Asian Pacific Journal of Cancer Prevention最新文献

Background: Regenerative medicine increasingly relies on stem cell-based therapies, yet their clinical success is largely determined by immunological compatibility. Fetal liver-derived progenitor and stem cells represent a promising, yet insufficiently characterized, source for transplantation.

Objective: This study aimed to evaluate the immunogenicity of fetal liver cells by analyzing the expression of HLA class I and II molecules and detecting the presence of anti-HLA antibodies after cryopreservation at early gestational ages.

Methods: Cell suspensions were obtained from fetal livers at 5-12 weeks of gestation. Flow cytometry was performed using a CyFlow Space cytometer (Sysmex, Germany), and results were analyzed with Statistica 10. HLA class I (HLA-ABC) and class II (HLA-DR/DP/DQ) expression was quantified as the percentage of positive cells and their mean fluorescence intensity. Anti-HLA antibodies were assessed in the cell suspensions. Statistical analysis included descriptive statistics, group comparisons, and correlation analyses with gestational age.

Results: HLA class I expression was consistently detectable across all samples. In contrast, HLA class II expression increased progressively with gestational age, reflecting the developmental maturation of the fetal immune system. Importantly, these antigens primarily indicated differentiation toward myeloid lineages, which are unlikely to provoke graft-versus-host immune reactions. Anti-HLA antibodies were not detected in any of the analyzed suspensions.

Conclusions: This study provides the first systematic assessment of HLA expression in fetal liver-derived progenitor and stem cells following cryopreservation. The results suggest that these cells retain a favorable immunological profile, supporting their potential application in regenerative medicine. The findings highlight the importance of considering gestational age in evaluating immunogenicity. Further studies with larger sample sizes and in vivo validation are required to confirm clinical safety.

Purpose: Pancreatic cancer has poor prognosis, with a five-year survival rate of approximately 10%. This study evaluated the clinical outcomes of first-line chemotherapy (CMT) for patients with locally advanced and metastatic pancreatic ductal adenocarcinoma (LA/M-PDAC).

Patients and methods: A retrospective chart review was conducted of patients with LA/M-PDAC who underwent CMT between January 2008 and December 2018. Efficacy data (objective response rate [ORR], disease control rate [DCR], progression-free survival [PFS], and overall survival [OS]) were evaluated and compared using Pearson's chi-squared tests, Kaplan-Meier plots, and log-rank tests.

Results: Of 998 patients diagnosed with LA/M-PDAC, 332 (33.3%) underwent systemic CMT. Among the treatment regimens used, gemcitabine (GEM) was most commonly administered (33.7%). The next most common therapies were (m)FOLFIRINOX and GEM plus capecitabine (GEMCAPE), accounting for 27.4% and 26.2% of cases, respectively. The ORRs were 4.5, 10.3, 23.1, and 19.4% for GEM, GEMCAPE, (m)FOLFIRINOX, and Platinum doublets (PlatD), respectively. Patients who received combination CMTs had significantly longer median PFS than those who received GEM alone (PFS = 4.93 months (mos) for GEMCAPE, 9 mos for (m)FOLFIRINOX, 9.43 mos for PlatD, and 3.87 mos for GEM). However, no significant differences were observed in the median OS rates among the four regimens. The treatment-related grade 3 or 4 adverse events were highest in the (m)FOLFIRINOX group.

Conclusion: In the first-line treatment of PDAC, (m)FOLFIRINOX exhibited higher ORR and PFS than GEM or GEMCAPE. However, no survival advantage was observed in the (m)FOLFIRINOX group, suggesting an influence of subsequent therapy.

Objective: This study aimed to forecast the radiotherapy demand among geriatric patients in Southern Thailand's largest quaternary hospital by 2030 using an Autoregressive Integrated Moving Average (ARIMA) model.

