BMC Cancer最新文献

Background: The Nutritional Risk Screening 2002 (NRS 2002) is used to identify patients at risk who may benefit from nutritional intervention, while the Global Leadership Initiative on Malnutrition (GLIM) criteria serve as a diagnostic tool for malnutrition. However, their impacts on response to immunotherapy in patients with lung cancer are unknown. Therefore, this study investigated the role of NRS 2002 and GLIM criteria in predicting overall survival (OS) in patients with lung cancer receiving immune checkpoint inhibitors (ICIs).

Methods: This retrospective study included 146 patients with lung cancer treated with ICIs. Nutritional risk was evaluated using the NRS 2002, while nutritional status was assessed using the GLIM criteria. The OS rates were analyzed using Kaplan-Meier curves and Cox proportional hazard analyses. Two nomograms based on NRS 2002 and GLIM criteria were established to predict OS. Kendall's Tau was used to determine the relationship between NRS 2002 scores and GLIM criteria.

Results: The Kaplan-Meier survival revealed poor survival times in patients with nutritional risk (NRS 2002 score ≥ 3) and malnutrition as defined by the GLIM criteria. The multivariable Cox analyses identified that nutritional risk (hazard ratio [HR], 2.00, 95% confidence interval [CI]: 1.06-3.81, P = 0.033) and malnutrition (HR, 2.46, 95%CI: 1.28-4.77, P = 0.007) are independent factors predicting OS. Age, stage, NRS 2002 score, and GLIM criteria were used to develop the nomograms. Higher nomogram scores predicted significantly reduced OS (P < 0.0001). NRS 2002 scores and GLIM criteria showed a moderately strong positive correlation, with Kendall's tau = 0.709 (95% CI: 0.629-0.785; P < 0.001).

Conclusions: Nutritional risk and GLIM criteria-defined malnutrition are prognostic factors in patients with lung cancer receiving immunotherapy. NRS 2002 scores were significantly correlated with GLIM criteria in predicting diagnostic outcomes in lung cancer.

Introduction: Breast cancer remains a leading global health burden with rising incidence, particularly in low- and middle-income countries. Emerging evidence suggests that systemic inflammatory indices may correlate with malignancies' prognostic features. This study aimed to evaluate the diagnostic value of six peripheral blood inflammatory indices, including systemic immune-inflammation index (SII), lymphocytes-albumin to neutrophils ratio (LANR), neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), hemoglobin-to-red cell distribution width ratio (HRR), and glucose-to-lymphocyte ratio (GLR), in predicting breast tumor grade and immunohistochemical (IHC) markers expression.

Methods: This retrospective observational study involved 114 patients with breast cancer, admitted to Rasoul-Akram Hospital from September 2020 to 2024, undergoing elective tumor resection. Tumor grade and ER, PR, and HER2 expression were determined via biopsy. Ordinal logistic regression was applied to determine tumor grade and IHC marker expression predictors. ROC curve analyses were used to assess the diagnostic performance of significant indices.

Results: Among all indices, NLR showed a statistically significant association with tumor grade (p = 0.027), with higher NLR correlating with poorer differentiation. Additionally, ordinal regression analyses show that NLR and LANR were significantly associated with HER2 expression status. ROC analysis of NLR revealed moderate diagnostic value for tumor grade (AUC = 0.652, cutoff = 2.15, sensitivity = 59.3%, specificity = 69.0%). Other indices did not demonstrate significant predictive capacity for grade or IHC markers expression.

Conclusion: NLR, a cost-effective and widely accessible marker, showed moderate diagnostic value for predicting tumor grade and HER2 status in breast cancer. Incorporating NLR into preoperative evaluations may aid early risk stratification and guide individualized treatment planning.

Objectives: This study aimed to evaluate the performance of continuous-time random walk (CTRW), diffusion kurtosis imaging (DKI), and diffusion-weighted imaging (DWI) in predicting the proliferative state of endometrial cancer (EC).

Methods: A cohort of 81 EC patients was recruited. The parameters obtained from CTRW (α, β, and D_m), DKI (D_app, K_app), and DWI (ADC) were computed and compared between the high- and low-proliferation groups. Logistic regression analysis was used to identify independent predictors and perform a combined diagnosis. The area under the receiver operating characteristic curve (AUC), DeLong analysis, and calibration curves were used to assess the diagnostic performance.

Results: K_app was higher and α, β, D_m, D_app, and ADC were lower in the high-proliferation group than in the low-proliferation group (P < 0.05 for all). α, K_app, and D_app were identified as independent predictors of Ki-67 status in EC. The combined use of these predictors achieved optimal diagnostic efficacy (AUC = 0.949). The diagnostic performance of this combined approach was significantly superior to that of individual modalities such as DKI (D_app + K_app) and DWI (ADC) and individual parameters such as α, β, D_m, D_app, and K_app. However, no significant difference was observed between the results of the combined approach and those obtained from CTRW (α + β + D_m, AUC = 0.908, P = 0.165). The calibration curve showed that the combined approach offered good stability.

Conclusion: The combination of CTRW-derived parameter α, DKI-derived parameter K_app, and parameter D_app may be a promising set of biomarkers for assessing Ki-67 status in EC patients, providing a new reference for related clinical diagnosis and treatment.

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: 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: 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.