BMC Cancer最新文献

Background: Lung adenocarcinoma (LUAD) is a common type of lung cancer and its pathogenic mechanism is complicated. A profound research for the molecular mechanism in LUAD is indispensable.

Methods: Gene levels were detected via real-time quantitative polymerase chain reaction and western blot. Proliferation, migration and apoptosis were assessed using colony formation assay, wound healing assay, and flow cytometry. Ferroptosis was evaluated through oxidative stress and iron level. Relations between genes were analyzed using Immunoprecipitation (IP) assay and ubiquitination assay, as well as ChIP assay and dual-luciferase reporter assay. USP18 function in vivo was explored using xenograft model.

Results: Ubiquitin-specific protease 18 (USP18) was overexpressed in LUAD tissues and cells. LUAD cell proliferation and migration were suppressed but apoptosis and ferroptosis were enhanced after USP18 knockdown. Pou domain, class 4, transcription factor 1 (POU4F1) protein expression was stabilized through USP18-mediated deubiquitination. Function of USP18 silence was reversed by POU4F1 overexpression in LUAD cells. POU4F1 promoted transcription of AMPK-α2 (PRKAA2) and USP18 modulated PRKAA2 protein level via affecting POU4F1. POU4F1 regulated LUAD cell behaviors by upregulating PRKAA2. USP18 enhanced tumor growth in vivo via mediating POU4F1 and PRKAA2.

Conclusion: All data demonstrated that USP18 acted as an oncogene in LUAD via interacting with POU4F1/PRKAA2 axis.

Background: Approximately 50% of ovarian cancer (OC) survivors report fear of cancer recurrence/progression (FCR/P) as the most challenging aspect of living with cancer. This pilot, randomised waitlist-controlled trial aimed to evaluate the feasibility, acceptability, and safety of iConquerFear, a self-guided online FCR intervention for OC survivors.

Methods: Stage I-III OC survivors were recruited via Ovarian Cancer Australia (OCA) between October-December 2022. Participants were randomised to access iConquerFear immediately (intervention) or after 8 weeks (waitlist-control). Primary outcomes were feasibility, acceptability, and safety. Secondary outcomes included: engagement barriers/enablers, perceived impact of iConquerFear, and suggested improvements via semi-structured interviews. Exploratory outcomes included group differences in FCR and FoP after iConquerFear use.

Results: Of 62 eligible survivors, 55 (61%) were randomised (intervention n = 29; control n = 26). At baseline 55% (30/55) reported severe FCR (FCRI-SF ≥ 22). Of those randomised, 51% (n = 28) accessed iConquerFear; 16/28 (57%) users completed ≥ 3/5 modules. Mean post-intervention acceptability score (IEUQ) was 3/4 (SD = 0.8). Three (11%) users withdrew due to distress from iConquerFear. Qualitative interviews (n = 13) identified 6 key themes (e.g., participant factors influencing engagement). Differences between intervention and control group changes in FCR/P were non-significant.

Conclusions: iConquerFear does not appear appropriate for OC survivors in its current format due to limited engagement, varied acceptability, safety concerns and minimal group differences in FCR/P after iConquerFear use. More work is needed regarding how to augment online interventions addressing sensitive issues such as FCR/P in OC survivors (e.g., offering complementary in-person support) to ensure feasibility, acceptability and safety.

Trial registration: This trial is registered with ANZCTR.org (ACTRN12622000592741p) on 21 April 2022.

Background: To evaluate the efficacy and safety of track sealing using subpleural injection of gelatin sponge particles in reducing the incidence of pneumothorax after percutaneous CT-guided lung biopsy.

Methods: This study conducted a retrospective analysis of 1,026 patients who underwent CT-guided lung biopsy at our center from January 2022 to July 2024. After propensity score matching (PSM) to minimize the impact of confounding variables like smoke, lesion diameter, and tract length, 338 patients were ultimately included and assigned to the sealant group (169 patients) or the non-sealing group (169 patients) according to whether using the gelatin sponge particles sealing after needle withdraw to the subpleural area. Clinical and operative characteristics data were collated from electronic medical records (EMR) and Picture Archiving and Communication Systems (PACS). A multivariable logistic regression analysis was conducted to identify predictors of pneumothorax.

