Cancer diagnosis & prognosis最新文献

Background/aim: Indices based on the white blood cell (WBC) count and WBC differential count are simple and can be easily calculated using routine blood tests. Many studies have examined the usefulness of these indices for predicting prognosis for various cancers, including lung cancer. However, no studies have focused on the relationships between indices based solely on WBC and WBC differential counts and the prognosis of patients with extensive-stage small cell lung cancer (ES-SCLC). The aim of this study was to evaluate the prognostic value of indices based on WBC and WBC differential counts in patients with ES-SCLC treated with platinum-doublet chemotherapy.

Patients and methods: The pretreatment neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), neutrophil-to-monocyte ratio (NMR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-WBC ratio (NWR), lymphocyte-to-WBC ratio (LWR), monocyte-to-WBC ratio (MWR), neutrophil-to-eosinophil ratio (NER), lymphocyte-to-eosinophil ratio (LER), monocyte-to-eosinophil ratio (MER), eosinophil*neutrophil-to-lymphocyte ratio (ENLR), systemic inflammation response index (SIRI), and inflammatory related ratio (IRR) of patients with ES-SCLC who were treated with platinum-doublet chemotherapy as first-line treatment at Kainan Hospital were retrospectively analyzed.

Results: Data from 102 patients were analyzed. On multivariate analysis, patients with low MLR, MWR, NER, MER, and IRR values had significantly longer overall survival (OS) than patients with high MLR, MWR, NER, MER, and IRR values. In addition, patients with low WBC and monocyte counts had significantly longer OS than patients with high WBC and monocyte counts.

Conclusion: Indices based on WBC and WBC differential counts, especially monocyte-related indices, may be useful markers for predicting the prognosis of patients with ES-SCLC treated with platinum-doublet chemotherapy.

Background/aim: This systematic review and meta-analysis evaluated the relationship between lymphatic vessel invasion (LVI) and lymphatic vessel density (LVD) - with specific focus on distinguishing peritumoral from intratumoral LVD, assessed by immunohistochemistry - and survival outcomes in patients with colorectal carcinoma (CRC).

Materials and methods: Following Cochrane Handbook and PRISMA guidelines, we included original studies evaluating tumor LVD and/or LVI in colorectal cancer using immunohistochemistry and reporting hazard ratios for overall survival (OS) and/or disease/recurrence-free survival (DFS). Data from MEDLINE, Cochrane Library, and PubMed (past 25 years) were extracted, analyzed with Stata, and assessed for heterogeneity and publication bias.

Results: The principal results of the present study were the statistically significant correlations between a) LVI and reduced OS (p=0.003), b) high peritumoral LVD and longer DFS (p=0.044) and c) high LVD (total) and reduced OS (p<0.001). However, no statistically significant correlation was found between peritumoral or intratumoral LVD and OS.

Conclusion: LVI and LVD parameters (peritumoral, intratumoral, total), evaluated using immunohistochemistry, may provide valuable information with respect to the prognosis of patients with CRC.

Background/aim: To reduce recurrence, immediate postoperative intravesical chemotherapy (IVC) is recommended for patients with low-risk non-muscle-invasive bladder cancer (NMIBC). This study evaluated recurrence outcomes in patients with low-risk NMIBC who did not receive immediate IVC and the potential benefit of introducing this approach.

Patients and methods: We retrospectively analyzed 100 patients with low-risk NMIBC who were selected from 1,845 patients who underwent transurethral resection of bladder tumor at our institution. According to international guidelines, low-risk was defined as primary, single, solitary (<3 cm), pTa, low-grade tumors without concomitant carcinoma in situ. None of the patients received immediate IVC. Tumors were re-evaluated using the 1973 and 2004/2016 World Health Organization classifications. Recurrence rates and patterns and oncological outcomes were examined.

