Asian Pacific Journal of Cancer Prevention最新文献

Introduction: The work environment of oncology nurses exposes them to patient suffering, making them vulnerable to developing Secondary Traumatic Stress (STS). Most research on STS has been conducted in high-income countries with stable healthcare systems, whereas little is known about its occurrence or risk factors in conflict-affected regions. This study aims to determine the prevalence of STS and identify its predictors among Palestinian oncology nurses who face unstable political conditions, insufficient resources, and limited mental health services.

Methods: A cross-sectional analytical study was conducted in ten oncology departments across hospitals in the West Bank and East Jerusalem between August and October 2024. A total of 293 participants completed a questionnaire assessing sociodemographic characteristics, STS, burnout, social and organizational support, and coping strategies. Data were analyzed using SPSS 27 with descriptive and inferential statistics, including regression analyses to identify significant predictors.

Results: The mean STS score was 3.13 ± 0.73, with the intrusion-related symptoms being most prominent (3.18 ± 0.94). STS levels varied significantly with age, working hours, and parental status. Regression analysis identified the number of children as a negative predictor of STS (B = -0.081, p = 0.004), while education level (B = 0.096, p = 0.034) and Personal Accomplishment (B = 0.015, p < 0.001) were positive predictors. Perceived Organizational Support remained a strong negative predictor (B = -0.109, p < 0.001).

Conclusion: This study provides the first evidence of STS among oncology nurses in a conflict-affected work environment. Strengthening organizational support and tailoring coping strategies to the local context may help reduce STS while promoting nurse well-being. These findings underscore the global relevance of integrating stress management programs into oncology education and workplace policies.

Objective: To evaluate the performance of a new Brazilian self-sampling device (COARI®) compared with clinician-collected samples for high-risk human papillomavirus (hrHPV) detection and partial typing.

Methods: This diagnostic agreement study included 57 women who underwent routine cervical screening or follow-up at a private health center in Maringá, Brazil, between May and October 2023. Each participant provided two samples: a self-collected vaginal sample using the COARI® device (Kolplast, Brazil) and a clinician-collected cervical sample. Both were tested using the Cobas® HPV 4800 assay (Roche, USA), which detects HPV16, HPV18, and a pooled group of 12 other hrHPV types.

Results: hrHPV detection was significantly higher in self-collected samples than in clinician-collected ones (52.9% vs. 37.2%; P = 0.008). The Overall agreement between sampling methods was 84.3%. All discordant cases (15.7%) were hrHPV-positive in self-collected samples and negative in clinician-collected specimens, suggesting potentially greater sensitivity for self-sampling. The COARI® device showed 100% sensitivity and a 100% negative predictive value, with an overall accuracy of 84.3%.

Conclusion: The COARI® self-sampling device demonstrated reliable and effective performance for hrHPV detection and partial typing, showing strong potential to increase access to and coverage of cervical cancer screening in Brazil. Further studies with larger and more diverse populations are needed to validate these findings and inform public health implementation.

Objective: Breast cancer is a public health problem with increasing incidence, prevalence, and mortality worldwide. Germline variants in the DNA repair genes BRCA1/2 are involved in the pathogenesis of hereditary breast/ovarian cancer. However, for many ethnic groups that are isolated geographically worldwide, founder variants of breast cancer still have not been found. In this study, we provide whole exome sequencing data performed in a group of breast/ovarian cancer patients who belong to the Buryats.

Methods: Our study included 56 Buryat patients with histologically confirmed primary breast/ovarian cancer who completed an anonymous questionnaire about basic information and nationality. Genomic DNA was isolated from peripheral blood leukocytes. Libraries were prepared using a BGI Optimal DNA Library Prep kit (MGI, China). An Agilent SureSelect Human All Exon V6 kit (Agilent, USA) was used for hybridization. High-throughput sequencing was performed on a DNA nanoball sequencing platform DNBSeq-G400 (MGI, China).  Result: In the overall group of patients with signs of hereditary breast/ovarian cancer, likely pathogenic/pathogenic variants were detected in 16% (9/56). We have discovered likely pathogenic/pathogenic variants that can either directly (BRCA2, RAD51D, FANCG) or indirectly (POLR2C, FOXL2, GDF9, CYP21A4) initiate breast/ovarian cancer. For the first time, three rare germinal variants in the BRCA2 gene were detected in a small Buryat ethnic group. Further studies are required to confirm their role in the pathogenesis of breast /ovarian cancer in this ethnic group. We found that the RAD51D gene variant c.757C>T is recurrent and was observed in 4% of Buryat patients with breast/ovarian cancer.

