Pub Date : 2022-06-22DOI: 10.30683/1927-7229.2022.11.01
R. Bayramov, R. Abdullayeva, S. E. Huseynova, F.R. Bayramli
Objective: Total gastrectomy is a complex surgical procedure that is characterized by significant postoperative morbidity and mortality rates and the patients may continue to experience adverse events beyond the standard 30-day follow-up period after surgery. The aim of this study is to investigate postoperative complication and 30-day/90-day mortality rates following total gastrectomy in a cohort of patients and highlight the possible ways that can improve the short-term outcome of this surgical procedure. Material and Methods: 401 patients underwent total gastrectomy for gastric carcinoma by a single surgical team from January 2001 till December 2021. The patients stratified in 3 groups based on the time period when surgery was performed, hospital- and treatment-related objective factors: group I (61 patients); group II (163 patients) and group III (177 patients). Results: Esophagojejunal anastomotic leakage rate varied with periods and ranged from 1.1% to 3.3%, 1.7% in total. Differences were insignificant in complication and death rates between the patients aged ≤70 years and > 70 years (p>0.05). Postoperative death rate within 90 days was higher by 42% compared to that in standard 30-day follow-up period. Neaodjuvant chemotherapy was not found to be associated with an increased rate of 30-day postoperative mortality (p>0.05). Conclusion(s): Total gastrectomy for gastric cancer may be associated with minimal rates of esophagojejunal anastomotic leakage and mortality when performed by specialized and experienced high-volume surgeons. 90-day mortality rate after total gastrectomy is 42% higher compared to 30-day mortality that warrants more intense monitoring of the relevant patients within 3 months after surgery.
{"title":"Postoperative Mortality Rates following Total Gastrectomy for Gastric Cancer: Experience of a Single Surgical Team","authors":"R. Bayramov, R. Abdullayeva, S. E. Huseynova, F.R. Bayramli","doi":"10.30683/1927-7229.2022.11.01","DOIUrl":"https://doi.org/10.30683/1927-7229.2022.11.01","url":null,"abstract":"Objective: Total gastrectomy is a complex surgical procedure that is characterized by significant postoperative morbidity and mortality rates and the patients may continue to experience adverse events beyond the standard 30-day follow-up period after surgery. The aim of this study is to investigate postoperative complication and 30-day/90-day mortality rates following total gastrectomy in a cohort of patients and highlight the possible ways that can improve the short-term outcome of this surgical procedure. \u0000Material and Methods: 401 patients underwent total gastrectomy for gastric carcinoma by a single surgical team from January 2001 till December 2021. The patients stratified in 3 groups based on the time period when surgery was performed, hospital- and treatment-related objective factors: group I (61 patients); group II (163 patients) and group III (177 patients). \u0000Results: Esophagojejunal anastomotic leakage rate varied with periods and ranged from 1.1% to 3.3%, 1.7% in total. Differences were insignificant in complication and death rates between the patients aged ≤70 years and > 70 years (p>0.05). Postoperative death rate within 90 days was higher by 42% compared to that in standard 30-day follow-up period. Neaodjuvant chemotherapy was not found to be associated with an increased rate of 30-day postoperative mortality (p>0.05). \u0000Conclusion(s): Total gastrectomy for gastric cancer may be associated with minimal rates of esophagojejunal anastomotic leakage and mortality when performed by specialized and experienced high-volume surgeons. 90-day mortality rate after total gastrectomy is 42% higher compared to 30-day mortality that warrants more intense monitoring of the relevant patients within 3 months after surgery.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81019602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-07-22DOI: 10.30683/1927-7229.2022.11.03
Myla Worthington, Chelsey Aurelus, Narendra Banerjee, Christopher Krauss, William Kahan, Satyendra Banerjee, Sherita Gavin, Victoria Bartlett, Gloria Payne, Jeffrey Rousch, Mukesh Verma, Fazlul Sarkar, Hirendra Nath Banerjee
There is a need for additional biomarkers for the diagnosis and prognosis of prostate cancer. MicroRNAs are a class of non-protein coding RNA molecules that are frequently dysregulated in different cancers including prostate cancer and show promise as diagnostic biomarkers and targets for therapy. Here we describe the role of micro RNA 146 a (miR-146a) which may serve as a diagnostic marker for prostate cancer, as indicated from the data presented in this report. Also, a pilot study indicated differential expression of miR-146a in prostate cancer cell lines and tissues from different racial groups. This report provides a novel insight into understanding the prostate carcinogenesis.