Methods: This retrospective analysis was conducted using data from January 2004 and December 2022 and comprised patients aged ≥65 years who received radiotherapy. Monthly time-series data were analyzed in two phases. First, descriptive statistics were used to summarize patient demographics, cancer types, and treatment intent over time. Time-series decomposition and automatic machine learning were used to explore these patterns. Stationarity was assessed using the augmented Dickey-Fuller test. The model parameters were selected based on autocorrelation and partial autocorrelation plots and refined through optimization. Model selection was performed based on the Akaike Information Criterion, and forecasting accuracy was measured using the Mean Absolute Percentage Error (MAPE). Residual diagnostics included the Ljung-Box and Jarque-Bera tests as well as the assessment of heteroskedasticity.

Results: Of the 39,653 patients who underwent radiotherapy, 10,717 (27%) were aged ≥65 years (mean age 71.8; 60% male). The most common cancers were head and neck, lung, colorectal, and breast. Most patients received curative treatment, with increasing trends in radiotherapy utilization, particularly for lung, colorectal, breast, and prostate cancers. The optimal model, ARIMA(3,1,0)(0,0,1,4), incorporating exogenous variables related to the older adult population in Southern Thailand, achieved a MAPE of 0.17 and successfully passed all residual diagnostics. By 2030, the model forecasted approximately 74.7 new monthly cases of geriatric radiotherapy, with a 95% confidence interval of 53.8-95.7.

Conclusion: The demand for radiotherapy among older adults is projected to increase, underscoring the need for capacity planning. Future studies should explore sophisticated prediction techniques and include more clinical variables to enhance the accuracy of forecasts and aid thorough oncology planning.

Aim: The goal of this study is to increase the accuracy and reliability in diagnosing lung cancer with a new approach that employs Ant Colony Optimization in an ensemble with deep learning models: DenseNet, ResNet 50, VGG 19, and Long Short-Term Memory networks.

Background: In this study, Ant Colony Optimization has been united with advanced deep learning models like DenseNet, ResNet 50, VGG 19, Long Short-Term Memory networks, for improved detection of lung cancer from CT images and medical records. ACO optimization in feature selection was performed, greatly enhancing the performance of models, which when tested showed high accuracy rates in AI-driven health care solutions.

Objective: DenseNet, combined with ACO and LSTM, achieved an accuracy of 97.9%. The study demonstrates the effectiveness of ACO in improving diagnostic precision, setting a foundation for future AI-driven healthcare solutions to improve lung cancer diagnosis and patient outcomes.

Methods: This research integrates Ant Colony Optimization (ACO) with advanced deep learning models DenseNet, ResNet 50, and VGG 19 and Long Short-Term Memory (LSTM) networks to improve lung disease diagnosis from CT scans and medical records.

Results: This research enhances lung cancer diagnosis by integrating Ant Colony Optimization (ACO) with advanced deep learning models like DenseNet, ResNet 50, VGG 19, and LSTM networks. ACO optimizes feature selection, improving model accuracy. DenseNet with ACO and LSTM achieved the highest accuracy of 97.9%. ResNet 50 reached 96.2%, while VGG 19 had 92.3%. The study demonstrates the effectiveness of combining swarm intelligence with deep learning for improved medical diagnosis.

Conclusion: The ACO approach effectively optimizes feature selection, significantly improving model performance. With DenseNet achieving an accuracy of 97.9%, this study highlights promising advancements in AI-driven healthcare solutions for more precise and reliable lung cancer diagnosis and prognosis.

Objective: This study investigates the role of PDGF-BB in oral squamous cell carcinoma (OSCC) and its impact on the PI3K/AKT/mTOR pathway. The goal is to elucidate the expression levels analysis of PDGF-BB and signaling molecules in OSCC pathogenesis, potentially identifying novel biomarkers or therapeutic targets.

Methods: A combined approach involving in silico and experimental methods was employed. Protein sequence data for PDGF-BB were obtained from UniProt, and protein-protein interactions were analyzed using STRING to visualize PDGF-BB's network. Pathway enrichment analysis was conducted via PANTHER to identify relevant signaling pathways. The study included 30 OSCC patients and 30 matched healthy controls. Serum PDGF-BB protein levels were quantified using enzyme-linked immunosorbent assay (ELISA), while mRNA expression of PI3K, AKT, and mTOR was measured in OSCC and adjacent non-tumor tissues using quantitative real-time PCR (RT-qPCR).

