BMC Cancer最新文献

Background: Behaviour change interventions that increase human papillomavirus (HPV) vaccine uptake in school children have been identified, but not which behaviour change techniques (BCTs) make them effective, or whether interventions are best targeted towards adolescents or their parent/carer(s). We aimed to assess the efficacy of behaviour change interventions to increase HPV vaccination compared to usual care according to BCTs implemented, and to identify whether parent/carer(s), adolescents or both are the optimal intervention target population.

Methods: We searched Central, Embase, Medline and Eric databases from 1st September 2008 to 17th July 2023 for randomised controlled trials (RCTs) reporting on HPV vaccine uptake following behaviour change interventions. We coded BCTs in interventions using the BCT taxonomy (v1). Random-effects meta-analyses and subgroup analyses were performed with data from studies that provided count data on HPV vaccine uptake by BCTs implemented and intervention target population.

Results: One thousand three hundred sixty-three unique records were identified, of which eight were eligible for inclusion. Implementing any behaviour change intervention was associated with a borderline significant increase in HPV vaccine uptake (OR 1.2 95% CI 1.0 to 1.4), interventions that implemented 'Instruction on how to perform the behaviour' (BCT 4.1) and 'Information about health consequences' (BCT 5.1) were not associated with increased HPV vaccine uptake (OR 1.7 95% CI 0.8 to 3.5), but analysis of two interventions implementing 'Adding objects to the environment' (BCT 12.5) in addition showed that this combination may be associated with significantly greater HPV vaccination (OR 13.6 95% CI 3.9 to 46.5). We found that interventions targeting parent/carer(s)-only were associated with a small significant increase in HPV vaccine uptake (OR 1.3 95% CI 1.1 to 1.5), but adolescent-only or parent/carer(s) and adolescent targeted interventions were not.

Conclusions: To our knowledge this is the first systematic review and meta-analysis to quantify the efficacy of behaviour change interventions to increase HPV vaccine uptake according to BCTs implemented. We have demonstrated that implementing any behaviour change intervention marginally increases HPV vaccine uptake, and have identified a combination of BCTs that may be associated with significantly increased HPV vaccine uptake. Our work provides compelling evidence that public health interventions must be specific and evidence-based and calls for the implementation of changes to usual care in school-based vaccination programmes.

Background: While hepatotoxicity has been widely reported with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), the comparative risk among them remains unclear. This study aimed to directly compare the relative risk (RR) of hepatotoxicity between new-generation (afatinib, osimertinib, dacomitinib) and first-generation (gefitinib, erlotinib) EGFR-TKIs in non-small-cell lung cancer (NSCLC) and to evaluate their overall risk-benefit profile.

Methods: PubMed, Embase, Cochrane library databases and clinicaltrials.gov were searched for trials up to September 2025. A study protocol was registered in PROSPERO: CRD42023457906. Among the 5371 records identified, 6 studies finally fulfilled the established criteria. Data extracted for each study included study characteristics, baseline patient information, interventions and data on all-grades alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB) elevation, overall survival (OS), progression-free survival (PFS) and objective response rate (ORR). RR, hazard ratio (HR) and 95% confidence interval (CI) were calculated using the inverse variance method.

Results: Six trials involving 2528 patients were analyzed. Decreased risks of hepatotoxicity due to the elevation of AST and ALT were observed for each new-generation EGFR-TKI. The pooled RRs of all-grades ALT, AST and TB elevation were 0.36 (95% CI 0.24-0.52, P < 0.001), 0.44 (95% CI 0.36-0.54, P < 0.001) and 0.83 (95% CI 0.50-1.39, P = 0.48), respectively. New-generation TKIs did achieved benefit in PFS (HR 0.65, 95% CI 0.50-0.83, P < 0.0001) and ORR (RR 1.14, 95% CI 1.00-1.29, P = 0.04). The OS of patients with new-generation TKI treatment was extended (afatinib, HR 0.73, 95% CI 0.58-0.92, P = 0.008 and osimertinib, HR 0.71, 95% CI 0.53-0.95, P = 0.02), except dacomitinib (HR 0.97, 95% CI 0.72-1.29, P = 0.81).

Conclusions: New-generation EGFR-TKIs (afatinib, osimertinib, and dacomitinib) demonstrate a superior efficacy and safety profile, with a significantly lower risk of hepatotoxicity, compared to gefitinib and erlotinib.

