Journal of the Egyptian National Cancer Institute最新文献

Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Due to the advanced stage in which HCC presents, most patients are only eligible for transarterial chemoembolization (TACE) or radioembolization (Y⁹⁰). The purpose of this study is to examine the differences in survival and health-related quality of life (HRQOL) in patients diagnosed with HCC and treated with TACE or Y⁹⁰.

Methods: Two hundred thirty-four patients with HCC were enrolled in studies examining HRQOL between 2003-2009. HRQOL was evaluated using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). Between-group differences were examined using chi-square and ANOVA. Survival was assessed using Kaplan-Meier and Cox regression analyses.

Results: Significant baseline differences between patients treated with TACE versus Y⁹⁰ were found. Patients who received Y⁹⁰ tended to be older (p < 0.001), female (p < 0.001), had fewer lesions (p = 0.03), had smaller tumors (p = 0.03), and were less likely to have vascular invasion (p = 0.04). After adjusting for demographic and disease-specific factors, no significant differences in HRQOL were observed at 3 months (p = 0.79) or 6 months (p = 0.75). Clinically meaningful differences were found, with the TACE group reporting greater physical, social, and emotional well-being at 3 and 6 months and greater overall HRQOL at 6 months. No significant differences in survival were found.

Conclusions: Treatment with TACE and Y⁹⁰ was similar with regard to survival. However, TACE showed statistically and clinically meaningful benefits in physical, social/family, and emotional well-being. Further research is warranted to identify profiles of patients who may demonstrate a preferential response to either TACE or Y⁹⁰.

Background: With the third incident rate and a second mortality rate, colorectal cancer (CRC) continues to be one of the most prevalent and deadly malignancies worldwide. Adenomas usually develop into adenocarcinomas in colorectal cancer (CRC), a process that can be halted by early detection and prevention care.

Main body: Faecal immunochemical testing (FIT) and endoscopies are examples of current screening tools that dramatically lower the incidence and death of colorectal cancer. Current development centre on non-invasive methods that provide better accuracy and lower dangers, such as blood-based liquid biopsies and imaging modalities like CT and MR colonography. For early detection, liquid biopsies-especially those using methylated DNA tests like SEPT9-offer encouraging outcomes. Circulating tumour DNA (ctDNA) has emerged as a crucial biomarker, increasing early identification and therapy monitoring. Proteomic and metabolic indicators further improve screening by figuring out who is at high risk and keeping an eye out for recurrence. The accuracy and detection rates of polyps have increased due to advancements in imaging technologies like as artificial intelligence (AI), narrow-band imaging (NBI), and high-definition colonoscopy. The emphasis has been on preventive measures, such as chemoprevention and lifestyle modifications, dietary fibre, regular exercise, and chemoprotective drugs like aspirin have demonstrated potential in lowering the incidence of colorectal cancer. There are still issues with the global implementation of screening, including differences in access to screening between socioeconomic and racial groups. Hope for more individualized and efficient CRC screening and prevention are provided by new research on biomarkers and technological advancements like artificial intelligence and polygenic risk classification.

Conclusion: With a variety of invasive and non-invasive techniques available to identify cancer early. With a variety of invasive and non-invasive techniques available to identify cancer early. To enhance prognosis and lower mortality, colorectal cancer screening has undergone tremendous advancement. Although colonoscopy and faecal immunochemical assays (FIT) are still good standards for detecting colorectal cancer (CRC), advances in liquid biopsy, proteomics, and imaging have transformed the field and offered less invasive, more precise choices, for early identification and surveillance, circulating tumour DNA (ctDNA) and other biomarkers show tremendous potential.

Introduction: The nodal positivity in advanced ovarian cancers is approximately 68-70% histopathologically. Even after neoadjuvant chemotherapy (NACT) chance of nodal positivity is around 50-80%. In the prevailing literature, the nodal burden is a neglected entity in both assessment and documentation and complete clearance during the CRS. We aim to highlight the importance of nodal dissection and propose a Nodal Cancer Index (NCI) like PCI for ovarian cancers based on our experience of 105 cases.

