Asian Pacific Journal of Cancer Prevention最新文献

Background: Worldwide, ovarian cancer is the eighth most common cancer among females and the fifth leading cause of cancer-related deaths in women. In Egypt, it accounts for 4.5% of all cancer cases and ranks the fourth most common cancer among women. Cancer stem cells (CSCs) play a crucial role in tumor growth and chemoresistance. Our study examined the expression of cancer stem cell markers (ZIP-4 and aldehyde dehydrogenase-1 member A1 (ALDH1A1)) in ovarian serous carcinoma tissues using immunohistochemistry. We also analyzed the relationship between their expression levels and clinicopathological features, patient survival, and response to platinum-based chemotherapy.

Subjects & method: This study included 55 patients with ovarian serous carcinoma.  Immunohistochemical staining for ZIP-4 and ALDH1A1 was performed.

Results: Statistically significant relationships were detected between high ZIP-4 and ALDH1A1 expressions and patient age, tumor size, presence of malignant ascites, lymphovascular invasion, elevated cancer antigen-125 (CA-125) levels, disease stage, and lymph node involvement (P < 0.001 for each). Additionally, the log-rank test showed that high ZIP-4 and ALDH1A1 expressions were associated with shorter disease-free survival (DFS) (P = 0.002 and <0.001, respectively) and overall survival (OS) (P < 0.001 for each).

Conclusion: Ovarian cancer stem cell markers (ZIP-4 and ALDH1A1) can be considered potential prognostic markers in ovarian cancer patients. Moreover, ZIP-4 and ALDH1A1 expressions are related to resistance to platinum-based chemotherapy, which leads to ovarian serous carcinoma progression. Clinical implications suggest that future therapeutic regimens targeting ZIP-4 and ALDH1A1 may help overcome platinum-based chemotherapy resistance and improve patients outcomes.

Objective: This study aimed to systematically evaluate the diagnostic performance of artificial intelligence (AI) in differentiating hepatocellular carcinoma (HCC) from cholangiocarcinoma (CCA) using abdominal CT and MRI, with an emphasis on its clinical implications for liver cancer management.

Methods: Following the PRISMA guidelines, we conducted a comprehensive literature search across five major databases (PubMed, Web of Science, ScienceDirect, Scopus, and Google Scholar) from 2000 to May 6, 2025. Eligible studies included original research that applied AI for the diagnosis of HCC or CCA. Data were extracted on study design, population characteristics, imaging modality, AI methodology, diagnostic performance (sensitivity, specificity, accuracy, AUC), validation strategies, and risk of bias, which was assessed using QUADAS-2.

Results: A total of 44 studies met the inclusion criteria. Most were retrospective, while only a few prospective designs provided real-time validation. CT and MRI were the dominant imaging modalities, with MRI showing superior sensitivity for small lesions, while CT was more effective for large tumors and vascular involvement. Convolutional neural networks (CNNs) were the most frequently used model architectures, although more advanced deep learning and hybrid radiomic-clinical models were also reported. Diagnostic performance was consistently strong: sensitivity and specificity ranged from 75% to 100%, overall accuracy from 73% to 96%, and AUC values from 0.74 to 0.99. Studies incorporating multi-modal imaging (CT+MRI) or radiomic-genomic features achieved the highest diagnostic performance, with accuracy and specificity exceeding 90-95%. Subgroup analyses revealed that tumor size, location, microvascular invasion, and patient demographics influenced AI model performance. Risk of bias was generally low-to-moderate, with limitations related to retrospective data and limited external validation.

Conclusion: AI models, particularly CNN- and radiomics-based, show accuracy comparable to radiologists in distinguishing HCC from CCA. Multi-modal integration and feature fusion hold the greatest promise for improving workflows. Large-scale, multi-center validation is needed to confirm their utility and enable adoption in liver cancer care.

Objective: Toxoplasma gondii is an intracellular protozoan that may disrupt the traditional cell barriers against cancer, allowing the accumulation of oncogenic mutations over time. Our research aimed to explore the relationship between T. gondii infection and liver cancer development.

