Wspolczesna Onkologia-Contemporary Oncology最新文献

Introduction: This study aims to explore the opinions of female cancer patients regarding the donation of cancer and reproductive cells for reproductive and research purposes.

Material and methods: The study involved 373 female cancer patients from 2 hospitals with oncology departments in Poznan, Poland. They completed a pen-and-paper questionnaire-based survey.

Results: While most female cancer patients declared their willingness to donate cancer tissues for fertility research (87.9%), they were reluctant to share their reproductive cells for research purposes (82.3%). Additionally, 88.2% of respondents were unwilling to donate embryos that remain after in vitro treatment for research purposes. Simultaneously, 57.1% of woman supported the preservation of fertility cells, 62.5% believed it should be ethically and legally regulated in Poland, and 74% believed it should be re-imbursed by the National Health Fund. Women's opinions were linked to their age, education, place of residence, family status, and declared religiosity.

Conclusions: Because most female cancer patients expressed their willingness to share their reproductive cells for reproductive purposes and believed that the preservation of cells for fertility purposes should be reimbursed by the State, there is a need for doctors and nurses to inform patients about the available ways to preserve fertility. However, because donation of reproductive cells for biomedical research raises many concerns, healthcare professionals should be trained to discuss with patients the ethical and legal issues related to fertility preservation and biomedical research involving reproductive cells.

Introduction: Breast cancer (BC) is among the most frequently diagnosed malignant tumours in females. The optimal treatment of early HR+, HER2-, and lymph node-negative (N0) BC remains challenging. Since individual assessment of recurrence risk and expected benefits from adjuvant chemotherapy (CT) based on clinicopathological features alone appear inadequate, gene expression profiling tests have been developed. This study aimed to evaluate the impact of Oncotype DX Breast Recurrence Score^® (Oncotype DX Breast RS) test results on physicians' decisions concerning adjuvant CT in the Polish population.

Material and methods: The PONDx survey investigated the real-life use of Oncotype DX Breast RS in 204 pa- tients with HR+, HER2-, N0 BC in 8 clinical reference centres in Poland. Data on clinicopathological features and changes in treatment based on the Oncotype DX Breast RS test were collected.

Results: Chemotherapy plus endocrine therapy (ET) was initially recommended in 44.8% and ET alone in 55.2% of patients. After the introduction of recurrence score results, the recommendation for CT decreased significantly: relative reduction of 25.5% (95% CI: 11.7-52.3) and absolute reduction of 11.4% (95% CI: 1.9-21.0). Among patients initially recommended for CT, treatment was de-escalated in 62.2%; conversely, among patients initially recommended for ET alone, 29.7% were escalated to CT after testing. The relative reduction was especially pronounced in post-menopausal patients (29.6%) and in those with lobular BC (42.9%).

Conclusions: The Oncotype DX Breast RS result significantly influenced treatment decisions, with 44.3% of patients changing treatment, thus avoiding overtreatment or undertreatment. The Oncotype DX Breast RS test improves patient management and increases physician confidence in treatment recommendations.

Chondromyxoid fibromas (CMF) are uncommon benign bone tumours, known for their moderate risk of local recurrence, that may manifest through various symptoms such as pain, swelling, tenderness, or be asymptomatic. Diagnosing CMF is challenging and requires a comprehensive, multidisciplinary diagnostic approach because the tumour frequently resembles numerous other bone lesions. This report describes a case of a 66-year-old female patient with a tumour in her right fibula. The initial diagnosis of a neuroma of the right tibial nerve was based on a magnetic resonance imaging scan. The lesion was surgically removed. Preliminarily subsequent histopathological evaluation identified the mass as a parosteal osteosarcoma. However, due to the uncharacteristic presentation of the tumour, further investigation was carried out. Using immunohistochemical and genetic analyses focused on the expression of MDM-2 and RB-1, along with an examination for alterations in the GNAS gene, the mass has been finally and conclusively identified as a chondromyxoid fibroma. This case demonstrates the ambiguity of the CMF presentation, the accurate diagnosis of which may frequently rely on additional diagnostic measures, including histopathology and targeted genetic tests. Furthermore, this report illustrates an atypical diagnostic journey, from an initial neuroma through a low-grade osteosarcoma, to a final benign chondromyxoid fibroma.

Introduction: Gold nanoparticles (AuNPs) have unique properties that promise new and improved methods for targeting cancer treatment and diagnosis. However, despite their relatively high biocompatibility, AuNPs can negatively affect cell viability. Research indicates that the interactions with the plasma membrane and cellular uptake of AuNPs depend significantly on size, shape, and surface modifications.

Material and methods: We evaluated the use of human lymphocyte primary culture as a model for assessing the to-xicity of AuNPs in proliferating cells. We compared the toxicity of rod-shaped, PEGylated AuNPs (gold nanorods, AuNRs) of two different sizes and gold nanospheres (AuNSs).

