Asian Pacific Journal of Cancer Prevention最新文献

Background: This study aimed to analyzed overall survival and prognostic factors in a 27-year historical cohort of women with breast cancer in the Brazilian city of Goiânia.

Methods: This retrospective cohort study used data from the population-based cancer registry in Goiânia, Goiás, Brazil, to evaluate overall survival between 1988 and 2015. Survival curves were constructed using the Kaplan-Meier method and compared with the log-rank test. Multivariate Cox regression analysis was performed to evaluate predictors of survival, with significance established at p<0.05.

Results: The most common age group among the 7,395 women included in this study was 50-69 years (45.4%). The majority had localized breast cancer (62.4%) and the luminal A subtype (50.1%). The median  survival was 122 months, with a 5-year overall survival rate of 83.1% and a 10-year overall survival rate of 65.5%. When evaluating ethnicity, survival was found to be greater for among white women compared to black women (mean of 120 months versus 110 months). In the Cox regression analysis, the following factors were found to be associated with decreased overall survival: age >70 years (HR: 1.33; p<0.001), histologic grade III (HR: 1.21; p=0.042), estrogen receptor-negative breast cancer (HR: 1.26; p=0.010), progesterone receptor-negative breast cancer (HR: 1.47; p=0.041), triple-negative subtype (HR: 2.36; p=0.008) and regional disease extension (HR: 1.73; p=0.023) or metastasis (HR: 2.67; p=0.012).

Conclusion: During the study period, the overall survival rate in this cohort of women with breast cancer was 83.1% at five years and 65.5% at ten years. Different clinical, biological and tumor-related factors significantly affected prognosis in this population.

Introduction: Pulsed electric fields (PEFs) are applied to facilitate the transfer of various types of molecules, such as pharmaceuticals, into living cells. In the present study effect of microsecond PEF on human medulloblastoma cell line (D283Med cells) is investigated to find the crucial targeted genes.

Methods: Gene expression profiles of the human medulloblastoma (D283) cell line in response to microsecond PEF versus control are extracted from the Gene Expression Omnibus (GEO) database. The samples are analyzed via the GEO2R program to find the significant differentially expressed genes (DEGs). The significant DEGs were assessed via protein-protein interaction (PPI) network using Cytoscape software and its applications.

Results: Among 410 significant DEGs, 23 hubs and bottlenecks were determined. A total number of seven hub-bottlenecks including MAPK3, KIT, APP, RUNX2, CXCR4, LMNA, and BMP4 were pointed out as the crucial targets of microsecond PEF. MAPK3 and KIT were down-regulated while, APP, RUNX2, CXCR4, LMNA, and BMP4 were up-regulated.

Conclusion: It can be concluded that, down-regulation of MAPK3 and KIT and up-regulation of BMP4 which are the consequence of microsecond PEF treatment inhibit medulloblastoma. The results exhibited the significant role of MAPK3 in response to microsecond PEF treatment.

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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Background: Colorectal cancer (CRC) is one of the most common gastrointestinal cancers worldwide. Thus, genes targeting is useful for the prognosis and therapy of CRC. This study aimed to identify a promising and valuable signature model of prognostic biomarkers associated with overall survival (OS) in CRC.

Methods: Two mRNA microarray datasets (GSE18105 and GSE113513) from the Gene Expression Omnibus (GEO) database were screened to extract key genes from differentially expressed genes (DEGs) to establish a multiscale embedded gene co-expression network, protein-protein interaction network, and survival analysis. Univariate Cox analysis was conducted to construct a prognostic signature for OS using Kaplan-Meier analysis. Then, we constructed and analyzed the protein-protein interaction network using STRING and Cytoscape, respectively to establish the key genes. Finally, the selected potential prognostic genes were validated in tissue samples of CRC by quantitative real-time PCR (qRT-PCR).

Results: In the present study, among 340 identified DEGs, four key genes (SPP1, CHEK1, KIF18A, and MAD2L1) were detected. The prognostic gene signature model demonstrated strong performance in the prognosis of CRC (AUC > 0.9). Moreover, the four key genes were also used to construct a risk-score prognostic model for OS and the findings showed that the prognostic gene signature model was highly effective in predicting the OS in CRC patients. The Gene Ontology (GO) enrichment analysis indicated the key genes were significantly associated with several CRC-related signaling pathways such as calcium-independent cell-cell adhesion. Finally, the results of qRT-PCR showed that the upregulation of SPP1, CHEK1, KIF18A, and MAD2L1 was associated with poor prognosis and served as risk factors for CRC patients compared to controls.

