Journal of the Egyptian National Cancer Institute最新文献

Introduction: Breast cancer is considered to be the most common cancer that affects women worldwide, where it accounts for approximately 38.8% of all cancer cases among females. Luminal subtypes are the most prevalent in Egypt. Small noncoding RNAs also called microRNAs (miRNAs) influence gene expression posttranscriptionally. Since they regulate the epithelial-mesenchymal transition process, which is vital for tumor invasion and metastasis, microRNAs play a critical role in the progression of cancer.

Methods: This study has investigated the expression profiles of four microRNAs (miR-101-3p, miR-106a-5p, miR-106b-5p, and miR-130b-5p) and their impacts on genes associated with epithelial-mesenchymal transition (EMT) in luminal breast cancer. Tissue samples from 43 luminal breast cancer patients and 18 controls have been studied via real-time PCR (RT-qPCR). The association between the expression levels was evaluated using the Pearson correlation test. The correlation between the measured variables and numerous clinicopathological characteristics was assessed using the linear regression test.

Results: The results demonstrated that miR-101-3p, miR-106a-5p, and miR-106b-5p were significantly dysregulated, highlighting their possible role as oncogenes or tumor suppressors in the development of breast cancer. EMT markers, especially Twist, SNAI1, and E-cadherin, show significant alterations, indicating the activation of EMT pathways in luminal breast cancer. Correlation analysis showed interactions between miRNAs and EMT-related genes, showing a negative correlation between miR-101-3p and SNAI1, as well as a positive correlation between Twist and miR-106a-5p. Moreover, logistic regression analysis associated expression levels of those miRNAs with clinicopathological characteristics, such as body weight, age, and tumor laterality.

Conclusion: These findings highlight the leading role of miR-101-3p and miR-106b-5p in the progression of luminal breast cancer via interacting with the EMT process and their potential as diagnostic, prognostic, and therapeutic targets.

Background: Hepatocellular carcinoma (HCC) is a major global health concern due to its high prevalence and mortality rate. Although emodin, a natural anthraquinone derivative, has demonstrated in vitro anticancer activity against HCC cells, its specific molecular targets in HCC remain unclear.

Method: This study used an integrated approach combining in silico network pharmacology, molecular docking, molecular dynamics simulations (MDS), and in vitro cytotoxicity assays to evaluate three emodin derivatives: emodin, 3-acetyl emodin (ACE), and 1,3,8-triacetyl emodin (TAEM). Target predictions were performed using the SwissTargetPrediction database, and HCC-related genes were retrieved from cBioPortal. Functional annotations (Gene Ontology and Reactome) identified EGFR and KIT as key targets. Docking simulations were conducted to assess binding affinities, followed by 100 ns MDS to evaluate stability. Cytotoxic effects on HepG2 cells were also assessed.

Result: TAEM showed the strongest binding affinity to both EGFR and KIT and demonstrated the highest cytotoxicity against HepG2 cells (IC50 = 0.021 mM). MDS results indicated that the KIT-TAEM complex was the most stable among all tested combinations, supported by RMSD, RMSF, Rg, protein-ligand distance, and MM-GBSA binding energy analyses.

Conclusion: These findings highlight TAEM as a promising therapeutic candidate for HCC. The study demonstrates the value of integrating computational predictions with experimental validation in early-stage drug discovery.

Introduction and background: Non-small cell lung cancer (NSCLC) is the third most common type of cancer in Palestine and has the highest mortality rate. Treatment approaches for NSCLC depend on many factors including stage, histology, molecular profile, and patient performance status.

Objectives: This study explored the patient characteristics, molecular profiles, metastatic sites, prognosis, and treatment modalities.

Methods: This observational retrospective cohort study was conducted at multiple Palestinian hospitals. This study included patients diagnosed with metastatic NSCLC between 2016 and 2022. Patients with small-cell lung cancer (SCLC), newly diagnosed lung cancer, or incomplete information were excluded from the study. Patient data were obtained from the date of lung cancer diagnosis until death or loss to follow-up. Data were analyzed using IBM SPSS, and overall survival was calculated using the Kaplan-Meier estimate.

Results: The study included 102 patients, 80.4% were male, 40.2% were current smokers, 42.2% were ex-smokers, and 17.6% were nonsmokers. (86.35%) of the patients were diagnosed with adenocarcinoma, and (77.5%) were diagnosed with stage IV NSCLC. Tumor recurrence was observed in 47.1% of patients after surgery. A total of 56.9% had PDL-1 expression ≥ 10%, and 45.1% had EGFR mutations. Fourteen (13.7%) received mono-chemotherapy with an estimated OS of (1219.200) days, 34 (33.3%) received mono-immunotherapy with an estimated OS of (720.152) days, and 54 (52.9%) received a combination of chemotherapy and immunotherapy with an OS of 2006.777 days. PFS (> 1 year) was higher in patients receiving combination therapy (58.3%). Myelosuppression, renal damage, and liver damage are some of the major side effects experienced by patients receiving either type of treatment.

Conclusion: The findings of this study provide vital information on tumor molecular mutation patterns and PDL expression for the adoption of appropriate measures in prevention and treatment strategies for NSCLC in Palestine. The majority of patients diagnosed with NSCLC were males with a history of smoking and were diagnosed at an advanced stage, which requires increased education, wariness of lung cancer, and smoking cessation programs at the national level.

Background: The literature on nutrition support therapy prescribing practices by physicians and the roles of nutrition support pharmacists in palliative and hospice care cancer patients is limited.

Methods: The study aimed to analyze the prescribing practices of physicians and the roles of clinical pharmacists at a tertiary cancer center. A retrospective analysis of 12527 electronic records of hospice and palliative care cancer patients. All nutrition support therapy prescriptions by physicians and clinical pharmacists' interventions were recorded. Analysis was conducted utilizing the Jamovi statistical package 2022.