Methods: The present study, conducted in the city of Nasiriya, Iraq, involved 80 blood samples collected from individuals aged 18 to 70 years, of both sexes. The samples were divided into two groups: 40 from patients diagnosed with liver cancer and 40 from healthy individuals. All samples were tested using ELISA to detect anti-Toxoplasma gondii antibodies (IgG and IgM).

Results: The results showed that 21 liver cancer patients and 14 healthy individuals tested positive for T. gondii. Furthermore, liver enzyme levels (ALT, AST, and ALP) were assessed in all participants. The findings revealed a notable elevation in enzyme levels among liver cancer patients co-infected with T. gondii, compared to both non-infected liver cancer patients and the healthy control group. Using PCR, the B1 gene was amplified to confirm infection in selected samples. Ten B1-positive samples (5 from liver cancer and 5 from control) were tested for the GRA6 gene using nested PCR. DNA was extracted with a commercial kit, and amplification was performed using specific primers. Genotyping was conducted via PCR-RFLP targeting the GRA6 gene, using the MseI enzyme to distinguish T. gondii strains based on fragment sizes. RFLP analysis using MseI differentiated genotypes I, II, and III.

Conclusion: This study genotyped Toxoplasma gondii in liver cancer patients using nested-PCR and RFLP targeting the GRA6 gene. Genotype I predominated among liver cancer patients, whereas control Genotypes II was predominance in the control group.

Objective: This study aimed to evaluate the therapeutic efficacy of multi-pathway inhibition, targeting EGFR, MAPK, and PI3K/Akt in oral carcinoma.

Methods: In vitro experiments were conducted using human oral carcinoma cell lines (HSC-3 and SCC-4) treated with EGFR, MAPK, and PI3K/Akt inhibitors individually and in combination. Cell viability was assessed using the MTT assay, apoptosis with Annexin V-FITC/PI staining, and pathway inhibition through Western blot. In vivo, nude mice (n=30, equal gender distribution) with xenograft tumours were treated with the same inhibitors, and tumour volume was measured over a period of 3 weeks.

Results: Combination therapy reduced cell viability by 65% (vs. 40-45% for monotherapies) and increased apoptosis to 55% (vs. 25-30% for monotherapies). In vivo, tumour volume decreased by 64% with combination therapy (vs. 28-44% for monotherapies). Western blot analysis confirmed synergistic suppression of all three pathways in the combination group (p<0.05 for all comparisons).

Conclusion: Multi-pathway inhibition significantly enhances therapeutic efficacy in oral carcinoma by concurrently disrupting EGFR, MAPK, and PI3K/Akt signaling.

Objective: This study aims to compare the oncological outcomes of radical prostatectomy (RP) and brachytherapy (BT) in patients with low- and intermediate-risk prostate cancer, and determine whether one treatment demonstrates superiority over the other.

Methods: A systematic literature search was conducted using databases, including PubMed, ScienceDirect, Google Scholar, EBSCO, and the Cochrane Library, to identify relevant clinical studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, with HRs >1 indicating RP superiority and HRs <1 indicating BT superiority. Outcomes assessed included biochemical relapse-free survival (BCRFS), clinical relapse-free survival (CRFS), overall survival (OS), and cancer-specific survival (CSS). Statistical analyses, including heterogeneity, publication bias, and risk of bias, were performed using R Studio 4.3.3 and Review Manager (RevMan) 5.4.

Result: A total of seven studies involving 5663 patients were included in the analysis, with 2389 patients receiving brachytherapy (BT) and 3274 undergoing radical prostatectomy (RP). The pooled results demonstrated that BT was associated with significantly better biochemical relapse-free survival (BCRFS) compared to RP, with an HR of 0.84 (95% CI: 0.78-0.89; p<0.01). Although clinical relapse-free survival (CRFS) also favored BT, the result was not statistically significant (HR 0.90; 95% CI: 0.77-1.05; p=0.17). For overall survival (OS) and cancer-specific survival (CSS), the differences between the two treatment modalities were not statistically significant, with HRs of 1.08 (95% CI: 0.87-1.34; p=0.50) and 1.05 (95% CI: 0.82-1.36; p=0.70), respectively. Subgroup analyses based on risk stratification and follow-up duration revealed variability in treatment outcomes, particularly favoring BT in certain intermediate-risk groups.