Conclusion: The findings of the present study provided a set of four key genes with valid clinical utility that can serve as an alternative tool for prognosis and identification of new targets in CRC treatment.

Objective: Variation in the DNA repair gene RAD51 has been linked to breast cancer (BC), the most common cancer worldwide, raising concerns about radiotherapy (RT) resistance. This study aims to determine RAD51 levels and polymorphisms in Iraqi women with BC before and after RT and to evaluate their potential as cancer risk and treatment response biomarkers.

Methods: This follow-up study examined 90 blood samples from 30 newly diagnosed BC patients aged 34-56 years before and after RT at the Al-Amal National Hospital for Cancer Management in Baghdad collected from July 2024 to January 2025, and from 30 age- and sex-matched healthy controls. In ELISA, serum RAD51 levels were estimated. RAD51 SNPs were genotyped through PCR amplification with specific primers and DNA sequencing.

Result: Post-RT, BC patients had significantly more RAD51 levels than pre-treatment patients and controls (2.51±0.70 vs. 1.22±0.19 vs. 1.27±0.21 ng/ml). The Iraqi population's rs1801320 (G>C) and rs1801321 (G>T) SNPs in exon 1 of the RAD51 were identified and recently registered at the NCBI (PV661827 and PV661828). The RAD51 (G>T) polymorphism's GT genotype and T allele were significant risk factors for BC (OR=11.07, CI=3.20-37.87 and OR=4.92, CI=1.82-13.35). BC patients had a lower variation post-RT compared to prior (20.0% vs. 27.0%). The RAD51 (G>C) polymorphism GC genotype or C allele was not linked with BC risk (OR=2.25, CI=0.50-9.93 and OR=2.11, CI=0.503-8.87, P>0.05).

Conclusion: The Iraqi BC risk was associated with the RAD51 (G>T) polymorphism. GT genotype / T allele patients responded well to RT, indicating that RAD51 might predict cancer risk and RT effectiveness. Iraqi women may benefit from the RAD51 (G>C) GG genotype in protection against BC.

Background and objectives: Colorectal carcinoma (CRC) is one of the most common causes of cancer-related deaths worldwide. The prognosis of CRC patients is variable even within the same cancer stage. The tumor microenvironment (TME) plays a crucial role in CRC, yet its prognostic value remains incompletely understood. We hypothesize that different components of TME can affect patient outcomes in multiple ways. In this study, we assessed the prognostic implications of the desmoplastic reaction (DR) and immune cell infiltration within the TME of CRC through morphological and immunohistochemical (IHC) evaluation.

Methods: A retrospective cohort of 65 CRC patients was examined. The patterns of DR and the density of tumor infiltrating lymphocytes (TILs) were evaluated in Hematoxylin and Eosin (H&E)-stained sections. IHC was performed for periostin (POSTN), CD8, CD4, and CD68. Associations with clinicopathological parameters and overall survival (OS), both in the entire study group and in the subgroup treated with adjuvant-therapy were investigated. The relation between different components of TME was also assessed.

Results: High stromal POSTN expression correlated significantly with poor prognosis and reduced OS (p=0.005). High density of TILs in H&E-stained slides, CD8⁺, CD4⁺, and combined (CD8+CD4) T-lymphocytes was associated with improved OS (p=0.03, 0.02, p=0.03, and <0.001, respectively), while a high density of CD68+ macrophages was linked to poor prognosis (p=0.006). The combined (CD8+CD4) T-lymphocytes score emerged as an independent prognostic factor for OS (HR=0.1, p<0.001), outperforming the other studied parameters.

Conclusion: Stromal POSTN expression and immune cell infiltration, particularly combined (CD8+CD4), offer significant prognostic insights in CRC and may guide therapeutic decisions.

Objective: This study aimed to assess the efficacy of Levofloxacin in preventing febrile neutropenia (FN) after cytarabine-based consolidation therapy in newly diagnosed acute myeloid leukemia (AML) patients.