{"title":"A Study to Investigate the Role of Noncoding RNA miR146 Alpha as a Potential Biomarker in Prostate Cancer.","authors":"Myla Worthington, Chelsey Aurelus, Narendra Banerjee, Christopher Krauss, William Kahan, Satyendra Banerjee, Sherita Gavin, Victoria Bartlett, Gloria Payne, Jeffrey Rousch, Mukesh Verma, Fazlul Sarkar, Hirendra Nath Banerjee","doi":"10.30683/1927-7229.2022.11.03","DOIUrl":"10.30683/1927-7229.2022.11.03","url":null,"abstract":"<p><p>There is a need for additional biomarkers for the diagnosis and prognosis of prostate cancer. MicroRNAs are a class of non-protein coding RNA molecules that are frequently dysregulated in different cancers including prostate cancer and show promise as diagnostic biomarkers and targets for therapy. Here we describe the role of micro RNA 146 a (miR-146a) which may serve as a diagnostic marker for prostate cancer, as indicated from the data presented in this report. Also, a pilot study indicated differential expression of miR-146a in prostate cancer cell lines and tissues from different racial groups. This report provides a novel insight into understanding the prostate carcinogenesis.</p>","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"11 ","pages":"21-23"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10415341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-12DOI: 10.30683/1927-7229.2021.10.06
S. Hibi, Y. Shirokawa, K. Nanya, Y. Kato, Nobuto Ito, T. Kataoka, T. Yoshida, Yoshiaki Marumo, S. Kayukawa, S. Yuasa, Yoshiteru Tanaka, K. Ina
Background: Immune checkpoint inhibitors (ICIs) sometimes cause immune-related adverse events (irAEs), the timing of occurrence of which is difficult to predict. We created a system to safely manage the patients treated with ICIs who visit hospital during an emergency. Methods: We utilized the Plan-Do-Check-Act (PDCA) cycle method to improve the quality of countermeasures for irAEs in the emergency room. First, an icon showing the patients treated with ICIs was developed for inclusion in electronic medical records. Second, ICI-specified urgent sets of clinical laboratory tests were prepared to cover the spectrum of irAEs. Third, a direct call system to either the attending physician or the chemotherapy team was established. A flow chart for managing irAEs has been prepared since September 2018. We retrospectively analyzed the electronic medical records from September 2018 to December 2020 to determine the effectiveness of the developed system. Results: In the first cycle of PDCA, 24 patients administered ICIs were retrospectively surveyed and seven visited the emergency room. Six cases were examined according to the flow chart, whereas the other patient complaining of grade 2 diarrhea were not examined because of incomplete knowledge regarding ICIs and irAEs. As part of the “Act” step, we reminded the doctors of the flow chart and gave a lecture to the residents on how to manage irAEs. During the second and seventh cycle, no cases were observed without consulting the flow chart. Conclusions: Quality improvement activities for the management of irAEs were conducted using the PDCA cycle methodology. Patients on ICIs are now being continuously monitored to further improve management quality.
