Tumori最新文献

Cancer is one of the leading causes of death worldwide, and early tumor detection can significantly reduce mortality rates. Liquid biopsy is a minimally invasive, repeatable method with a high economic benefit ratio, and it shows excellent prospects for tumor diagnosis. However, the detection methods relying on classical biomarkers have limited sensitivity and accuracy. The application of auxiliary reagents, such as iRGD, promotes the release of alpha-fetoprotein (AFP) to improve the detection efficiency of liver cancer. Artificial intelligence (AI) technology is increasingly being applied as an assistant in tumor diagnosis. It can automatically identify tumor lesions in imaging, analyze tumor-related gene mutations, classify circulating tumor cells (CTCs), and integrate multi-omics data. These auxiliary means have enhanced the efficiency of tumor screening or detection. In this review, we summarize the combined applications of iRGD and AFP. We also discuss emerging new detection techniques, including CTCs, circulating tumor DNA (ctDNA), exosomes, and tumor-educated platelets (TEPs), specifically with the help of AI. The aim is to better understand the auxiliary role of the iRGD reagent and AI technology in early tumor detection.

Background: Tobacco smoking is a leading cause of global mortality, with cessation being the primary prevention strategy. Nicotine addiction has a genetic component; the rs503464 single nucleotide polymorphism (SNP) in the CHRNA5 gene is associated with smoking cessation therapy success. However, the impact of communicating genetic risk to patients remains unclear. This study evaluated whether knowledge of the rs503464 genotype influences smoking cessation rates.

Methods: 270 smokers were enrolled and randomized into two groups: informed and uninformed of their rs503464 genotype. All participants received standard pharmacological-behavioral interventions. Cessation rates were assessed at 1, 3, 6, and 12 months. Multivariable logistic regression models analyzed the effect of knowing the rs503464 genotype and other variables on cessation success.

Results: Among the 219 subjects who started prescribed smoking cessation medication, no significant differences in cessation rates were observed between participants informed or not informed of their rs503464 genotype at any follow-up point (P > 0.05). Male gender and higher baseline carbon monoxide levels were associated with lower success rates at three months. The medications used were equally effective.

Conclusions: Communication of the rs503464 genotype did not influence smoking cessation success, proving that it does not disturb this process. This result opens the possibility of using genetic information to personalize anti-smoking treatment.

Objective: The autoimmune regulator (AIRE), an atypical transcriptional regulator, exhibits aberrant expression in multiple tumor types. However, its significance in lung squamous cell carcinoma (LUSC) is still uncertain. This study investigated AIRE's expression, immune microenvironment association, and prognostic value in LUSC.

Method: AIRE expression was analyzed using TCGA database, validated via RT-qPCR/Western blot in LUSC (H1703, SK-MES-1, EBC-1) vs. normal (BEAS-2B) cells. Tissue microarray immunohistochemistry (IHC) quantified nuclear/cytoplasmic AIRE in clinical samples. Clinicopathological correlations, immune infiltration (CIBERSORT), and survival outcomes were assessed. A nomogram integrating nuclear AIRE and clinical factors predicted 1/3/5-year survival (C-index evaluation).

Result: AIRE was upregulated in LUSC. Nuclear AIRE was tumor-specific (absent in normal tissue), elevated in inflammatory stroma (6.29 ± 4.57 vs. 3.10 ± 3.66, P < 0.001), and correlated with lymphocyte infiltration (R = 0.437, P < 0.001). High AIRE linked to increased Tregs (P< 0.001) and reduced dendritic cells (P< 0.01). No association with age, stage, or Ki-67 (P > 0.05) was observed. Patients with high AIRE had worse survival (HR = 2.00 [1.02 - 3.93], P = 0.043). The nomogram incorporating nuclear AIRE achieved a C-index of 0.814 for outcome estimation in our cohort.

Conclusion: In a LUSC cohort, nuclear AIRE expression is associated with immune microenvironment features and poorer overall survival. However, its incremental prognostic value beyond established clinicopathological variables appears modest, and further external validation and functional studies are warranted.

Background: Breast cancer is a leading malignancy among women worldwide, significantly affecting physical, psychological, and sexual well-being. Surgical options such as breast conservation surgery (BCS) and mastectomy have distinct implications on patients' quality of life. This study aimed to compare health-related quality of life (HRQoL) and sexual functioning in breast cancer patients undergoing BCS or mastectomy.