Results: During a median follow-up of 69 months, 45 (45%) patients experienced recurrence. The cumulative recurrence rates were 21.6% at 1 year and 46.1% at 5 years. At first recurrence, high-grade progression was observed in 12% of the patients and upstaging to pT1 in 4%. Subsequently, 2% of patients progressed to muscle-invasive disease. The 5-year recurrence rates were 38.0% and 51.6% in G1 and G2 patients, respectively (p=0.204). The 5-year cancer-specific and overall survival rates were 98.3% and 89.4%, respectively.

Conclusion: The recurrence rate was high in low-risk patients with NMIBC who did not receive immediate IVC, and a subset of patients progressed to more aggressive disease. These findings underscore the potential benefit of introducing immediate IVC in this population.

Background/aim: The therapeutic efficacy of Immuno-Oncology combination therapy based on the number of metastatic organs in renal cancer has yet to be examined. Therefore, we herein compared the efficacy of dual immune checkpoint blockade (IO-IO) and combination of immunotherapy with tyrosine kinase inhibitors (IO-TKI) strategies in metastatic renal cell carcinoma (mRCC), with a focus on how the number of metastatic organs affects clinical outcomes.

Patients and methods: This retrospective study included 147 patients with mRCC treated with systemic therapies between August 2015 and July 2023. A multivariable Cox proportional hazards model was used to examine the relationships between clinical parameters and survival. To examine whether the effects of the number of metastatic organs on survival varied between treatment regimens, interaction terms were evaluated.

Results: In the multivariate Cox regression analysis, IMDC poor risk [hazard ratio (HR)=1.95; 95% confidence interval (CI)=1.19-3.18] and the presence of three or more metastatic organs in the IO-TKI group (HR=3.72; 95% CI=1.35-10.23) were identified as independent predictors of progression-free survival (PFS). In the IO-TKI group, patients with <3 metastatic organs had longer PFS than those with ≥3 metastatic organs. No significant difference in PFS was observed between <3 and ≥3 metastatic organs in the IO-IO group. This differential effect of the metastatic burden was confirmed by a significant interaction between the treatment group and number of metastatic organs (p for interaction=0.001).

Conclusion: The number of metastatic organs affects the efficacy of IO-TKI but has no effect on the efficacy of IO-IO treatment. We recommend considering the number of metastatic organs as an additional prognostic factor to optimize treatment selection for patients with mRCC.

Background/aim: Cervical cancer remains a major global health burden among women, with high morbidity and mortality driven by dysregulation of key cell cycle regulatory pathways. MicroRNAs (miRNAs) act as post-transcriptional regulators of genes controlling cell proliferation and differentiation. This study analyzed the expression and prognostic significance of six cell cycle-related miRNAs (hsa-miR-15a, hsa-miR-93, hsa-miR-106b, hsa-miR-195, hsa-miR-221, and hsa-miR-222) in a cervical squamous cell carcinoma and endocervical adenocarcinoma cohort (TCGA-CESC) obtained from TCGA data.

Materials and methods: Expression data from 306 CESC tumor tissues and two normal cervical tissue samples were retrieved from TCGA via the UALCAN portal. Differential expression of the selected miRNAs was assessed, and associations with clinical and pathological parameters - including tumor stage, histologic grade, lymph node involvement, and patient age - were evaluated. Kaplan-Meier and log-rank analyses were used to determine correlations between miRNA expression and overall survival (OS).

Results: Among the analyzed miRNAs, hsa-miR-15a, hsa-miR-106b, hsa-miR-221, and hsa-miR-222 were significantly up-regulated in CESC, whereas hsa-miR-195 was significantly down-regulated. Age-stratified analysis demonstrated higher expression of hsa-miR-15a, hsa-miR-106b, and hsa-miR-222 in younger and middle-aged patients, suggesting age-dependent modulation of cell cycle miRNAs. Across tumor stages and grades in CESC, hsa-miR-15a, hsa-miR-106b, hsa-miR-221, and hsa-miR-222 were significantly up-regulated in Stage II and in moderately differentiated tumors (Grades 2-3), whereas hsa-miR-195 remained consistently down-regulated across all stages and lower tumor grades. Kaplan-Meier survival analysis demonstrated that high expression of hsa-miR-15a (p=0.023) and hsa-miR-221 (p=0.048) significantly correlated with poorer overall survival, suggesting their potential prognostic values.