Results: Pathway analysis identified 12 significant signaling pathways associated with PDGF-BB, with the PI3K/AKT/mTOR pathway chosen for validation due to its relevance in cancer-related signaling. STRING analysis confirmed PDGF-BB's interaction with this pathway. ELISA revealed significantly elevated serum PDGF-BB levels in OSCC patients (3.44 ng/mL) compared to controls (1.38 ng/mL, p < 0.05). RT-qPCR demonstrated significant upregulation of PI3K, AKT, and mTOR mRNA in OSCC tissues, with fold changes of 1.93, 2.1, and 1.9, respectively, relative to adjacent non-tumor tissues.

Conclusion: PDGF-BB is significantly upregulated in OSCC and likely contributes to OSCC progression by activating the PI3K/AKT/mTOR pathway. These findings highlight PDGF-BB's potential as a biomarker and therapeutic target in OSCC. Targeted therapies aimed at disrupting PDGF-BB and PI3K/AKT/mTOR signaling may improve OSCC outcomes, offering a promising avenue for future research and clinical applications.

The outcome of acute myeloid leukemia (AML) is heterogeneous, with both patient-related and disease-related factors contributing to an individual patient's likelihood of achieving a therapeutic response and survival. The Calcitonin Receptor-Like (CALCRL) gene, which encodes the calcitonin receptor-like receptor, has emerged as a point of interest in studying AML. Its expression levels may hold clinical relevance and contribute to the prognostic assessment of AML patients. In the current study, we evaluated CALCRL gene expression levels to verify their possible association with the clinical and laboratory characteristics of AML and to clarify its potential role as a molecular prognostic marker in a cohort of Egyptian AML patients.

Methods: CALCRL gene expression was estimated in 80 newly diagnosed adult Egyptian AML patients by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR).

Results: CALCRL gene expression in AML cases ranged from 0.11 to 104.11, with a median value of 2.1. It was higher in AML cases compared to controls; however, the difference was not statistically significant. AML cases were stratified into high and low CALCRL expression groups. Overall survival (OS) was higher in CALCRL-low compared to CALCRL-high expressers, yet the difference was not statistically significant. There was no statistical difference between CALCRL-high and CALCRL-low expressers regarding their complete remission rate (CR) and relapse-free survival (RFS). However, the incidence of relapse was higher in CALCRL-low expressers. In our study, the median age of the AML cases was 43 years. OS was significantly longer in CALCRL-low expressers, while RFS was significantly longer in CALCRL-high expressers younger than 43 years old.

Conclusion: Studying CALCRL gene expression in larger cohorts and over longer follow-up periods is highly recommended to gain deeper insight into its functional role in oncogenesis and chemoresistance, as well as its potential as a molecular prognostic marker and future therapeutic target.

Objective: This study aimed to evaluate the pathological complete response rate (pCR) in HER2 breast cancer by comparing anthracycline-containing and anthracycline-free regimens.

Methods: A retrospective cohort study was performed to obtain data from women undergoing neoadjuvant chemotherapy associated with two groups: • AC-TH patients: treated with trastuzumab with confirmed HER2-positive breast cancer using an anthracycline-based therapy followed by taxane. • CTH patients: recieved trastuzumab concurrently during taxane use in an anthracycline-free regime (carboplatin plus a taxane). Clinical data, pCR, free-disease survival, and overall survival were compared using chi-square, log-rank Mantel-cox, multinomial logistic and Cox regression tests (p < 0.05, SPSS v20.0).