Materials and methods: We included 105 patients with advanced ovarian cancers who underwent CRS. Retroperitoneal lymph nodes and bilateral pelvic lymph node dissection were routinely done in all the cases. For Nodal Cancer Index calculation, the abdomen is divided into 13 zones, zones 1-6 for retroperitoneum, zones 1-6 for Pelvic nodes, and zone 0 for extra-abdominal nodes. Furthermore, a Nodal size score ranging from 1 to 3 has been proposed so that the Nodal Cancer Index ranges from 13 to 39.

Results: The median age of the patients was 51 years (range 19-71) and the most significant patients were in stage III (65.7%), and 34.3% had stage IV disease at presentation. The lymph nodes were found to be positive in 62 patients (59%), and the positivity rate was higher in patients who underwent upfront surgery 36 (58.1%) as compared to 26 (41.9%) in those who received NACT. The majority of the patients (56.6%) had positive lymph nodes in both the pelvic and retroperitoneal groups, whereas 19.3% had only pelvic nodes positive, and 24.2% had only retroperitoneal nodes positive. The probability of overall survival at 5 years in our patients was 48.9% (95% CI = 35.5-61).

Conclusion: The results of our analytic observation confirm that systemic lymphadenectomy of all 13 zones proposed by our study should be an integral part of optimal CRS in the advanced carcinoma ovary and this will help us manage these advanced cases in a better objective manner.

Objective: This meta-analysis investigates the association between acute lymphoblastic leukemia (ALL) susceptibility and IKZF1 gene SNPs.

Methods: Utilizing EMBASE, PubMed, and other databases, the study evaluated methodological quality through the Newcastle-Ottawa Scale (NOS) scoring and Hardy-Weinberg Equilibrium (HWE) value. The present meta-analysis used Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Review Manager 5.4 software was employed for data analysis, emphasizing genetic variants' significance (p < 0.05). Visualizations were achieved using funnel and Circos plots.

Results: A significant association was found between rs4132601 and ALL across genetic models, contrasting with the non-significant correlation for rs11978267. The findings underscore the complex interplay of genetic factors in ALL susceptibility, particularly related to IKZF1 SNPs. Ethnicity emphasizes the importance of diverse population considerations.

Conclusion: This meta-analysis highlights the significance of rs4132601 in ALL's genetic foundation, suggesting potential advancements in diagnostics. The lack of correlation for rs11978267 highlights the complexity of its genetic association. Future studies should prioritize larger, diverse samples for a comprehensive understanding and improved strategies for ALL diagnoses and treatments.

Background: Coinfections and reactivation of persistent or latent viral infections such as herpesviruses (HHV) and/or measles virus (MeV) have been reported among COVID-19 patients. However, there is limited information regarding cancer patients who experienced severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). The primary purpose of this study was to investigate the interplay between SARS-CoV-2, HHV and MeV in cancer patients, aiming to provide insights into the pathophysiology of these infections and to enhance the patients' health outcomes.

Methods: A prospective observational study was conducted on 4 groups (n = 147): newly diagnosed cancer patients infected with SARS-CoV-2 (n = 37), newly diagnosed cancer patients non-infected with SARS-CoV-2 (n = 13), apparently normal individuals infected with SARS-CoV-2 (n = 82) and finally a normal control group (n = 15). All samples were tested for SARS-CoV-2 infection using the real-rime quantitative reverse transcription polymerase chain reaction (qRT-PCR). Antibody responses were analyzed using indirect enzyme-linked immunosorbent assay (ELISA), and antibody levels were compared between patients and controls. Potential re-activation was investigated using fourfold (i.e. 400%) rise model criterion.