Conclusion: Dysregulated expression of cell-cycle-related miRNAs, particularly hsa-miR-15a and hsa-miR-221, may contribute to CESC progression and serve as potential prognostic biomarkers.

Background/aim: Peripheral blood neutrophil-lymphocyte ratio (NLR) has been reported to predict the effects of surgery and chemotherapy in breast cancer patients. However, the majority of the studies performed only one-time evaluation before commencement of treatment, while few evaluated the ratio over a period of time. In this study, we calculated NLR before surgery and postoperative adjuvant chemotherapy for patients with resectable breast cancer who underwent surgery as the initial treatment, and examined its correlation with clinicopathological factors and prognosis.

Patients and methods: A total of 1,095 patients with primary resectable breast cancer underwent curative resection as the first line of treatment between December 2007 and October 2018. Of these 1,095 patients, 178 were included in this study. Peripheral blood was collected before, and after the surgery. Preoperative NLR was evaluated during the first hospital visit before biopsy.  Postoperative NLR was evaluated using peripheral blood collected immediately prior to postoperative adjuvant chemotherapy. The cut-off value of NLR was set to 3, which has been reported to be the most commonly used value.

Results: Examination of postoperative NLR and prognosis in 24 breast cancer patients with higher pre-NLR revealed no significant difference [disease-free survival (DFS), p=0.320; overall survival (OS), p=0.409, log-rank test]. However, when post-NLR and prognosis were examined in 154 breast cancer patients with lower pre-NLR, the lower post-NLR group showed significant prolongation in DFS (p<0.001, log-rank test). Furthermore, OS tended to be prolonged in the lower post-NLR group (p=0.056, log-rank test). Multivariate analysis of DFS in 154 breast cancer patients with lower pre-NLR showed that large tumors [hazard ratio (HR)=4.132, p=0.009], nuclear grade 3 (HR=2.746, p=0.043), and higher post-NLR (HR=4.639, p=0.003) were independent factors.

Conclusion: Prognosis of breast cancer patients can be predicted by evaluating the NLR over time.

Background/aim: Adrenocortical carcinoma (ACC) is a rare but highly malignant endocrine tumor arising from the adrenal cortex, with a 5-year survival rate of less than 40%. Identifying prognostic biomarkers and therapeutic molecular targets is essential to improve the survival rate of ACC patients. Minichromosome maintenance protein 10 (MCM10) is known to play a role in DNA replication, and recently, the relationship between MCM10 expression and the prognosis of various cancers has been reported. However, the expression levels of MCM10 mRNA in ACC tissues and the relationship between MCM10 expression and prognosis of ACC patients have not yet been reported.

Materials and methods: MCM10 mRNA expression and survival in ACC patients were analyzed using the TCGA database with UALCAN and GEPIA platforms, assessing MCM10 mRNA expression across disease stages and its correlation with patient survival.

Results: MCM10 was found to be significantly overexpressed in ACC tissue from stage IV patients compared to stage I and II patients (p<0.001), and elevated MCM10 expression correlated with poorer prognosis in ACC patients (p<0.001).

Conclusion: These findings suggest that MCM10 may be a potential prognostic biomarker for ACC and may provide new insights into its role in tumor biology. Further studies are needed to elucidate the therapeutic significance of MCM10 and its mechanistic involvement in ACC progression.

Background/aim: High expression of p62 and ALDH1A3 indicates a poor clinical outcome in luminal B breast cancer, and p62 is involved in the progression of ALDH1-positive luminal B breast cancer stem cells. However, the association between endocrine therapy and high p62 and ALDH1A3 expression, in luminal B breast cancer remains unclear.

Materials and methods: Two datasets with gene expression and clinical data for patients with primary breast cancer (METABRIC, n=2,509; The Cancer Genome Atlas, n=1,084) were downloaded and statistically analyzed. To evaluate the association between the p62 and ALDH1A3 expression levels and endocrine therapy, including tamoxifen and aromatase inhibitor, in patients with luminal B breast cancer, disease-specific survival was examined using Kaplan-Meier and multivariate Cox regression analyses.

