Cancer reports最新文献

Objectives

Sepsis is defined as a life-threatening, dysfunctional body-response to infection. Procalcitonin (PCT) is considered a marker of sepsis due to bacterial infections and it has been extensively used as a guide to antimicrobial management in the general population. The clinical role of PCT in cancer patients admitted to the Emergency Department (ED) for infection is still little researched.

Methods

A prospective observational study enrolling all adult patients hospitalized for infection referred to the ED of IRCCS Azienda Ospedaliero-Universitaria di Bologna between February 1st, 2023 and July 31st, 2023 was conducted. The primary endpoint was to evaluate the accuracy of PCT in the diagnosis of sepsis (defined according to the latest guidelines) in patients with cancer in comparison to non-cancer patients.

Results

1041 out of 1125 eligible patients were enrolled (559 males and 482 females), out of whom 289 (27.8%) had active cancer. PCT levels differed between cancer and non-cancer patients (1 ng/mL with IQR 5.85 vs. 0.6 ng/mL with IQR 2.7; p < 0.001). The AUROC of PCT for the diagnosis of sepsis in the entire enrolled population was 0.717 (95% CI 0.683–0.745), whereas it was 0.655 (95% CI 0.592–0.718) in cancer patients and 0.743 (95% CI 0.708–0.778) in non-cancer patients (p = 0.016). A PCT cut-off of 0.5 ng/mL (PCT ≥ 0.5 ng/mL) confirmed its accuracy for predicting sepsis in non-cancer patients (sensitivity 71.5%, specificity 64.1%) but the specificity fell to 44.7% in cancer patients, although sensitivity remained good (sensitivity 78.9%). Conversely, a higher PCT cut-off of 1 ng/mL, as the most accurate threshold identified in the present study in the cancer population, showed a sensitivity of 66.9% and specificity of 61.2% in predicting sepsis in cancer patients.

Conclusion

Our study confirms the clinical role of PCT as a part of the diagnostic algorithm for sepsis but its diagnostic role is sub optimal in cancer patients.

Background

Tumor immunity is involved in the progression of malignant tumors. However, there are few reports on the relationship between the immunological environment and the efficacy of immune checkpoint inhibitors in small cell lung cancer (SCLC). We analyzed the relationship between tumor-infiltrating immune cells and protein expression and survival in patients with SCLC treated with combined therapy with immune checkpoint inhibitors plus chemotherapy.

Methods

Patients with SCLC who received combined therapy with immune checkpoint inhibitors plus chemotherapy between 2019 and 2023 were enrolled. Immune cell infiltration levels, including CD4, CD8, FOXP3, CD163-positive cells and expression levels of TGFβ1 and SMAD3 proteins in tumor tissue were evaluated by immunohistochemistry. Progression-free survival (PFS) and overall survival (OS) were evaluated as endpoints.

Results

Data from 22 patients were analyzed. The high CD4-positive T lymphocyte (p = 0.008, log-rank test) and the high CD8-positive T lymphocyte infiltration group (p = 0.031, log-rank test) showed statistically significantly longer OS than the low infiltration group. On the other hand, the low TGFβ1 expression group showed significantly longer PFS (p = 0.026, log-rank test) and the low SMAD3 expression group showed significantly longer OS (p = 0.042, log-rank test) than the high expression group.

Conclusion

In conclusion, it is suggested that infiltration of T lymphocytes and expression of TGFβ1 and SMAD3 may be related to the efficacy of the combined therapy with immune checkpoint inhibitors plus chemotherapy in patients with SCLC.

Introduction

Internet-based interventions have become a necessity in providing care. To assess quality-of-life perceptions among women living with breast cancer (BC) receiving any type of internet-based treatments.

Methods

The present systematic review and meta-analysis were registered in PROSPERO with the ID no. CRD42024498834. All internet-based interventional studies among women living with BC assessing their quality of life perceptions before and after the intervention or between the usual and the intervention group were included. We consulted the British Nursing Database, CINHAL, Embase, Medline, Nursing & Allied Database, PubMed, Scopus, and Web of Science databases. Quality of life perceptions were assessed thanks to the Functional Assessment of Cancer Therapy–Breast (FACT-B) and the EORTC-QLQ-core Questionnaire (EORTC-QLQ-C30).