Results: Our results show that at high concentrations, both AuNSs and AuNRs negatively affect the viability of activated human lymphocytes in vitro. The cytotoxic effect varies with size and concentration, with larger AuNRs (approx. 22 × 50 nm) being more toxic than smaller ones (approx. 20 × 40 nm) and 15 nm AuNSs exhibiting the lowest toxicity.

Conclusions: Our results confirm that the application of AuNPs in cancer the-rapy and diagnostics must be accompanied by a thorough cytotoxicity assessment. Despite certain limitations, using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction test for viability assessment of proliferating cells proves to be a simple and cost-effective method useful in nanoparticle toxicity studies.

Introduction: Partial nephrectomy (PN) is the primary treatment for T1 renal cell carcinoma (RCC). Also, percutaneous cryoablation is gaining attention as a curative option in appropriately selected patients. However, even mini-mally invasive procedures are not free from toxicity. The objective of this study was to assess the safety profile of the percutaneous renal cryoablation (PCA) procedure during the learning curve of the first 75 cases.

Material and methods: All procedures were performed by urologists with vast experience in ultrasonography (USG)-guided percutaneous renal procedures and interventional radiologists skilled in computed tomography (CT) interventions. The cryoprobes were inserted percutaneously under hybrid USG/intermittent CT guidance. Complications that took place in the first 4 weeks after the procedure, both during hospitalisation and after discharge, were evaluated.

Results: The study included 68 patients with 75 tumours treated with PCA in our centre. The patients were old (mean 72 years), overweight (mean BMI 29.1) and severely comorbid (aver-age Charlson comorbidity index 5.9; ASA score 2.8). Pain during the surgery was reported by 21.3% of the patients. Five (6.7%) perirenal haematomas > 4 cm developed immediately after the surgery. The most common postoperative ailments included: ma-laise (20.0%), pain (16.0%), nausea and vomiting (8.0%) and haematuria (6.7%). Other complications occurred in less than 5% of the cases. Nonetheless, no blood transfusions were neces-sary and only one patient required a minor surgical intervention.

Conclusions: According to this study, PCA is a safe procedure with a very low risk of major complications.

Introduction: Patients with colorectal cancer (CRC) have a higher chance of survival when the disease is detected and treated effectively at an early stage. Plasmacytoma variant translocation 1 (PVT-1), an oncogenic lncRNA, and neuroblastoma associated trans-cript 1 (NBAT1), a tumor suppressor lncRNA, have been linked to CRC progression, acting as competing endo-genous RNAs to the tumor suppressor miRNA-145 and oncomiRNA-21. The aim of the current study was to construct a competing endogenous RNA (ceRNA) associated with CRC. In addition, we aimed to investigate the impact of single nucleotide polymorphisms in the rs13255292 lncRNA PVT-1 on miR-145 expression levels and the lncRNA-NBAT1/miR-21 axis in the progression of CRC.

Material and methods: Bioinforma-tic analysis was performed to determine differentially expressed genes (DEGs), differentially expressed micro-RNAs (DEMs), and differentially expressed lncRNAs (DELs) in CRC. PVT-1 rs13255292 C/T was genotyped and serum PVT-1, NBAT-1, miRNA-145 and miRNA-21 were assessed by qPCR in 85 CRC patients, 80 AP, and 85 controls.

Results: The frequencies of the PVT-1 rs13255292 CT/TT genotype and T al-le-- le were significantly elevated in the CRC group compared to the controls. PVT-1 serum levels significantly increased due to the presence of the T allele in the studied groups, which was associated with downregulation of the miR-145 tumor suppressor. Also, the expression of NBAT-1 was significantly down-expressed, while that of oncomiR-21 was significantly elevated.

Conclusions: Bioinformatics analyses provides effective identification of potential lncRNAs linked with CRC. PVT-1/miR-145 and NBAT1/miR-21 are being investigated as potential non-invasive diagnostic biomarkers for CRC.

Introduction: Radical resection is the only potentially curative treatment for pancreatic adenocarcinoma; however, only a minor fraction of patients are eligible for resection. Induction therapy may be offered to patients, but the response rate in cases with significant vascular involvement is limited. This study aimed to evaluate the efficacy and safety of modified of FOLFIRINOX chemotherapy (mFFX) + stereotactic body radiotherapy (SBRT) in combination as induction therapy for locally advanced pancreatic carcinoma. The primary endpoints were the resection rate and one-year overall survival (OS). The secondary endpoints were progression-free survival (PFS), toxicity, and quality of live (QoL).

Material and methods: Thirty patients with locally advanced pancreatic adenocarcinoma were treated with 6 cycles of mFFX, followed by SBRT and additional 3 cycles of mFFX. The response was measured prior to SBRT and after regimen completion. In the absence of disease progression, the patients were referred for surgery. The patients were requested to complete quality of life questionnaires (QLQ)-C30 and QLQ-PAN26 questionnaires biweekly.