Results: Patients with p62 ^high ALDH1A3 ^high luminal B breast cancer treated with endocrine therapy exhibited a poor prognosis. Moreover, patients with p62 ^high ALDH1A3 ^high luminal B breast cancer treated with tamoxifen showed a trend towards a poor prognosis, but those treated with aromatase inhibitors showed a significantly poor prognosis. These results suggest that endocrine therapy, especially aromatase inhibitors, exhibits a reduced effectiveness against p62 ^high ALDH1A3 ^high luminal B tumors.

Conclusion: p62 and ALDH1A3 could be used together as a prognostic biomarker for predicting the efficacy of endocrine therapy for luminal B breast cancer.

Background/aim: Prostate cancer (PCa) incidence varies significantly by race, with Black men experiencing nearly 1.8 times higher prevalence than White men in the USA. Current prostate specific antigen (PSA)-based diagnostics lack specificity, and many machine learning models fail to consider racial differences in gene expression. This study proposes a race-aware PCa detection framework using optimized feature selection to improve diagnostic accuracy and fairness.

Materials and methods: RNAseq-Count-STAR and clinical phenotype data from TCGA (554 patients) were analyzed. A feature selection pipeline integrating Differential Gene Expression analysis, Receiving Operating Characteristic (ROC) analysis, and Gene-Set Enrichment Analysis identified a 9-gene subset strongly associated with the PCa clinical pathway. The model was trained on White population data and validated on the Black population dataset using various data balancing techniques.

Results: The 9-gene logistic regression model achieved 95% accuracy in the White population and 96.8% accuracy in the Black population. Fairness analysis indicated minimal disparity between groups (4% difference in demographic parity, p=0.518). These results highlight the predictive value of race-specific biomarkers and demonstrate that biologically informed feature selection improves both accuracy and interpretability.

Conclusion: This study introduces a race-specific PCa detection framework that improves diagnostic accuracy using targeted biomarkers. It addresses misclassification risks in race-agnostic models and emphasizes the need for race-aware gene expression in ML diagnostics. Beyond detection, it enables personalized treatment, advancing precision medicine in PCa care.

Background/aim: Breast cancer (BC) is the most commonly diagnosed cancer worldwide, with rising incidence among women under 46 years - particularly in the United Arab Emirates (UAE). Despite this, no effective screening tools exist for this population. This study evaluated, for the first time, the diagnostic potential of hPG₈₀ (circulating progastrin), a promising multi-cancer blood biomarker, in young women with BC through a monocentric prospective clinical trial at the University Hospital of Sharjah, UAE.

Patients and methods: Plasma hPG₈₀ levels were measured using the DxPG80.lab ELISA kit (Biodena Care, France) in blood samples. The study enrolled 50 treatment-naïve BC patients -21 under 46 years- along with 47 asymptomatic individuals under 45, and 78 asymptomatic individuals above 45. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses.

Results: hPG₈₀ levels were significantly higher in BC patients compared to asymptomatic individuals [median: 3.55 pM, interquartile range (IQR)=1.38-4.89 vs. 1.66 pM, IQR: 0.00-3.51; p=0.0006], with an AUC of 0.68 [95% confidence interval (CI)=0.58-0.77; p=0.0008]. Among young women, hPG₈₀ was also elevated in BC patients (median: 2.24 pM, IQR=0.87-4.09) versus asymptomatic individuals (median: 1.66 pM, IQR=0.00-2.47; p=0.0425), with an AUC of 0.65 (95%CI=0.50-0.80; p=0.0443). Using the kit's limit of quantification (3.3 pM) as cutoff, sensitivity was 47.6%, specificity 89.4%, negative predictive value 79.2%, and positive predictive value 66.7% for distinguishing early-onset BC from asymptomatic individuals.

Conclusion: hPG₈₀ may serve as a useful blood-based biomarker to support BC screening in young, high-risk women, particularly when combined with imaging. Validation in larger cohorts is warranted to confirm its role in early BC detection.