Methods: A prospective observational study was conducted over a 10-month period at a tertiary care hospital. Sixty-five breast cancer patients aged 20-50 years, who underwent either BCS (n=33) or mastectomy (n=32), were enrolled. Data were collected on baseline characteristics and HRQoL and sexual functioning were assessed using the EORTC QLQ-BR42 and Female Sexual Function Index (FSFI) questionnaires.

Results: BCS patients reported significantly better scores in FSFI domains such as desire, lubrication, orgasm, and satisfaction (p<0.05), with a higher final FSFI score (5.53 ± 1.78) compared to mastectomy patients (3.93 ± 1.06). On the BR42 scale, BCS patients showed better body image and satisfaction scores (p<0.05). No significant differences were observed in systemic side effects, future health worries, and sexuality domains between the groups.

Conclusion: Breast conservation surgery patients had better sexual function and quality of life compared to mastectomy patients. These findings underscore the importance of incorporating quality-of-life outcomes in surgical decision-making and preoperative counseling for breast cancer patients.

Purpose: The PROFFIT questionnaire was previously developed and validated, to assess financial toxicity (FT) in Italian patients with cancer. Here we describe FT in patients treated in a public Italian institution in 2024, with a focus on potential determinants of the problem.

Methods: PROFFIT was administered cross-sectionally to outpatients undergoing cancer therapy at AOU Città della Salute e della Scienza, Turin. Analysis was descriptive. Multivariate analysis explored association between clinical/demographic features, PROFFIT determinants and PROFFIT score.

Results: From October 2024 to December 2024, 359 patients filled in PROFFIT. Median PROFFIT score (0-100 scale) was 33.3 (IQR 14.3-52.4). One hundred and twenty five patients (35%) declared that illness reduced their financial resources. One hundred and three patients (29%) felt that their economic situation affects the possibility of receiving medical care; 124 (35%) felt that National Health Service does not cover all disease costs; 162 (46%) declared payments for private medical exams, 204 (56%) for additional medicines/supplements, 144 (40%) for additional treatments. PROFFIT score was significantly higher in younger patients, in those with worse educational level, in divorced/unmarried patients, in those with economically dependent family members, and in unemployed patients. PROFFIT score was higher for patients with a longer distance to travel to the hospital, although it was not statistically significant. At multivariate analysis, characteristics associated with PROFFIT score were educational level, economically dependent family members, employment status and time from diagnosis; PROFFIT determinants associated with PROFFIT score were payments for additional medicines, payments for additional treatments and travel expenses.ConclusionsEven within the Italian public health system, FT is not negligible among patients with cancer.

Choriocarcinoma is a malignant neoplasia which develops from trophoblastic cells. In males it is rare and often associated with other non-seminomatous germ cell tumours of the testis. Choriocarcinoma often presents with metastatic disease and elevated βHCG levels. Usually, patients' symptoms are associated with the different metastatic sites and they can be severe or even life-threatening. Moreover, choriocarcinoma is chemosensitive and the administration of chemotherapy with curative intent may lead to tumour-lysis syndrome and the more specific choriocarcinoma syndrome (CS). Therefore, the treatment of metastatic choriocarcinoma is complex, involving both oncological therapy and the management of acute complications. This review explores choriocarcinoma in males, focusing on its clinical presentation, pathogenetic mechanisms, and treatment options, including investigational therapies. Additionally, we aim to highlight the severe complications of CS and discuss its management strategies.

Objective: Many studies have highlighted that elevated body mass index (BMI) not only correlates with an elevated likelihood of developing breast cancer (BC) but may also influence patients' responsiveness to therapeutic regimens and long-term survival outcomes. The impact of BMI on therapeutic response to neoadjuvant chemotherapy (NAC) in patients with BC remains inconclusive. This study seeks to evaluate the effect of BMI on treatment response in the BC population undergoing NAC via a meta-analysis, thereby providing evidence-based support for clinical decision-making.

Methods: PubMed, Embase, Web of Science, and the Cochrane Library were thoroughly searched until July 29, 2024. Eligible studies were selected as per predefined eligibility criteria. Data extraction and quality assessment were executed via the Newcastle-Ottawa Scale (NOS). Statistical analyses were enabled by R 4.4.1 and Stata 17.