Conclusion: For the first time, rare germinal variants in the BRCA2, RAD51D, FANGC, CYP24A1 genes were detected in a small Buryat ethnic group. Our data are consistent with existing data showing that variants in the RAD51D gene may be involved in the pathogenesis of breast/ovarian cancer. We also showed that the Mongolic-speaking Buryat populations exhibited strong genetic resemblance to those of Chinese.

Background: Urinary bladder carcinoma is one of the most immunogenic cancers. Several immune checkpoint inhibitors targeting programmed death-ligand 1 (PD-L1) have been approved by the FDA for bladder carcinoma treatment. However, additional immunotherapeutic targets are still needed. CD155 is another immune checkpoint molecule that has been shown to be overexpressed in several cancers and is associated with poor prognosis.

Aim: This study aimed to evaluate CD155 expression in cases of urinary bladder urothelial carcinoma using immunohistochemistry and to correlate this expression with the clinicopathological parameters of the cases as well as with PD-L1 expression.

Methods: Immunohistochemical staining for CD155 and PD-L1 was performed on 67 cases of urothelial carcinoma of the urinary bladder.

Results: CD155 was positive in 41.8% of cases and was significantly associated with invasive tumors and advanced T stage. PD-L1 was positive in 35.8% of cases and was significantly associated with advanced T stage, distant metastasis, muscle invasion and lymphovascular emboli. A statistically significant positive correlation was observed between the expression of both CD155 and PD-L1.

Conclusion: Our study demonstrated increased expression of CD155 in urothelial carcinoma of the urinary bladder with advancing stage, suggesting its potential as a therapeutic target. Additionally, CD155 expression correlated positively with PD-L1 expression, indicating that some patients might benefit from a combined blockade of both targets.

Background: Cervical cancer remains a leading public health problem in Indonesia, with low screening and HPV vaccination coverage, particularly in rural areas where knowledge gaps and limited healthcare access persist. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding HPV infection and cervical cancer, and the role of information-seeking behavior in identifying effective channels for raising awareness on these issues.

Methods: A cross-sectional study was conducted between 20 March 2023 and 20 January 2024, involving 220 women from two rural districts in North Moluccas, selected via convenience sampling. Data were collected using a validated questionnaire administered through face-to-face interviews. Data were analyzed using SPSS version 25.0 with descriptive statistics, normality testing (Kolmogorov-Smirnov), bivariate analyses (Chi-square, Fisher's Exact, Pearson's or Spearman's tests), and multivariate logistic regression (backward LR, p < 0.05), with model performance assessed using ROC curves and AUC values.

Results: Most participants demonstrated poor KAP, with 18.7% showing good knowledge, 22.7% expressing a positive attitude, and 44.5% engaging in favorable practices. KAP were found to be positively correlated (p<0.001). Key predictors of good knowledge included higher education (AOR = 7.07), family history of cancer (AOR = 15.20), private vehicle use (AOR = 4.15), and active health-information seeking behavior (HISB) (AOR = 3.41). Determinants for a positive attitude included higher education (AOR = 3.79), family history of cancer (AOR = 4.42), active HISB (AOR = 3.88), and good knowledge (OR = 10.29). Favorable practices were influenced by private vehicle use (AOR = 2.66) and positive attitude (AOR = 20.62).

Conclusion: In conclusion, KAP are influenced by HISB, and involving healthcare workers in providing information, particularly through digital platforms, has the potential to improve KAP in rural communities.

Background: Breast cancer is a prevalent malignancy worldwide, with a growing number of survivors requiring post-treatment surveillance to improve outcomes. Radiologic surveillance, particularly mammography, is essential for early detection, however, there are disparities in the accuracy and effectiveness of various imaging modalities.

Objectives: The aim of this systematic review and meta-analysis is to evaluate the effectiveness of radiology surveillance techniques for breast cancer survivors, focusing on diagnostic accuracy and mortality reduction.