Methods: A prospective study conducted between January and December 2023. Newly diagnosed AML patients received Levofloxacin 750 mg once daily for 10 days, starting five days after the last cytarabine dose. Febrile neutropenia was diagnosed based on established guidelines, and outcomes were compared with a historical control group (January 2020 to December 2022) where Levofloxacin prophylaxis was not given.

Results: A total of 43 patients were included, 55% were male with a median age of 42. Levofloxacin recipients (n=19) experienced significantly lower febrile neutropenia incidence compared to the control group (n=24) (36.8% vs. 100%, P<0.001). Levofloxacin prophylaxis also delayed the onset of febrile neutropenia (HR 0.14, 95% CI 0.06-0.36; P<0.001), reduced hospitalization rates (36.8% vs. 100%, P<0.01), and shortened hospital stays (4 vs. 7 days, P=0.002). There were no increases in antibiotic resistance or serious adverse events.

Conclusion: Levofloxacin effectively reduced febrile neutropenia episodes, lowered hospitalization rates, and shortened hospital stays in post-cytarabine consolidation AML patients.

Background: With the increase in Japan's aging population, the number of total colonoscopies (TCS) performed in individuals aged over 80 years is rising. However, TCS carries an increased risk of complications in older individuals, raising concerns about its utility in this population. This study aimed to evaluate the clinical value of TCS in older individuals diagnosed with advanced colorectal cancer (CRC) at our institution.

Materials and methods: We conducted a retrospective review of patients aged ≥80 years who underwent TCS between January 2010 and December 2021. Patients diagnosed with advanced CRC were categorized into symptomatic and asymptomatic groups based on the presence or absence of symptoms. The groups were compared in terms of clinical characteristics, pathological features, and long-term outcomes.

Results: Among 4,130 older patients who underwent TCS, 297 (7.2%) were diagnosed with advanced CRC. Of these, 221 (74%) were symptomatic, and 76 (26%) were asymptomatic. Compared with symptomatic patients, asymptomatic patients had significantly higher body mass index (23.6 vs. 21.5 kg/m²), serum albumin levels (3.7 vs. 3.5 g/dL), and lower carcinoembryonic antigen (CEA; 3.9 vs. 5.6 ng/mL) and carbohydrate antigen 19-9 (CA19-9; 13.4 vs. 19.7 U/mL) levels (all p<0.05). The asymptomatic group also had a higher rate of early-stage disease (68.4% vs. 36.2%) and a greater history of prior TCS (21.1% vs. 5.4%, p<0.001). Five-year overall and disease-specific survival rates were significantly higher in the asymptomatic group (68.3% and 88.3%, respectively) compared to the symptomatic group (38.7% and 65.5%) (p<0.001). No severe complications, such as perforation, were observed.

Conclusion: TCS facilitates early detection and improves prognosis in older patients with advanced CRC, supporting its use in appropriately selected individuals.

Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy worldwide and is associated with a high mortality rate. The unique genetic features and structural properties of extrachromosomal circular DNA (eccDNA) offer a promising approach for early cancer diagnosis.

Objective: This study aims to investigate the potential of eccDNA as a diagnostic marker by identifying its distinguishing characteristics using a two-dimensional cell culture model.

Methods: EccDNA was isolated from the supernatant of HepG2 and THLE-2 cell cultures. Long-read sequencing and bioinformatic analysis were employed to detect and characterize eccDNA. The size distribution, chromosomal origin, and genomic annotation of eccDNA from both cell types were compared. PCR was performed to validate DNA fragments at the junctions of the closed-circular forms.

Results: The total number of cell-free eccDNA derived from HepG2 cells averaged 2,669,673 bases, encompassing 2,542 sequences, while THLE-2 cells averaged 857,718 bases with 975 sequences. Size distribution analysis revealed that most cell-free eccDNA from both cell types ranged from 351 to 600 bp. Bioinformatic analysis revealed that approximately 80% of eccDNAs corresponded to gene coding regions. Ten eccDNAs were the most frequently detected in HepG2 cells, with four eccDNAs harboring CDC27P11, RAC1P3, LOC112268123, and LOC124902279 genes successfully validated and uniquely detected in HepG2 cells, suggesting their potential as biomarkers for HCC diagnosis.

Conclusion: Distinct eccDNA types were identified in HepG2 cells, which may serve as promising biomarkers for HCC diagnosis.