{"title":"Application of the Plan-Do-Check-Act Cycle for Managing Immune-Related Adverse Events","authors":"S. Hibi, Y. Shirokawa, K. Nanya, Y. Kato, Nobuto Ito, T. Kataoka, T. Yoshida, Yoshiaki Marumo, S. Kayukawa, S. Yuasa, Yoshiteru Tanaka, K. Ina","doi":"10.30683/1927-7229.2021.10.06","DOIUrl":"https://doi.org/10.30683/1927-7229.2021.10.06","url":null,"abstract":"Background: Immune checkpoint inhibitors (ICIs) sometimes cause immune-related adverse events (irAEs), the timing of occurrence of which is difficult to predict. We created a system to safely manage the patients treated with ICIs who visit hospital during an emergency. \u0000Methods: We utilized the Plan-Do-Check-Act (PDCA) cycle method to improve the quality of countermeasures for irAEs in the emergency room. First, an icon showing the patients treated with ICIs was developed for inclusion in electronic medical records. Second, ICI-specified urgent sets of clinical laboratory tests were prepared to cover the spectrum of irAEs. Third, a direct call system to either the attending physician or the chemotherapy team was established. A flow chart for managing irAEs has been prepared since September 2018. We retrospectively analyzed the electronic medical records from September 2018 to December 2020 to determine the effectiveness of the developed system. \u0000Results: In the first cycle of PDCA, 24 patients administered ICIs were retrospectively surveyed and seven visited the emergency room. Six cases were examined according to the flow chart, whereas the other patient complaining of grade 2 diarrhea were not examined because of incomplete knowledge regarding ICIs and irAEs. As part of the “Act” step, we reminded the doctors of the flow chart and gave a lecture to the residents on how to manage irAEs. During the second and seventh cycle, no cases were observed without consulting the flow chart. \u0000Conclusions: Quality improvement activities for the management of irAEs were conducted using the PDCA cycle methodology. Patients on ICIs are now being continuously monitored to further improve management quality.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"183 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85078360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-05DOI: 10.30683/1927-7229.2021.10.04
K. Somaratne, S. Kumara, R. Ratnayake, Priyantha Liyanage, N.A.A.P.D. Gunasekera
Introduction: Oral cancer is one of the most common cancers globally and in Sri Lanka, which follows premalignant lesions. It is curable if it is detected early. Several adjunctive methods to diagnose premalignant lesions early are available. Among these, Toluidine blue staining method before a biopsy is currently receiving much attention. Method: This is a prospective study done by studying 103 patients presented to the Oral and Maxillofacial Surgery Unit, District General Hospital, Gampaha, Sri Lanka. The oral lesions of all the patients are categorized as benign, premalignant, and malignant by clinical examination. Toluidine Blue mouth wash is introduced to all the patients, followed by biopsy from the stained sites and the clinically decided sites in non-stained lesions. Histopathological diagnosis was obtained for all cases. The accuracy of diagnosis of premalignant, malignant, and benign cases by clinical assessment and by using Toluidine blue was assessed and compared statistically in relation to sensitivity, specificity, positive predictive and negative predictive values, and likelihood ratios (LR). Results: Toluidine blue has no added advantage over clinical examination in our setup even though it might be helpful in screening. However, it has an added value to confirm clinically benign cases as benign. Conclusion: Toluidine Blue can be used as an adjunct in screening and to confirm clinically benign cases so that those can be followed up in clinics without doing unnecessary biopsies.