Results: In all positive cases of SARS-CoV-2, recent infections or re-infection of herpes simplex viruses 1 and 2 (HSV1/2 or HHV1-2) were found to be significantly increased approximately three-fold higher in COVID-19 patients (p = 0.007) identified via pooled HSV1/2 IgM levels in plasma. Furthermore, reactivation of HSV1/2 was 29.7% in cancer/COVID-19 patients (n = 37) versus 0.0% of normal/COVID-19 group (n = 22) (p = 0.008). Likewise, Epstein-Barr Nuclear Antigen-1 (EBNA-1) IgG levels showed a ≥ fourfold increase in 20% (p = 0.034) of cancer patients (n = 50) versus 4.9% of controls (n = 41) for reactivation of Epstein-Barr virus (EBV or HHV-4). Obviously, MeV IgG levels increased up to 78.0% in cancer patients (n = 50) versus 17.5% in non-cancerous group (n = 40, p < 0.001). Reactivation of MeV in cancer and COVID-19 patients was 43.2% versus 30.8% cancer non-COVID-19 group, 3.3% normal COVID-19, and 0.0% in healthy volunteers (p < 0.001).

Conclusion: Cancer patients infected with SARS-CoV-2 were at increased risk of HHV and MeV co-infection and reactivation.

Chronic myeloid leukemia (CML) is a kind of leukemia that arises due to the translocation betwixt chromosomes 9 and 22. Philadelphia chromosome is characterized by the BCR::ABL fusion gene, which results from this recombination. It transcribes into active tyrosine kinase variants such as P185, P190, P210, and P230, depending on breakpoint chain variations. The fusion protein, encodes tyrosine kinases with varying exons, resulting in uncontrollable ATP-utilizing downstream signaling activities. Targeted therapy with various tyrosine kinase inhibitors (TKIs) is used to combat BCR::ABL fusion kinases and increase the survival rate of patients. However, the incidence of TKI resistance among CML patients is widely noticed around the world. Hence, an elaborate and accurate understanding of the structural interactions between BCR::ABL encoded tyrosine kinases, which are responsible for sensitivity and resistance, is mandatory for hassle-free targeted therapy. This review is intended to cover the reported structural interactions between BCR::ABL variants and TKI ligands in detail to highlight strategies that may be applied in the near future to overcome the resistance and other cross-reactions.

Introduction: Skin tumours comprise an important fraction of dermatology practice. Skin tumours can be benign or malignant, and patients can present with a merely unsightly nodule to a rapidly growing nodule. The diagnosis is made on pathological basis, which is done after performing skin biopsies.

Aim: In this study, we aim to describe the characteristics of malignant skin tumors diagnosed by skin biopsies over a one-year period (2023) at the Department of Dermatology, King Hussein Medical Center (KHMC).

Methods: In this retrospective study, data from biopsies that were done at our department and diagnosed as skin cancers were collected, patients' demographics were registered; including age, gender, and tumour location, and final diagnosis was recorded. Data was registered on an Excel® datasheet and analyzed using simple statistical methods.

Results: There were 78 biopsies that were diagnosed as skin cancers at the department of Dermatology. Of these, the most common diagnosis was basal cell carcinoma with 38% of the biopsied cancers. Eighteen per cent were diagnosed as squamous cell carcinomas, and 15% were melanomas. Mycosis fungoides and cutaneous T cell lymphoma cases were included in this study and reached 18% of the diagnosed skin cancers in our patients.

Accumulated evidence supported the crucial role of a tiny population of cells within the tumor called cancer stem cells (CSCs) in cancer origination, and proliferation. Additionally, these cells are distinguished by their self-renewal, differentiation, and therapeutic resistance capabilities. Interestingly, many studies recorded dysregulation of different types of noncoding RNAs, such as microRNA (miRNA) and long non-coding RNA (LncRNA), in cancer cells as well as CSCs. Moreover, several studies also supported the regulation of the transcription factors and signaling pathways required for CSC progression by these noncoding RNAs. However, the exact biological functions of all these noncoding RNAs are not well understood yet. These findings are of great interest, implying usage of noncoding RNA as therapeutic tool to target these cells. In this review, we provide an insight into how noncoding RNAs regulate CSCs and how this correlation is manipulated to develop new therapies to eradicate cancer cells successfully.

