide a detailed step-by-step description of robotically assisted Total Müllerian Compartment resection (R-TMCR) for cervical cancer and present feasibility data from a cohort of 20 patients.

Subjects and methods: 20 patients with stage IA1-IB2 cervical cancer, robot-assisted resection of the Müllerian embryonic compartment was undertaken. Key metrics such as operative duration, intraoperative blood loss, and postoperative complication rates were meticulously recorded and analyzed.

Results: The duration of the surgery varied from 185 to 500 minutes, with intraoperative blood loss ranging between 5 mL and 300 mL. Postoperative hemoglobin levels dropped by -15 to 40 g/L from their preoperative values. Notably, there were no instances necessitating conversion to open surgery, and no intraoperative complications occurred. The rate of postoperative complications was 0%. Over the follow-up period, which averaged 18 months, there were no observed locoregional recurrences of cervical cancer, nor were there any deaths attributed to cervical cancer during this time.

Conclusion: The application of robotic Müllerian compartment resection in the surgical treatment of cervical cancer is both safe and feasible. Utilizing robotic technology enables more precise and refined surgical outcomes. Combining embryonic compartment-based radical hysterectomy with the principles of membrane anatomy can standardize and optimize the surgical process, helping surgeons master radical hysterectomy more quickly and effectively.

Background: Endometrial stromal sarcoma (ESS) is a rare type of uterine malignancy typically classified into low-grade ESS (LG-ESS) and high-grade ESS. LG-ESS is characterized by low malignancy and limited metastasis, primarily to the lungs. Metastasis of the breast is extremely rare, posing significant challenges in clinical diagnosis and treatment.

Case demonstration: A 33-year-old female with a history of two cesarean sections was diagnosed with uterine LG-ESS five months prior. She was admitted for the excision of a left breast mass discovered during a routine examination. A histopathological biopsy confirmed the mass as a breast metastasis of LG-ESS. Postoperatively, she underwent radiotherapy and chemotherapy at a cancer hospital. She has been followed up on for two years with no recurrence.

Conclusions: ESS with breast metastasis is extremely rare. The morphological features of ESS with breast metastasis can resemble mesenchymal and sex cord-stromal tumors, complicating imaging and pathological diagnosis, especially if there is no known history of uterine ESS. This study highlights the clinicopathological features of LG-ESS with breast metastasis, including clinical manifestations, imaging features, histopathology, immunohistochemistry, molecular genetic features, and treatment prognosis. It aims to provide new insights for the clinical diagnosis and treatment of ESS with breast metastasis.

Objective: The aim of this study was to enhance the precision of categorization of endometrial lesions in ultrasound images via a data enhancement framework based on deep learning (DL), through addressing diagnostic accuracy challenges, contributing to future research.

Materials and methods: Ultrasound image datasets from 734 patients across six hospitals were collected. A data enhancement framework, including image features cleaning and soften label, was devised and validated across multiple DL models, including ResNet50, DenseNet169, DenseNet201, and ViT-B. A hybrid model, integrating convolutional neural network and transformer architectures for optimal performance, to predict lesion types was developed.

Results: Implementation of our novel strategies resulted in a substantial enhancement in model accuracy. The ensemble model achieved accuracy and macro-area under the receiver operating characteristic curve values of 0.809 of 0.911, respectively, underscoring the potential for use of DL in endometrial lesion ultrasound image classification.

Conclusion: We successfully developed a data enhancement framework to accurately classify endometrial lesions in ultrasound images. Integration of anomaly detection, data cleaning, and soften label strategies enhanced the comprehension of lesion image features by the model, thereby boosting its classification capacity. Our research offers valuable insights for future studies and lays the foundation for creation of more precise diagnostic tools.