{"title":"Adjunctive Utility of Toluidine Blue in Detecting Dysplastic Cells in Oral Mucosal Lesions in Comparison with Histopathology","authors":"K. Somaratne, S. Kumara, R. Ratnayake, Priyantha Liyanage, N.A.A.P.D. Gunasekera","doi":"10.30683/1927-7229.2021.10.04","DOIUrl":"https://doi.org/10.30683/1927-7229.2021.10.04","url":null,"abstract":"Introduction: Oral cancer is one of the most common cancers globally and in Sri Lanka, which follows premalignant lesions. It is curable if it is detected early. Several adjunctive methods to diagnose premalignant lesions early are available. Among these, Toluidine blue staining method before a biopsy is currently receiving much attention. \u0000Method: This is a prospective study done by studying 103 patients presented to the Oral and Maxillofacial Surgery Unit, District General Hospital, Gampaha, Sri Lanka. The oral lesions of all the patients are categorized as benign, premalignant, and malignant by clinical examination. Toluidine Blue mouth wash is introduced to all the patients, followed by biopsy from the stained sites and the clinically decided sites in non-stained lesions. Histopathological diagnosis was obtained for all cases. The accuracy of diagnosis of premalignant, malignant, and benign cases by clinical assessment and by using Toluidine blue was assessed and compared statistically in relation to sensitivity, specificity, positive predictive and negative predictive values, and likelihood ratios (LR). \u0000Results: Toluidine blue has no added advantage over clinical examination in our setup even though it might be helpful in screening. However, it has an added value to confirm clinically benign cases as benign. \u0000Conclusion: Toluidine Blue can be used as an adjunct in screening and to confirm clinically benign cases so that those can be followed up in clinics without doing unnecessary biopsies.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75078655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-27DOI: 10.30683/1927-7229.2021.10.03
M. Dehghani, Shirin Haghighat, Zahra Radmard, N. Namdari, A. Rezvani, M. Ramzi
Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization in the first 30 days after Hyper-CVAD chemotherapy in all patients with acute lymphoblastic leukemia. Methods: This descriptive, analytical and cross-sectional study was performed on 827 admissions in ALL patients aged 18 years and older with unplanned hospitalization after HyperCVAD chemotherapy in less than 30 days’ post chemotherapy from April 2016 to April 2018 in Hematology and medical oncology department. Results: The rate of unplanned re-admission was 9.91% in all patients. Mean follow-up time was 13.77 ± 6.26 months and the mean age of patients was 35.55 ± 14.6 years. Re-admission rate was more frequent in men (65.7%) and most patients were readmitted only once. The mean duration of re-admission was 8.2±4.15 days and most patients were re-admitted after cycles IB, IIIB and IVB of hyper-CVAD chemotherapy. The most common causes of readmission were febrile neutropenia and pancytopenia. Except for significant changes in CBC, no significant changes were observed in other laboratory tests. Urine culture and blood culture were reported positive in 13.6% and 31.57% respectively, and E-coli was the most common organism isolated from cultures. Conclusion: We found increased rate of re-admission following hyper-CVAD chemotherapy in patients with acute lymphoblastic leukemia which was due to side effects of chemotherapy regimen. It seems to be important not only for high rate of mortality and morbidity in patients resulting from this chemotherapy regimen, but also imposing the heavy cost on health system. Therefore, more effective preventive measures are necessary and useful.
{"title":"Unplanned 30-Day Readmissions after Hyper-CVAD Chemotherapy in Patients with Acute Lymphoblastic Leukemia","authors":"M. Dehghani, Shirin Haghighat, Zahra Radmard, N. Namdari, A. Rezvani, M. Ramzi","doi":"10.30683/1927-7229.2021.10.03","DOIUrl":"https://doi.org/10.30683/1927-7229.2021.10.03","url":null,"abstract":"Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization in the first 30 days after Hyper-CVAD chemotherapy in all patients with acute lymphoblastic leukemia. \u0000Methods: This descriptive, analytical and cross-sectional study was performed on 827 admissions in ALL patients aged 18 years and older with unplanned hospitalization after HyperCVAD chemotherapy in less than 30 days’ post chemotherapy from April 2016 to April 2018 in Hematology and medical oncology department. \u0000Results: The rate of unplanned re-admission was 9.91% in all patients. Mean follow-up time was 13.77 ± 6.26 months and the mean age of patients was 35.55 ± 14.6 years. Re-admission rate was more frequent in men (65.7%) and most patients were readmitted only once. The mean duration of re-admission was 8.2±4.15 days and most patients were re-admitted after cycles IB, IIIB and IVB of hyper-CVAD chemotherapy. The most common causes of readmission were febrile neutropenia and pancytopenia. Except for significant changes in CBC, no significant changes were observed in other laboratory tests. Urine culture and blood culture were reported positive in 13.6% and 31.57% respectively, and E-coli was the most common organism isolated from cultures. \u0000Conclusion: We found increased rate of re-admission following hyper-CVAD chemotherapy in patients with acute lymphoblastic leukemia which was due to side effects of chemotherapy regimen. It seems to be important not only for high rate of mortality and morbidity in patients resulting from this chemotherapy regimen, but also imposing the heavy cost on health system. Therefore, more effective preventive measures are necessary and useful.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83112531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-27DOI: 10.30683/1927-7229.2021.10.02