Results: There are no differences between AC-TH and CTH in terms of: • pCR (p=0.745), •Disease- free survival (p=0.840), • Overall survival (p=0.642). The major prognostic factor for overall survival were: • Nodal metastasis (p=0.043, HR = 0.263 (CI95% = 0.072-0.959) and • Dose reduction (p=0.021, HR = 0.070 (CI95% = 0.007-0.667) and For disease-free survival: • Age (p=0.038, HR = 3.288, CI95% 1.068-10.123) and • pCR (p=0.028, HR = 0.354, CI95% = 0.140-0.895). AC-TH showed more cardiotoxicity (9.3% vs 3.4%).

Conclusion: Chemotherapy regimens with or without anthracycline, when combined with trastuzumab, demonstrate similar rates of pathological complete response and recurrence-free survival. Pathological complete response and age are independent variables associated with recurrence. However, the use of anthracycline leads to increased cardiotoxicity.

Background: Platelets possess an important biological role at several stages of various malignant diseases. Platelet activation, as manifested by platelet indices, could help establish them as a diagnostic non-invasive biomarker for use in distinguishing benign and malignant breast lumps.

Objectives: To compare various platelet indices in patients with different categories of breast lesions and among different cytological or histological grades of breast carcinoma.

Methods: This was a prospective cross-sectional analytical study conducted in the Department of Pathology at Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. It included 93 cytologically and histopathologically proven cases of breast lesions over a period of 9 months from September 2024 to May 2025. Blood samples from all 93 patients and 31 healthy controls were assessed for various parameters. The ANOVA test was used to compare different platelet indices across different categories and grades of breast lesions.

Result: Statistically significant differences in platelet counts, mean platelet volume, platelet-large cell ratio and platelet-lymphocyte ratio were observed when comparing the control group with the malignant group (p<0.001 in all indices), the non-neoplastic group with the malignant group (p<0.001 in all indices), and the benign group with the malignant group (p<0.001 in all indices). Platelet distribution width additionally showed significant differences between non-neoplastic group and benign group (p value 0.008). Amongst the various grades within malignant group, differences in platelet indices were not significant.

Conclusion: Malignant breast tumors are associated with higher levels of platelet activation and systemic inflammatory response, which are reflected in altered platelet parameters. Platelet indices may assist in distinguishing between malignant and non-malignant lesions, but are less reliable in grading the malignancy.

Background: Esophageal cancer is a significant health concern globally. In Punjab, where pesticides use and heavy metal exposure are widespread esophageal squamous cell carcinoma is among the leading cancers. This study aims to investigate the association between these environmental factors and esophageal carcinoma, for instituting preventive strategies.

Methods: We conducted a case-control study in Punjab, with 380 carcinoma cases and 760 age, gender, and district-matched controls from hospital and community settings. The participants completed a case report form with validated questions on risk factors. The urine, water, oral cytology, blood, and esophageal biopsies samples were collected from a subset of the population to evaluate pesticide metabolites, heavy metal exposure, cytological changes and infections like H. pylori and HPV.

Findings: The mean age of cases was 57.17 ± 9.54 (SD) years, similar to that of controls, 56.96 ± 8.93 (SD)years  (p>0.05).The key risk factors for esophageal carcinoma were, Dimethylphosphate presence in urine (5.41 (95% CI: 1.42-20.67, p<0.05), tobacco use  (OR 1.60, 95% CI 1.24-2.06, p < 0.001), alcohol use (OR 1.65, 95% CI 1.31-2.08, p < 0.001) and hot beverages (OR 1.81, 95% CI 1.44-2.28, p < 0.001), with population attributable fraction of 86.7%, 10.8%, 16.5%, and 16.7%, respectively.. The daily intake of fruits (OR 0.74, 95% CI 0.59-0.92, p = 0.008) and vegetables (OR 0.81, 95% CI 0.65-0.99, p = 0.045) had protective association, with inadequate intake contributing to 27% and 26.8% of risk, respectively. The exposure to heavy metals from drinking water was higher in both groups but not statistically significant.

Interpretation: This study confirms established risk factors like tobacco, alcohol, and diet contribute to esophageal squamous cell carcinoma in Punjab, while identifying pesticide exposure as a new risk factor. It calls for stricter regulations, public health interventions, and further research into environmental risks.