Methods: Studies assessing radiologic surveillance (e.g. mammography, ultrasonography, magnetic resonance imaging [MRI], and digital breast tomosynthesis) were included in this review. A comprehensive literature search was conducted in Medline, Cochrane Central Register of Controlled Trials, and Scopus databases. To obtain pooled estimates for sensitivity, specificity, accuracy, and mortality, we extracted and synthesized data using a random-effects model. The Newcastle-Ottawa Scale and QUADAS-2 instruments were used to assess the risk of bias.

Results: A total of eighteen studies met the eligibility criteria for the review, of which eight were included in the meta-analysis (three for diagnostic accuracy and five for mortality. The pooled sensitivity, specificity, and accuracy of mammographic surveillance were 81% (95% CI 0.63-0.91), 71% (95% CI 0.31-0.93), and 76% (95% CI 0.59-0.88). A 50% reduction in mortality risk was linked to mammographic surveillance (OR 0.50; 95% CI 0.27-0.92). Heterogeneity was substantial for mortality analysis (I2=93%), while there was a low heterogeneity for the sensitivity analysis (I2=16%). MRI showed better sensitivity (91%) and specificity (82%) than ultrasonography and mammography.

Conclusion: Although mammographic surveillance has a lower diagnostic accuracy than that observed in the screening population, it considerably lowers mortality among breast cancer survivors. The use of adjunct imaging modalities, such as MRI, may enhance early detection. Standardized surveillance protocols and further research on imaging strategies in diverse populations are required to improve post-treatment monitoring and patient outcomes.

Background: Breast cancer is the most common cancer affecting females according to WHO 2020 report, with BRCA1 and BRCA2 identified as the major tumor suppressor genes linked to disease susceptibility. Hence, the purpose of the current study was to investigate germline mutations among these genes in a group of Egyptian female breast cancer patients.

Methods: Blood samples from primary breast cancer patients (n=22), benign breast lesions (n=5) and healthy controls (n=7) were sequenced for BRCA genes by next generation sequencer.

Results: A total of 135 genetic variations were detected, 59 in BRCA1 and 76 BRCA2, 2 indels (insertion-deletion) and 133 SNV (single nucleotide variation), nearly 55% of those variants were missense variants, 38% were synonymous and 7% were nonsense. A total of 59 variations were detected in BRCA1 and they were categorized as exonic (n=10) and intronic (n=49) regions, BRCA1 exonic variants were categorized into: missense (n=12), non-coding transcript (n=11) synonymous (n=6), splice region synonymous (n=2), stop gain (n=2) and 3-prime UTR (n=1) variants. Regarding variations detected in BRCA2, 55 intronic and 21 exonic variants were identified. Among these 21 variants; 13 novel mutations and 8 formally reported as follows: 7 as benign and one previously reported with contradictory pathogenicity according to the Clinvar database which is a freely available, public archive of reports of the relationships between human variations and phenotypes hosted by the National Center for Biotechnology Information (NCBI) and funded by intramural National Institutes of Health (NIH) funding.

Conclusion: BRCA1 and BRCA2 germline profiling based on next-generation sequencing technology among Egyptian breast cancer female patients revealed 135 germline variations -104 intronic and 31 exonic, respectively. Among the exonic variants; 13 were newly reported mutations. Hence further study is required to enhance mutational analysis which may benefit clinical system.

Purpose: This study aims to evaluate the impact of varying Aperture Shape Controller (ASC) settings on the optimization of VMAT plans for tongue carcinoma (Ca-Tongue), focusing on their role in modulating plan complexity, maintaining dosimetric integrity, and ensuring accurate treatment delivery.

Materials and methods: Twenty Ca-Tongue patients were retrospectively planned using four ASC settings: Off, Very Low, Moderate, and Very High, totaling 80 plans. Complexity metrics such as Modulation Complexity Score (MCSv), Small Aperture Score (SAS), and Monitor Units per cGy (MU/cGy) were computed using MATLAB from exported DICOM RT files. Each plan underwent portal dosimetry QA with gamma analysis (3%/3mm and 2%/2mm). Dosimetric quality was evaluated using Conformity Index (CI), Homogeneity Index (HI), and PTV D98%, along with doses to organs-at-risk (OARs). Statistical analysis included the Wilcoxon signed-rank test and linear regression.