Results

The heterogeneity test findings of the eight studies exploring the FACT-B suggested that there was a significant heterogeneity among the selected studies (I² = 68%, p = 0.002). The FACT-B mean score among women living with BC was 0.31 (95% CI: 0.08–0.53). The heterogeneity test among the four studies exploring the EORTC-QLQ-C30 score revealed that there was a significant heterogeneity among the selected studies (I² = 74%, p = 0.009). The EORTC-QLQ-C30 mean score was 0.24 (95% CI: −0.11 to 0.58).

Conclusion

Internet-based interventions could ameliorate quality of life perceptions since most of the enrolled participants revealed as complicated the home community management allowing regular participation.

Background

Osteosarcoma is the most frequent primary bone malignancy, affecting mainly children, adolescents, and young adults. For the past 40 years, improvements in the survival of patients with osteosarcoma have been minimal, primarily as a consequence of the lack of systemic therapy options beyond traditional cytotoxic agents. In particular, management of metastatic and recurrent disease continues to be a significant clinical challenge.

Recent Findings

Mouse models of osteosarcoma serve as a valuable tool to study disease biology, metastasis, and response to novel treatments. In recent years, mouse models have been employed to evaluate the efficacy of several innovative drugs, including nanoparticle formulations that can target drug delivery to osteosarcoma tumor cells and diminish off-target effects. In addition, significant preclinical advancements in immune checkpoint inhibitors and immunotherapies for osteosarcoma have been made with the aid of mouse models.

Conclusion

This review provides insight into the advantages and shortcomings of the numerous osteosarcoma mouse models described in the literature, including transgenic, orthotopic, and heterotopic models as well as patient-derived xenografts. We highlight how these models are currently being used to support preclinical studies focused on the development of novel therapies.

Background

Cancer is generally perceived as a major stressor. Occasionally, patients are able to accept their diagnosis and prognosis, and it is not uncommon for patients who initially experience great distress to eventually learn to accept their disease. A deeper understanding of acceptance can enable clinicians to better support patients in achieving a more peaceful state of mind. The purpose of this literature review was to provide a comprehensive overview of existing research on acceptance in patients with cancer.

Recent Findings

Study selection resulted in the inclusion of 54 studies. All studies except one were published after the year 2000. Acceptance was defined in terms of cognition, emotion, behavior, spiritual processes, social processes, or other terms. Acceptance focused on disease, illness, cancer, poor prognosis/imminent death, or was not specified, and was measured by interview or questionnaire. Evidence was found for a range of factors associated with acceptance.

Conclusions

Acceptance is a relatively new field of research, characterized by significant heterogeneity in both its definition and focus, as well as the hypothesized determinants and outcomes. To advance this field, it is essential to develop a generally accepted definition of acceptance and to consistently specify its focus. The present scoping review provides a solid foundation for this endeavor.

Introduction

Breast cancer in males is rare, accounting for just 0.5% to 1% according to World Health Organization data. This is the first reported case of IESCM from breast cancer in an African male, which makes it noteworthy. Furthermore, unlike previously reported cases in females, this case involved L1–L2 metastasis with sphincter dysfunction and a subsequent relapse leading to mortality, thereby expanding the documented spectrum of IESCM presentations and outcomes.

Case Presentation

This is a case of a 77-year-old male with invasive ductal carcinoma of the left breast and intradural extramedullary spinal cord metastasis diagnosed via Magnetic Resonance Imaging after presenting with neurological symptoms 4 years post-mastectomy. He eventually passed away following a right Deep Venous Thrombosis, which led to bilateral pulmonary embolism after his second relapse.

Conclusion

Late presentation most likely contributed to the worsening of symptoms and poor prognosis. This report overstates the importance of prompt access to healthcare and the essence of thorough investigations, especially in breast cancer, where neurological symptoms may point to a metastatic diagnosis.

Background

Ferroptosis and cuprotosis, two distinct mechanisms of programmed cell death, play key roles in colon cancer development. This study aimed to construct a prognostic model for predicting colon adenocarcinoma (COAD) prognosis based on the differential expression of cuproptosis-related ferroptosis genes (CFRGs).