Results: The study population comprised inpatients and homecare patients. The most frequently prescribed nutrition support therapy was vitamins and minerals supplements, followed by enteral nutrition and parenteral nutrition. The total number of nutrition support pharmacist interventions was 660 (5.2%). The acceptance rate of interventions by physicians was 90%. Initiating mineral use was the most frequent intervention, followed by discontinuation of mineral use.

Conclusion: Vitamins and mineral supplements are the most prescribed type of nutrition support therapy. The interventions of clinical pharmacists were highly accepted by physicians. Initiating mineral use is the most frequent intervention. Further research is needed to explore the impact of nutrition support therapy on patient outcomes and barriers to its implementation.

Background: Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5 days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5 days (Paxlovid).

Case presentation: Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.

Conclusion: Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.

Introduction: Oral cancer (OC) is one of the major global health problems with a high incidence rate in developing countries. Early detection can improve the prognosis and survival rate of the disease.

Aim: The current study evaluates dentists' general awareness, knowledge, attitude, and practice regarding oral cancer.

Methods: In the current cross-sectional study, a self-reported questionnaire was distributed to a sample of dentists in Egypt. A total of 700 dentists participated. The questionnaire included 27 questions on oral cancer knowledge, opinions, attitudes, and practices.

Results: The highest awareness of risk factors concentrated around tobacco and alcohol consumption, and the most acknowledged clinical presentations were non-healing ulcers, red lesions, white lesions, and induration. The tongue was considered a high-risk site by 69% of participants, followed by the floor of the mouth and the buccal/lip mucosa. Only 37% of the participants carried out proper clinical screening for OC, while only 31% carried out routine lymph node examinations. Sixty-six percent of participants considered themselves incompetent regarding detection of OC. Ninety-two percent of participants acknowledged the important role of dentists in the early detection of oral cancer, and 99% of them thought that oral cancer awareness campaigns are needed and would be effective. Awareness was significantly associated with years of practice.

Conclusion: Awareness regarding OC among the Egyptian dentists participating in the current survey showed definitive defects. Hence, efforts to raise awareness of OC among dental practitioners are an important factor in improving/early detection of OC, with the resultant increase in survival rate and decrease in morbidity. This can be reached only through more solid undergraduate syllabi and training as well as workshops and campaigns.

Triple-negative breast cancer (TNBC) accounts for 10-20% of all breast cancers. These tumors are heterogeneous, highly aggressive, and associated with a poor prognosis and a high risk of recurrence. In both hematologic and solid malignancies, immune checkpoint inhibitors (ICIs) have demonstrated the ability to enhance long-term survival and sustain robust anti-tumor responses. Immunotherapy has also been introduced as a treatment option for TNBC, a subtype characterized by a high presence of intra-tumoral tumor-infiltrating lymphocytes (TILs) and stromal immune cells. This heightened immune activity within TNBC serves as a prognostic marker, indicating a potential for better responses to immunotherapy due to increased tumor immune infiltration. This review provides an overview of the current landscape of immunotherapy in TNBC, exploring its rationale and application across different disease stages. Trial registration NCT02555657.

Background: Hepatocellular carcinoma during pregnancy is rare and poses significant potential risks to both the pregnant individual and the fetus. Here, we report a case of hepatocellular carcinoma during pregnancy. The 28-week gestational is a critical point of fetal maturation. A literature review revealed no similar case with survival exceeding 2 years, following resection of a large hepatocellular carcinoma diagnosed in late-stage pregnancy. This article may contribute to future research aimed at extending the survival time of patients with hepatocellular carcinoma diagnosed in late pregnancy.

Case presentation: A 33-year-old pregnant woman was diagnosed with hepatocellular carcinoma at 34 weeks of pregnancy. A cesarean section was performed at 34 weeks of pregnancy. Under general anesthesia, a right lobectomy of the liver was conducted after 15 days. The patient received continuous support from the clinical psychology team throughout the entire perioperative period. The postoperative recovery was smooth, and the patient was discharged without any significant complications. Approximately 2 years post-surgery, follow-up indicated that the patient remained alive and in good health.

Conclusions: The physiological changes associated with pregnancy can promote rapid tumor growth, leading to poor prognoses. Expert decision-making should be guided by the growth and maturation status of the fetus in relation to hepatocellular carcinoma development. For patients in the late stage of pregnancy, timely termination of pregnancy and tumor resection surgery, along with obtaining assistance from the clinical psychology team during the perioperative period, followed by post-discharge treatment with a combination of Sintilimab and Lenvatinib, constitutes an effective strategy for prolonging patient survival.

HCC is one of the most life-threatening human cancers in the world. It is considered the major malignant tumor of the liver in adults and is the most common cause of death in people with cirrhosis. Chemotherapy is widely used for HCC treatment, but it has many side effects. Therefore, an alternative, safe method with low side effects, low toxicity, and a higher anti-cancer effect is in demand. In our study, we used Se-NPS alone and combined it with Gamma and UV radiation at different doses. We also used the chemotherapeutic drug sorafenib on Hep G2 cell lines to compare the effect of Se-NPS (with and without radiation) with the sorafenib group. Our results showed that Selenium alone without radiation had a lesser effect on eliminating cancer cells, with high cell viability and fewer apoptotic effects. On the other hand, Selenium combined with radiation, especially at high doses of UV (180 s) and gamma (0.2 Gy), had the highest effect on killing cancer cells. This combination resulted in significantly lower cell viability, high DNA fragmentation, and a high apoptotic effect due to a significant elevation of P53 and cytosolic cytochrome C, which was better than the Radiation-only groups.