Results: On the first evaluation, disease control was noted in 26 (86.7%) patients. Stereotactic body radiotherapy was performed in 20 patients. Twelve patients underwent laparotomy, with radical resection possible in 3 cases. The one-year OS rate was 63.3%. Overall, 11 grade ≥ 3 adverse events were noted. No deterioration in the overall QoL was observed. The median PFS was 7.53 months.

Conclusions: The expected resection rate of ≥ 30% was not achieved. However, the combination was associated with good local control, low adverse event rate, and good QoL, which advocate its further investigation in this clinical situation.

Introduction: Despite advances in diagnostics and therapy, the 5-year mortality rate of oral squamous cell cancer (OSCC) remains at about 50%. Prognostic molecular biomarkers are not yet approved for clinical application, mainly due to conflicting results. The aim of our study was to determine the programmed cell death ligand 1 (PD-L1) status in oral tongue squamous cell carcinoma and their influence on patients' outcomes.

Material and methods: Primary tumours were collected from 44 patients who underwent tumour surgical resection for primary OSCC from 2018 to 2022. Additionally demographic and clinical data were gathered.

Results: Final analysis included patients with a mean age of 61 years (range 26-90), mostly males (n = 30, 68%). About half of the patients were treated in early local stage disease (T1-2, n = 21; 47%). There was no correlation between the mRNA level of PD-L1 and age of patients, smoking status, alcohol dependence, T stage, N stage, perineural invasion, lymphovascular invasion, extranodal extension, margin status, recurrence, and adjuvant treatment. PD-L1 expression was a key predictor variable of survival probability (HR = 0.5655, 95% CI = 0.3448-0.8851, p = 0.0118) - higher expression of PD-L1 was indicative of significantly improved overall survival. Kaplan-Meier analysis revealed a significantly better overall survival in patients with higher level of PD-L1.

Conclusions: Patients with higher PD-L1 status in our study had better survival, which is contradictory to most of the published data. The reason for this may be the different detection method, and the examination of PD-L1 through mRNA is considered precise and repetitive. Studies with higher numbers of patients are needed to validate our conclusions.

Introduction: Ultrasound-guided fine- needle aspiration biopsy (FNAB) remains the primary method for diagnosing thyroid nodules, providing adequate information for definitive diagnosis and treatment decisions in most cases. However, cytological examinations sometimes yield inconclusive or non-diagnostic results. For rapidly growing tumours with suspected malignancy, a swift and accurate diagnosis is crucial to initiate timely treatment. Cases suggestive of anaplastic thyroid cancer (ATC) or poorly differentiated cancer present unique challenges in obtaining satisfactory diagnostic material through FNAB, due to advanced necrosis or extensive inflammatory components. In these instances, core needle biopsy (CNB) emerges as a complementary diagnostic tool when FNAB results are ambiguous. This study aimed to evaluate the effectiveness of CNB in diagnosing rapidly growing thyroid tumours with clinical indication of ATC.

Material and methods: Between 2019-2023, 31 CNBs were performed on large, rapidly expanding thyroid tumours.

Results: All cases exhibited clinical signs of malignancy, with previous FNAB outcomes being either equivocal or inconclusive. The subsequent CNBs demonstrated accurate results with minimal complications among the patients. While reservations about CNB for thyroid nodules persist, it offers a valuable diagnostic alternative, potentially preventing unwarranted surgical biopsy or removal of the thyroid.

Conclusions: Core needle biopsy deployment should be judicious, reserved for select cases, and carried out in a hospital environment to ensure diagnostic precision with the least risk of complications.

Introduction: In clear cell renal cell carcinoma (ccRCC), intravascular extension often results in neoplastic thrombus formation, impacting patient outcomes.

Material and methods: We assessed P-selectin glycoprotein ligand-1 (PSGL-1) expression in the primary tumours and thrombi of 82 ccRCC patients.

Results: Notably, PSGL-1 expression varied between tumour compartments, with higher prevalence in thrombus tumour cells (TC) and primary tumour-associated immune cells (TAIC). Positive TC PSGL-1 correlated with high-grade histology, while TAIC PSGL-1 was associated with tumour necrosis. Univariate survival analysis identified PSGL-1 positivity in TC of primary tumours and TAIC in thrombi as indicators of poorer overall survival. These findings suggest a potential role for PSGL-1 in the mediation of tumour thrombus formation, highlighting its relevance in biology of ccRCC.

Conclusions: The increased expression of PSGL-1 in venous thrombi suggests its potential role in facilitating TC interactions with platelets and endothelium, potentially contributing to metastatic spread and worse outcomes. Understanding these expression patterns may aid in the development of novel therapeutic strategies and personalised treatment approaches for ccRCC patients.