Background: Machine learning (ML) is a significant area of artificial intelligence, which can improve the accuracy of predictive or diagnostic models for differentiating between prostate biopsy outcomes. This study aims to develop a novel decision-support ML model for classifying patients with biopsy-negative (cancer-free), clinically significant, and non-clinically significant prostate cancer across two prostate-specific antigen (PSA) cut-offs ≤ 10 ng/ml and > 10 ng/ml.

Methods: The data for the current study were retrieved from the records of two main hospitals in Riyadh, Saudi Arabia from July 2018 through July 2024. Six machine learning algorithms were employed, and the dataset was randomly divided into a training set and a validation set at a ratio of 8:2. The following metrics were used as performance indicators across the six algorithms: Accuracy, Precision, Recall, F1-score, and area under the curve. Recent data from the two hospitals was utilized for external validation.

Results: The metrics for Random Forest, Extra Tree, and Decision Tree algorithms showed excellent capability in classifying the outcomes of prostate biopsy for the two PSA cut-offs. However, the metrics for the PSA cut-off > 10 ng/ml are higher than those for PSA ≤ 10 ng/ml. For the three-class classification, the accuracy and area under the curve for the cut-off > 10 ng/ml were 0.96 and 0.99, respectively. While for the cut-off ≤ 10 ng/ml they were 0.92 and 0.94 for Random Forest and 0.94 and 0.95 for the Extra Tree algorithm. The metrics of non-clinically significant and biopsy-negative cases outperformed those of clinically significant cases.

Conclusion: ML models are proving to be effective tools in differentiating between prostate biopsy outcomes, enhancing diagnostic accuracy, and potentially transforming clinical practices in prostate cancer management.

Background: To investigate the anticancer effects of 5-Fluorouracil (5-FU), thymoquinone (TQ), and/or coenzyme Q10 (CQ10), alone and combined, in HT29, SW480, and SW620 human colorectal cancer (CRC) cell lines.

Methods: Cell cycle progression and apoptosis were assessed by flow cytometry. Gene and protein expression of molecules involved in apoptosis (BLC2, survivin, BAX, Cytochrome-C, and Caspase-3), cell cycle (CCND1, CCND3, p21, and p27), the PI3K/AKT/mTOR/HIF1α oncogenic pathway, and glycolysis (LDHA, PDH, and PDHK1) were also analysed by quantitative RT-PCR and Western blot. Oxidative stress markers (ROS/RNS, MDA, and Protein carbonyl groups) and antioxidants (GSH and CAT) were quantified by ELISA.

Results: All treatments resulted in anticancer effects depicted by cell cycle arrest and apoptosis, with TQ demonstrating greater efficacy than CQ10, both with and without 5-FU. However, 5-FU/TQ/CQ10 triple therapy exhibited the most potent pro-apoptotic activity in all cell lines, portrayed by the lowest levels of oncogenes (CCND1, CCND3, BCL2, and survivin) and the highest upregulation of tumour suppressors (p21, p27, BAX, Cytochrome-C, and Caspase-3). The triple therapy also showed the strongest suppression of the PI3K/AKT/mTOR/HIF1α pathway, with a concurrent increase in its endogenous inhibitors (PTEN and AMPKα) in all cell lines used. Additionally, the triple therapy favoured glucose oxidation by upregulating PDH, while decreasing LDHA and PDHK1 enzymes. The triple therapy also displayed the most significant decline in antioxidant levels and the highest increases in oxidative stress markers.

Conclusions: This study is the first to demonstrate the superior anticancer effects of TQ compared to CQ10, with and without 5-FU, in CRC treatment. Moreover, this is the first report to reveal improved anticancer effects of the 5-FU/TQ/CQ10 triple therapy, potentially through promoting oxidative phosphorylation, attenuating the PI3K/AKT/mTOR/HIF1α pathway, and increasing oxidative stress-induced apoptosis.