P. Mehdipour
: Background : Circulating Tumor Cells (CTCs) are the reliable key for an early detection. The cell- based/classified/personalized diagnostic approaches are unavailable. Therefore, it was aimed to explore the expression behavior of tumor (T) cells in brain, peritoneal cavity (PC) and genomic level to deliver the hypothetical model through the metastatic events. Patients and Methods : The focal assay included protein expression (PE) by immunofluorescence in T-cells of cerebellarmeduloblastoma (CM), PC, and CTCs in a metastatic patient. The CCL2, VEGF, EGF, CD133/Cyclin E/ P21/Neuronal marker (NM), and CD45 were explored. Result : Frequency of T-cells lacking PE and the Ratio of T/CTCs in different sections of CM- tumor cells in brain and the metastatic PC revealed the diverse expression and co-expression of the involved proteins. The poor prognosis is offered upon the value of PE at T/CTCs ratio. High PE and harmonic co-expression played the influential role in the metastatic process and manner of evolution. Conclusions : Single cell- based analysis of expression and co-expression is the directive channel to unmask the heterogeneity through the metastatic process at genomic and somatic levels for providing the metastatic model. Present findings deliver the somatic/genomic ratio-based prognosis for further clinical managements. heterogeneity, Metastatic model (MM).
{"title":"Metastatic Model of Cerebellar Medulloblastoma Cells to Peritoneal Cavity: Exploration of Circulating Tumor Cells","authors":"P. Mehdipour","doi":"10.30683/1927-7229.2021.10.02","DOIUrl":"https://doi.org/10.30683/1927-7229.2021.10.02","url":null,"abstract":": Background : Circulating Tumor Cells (CTCs) are the reliable key for an early detection. The cell- based/classified/personalized diagnostic approaches are unavailable. Therefore, it was aimed to explore the expression behavior of tumor (T) cells in brain, peritoneal cavity (PC) and genomic level to deliver the hypothetical model through the metastatic events. Patients and Methods : The focal assay included protein expression (PE) by immunofluorescence in T-cells of cerebellarmeduloblastoma (CM), PC, and CTCs in a metastatic patient. The CCL2, VEGF, EGF, CD133/Cyclin E/ P21/Neuronal marker (NM), and CD45 were explored. Result : Frequency of T-cells lacking PE and the Ratio of T/CTCs in different sections of CM- tumor cells in brain and the metastatic PC revealed the diverse expression and co-expression of the involved proteins. The poor prognosis is offered upon the value of PE at T/CTCs ratio. High PE and harmonic co-expression played the influential role in the metastatic process and manner of evolution. Conclusions : Single cell- based analysis of expression and co-expression is the directive channel to unmask the heterogeneity through the metastatic process at genomic and somatic levels for providing the metastatic model. Present findings deliver the somatic/genomic ratio-based prognosis for further clinical managements. heterogeneity, Metastatic model (MM).","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90637420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-16DOI: 10.30683/1927-7229.2021.10.01
Kenneth K. Wu
Abstract: Intracellular tryptophan (Trp) is catabolized to a large repertoire of metabolites via two major pathways: indoleamine and tryptophan 2, 3-dioxygenases (IDO/TDO) and Trp hydroxylase (TPH) pathways. The catabolites possess diverse biological activities and carry out various physiological functions. Several catabolites such as kynurenine (Kyn) and serotonin promote while melatonin and 5-methoxytryptophan (5-MTP) suppress cancer growth and metastasis. Cancer cell-derived Kyn enhances cancer growth and evasion of immunosurveillance by interacting with cancer cell and immune cell membrane aryl hydrocarbon receptors (AHR), respectively. Serotonin exerts its tumor-promoting activities through type 1 and type 2 serotonin receptors. 5-MTP and melatonin suppress cancer growth and metastasis by common mechanisms, i.e., inhibition of p300 histone acetyltransferase (HAT) and NF-κB activation, and suppression of cyclooxygenase-2 and cytokine transcription. Both metabolites block p38 MAPK signaling pathway. Human cancer tissues express increased levels of IDO, TDO and kynurenine monooxygenase (KMO) which are correlated with reduced patient survival. In summary, cancer Trp metabolism regulates cancer growth and metastasis by complex mechanisms. 5-MTP and melatonin provide valuable lead to develop new drugs for chemo-prevention and adjuvant therapy of cancer.