Results: In the sealing group, the incidence of pneumothorax was 14.8%, whereas it was significantly higher in the non-sealing group at 23.7% (p < 0.05). There was no significant difference in the chest tube placement rates of 3% and 1.8% (p = 0.723). Importantly, no significant complications, such as air embolism, were observed in either group. A multivariate logistic regression analysis, using a propensity score-matched cohort, identified patient emphysema (OR = 2.35 [1.22-4.51], p = 0.01) and the tract length (OR = 1.25 [1.01-1.55], p = 0.042) as significant risk factors for pneumothorax. Furthermore, gelatin sponge particle needle-tract sealing demonstrated a marked and statistically significant reduction in the risk of pneumothorax (OR = 0.5 [0.27-0.91], p = 0.024), highlighting the distinct advantages and clinical value of this treatment in preventing such complications.

Conclusions: The gelatin sponge particle subpleural sealing technique can effectively reduce the incidence of pneumothorax in patients undergoing percutaneous CT-guided lung biopsy.

Purpose: There is a lack of consensus among physicians working in the field of disability assessment about the definition of a limited life expectancy. The aim of this study was to describe the mortality rate of employees with cancer who were judged to have a limited life expectancy and to study whether factors are associated with mortality.

Methods: A retrospective cohort study, including 534 Dutch employees with a diagnosis of cancer who were granted full work disability pension after being judged by physicians working in the field of disability assessment as having a limited life expectancy. Descriptive statistics were used to describe the one- and two-year mortality rates. Factors potentially associated with mortality were studied using univariate logistic regression analysis.

Results: The mortality rates one and two years after the disability assessment were 46% (n = 247) and 63% (n = 339), respectively. We did not observe a statistically significant association between age at death or between sex and death after one year, but after two years the probability of death was greater among men. Both one and two-years after the disability assessment, the probability of dying was greater among employees diagnosed with a digestive type of cancer, compared to employees diagnosed with a urogenital type of cancer.

Conclusions: Approximately six in ten people died within two years of their work disability assessment. In addition to the type of cancer, no factors in this study were associated with mortality. Physicians should be supported in making evidence-based assessments of life expectancy in patients with cancer.

Background: Tenosynovial giant cell tumour (TGCT) is one of the most prevalent soft tissue tumours of the foot and ankle. Although typically benign, it can exhibit locally aggressive behaviour. This study aims to evaluate the distribution, surgical management, and recurrence rates of localized (L-TGCT) and diffuse (D-TGCT) forms of TGCT.

Methods: A retrospective study of 34 TGCT cases in the foot and ankle treated surgically between 2010 and 2023 was conducted. Inclusion criteria required a histologically confirmed diagnosis and a minimum potential follow-up period of 18 months. Patient demographics, radiological findings, surgical approach and recurrence rates were evaluated.

Results: Of 34 cases, 61.8% were L-TGCT and 38.2% were D-TGCT. L-TGCT had a significantly shorter duration of symptoms (median: 6 months) than D-TGCT (36 months, p = 0.01) and affected significantly more females (76.2%; p = 0.013). Nineteen cases were intraarticular, and 15 cases extraarticular manifestationsMacroscopically complete resection was achieved in 95.2% of L-TGCT cases and 69.2% of D-TGCT cases (p = 0.037). The recurrence rate with limited follow-up was 26.7% for L-TGCT and 50.0% for D-TGCT (p = 0.263). Time to recurrence was 7.0 months for L-TGCT and 12.0 months for D-TGCT (p = 0.287). In 40% of these cases, therapeutic intervention was performed.

Conclusion: In the foot and ankle, L-TGCT is more common in females, presents earlier after symptom onset, and has a higher rate of complete resection, whereas D-TGCT has a longer symptom duration and higher recurrence rates. It's important for orthopaedic surgeons to weigh surgical margins against functional results, as stable outcomes appear to be attainable even in cases of residual or recurrent tumours.

Background: The Xizang Autonomous Region, located in China's southwestern frontier with an average elevation of 4000 m, faces socioeconomic development challenges influenced by its natural environment and regional disparities. Previous studies have indicated that cancer ranks as the fourth leading cause of death among permanent residents in Xizang. However, there is a paucity of research on the trends and characteristics of cancer mortality in this region. This study aims to analyze mortality data from Xizang between 2014 and 2023 to elucidate the characteristics and trends of cancer deaths and to provide a foundation for developing effective cancer prevention and treatment strategies.