Results: Fifteen studies encompassing 15,235 patients were incorporated. The meta-analysis revealed that in contrast to patients with a normal or low BMI, those who were overweight or obese had a significantly reduced pathlological complete response (pCR) rate (OR: 0.79, p = 0.040). The underweight cohort demonstrated a higher pCR rate in comparison to those with normal BMI (OR: 1.56, p=0.015). Moreover, overweight and obese cohorts displayed a lower pCR rate in contrast to those having normal BMI (OR: 0.83, p < 0.0001).

Conclusion: This study indicates that overweight and obese patients tend to exhibit a reduced pCR, highlighting the need for standardized BMI definitions. Future well-designed prospective studies are necessitated to validate these observations.

Objective: As a serious malignancy of the head and neck region, laryngeal cancer (LC) exhibits active glycolysis that produces lactate, a metabolite capable of inducing protein lactylation. However, the role of lactate-induced modifications in LC progression remains poorly understood. Although ALYREF has been identified as an oncogenic driver in several cancers, its function in LC has not yet been investigated.

Methods: Malignant cell behaviors were assessed using Cell Counting Kit-8, EdU staining, glucose uptake, lactate production, and extracellular acidification rate (ECAR) assays. The experimental methodology also included quantitative real-time PCR, western blot, and xenograft tumor models.

Results: Data demonstrated that ALYREF is markedly overexpressed in LC and holds potential diagnostic value. Knockdown of ALYREF impaired both proliferation and glycolytic capacity in LC cells. Mechanistically, increased lactate levels promoted lactylation of ALYREF at the K171 site, which in turn enhanced ALYREF expression. Elevated lactate concentrations rescued the suppression of oncogenic phenotypes and glycolysis induced by ALYREF reduction. Furthermore, in vivo experiments confirmed that ALYREF silencing inhibited tumor growth.

Conclusions: Our findings indicate that ALYREF promotes tumor progression by enhancing glycolysis. Glycolysis-derived lactate stabilizes the ALYREF protein via lactylation at K171, establishing a positive feedback loop that drives LC malignancy. Silencing ALYREF suppresses tumor growth, underscoring its potential as a therapeutic target in LC.

Introduction: Cachexia is a multifactorial syndrome prevalent in advanced illness. Guidelines rarely integrate the relational, multidimensional perspective of palliative care (PC). Addressing this gap is essential to optimize care. To achieve this, national consensus among PC physicians and nurses on principles and priorities for managing cachexia within PC settings is necessary.

Methods: A two-round Delphi study was conducted with 43 Italian PC experts (29 physicians, 14 nurses) meeting ⩾10 years' experience criteria. In Round 1, participants answered open-ended questions informed by literature and a prior exploratory study. Qualitative Framework Method analysis generated 28 statements. In Round 2, statements were rated on a 5-point Likert scale; consensus was defined as ⩾90% agreement (scores 4 or 5).

Results: Response rates were 82.2% (Round 1) and 95.5% (Round 2). High consensus (⩾90%) from both physicians and nurses was reached for 14 of 28 statements. Unanimous agreement (100%) supported the need for multiprofessional management, assessment of symptom clusters, and reframing the meaning of food in relation to illness stage. Strong agreement was found for dyadic care planning (97.7%), oral care (97.7%), and body image assessment (95.3%). Lower consensus occurred for prioritizing nutritional deficits (55.8%) and routine CRP/prealbumin testing (34.5%), reflecting contextual and prognostic considerations.

Conclusions: This study defines core PC-oriented principles for cachexia management: interprofessional collaboration, dyadic engagement, early holistic assessment, and goal-concordant interventions. Findings can inform future clinical guidelines, training, and policy development to address cachexia in advanced illness.

Our study evaluated the desire to procreate of 96 mothers of children treated for cancer at the Pediatric Oncology Unit of Istituto Nazionale Tumori of Milan in 2021. Even at a time during which they fear losing the child they already have, nearly one in four mothers expressed their desire to have another child.This wish emerged within a complex interplay of individual, relational, and sociocultural factors. Notably, cultural expectations surrounding motherhood, self-sacrifice, and the ideal of the "good mother" appeared to intensify feelings of guilt associated with procreative desire in the context of anticipatory grief. Future cross-cultural investigations could clarify how norms regarding motherhood and reproductive choices differ across societies and influence this phenomenon.Our results also showed a relation between mother's age, children's age, stage of disease and presence of siblings: procreative desire was mainly expressed by younger mothers with only one child, in preschool age and with a bad prognosis.