{"title":"Tryptophan Metabolism and Cancer Progression","authors":"Kenneth K. Wu","doi":"10.30683/1927-7229.2021.10.01","DOIUrl":"https://doi.org/10.30683/1927-7229.2021.10.01","url":null,"abstract":"Abstract: Intracellular tryptophan (Trp) is catabolized to a large repertoire of metabolites via two major pathways: indoleamine and tryptophan 2, 3-dioxygenases (IDO/TDO) and Trp hydroxylase (TPH) pathways. The catabolites possess diverse biological activities and carry out various physiological functions. Several catabolites such as kynurenine (Kyn) and serotonin promote while melatonin and 5-methoxytryptophan (5-MTP) suppress cancer growth and metastasis. Cancer cell-derived Kyn enhances cancer growth and evasion of immunosurveillance by interacting with cancer cell and immune cell membrane aryl hydrocarbon receptors (AHR), respectively. Serotonin exerts its tumor-promoting activities through type 1 and type 2 serotonin receptors. 5-MTP and melatonin suppress cancer growth and metastasis by common mechanisms, i.e., inhibition of p300 histone acetyltransferase (HAT) and NF-κB activation, and suppression of cyclooxygenase-2 and cytokine transcription. Both metabolites block p38 MAPK signaling pathway. Human cancer tissues express increased levels of IDO, TDO and kynurenine monooxygenase (KMO) which are correlated with reduced patient survival. In summary, cancer Trp metabolism regulates cancer growth and metastasis by complex mechanisms. 5-MTP and melatonin provide valuable lead to develop new drugs for chemo-prevention and adjuvant therapy of cancer.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77588315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-20DOI: 10.30683/1927-7229.2020.09.02
Krishnendu Ghosh
: Histopathologically classified low-grade brain tumours show overlapping biological characteristics making them difficult to distinguish. In the present study low-grade brain tumour patient samples of three different histopathological types have been trained through machine learning technique using selected features for its classification. We used specifically the fundamental proliferation, invasion, macrophage infiltration triangle of cancer hallmark with propidium iodide (PI) marked cell-cycle, Ki67 marked proliferative indexing, invasion with MMP2 expression and presence of macrophage/microglia by silver-gold staining, CD11b+ and Iba1+ cell presence as biological parameters. These parameters when trained with proper machine learning protocol through extraction of underling features and represented in a 2D perceivable space are found capable of distinguishing the tumour types. Extracted features from such parameters in a six-dimensional featured space were trained through statistical learning theory while support vector machine (SVM) maximizes their predictive precision. The leave one out (LOO) cross validation process was applied to judge the accuracy of training followed by auto-encoder (AE) to reduce feature dimension at two which is visually perceptible. From the biological features quantified with standard methods it was found impossible to demarcate the three types of low grade brain tumours. However, after training through SVM and LOO cross validation when the six- dimensional featured space had been reduced into two-dimension using AE, the combined output of the features showed clear zonation in that 2D space. This indicates that the overlapping biological characteristics of these tumour types, when trained through proper support vector machine and reduced from multiple to two dimensional space provides a clear patho-clinical classification edge using a combination of common biological features. Hence, machine learning applications may potentially be used as a complementary diagnostic protocol with the conventional practice.