Conclusion: This meta-analysis suggests that brachytherapy may offer superior outcomes in biochemical and clinical relapse-free survival compared to radical prostatectomy in patients with low- and intermediate-risk prostate cancer. However, no significant differences were observed in overall survival or cancer-specific survival, highlighting the need for individualized treatment decision-making based on patient risk profiles and preferences.

Background: Cholangiocarcinoma (CCA) is a significant problem in Southeast Asia, particularly Thailand. Changes in the expression of microRNAs (miRNA), is one of the mechanisms associated with the pathogenesis and progression of cancer.

Objective: In the present study, serum miRNA expression from advanced-stage intrahepatic CCA patients was investigated using the high-throughput technique (Nanostring Ncounter© technology).

Methods: Twenty-four intrahepatic CCA patients and eight healthy subjects were enrolled in this study. The CCA group was subgrouped according to disease progression into non-metastatic CCA and metastatic CCA.

Results: Of the 803 miRNAs, expression of 239 miRNAs was significantly different among the three groups (p < 0.001). Among them, miR-302d-3p showed the most significant expression (p < 9.02x10-7, FDR: 7.25x10-4), with upregulation in patients with metastatic CCA compared to non-metastic CCA and healthy groups. Fold change analysis revealed that miR-320e expression was the most significantly upregulated across all three groups (p < 0.001). Additionally, the expression levels of miR-223-3p, miR-23a-3p, and miR-302d-3p were significantly increased in patients with both metastatic and non-metastatic CCA compared to healthy controls. Several miRNAs were significantly downregulated, among them, miR-16-5p and miR-451a showed significant downregulation in metastatic and non-metastatic CCA compared with healthy groups.

Conclusions: These findings indicate that a panel of circulating miRNAs may serve as a useful tool for the diagnosis and prognosis of intrahepatic cholangiocarcinoma, warranting further validation in larger cohorts. Additionally, the accuracy of diagnostic tests may be improved by increasing the sample size and including diverse clinical subgroups to enhance the robustness and generalizability of the results.

Objectives: This study aimed to develop and evaluate a community-based social innovation to prevent Opisthorchis viverrini (OV) infection and cholangiocarcinoma (CCA), which are critical public health challenges in northeastern Thailand.

Methods: A research and development (R&D) approach was implemented across five provinces in Thailand's 10th Health Region. The intervention, "3 Health for a CCA-Free Society," focused on three domains: Health Behaviors, Health Hygiene, and Environmental Health. A manual-based innovation was co-developed through community engagement and expert collaboration. Using a quasi-experimental pre-post design, its effectiveness was evaluated in a prototype area that was randomly selected from the five provinces (n = 56). Structured questionnaires assessed participants' knowledge, health beliefs, and preventive behaviors. Paired t-tests and Wilcoxon signed-rank tests were applied to evaluate changes. Satisfaction was assessed using the Context, Input, Process, and Product (CIPP) model.

Results: Statistically significant improvements were found in knowledge (mean increase = 0.47, p < 0.001), health beliefs (mean increase = 3.92, p < 0.001), and preventive behaviors (mean increase = 3.07, p < 0.001). Satisfaction scores were high across all CIPP domains (mean = 4.88 ± 0.26). The manual was rated clear, relevant, and culturally appropriate, indicating strong potential for broader application.

Conclusion: This community-based social innovation significantly improved OV and CCA prevention outcomes in a high-risk area. The approach is feasible, scalable, and aligned with national strategies for participatory disease prevention. Further studies should explore its long-term impact and the potential for digital adaptation for broader dissemination.

Objectives: Cellular apoptosis plays a key role in the pathogenesis of periodontal disease. Meanwhile, diabetes mellitus can also promote cellular apoptosis of connective tissues. Abnormalities in the function of 8-oxoguanine DNA glycosylase (OGG1) can promote oxidative DNA damage, especially in the mitochondria. This study was performed to investigate expression of the genes associated with apoptosis and OGG1 in the gingival connective tissue of patients suffering from chronic periodontitis and diabetes mellitus.

Methods: Forty patients with diabetes and chronic periodontitis along with 20 nondiabetic patients with chronic periodontitis were investigated in this study. Four weeks after scaling and root planning for the treatment of periodontitis, periodontal surgery was performed. The gingival tissues obtained during the surgery were sent to the laboratory in order to investigate the expression of genes associated with apoptosis and OGG1.