Methods: Mortality data for cancer patients from 2014 to 2023 were extracted from the Death Information Registration and Management System of the Chinese Center for Disease Control and Prevention (CDC). The population data for Xizang were obtained from the Basic Information System of the Chinese CDC. Crude and age-standardized mortality rates were computed via SPSS software, and joinpoint regression models were employed to estimate the average annual percent change (AAPC) in mortality trends.

Results: Between 2014 and 2023, the crude mortality rate (CMR) for cancer increased from 31.38 per 100,000 to 49.37 per 100,000, whereas the age-standardized mortality rate (ASMR) rose from 50.15 per 100,000 to 66.42 per 100,000, with annual increases of 4.59% and 2.12%, respectively. The leading causes of cancer death are liver cancer, stomach cancer, lung cancer, esophageal cancer, and cervical cancer.

Conclusion: Cancer mortality in Xizang is increasing, with higher rates in men than in women, although the rate of increase is faster in women. Mortality rates increase with age, predominantly affecting middle-aged and elderly populations. Liver and stomach cancers are the primary contributors to cancer mortality. Given the severe cancer control situation, comprehensive prevention strategies and early diagnosis and treatment for high-risk populations are crucial.

Background: Salvage high-dose-rate brachytherapy (HDR-BT) is a potential treatment for localized recurrence of prostate cancer following definitive radiation therapy. This study aimed to evaluate the long-term safety and efficacy of HDR-BT alone, without androgen deprivation therapy (ADT), in this patient population.

Methods: We conducted a retrospective analysis of patients with prostate cancer who developed pathologically confirmed local recurrence after definitive radiation therapy and were treated with salvage HDR-BT alone at Kawasaki Medical School Hospital between 2007 and 2021. The prescribed HDR-BT dose was 22 Gy in 2 fractions. Biochemical relapse-free survival (bRFS), cause-specific survival (CSS), and overall survival (OS) were assessed using the Kaplan-Meier method. Adverse events were evaluated based on the Common Terminology Criteria for Adverse Events.

Results: Thirty-five patients were included, with a median follow-up of 66.0 months (range, 8.1-169.1). The 5-year bRFS, CSS, and OS rates were 29.7%, 100%, and 89.3%, respectively. Biochemical recurrence occurred in 21 patients (60.0%). Grade 2 adverse events were reported in eight patients (22.9%), while two (5.7%) experienced grade 3 adverse events. All grade 3 adverse events occurred in patients who had HDR-BT as their initial definitive radiation therapy.

Conclusions: Salvage HDR-BT without ADT is a safe and effective treatment option for localized prostate cancer recurrence after definitive radiation therapy. It provides excellent CSS rates with acceptable toxicity while potentially reducing the need for ADT. Further prospective studies are warranted to confirm these findings.

Background: Image-guided superficial radiation therapy (IGSRT) using a high resolution dermal ultrasound, is becoming a non-surgical highly effective treatment option for non-melanoma skin cancer (NMSC). In a previous study, we reported results from a multi-institutional study of 1616 patients with 2917 NMSC lesions treated with IGSRT showing a 99.3% rate of local control (LC) with mean follow-up of 16.06 months.

Methods: In this study, we analyze 133 additional lesions from 93 patients, as well as update previous findings with a longer follow-up duration, and perform subgroup analysis and Kaplan-Meier statistics. A retrospective analysis of 1709 patients with 3,050 Stage 0, I, and II NMSC lesions treated from 2017 to 2020 was performed.

Results: With image guidance, lesions received a median of 20 fractions of 50, 70, or 100 kilovoltage(kV) IGSRT. Average follow-up was 25.1 months with a maximum follow up of 65.6 months for the entire cohort. Sixty-eight patients expired, with deaths due to unrelated causes, who had no-evidence of disease (NED) at last follow-up prior to death, leading to Disease-Specific-Survival of 100% (Overall survival was 96%). Absolute LC of 99.2% was achieved in 3,027 of 3,050 lesions with overall absolute LC for BCC, SCC, and SCC-is being 99.0%, 99.2%, and 99.8%, respectively. As of January 2022, no other late complications were found.