{"title":"Brain Tumour Classification by Machine Learning Applications with Selected Biological Features: Towards A Newer Diagnostic Regime","authors":"Krishnendu Ghosh","doi":"10.30683/1927-7229.2020.09.02","DOIUrl":"https://doi.org/10.30683/1927-7229.2020.09.02","url":null,"abstract":": Histopathologically classified low-grade brain tumours show overlapping biological characteristics making them difficult to distinguish. In the present study low-grade brain tumour patient samples of three different histopathological types have been trained through machine learning technique using selected features for its classification. We used specifically the fundamental proliferation, invasion, macrophage infiltration triangle of cancer hallmark with propidium iodide (PI) marked cell-cycle, Ki67 marked proliferative indexing, invasion with MMP2 expression and presence of macrophage/microglia by silver-gold staining, CD11b+ and Iba1+ cell presence as biological parameters. These parameters when trained with proper machine learning protocol through extraction of underling features and represented in a 2D perceivable space are found capable of distinguishing the tumour types. Extracted features from such parameters in a six-dimensional featured space were trained through statistical learning theory while support vector machine (SVM) maximizes their predictive precision. The leave one out (LOO) cross validation process was applied to judge the accuracy of training followed by auto-encoder (AE) to reduce feature dimension at two which is visually perceptible. From the biological features quantified with standard methods it was found impossible to demarcate the three types of low grade brain tumours. However, after training through SVM and LOO cross validation when the six- dimensional featured space had been reduced into two-dimension using AE, the combined output of the features showed clear zonation in that 2D space. This indicates that the overlapping biological characteristics of these tumour types, when trained through proper support vector machine and reduced from multiple to two dimensional space provides a clear patho-clinical classification edge using a combination of common biological features. Hence, machine learning applications may potentially be used as a complementary diagnostic protocol with the conventional practice.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75010558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-20DOI: 10.30683/1927-7229.2020.09.10
Rajesh Javarappa
: Purpose: Radiation treatment of all malignancies inevitably includes certain percentage of bone marrow in the site and volume of irradiation. The purpose is to study the magnitude of radiation induced early haematological toxicity in relation to the total dose and volume of the marrow in the field of irradiation. Materials & Methods: A Prospective analysis was done in 60 patients treated with telecobalt. Haemoglobin, WBC and platelet counts were done before starting treatment and then weekly till the completion of treatment. The volume of bone marrow in the radiation fields was also recorded. Results: The haemoglobin percentage change between baseline and 5 th week was 5.19%(p=0.026) and7.35% (p=0.049) in <5%, 5-20% &>20% of bone marrow irradiated respectively. The percentage of change between baseline and 5 th week total WBC count was 23.79% (p=0.000), 35.53% (p=0.006) and 27.90% (p=0.000) in <5%, 5-20% &>20% of bone marrow irradiated respectively. The percentage change in platelets between baseline and 5 th week of 22.14%, 24.66% & 24.80% in patients with <5%, 5-20% and >20% of bone marrow irradiated respectively (overall p=0.000). Conclusion: The percentage of active bone marrow in the field of irradiation, dose per fraction and the total dose received are the best parameters for the study of haematological variations in patients being treated with radiotherapy. There is significant Haematological variations with decreasing trend in relation to volume of bone marrow irradiated and radiation dose.