Background: Inflammation plays a critical role in cancer initiation and progression by modulating the tumor microenvironment and immune responses. Interleukin-1 receptor-associated kinase 2 (IRAK2) is a key mediator of the Toll-like receptor and interleukin-1 receptor signaling pathways, its pan-cancer expression patterns, genomic and epigenetic features, immune-related roles, and clinical relevance remain unclear.

Methods: The expression patterns of IRAK2 across multiple cancer types, transcript variants, single-cell distribution, prognostic significance, and biological functions were comprehensively evaluated through analyses of multiple databases and multi-dimensional datasets. Furthermore, the correlations of IRAK2 with the immune microenvironment, epigenetic modifications, and drug sensitivity were investigated. The potential role of IRAK2 in hepatocellular carcinoma was further explored through both in vitro and in vivo experiments.

Results: Aberrant expression of IRAK2 was observed in the majority of cancer types, with a relatively high proportion of expression detected in macrophages, and was found to be associated with the prognosis of certain cancers. In most cancer types, IRAK2 expression showed significant correlations with immune cell infiltration, the cancer-immunity cycle, major histocompatibility complex molecules, immune checkpoints, tumor mutational burden, microsatellite instability, RNA modifications (including m1A, m5C, and m6A), and DNA methylation sites. Both in vitro and in vivo experiments demonstrated that knockdown of IRAK2 markedly reduced the proliferative capacity of hepatocellular carcinoma cells.

Conclusion: The present study highlights the potential of IRAK2 expression as a novel biomarker for predicting the prognosis and immunotherapeutic response across various human cancers.

Background: The incidence of lung adenocarcinoma has been gradually increasing in recent years. Its early diagnosis remains challenging. Dysregulation of miRNAs is involved in the development of many malignant tumors, miRNAs have shown potential promise in the early diagnosis of tumors. This study aimed to evaluate the value of serum miR-21, miR-210, and miR-942 expression in the early diagnosis of lung adenocarcinoma(LUAD).

Methods: Preoperative peripheral blood was collected from 155 patients with suspected lung nodules who were due to be operated on, and the serum levels of miR-21, miR-210, and miR-942 were determined by real-time fluorescence quantitative PCR (RT-qPCR). Based on the postoperative pathology results, 130 patients with stage I-II early-stage LUAD were selected as the study subjects, and 80 healthy people over the same time period were selected as the control group. An early diagnostic model of LUAD with the combination of the 3 miRNAs was established. The diagnostic performance was evaluated using a receiver operating characteristic (ROC) curve.

Results: Compared with the control subjects, the expression of the 3 miRNAs was significantly upregulated in the LUAD patients in both the training and testing sets. Based on the logistic regression model, the AUC value for diagnosing early-stage LUAD using the 3-miRNA panel in the training set is 0.909, with an accuracy of 87.1%. In the testing set, the AUC is 0.890, and the accuracy is 82.9%. The combined AUC for both the training and testing sets is 0.901, with an accuracy of 84.3%. Serum miRNA-21, miRNA-210, and miRNA-942 all showed higher diagnostic efficacy in comparison with the conventional tumor marker Cyfra21-1 (AUC: 0.554 vs. 0.790, 0.856, and 0.621, respectively). Subgroup analysis based on clinical features showed that the 3-miRNA panel has better predictive performance for lung nodules that appeared solid in imaging findings, with an AUC of 0.903, a sensitivity of 90.0%, and a specificity of 80.0%.

Conclusions: The combination of serum miR-21, miR-210, and miR-942 could be employed as potential serum markers for early diagnosis of LUAD.

Background: We examined the clinical significance of the distance between the tumor and collecting system or sinus (DTCS), representing the nearness (N) score in the RENAL nephrometry score, on outcomes of robotic-assisted partial nephrectomy (RAPN).

Methods: We retrospectively analyzed 425 patients who underwent RAPN between 2016 and 2021. Multivariate binary logistic regression was used to assess predictive preoperative clinical factors. Receiver operating characteristic (ROC) curve analysis determined the optimal DTCS cutoff point for each outcome.