Results: Increasing ASC level significantly reduced plan complexity: MCSv increased from 0.32±0.02 (Off) to 0.38±0.03 (Very High), SAS decreased from 0.47±0.04 to 0.37±0.07, and MU/cGy dropped from 2.25±0.09 to 2.03±0.12 (p < 0.05). However, higher ASC levels were associated with minor but consistent reductions in PTV coverage (D98%: 96.66% to 94.94%) and increases in OAR doses (e.g., spinal cord Dmax: 30.46 Gy to 34.90 Gy). CI and HI remained clinically acceptable across all settings. Gamma pass rates were uniformly high (≥98.85%), with no significant improvement across ASC levels. Weak or negligible correlations (R² <  0.323) were found between complexity metrics and gamma outcomes.

Conclusion: The ASC effectively reduces plan complexity in VMAT for Ca-Tongue without compromising delivery accuracy. While Very High ASC yields the greatest complexity reduction, it also introduces modest trade-offs in PTV coverage and OAR sparing. The Moderate ASC setting appears optimal, offering a balance between complexity control and dosimetric quality. Clinical implementation of ASC should be tailored to tumor site and anatomy, with Moderate ASC recommended for head and neck VMAT to ensure safety, efficiency, and robust QA performance.

Background: Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide. Variability in patient response to fluoropyrimidine-based neoadjuvant chemotherapy remains a critical challenge. We aimed to develop a nomogram that integrated dihydropyrimidine dehydrogenase (DPD) and methylenetetrahydrofolate reductase (MTHFR) expression to predict CapeOX (Capecitabine-Oxaliplatin) neoadjuvant chemotherapy outcomes in colorectal cancer.

Methods: A prospective cohort of 36 advanced-stage CRC patients who received CapeOX neoadjuvant chemotherapy at Wahidin Sudirohusodo Hospital from 2024 to 2025 was analyzed. mRNA expression levels of TS, DPD, and MTHFR were measured in tissue and blood using quantitative RT-PCR. The chemotherapy response was evaluated by RECIST 1.1. Statistical analysis was performed to identify predictors of response, which were incorporated into a nomogram with bootstrap validation.

Results: Among the 36 patients with advanced colorectal cancer, response to CapeOX chemotherapy was observed in 50%. Blood-based gene profiling revealed that responders had significantly lower DPD and MTHFR expression compared with non-responders (both p<0.001), while TS showed no predictive relevance. A nomogram that integrated only blood DPD and MTHFR achieved outstanding discrimination (AUC 0.932, C-index 0.78) and demonstrated strong calibration, accurately predicting treatment response across probability ranges. These results established circulating DPD and MTHFR as powerful non-invasive biomarkers and validated the nomogram as a robust tool for individualized response prediction.

Conclusion: A predictive nomogram that incorporated DPD and MTHFR has improved individualized estimation of CapeOX neoadjuvant chemotherapy response in CRC, supporting precision oncology strategies.
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Objective: This study aims at develop and evaluate an artificial intelligence programming software, an integrated system that automatically detects and classifies cells from microscopic Pap smear slide images taken on Android phones or tabs to diagnose the cervical cell morphology in a time-efficient and cost-effective manner.

Methods: This study presents an integrated system designed to automatically detect and classify cells in Pap smear slide images, differentiating cellular morphologies. The system leverages three deep learning (DL) and one machine learning (ML) models, each tailored to specific tasks in the image analysis pipeline. The analysis of 292 hospital in-house microscopic Pap smear images was conducted from July 2023 to December 2024 at CliniMed LifeSciences, Kolkata, India. The following article describes the datasets used, the training procedures and the performance metrics for each model.  Results: Pap smear images have been validated and standardized by using SipakMed, Herlev (public datasets) and hospital in-house data. A total of 292 in-house Pap smear images have been analysed through the newly developed AI software. Standardization and validation include an Intersection-over-Union score of cell-nuclei boundary extraction model of 71.14%, the accuracy of cell classification model and morphological feature based ML model are 99.213% and 91.23% respectively. The custom AI model could successfully classify 98.09% and 80.49%  of normal and abnormal cells in hospital in-house samples respectively. Also a significant meaningful correlation is observed between biopsy (gold standard) and AI reports.

Conclusion: AI offers a lot of promise for diagnosing cervical cancer, and its uses in cervical cytology screening are particularly well-established. Manual screening of cervical cytology smears is a time-tested method, but AI is set to revolutionize the process by improving outreach, availability, accuracy and economy. A total of 292 hospital in-house Pap smear images have been validated and examined in this study with significant accuracy percentages between AI and expert eyes.