{"title":"Acute Haematological Variations in Patients Receiving Radiotherapy and its Correlation with Volume of the Bone Marrow and Radiation Dose","authors":"Rajesh Javarappa","doi":"10.30683/1927-7229.2020.09.10","DOIUrl":"https://doi.org/10.30683/1927-7229.2020.09.10","url":null,"abstract":": Purpose: Radiation treatment of all malignancies inevitably includes certain percentage of bone marrow in the site and volume of irradiation. The purpose is to study the magnitude of radiation induced early haematological toxicity in relation to the total dose and volume of the marrow in the field of irradiation. Materials & Methods: A Prospective analysis was done in 60 patients treated with telecobalt. Haemoglobin, WBC and platelet counts were done before starting treatment and then weekly till the completion of treatment. The volume of bone marrow in the radiation fields was also recorded. Results: The haemoglobin percentage change between baseline and 5 th week was 5.19%(p=0.026) and7.35% (p=0.049) in <5%, 5-20% &>20% of bone marrow irradiated respectively. The percentage of change between baseline and 5 th week total WBC count was 23.79% (p=0.000), 35.53% (p=0.006) and 27.90% (p=0.000) in <5%, 5-20% &>20% of bone marrow irradiated respectively. The percentage change in platelets between baseline and 5 th week of 22.14%, 24.66% & 24.80% in patients with <5%, 5-20% and >20% of bone marrow irradiated respectively (overall p=0.000). Conclusion: The percentage of active bone marrow in the field of irradiation, dose per fraction and the total dose received are the best parameters for the study of haematological variations in patients being treated with radiotherapy. There is significant Haematological variations with decreasing trend in relation to volume of bone marrow irradiated and radiation dose.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80497912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-20DOI: 10.30683/1927-7229.2020.09.04
Krystal Hughes
: The improvement in tumor outcomes associated with the use of immune checkpoint inhibitors (ICIs) is supported by results of numerous clinical trials. Even though most publications reporting the clinical efficacy of these agents include a discussion of the biological mechanisms, narratives related to the complex nature of the adaptive immune response are frequently, though they should not be, mundane. It is also apparent that there tends to be a cursory, or even complete absence, of explanations related to the pathological mechanism(s) of the toxic reactions in the vast majority of papers that report adverse events associated with ICI therapy. Furthermore, the belief that cytotoxic CD8 + T cells mediate not only the antitumor, but also immune-related adverse, effects may be plausible, yet incorrect. This being the case, instead of providing only clinical details of a severe adverse event associated with combination ICI therapy in a patient with melanoma, the authors chose to scrutinize the repertoire and role of T cells in the pathogenesis of myocarditis as an example of other ICI-associated incidents of autoimmunity.
{"title":"Molecular Pathology of Immune Checkpoint Inhibitor-Induced Myocarditis","authors":"Krystal Hughes","doi":"10.30683/1927-7229.2020.09.04","DOIUrl":"https://doi.org/10.30683/1927-7229.2020.09.04","url":null,"abstract":": The improvement in tumor outcomes associated with the use of immune checkpoint inhibitors (ICIs) is supported by results of numerous clinical trials. Even though most publications reporting the clinical efficacy of these agents include a discussion of the biological mechanisms, narratives related to the complex nature of the adaptive immune response are frequently, though they should not be, mundane. It is also apparent that there tends to be a cursory, or even complete absence, of explanations related to the pathological mechanism(s) of the toxic reactions in the vast majority of papers that report adverse events associated with ICI therapy. Furthermore, the belief that cytotoxic CD8 + T cells mediate not only the antitumor, but also immune-related adverse, effects may be plausible, yet incorrect. This being the case, instead of providing only clinical details of a severe adverse event associated with combination ICI therapy in a patient with melanoma, the authors chose to scrutinize the repertoire and role of T cells in the pathogenesis of myocarditis as an example of other ICI-associated incidents of autoimmunity.","PeriodicalId":14957,"journal":{"name":"Journal of Analytical Oncology","volume":"2019 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90512483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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