Results: The mean DTCS was 4.0 mm (SD 4.6), and 79 were N1, 97 N2, and 249 N3. DTCS was significantly associated with opening of the collecting system (p < 0.001) and trifecta achievement (p = 0.085), but not with pentafecta achievement. Optimal DTCS cutoff values were 4 and 7 mm for opening of the collecting system, and 0 mm for trifecta achievement.

Conclusions: While the DTCS cutoff value of 4 and 7 mm may indicate surgical technical difficulty, the 0 mm appears to be the more clinically relevant cutoff value for perioperative outcome risk stratification.

Background: The Correa pathway describes the sequential progression of gastric cancer through Helicobacter pylori (H. pylori) infection, chronic gastritis, atrophic gastritis, intestinal metaplasia, adenoma, and gastric cancer. Clarifying the causal relationships along this pathway can provide robust evidence for targeted gastric cancer preventive strategies.

Methods: This study was conducted using data from the Korean National Health Insurance Service, including 6,863,103 individuals who participated in the National Cancer Screening Program for gastric cancer in 2018, with a 2-year follow-up. We used doubly robust targeted maximum likelihood estimation (TMLE) to quantify the total effect of H. pylori eradication on incident gastric cancer and applied causal mediation analysis (CMA) to evaluate indirect pathways through atrophic gastritis/intestinal metaplasia and adenoma. Analyses were adjusted for age, sex, income, smoking, alcohol use, and family history of gastric cancer.

Results: TMLE revealed that H. pylori infection significantly increased gastric cancer risk (relative risk [RR] = 6.40; 95% confidence interval [CI]: 6.05-6.77), as well as the risk of atrophic gastritis/intestinal metaplasia (RR = 1.41; 95% CI: 1.35-1.43) and adenoma (RR = 5.81; 95% CI: 5.68-5.94). atrophic gastritis/intestinal metaplasia substantially elevated the risk of adenoma (RR = 1.72; 95% CI: 1.67-1.77) and gastric cancer (RR = 1.33; 95% CI: 1.28-1.44). CMA showed that 3% of the H. pylori effect on gastric cancer was mediated through atrophic gastritis/intestinal metaplasia (odds ratio [OR] = 1.03, 95% CI: 1.02-1.04), and 36% was mediated via adenoma (OR = 1.97, 95% CI: 1.94-2.01). Among individuals with atrophic gastritis/intestinal metaplasia, adenoma accounted for 44% of the subsequent gastric cancer risk (OR = 1.13, 95% CI: 1.03-1.34).

Conclusions: Our findings demonstrate that H. pylori infection is the most important causal determinant of gastric cancer and adenoma, indicating that prevention of H. pylori is central to gastric cancer prevention.

Background: Identifying patients at risk for VTE and stratifying that risk is critical to determine who will benefit from thromboprophylaxis. China's clinical practice still faces limitations, particularly regarding systematic and practical VTE risk assessment tools for cancer patients. This study aims to develop and validate the CHIna's Cancer-Associated venous Thromboembolism risk assessment tool (CHI-CAT score) compared to the Khorana score.

Methods: Cancer patients aged 18 or older hospitalized in the Third People's Hospital of Chengdu from March 2022 to September 2023 were retrospectively involved in this study. The cohort was divided into two groups based on whether they experienced VTE. Patients with VTE were compared to those without VTE according to their Khorana and CHI-CAT scores, respectively. Model discrimination performance was comprehensively evaluated using the standard sensitivity, specificity, maximum approximate entry index, and the area under the receiver operating characteristic curve(AUC).

Results: Data from 868 patients were analyzed. The CHI-CAT score was developed from a derivation cohort (n = 428) and further assessed in the validation cohort (n = 440). The predictive threshold for the risk assessment tool was set at 8 points. The AUC of the CHI-CAT score was 0.808 (95% CI, 0.715-0.901), with a significance level of P < 0.001. The verification results indicate that the AUC of the CHI-CAT and Khorana scores were 0.782 and 0.662, respectively, with a significance level of P < 0.001. The sensitivity of these two models was 0.826 and 0.478, respectively, while the specificity was 0.640 and 0.751.

Conclusions: The CHI-CAT score has been developed and validated, demonstrating relatively comprehensive components and a predictive capability that exceeds the Khorana score. However, its reliability and validation need improvement through testing in larger internal and external retrospective cohorts.