Discussion: These updated results demonstrates that IGSRT should be considered a first-line option for the non-surgical treatment of NMSC as it continues to achieve low complication rates while maintaining a high level of LC.

Background: NDRG1, a cell differentiation-associated factor, has recently emerged as a regulator ferroptosis. Nevertheless, its role in modulating ferroptosis within hepatocellular carcinoma (HCC) remains uncharacterized.

Methods: The differential expression of NDRG1 and its prognostic value were analyzed in HCC using data from TCGA and GEO. Ferroptosis in HepG2 and Huh7 cells was assessed using flow cytometry, transmission electron microscopy, and propidium iodide staining following NDRG1 knockdown using shRNA. RNA-seq was performed to characterize the mRNA expression profiles in HepG2 cells, identifying differentially expressed mRNAs (DE-mRNAs) and NDRG1-related hub genes.

Results: NDRG1 was overexpressed in multiple malignant tumors, including HCC, and was associated with a significantly poor prognosis in HCC patients. A nomogram model integrating NDRG1 expression and clinical parameters demonstrated robust prognostic accuracy. NDRG1 knockdown potentiated erastin-induced alterations in Fe²⁺, total ROS, lipid ROS, and ferroptosis markers (PTGS2, ACSL4, GPX4, SLC7A11, GSH, GSSG), while exacerbating mitochondrial ultrastructural damage in HepG2 and Huh7 cells. Erastin induction elicited 1,056 DE-mRNAs, while subsequent NDRG1 knockdown revealed 1,323 DE-mRNAs in HepG2 cells. These DE-mRNAs are mainly involved in metastasis, immunity, growth, ferroptosis, and are associated with AMPK, MAPK, and PI3K/AKT pathways. Moreover, NDRG1 potentially interacted with HSPA8, CDH1, ALDOC, ANGPTL4, ANKRD37, CA9, ERBB3, FOS. qRT-PCR confirmed their expression changes consistent with RNA-seq.

Conclusion: NDRG1 exhibits strong predictive value for HCC, and accelerates tumor progression by suppressing ferroptosis.

Introduction: Dedifferentiated liposarcoma (DDLPS) is a fairly common subtype of soft tissue sarcoma, but relatively little is known about the clinical course and prognostic factors of this mesenchymal malignancy.

Methods: We performed a retrospective analysis of patients diagnosed with DDLPS at the University Hospital Leuven, Belgium between 1991 and 2022 based on an established clinical database and patient records.

Results: We identified 259 patients with DDLPS, with the retroperitoneum as most common location of the primary tumor (47.5%). 204/259 patients (78.8%) patients had primary surgery. Radiotherapy was administered in the pre- (46/259, 17.8%) or postoperative setting (51/259, 19.7%). At diagnosis 28/259 (10.8%) patients presented with locally inoperable disease and 26/259 (10.0%) with synchronous metastasis. In patients who had primary surgery, local relapses were seen in 114/259 (44.0%) patients and 80/259 (30.9%) patients developed metachronous metastasis. A total of 48/259 (18.5%) patients developed both local relapse and metastasis. Patients with inoperable or metastatic disease were often treated with systemic therapy. The most common first-line systemic therapies were doxorubicin (51/98, 52.0%), doxorubicin combined with ifosfamide (12/98, 12.2%) and different types of experimental treatments (18/98, 18.4%). The median overall survival from first diagnosis of DDLPS to death of all causes was 70.5 months (95% confidence interval [CI] 56.6-98.6) for all patients, 10.9 months (95% CI 3.6-29.2) in patients with inoperable disease, 28.4 months (95% CI 1.3-199.3) for patients with local relapse and only 9.4 months (95% CI 1.2-25.9) for patients with metastatic disease. We identified lower age, primary surgery, absence of synchronous metastasis, absence of local relapse and treatment with experimental therapy as statistically significant favorable prognostic factors.

Conclusions: DDLPS is a subtype of soft tissue sarcoma with an aggressive clinical course and very poor prognosis, especially in patients with inoperable or metastatic disease. The results with classic chemotherapy are poor, and experimental treatments may be a preferred choice for individual patients. Data from this retrospective series can inform the design of future prospective and ongoing trials in this setting.