Results: The mRNA and protein levels of caspase 3 and 9 were higher in the patients suffering from both diabetes and periodontitis compared to the nondiabetic chronic periodontitis patients (P<0.001). Furthermore, the expression level of OGG1 gene was higher in patients with chronic periodontitis and diabetes mellitus compared to the chronic periodontitis nondiabetic patients, though this difference was not significant.

Conclusion: The expression levels of genes associated with apoptosis and OGG1 in the gingival connective tissue of diabetic individuals with chronic periodontitis was higher than in nondiabetics with identical periodontal conditions. Thus, the signals and function of the genes examined in this study can be important and useful factor for further investigation in the treatment of patients with both periodontitis and diabetes.

Background: Candida infection has been implicated in the progression of Oral Squamous Cell Carcinoma (OSCC). Understanding the molecular pathways and gene interactions involved in this process could provide new insights into the mechanisms underlying OSCC development and identify potential therapeutic targets. This study utilizes bioinformatics tools to analyze the genes associated with Candida infection and its role in the possible progression of the disease.

Objective: To investigate the gene networks, enriched biological pathways, and chromosomal loci implicated in the progression of OSCC resulting from Candida infection using bioinformatics approaches.

Methodology: Genes associated with OSCC and Candida infection were analyzed using the STRING database to identify protein-protein interaction (PPI) networks. Enrichment analysis of biological pathways was conducted, focusing on key immune and inflammatory processes. Gene ontology (GO) terms and functional annotations were examined. Chromosomal mapping of enriched genes was performed to identify significant genomic regions. Data visualization was achieved through static signaling plots and network diagrams, representing fold enrichment of targeted pathways and chromosomal positioning.

Results: The cytokine-cytokine receptor interaction pathway exhibited the highest fold enrichment (~80-fold), indicating its significant role in immune modulation during OSCC progression. Other enriched pathways included viral protein interaction with cytokine receptors, cytosolic DNA-sensing pathways, and Th17 cell differentiation. Functional annotation revealed the involvement of macrophage proliferation, IL-33 signaling, and interferon responses, highlighting immune dysregulation in OSCC. Chromosomal mapping identified four enriched regions, primarily on chromosomes 2, 9, 12, and 16, indicating potential loci contributing to the disease's molecular pathogenesis.

Conclusion: The results suggest that immune signaling pathways, particularly cytokine-mediated interactions, play a critical role in Candida-mediated progression of OSCC. Chromosomal loci on chromosomes 2, 9, and 16 may harbor key genes involved in this process, potentially serving as targets for future therapeutic interventions. The findings further contribute to a deeper understanding of the immune-mediated mechanisms driving OSCC in the context of Candida infection.

Objective: To investigate the association between tumor morphology and muscle-invasive bladder cancer (MIBC) in patients with newly diagnosed bladder cancer (BC).

Methods: This retrospective study included 416 patients who underwent transurethral resection of a bladder tumor for newly diagnosed BC between January 2018 and December 2023 at a tertiary hospital in Vietnam. Multivariable logistic regression analysis was applied to assess the adjusted association between the sessile morphology of BC on cystoscopy and the risk of muscle invasion. Age, sex, tumor size, number of tumors, and pathological grade were considered confounders. Stratified analysis by tumor size and number of tumors was performed to clarify the effect modification.

Results: Patients with MIBC had a significantly higher prevalence of sessile morphology (68.8% vs. 28.4%, p<0.001). After controlling for confounders, patients with sessile tumors were three times more likely to have MIBC than those with papillary tumors (OR = 3.1, 95% CI = [1.8-5.3], p < 0.001). The association of sessile tumor with MIBC was higher in patients with tumor ≤3 cm (about 25%, OR = 3.9, 95% CI = [1.9-7.8]) and having >3 tumors (about 64%, OR = 5.1, 95% CI = [2.1-12.4]).

Conclusions: Sessile morphology is associated with the risk of MIBC in patients newly diagnosed with BC. This association was more pronounced in patients with tumor ≤3 cm and >3 tumors.