Methods and Results

Transcriptomic data and clinical data of COAD patients were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. A combination of methods, including analysis of variance, Pearson correlation analysis, Least absolute shrinkage and selection operator (LASSO) algorithm, and Cox regression was used to construct the CFRGs signatures. In addition, multiple algorithmic strategies were employed to explore the potential association between risk scores and immune infiltration features. Single-cell datasets were used to analyze model genes. Somatic mutations and drug sensitivities were compared across risk groups. Immunohistochemical analysis was performed to verify the expression of the main characterized genes. We identified eight pivotal genes in constructing the CFRGs signature. Single-cell RNA sequencing revealed differential expression of CFRGs in the COAD tumor microenvironment. The nomogram confirmed that risk scoring serves as an independent prognostic factor for COAD. The high-risk group exhibited higher immune cell and stromal cell infiltration, as well as immune checkpoint expression. Patients in the high-risk group may benefit from olanzapine administration. Both RT-PCR and immunohistochemistry have confirmed that the expression levels of GLS and YAP1 in COAD tissues are significantly higher than those in adjacent non-cancerous tissues.

Conclusions

The CFRGs risk prognosis model can effectively predict patients' immune infiltration and immunotherapy response, providing a new reference basis for individualized treatment plans for COAD patients.

Introduction

Endometrioid borderline ovarian tumor (EBOT) is rare and frequently misdiagnosed. This study aims to investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis, therapeutic approaches and disease prognosis, thereby establishing a robust foundation to mitigate misdiagnosis risks and deepen insights into the pathological diagnosis of this disease.

Case Presentations

From May 2020 to December 2022, two female patients diagnosed with EBOT were enrolled at Ningbo Yinzhou No. 2 Hospital. The patients, aged 30 and 34 years, respectively, both underwent left adnexal resection. Microscopically, the tumors displayed disorganized crowded endometrioid glands, mild-to-moderate epithelial atypia, and fibrous stroma interspersed among glands. Mulberry-like squamous metaplasia was also observed in some areas. Tumor cells were positive for cytokeratin (CK), cytokeratin 7 (CK7), estrogen receptor (ER) and progesterone receptor (PR), but negative for Wilms' tumor 1 (WT-1). The Ki-67 index ranged from 3% to 10%. Genetic analysis revealed a heterozygous CTNNB1 deletion in one tumor, whereas a heterozygous PTEN deletion in the other. As of the current follow-up (ranging from 10 to 40 months), both cases remained in a tumor-free status, with no signs of recurrence or metastasis to date.

Conclusion

EBOT are infrequent and may coexist with endometriosis or endometrioid carcinoma. Our cases demonstrated a heterozygous deletion of the CTNNB1 gene in one case, while a heterozygous deletion of the PTEN gene in the other. Surgery remains the main treatment, reflecting its efficacy in achieving disease control and a favorable prognosis.

Introduction

Hepatocellular malignant neoplasm, not otherwise specified (HCN-NOS) is a newly identified liver tumor with features of mixed hepatoblastoma (HB) and hepatocellular carcinoma (HCC). Although its prognosis and treatment strategies are not well defined, some reports suggested that complete resection with HB-targeting chemotherapy may yield favorable outcomes.

Case Presentation

We present herein a pediatric case of HCN-NOS in which the tumor was fully resected followed by postoperative chemotherapy. Unfortunately, the patient subsequently died.

Conclusion

This case highlights the fact that hepatoblastoma protocols may not always be effective in the treatment of HCN-NOS; therefore, developing treatment strategies tailored to HCN-NOS is crucial to improve patient prognosis.

Background

Medical crowdfunding (MCF) seeks to mitigate the financial harm to families with a child with cancer.

Aims

We sought to describe the illness phases, campaign creators, and the main topics discussed on MCF pages.

Methods and Results

Using publicly available campaigns on GoFundMe.com, we randomly selected 100 campaigns to extract information on stressors, appraisals, and additional attributes. We conducted descriptive statistics to describe the distributions of illness phases, creators, and topics, and Fisher's exact test to explore patterns in topics by illness phase and topics by creators.

Primary therapy was the most common illness phase (75%), and friend or family of the child with cancer was the most common campaign creator (76%). In 30/76 friend or family creators, a parent posted updates. The most common financial stressors were deductibles/co-pay costs (60%), employment disruptions (58%), and treatment-related travel (47%). Nearly all campaigns mentioned non-financial stressors including describing the illness (88%) and the path to diagnosis (86%). Most campaigns included a tertiary appraisal of worthiness to explain why their child (75%) or the family (49%) was worthy of donations. Most campaigns provided emotional support (84%), few provided peer support (22%), and even fewer provided informational support (10%). There were many significant differences in topics by type of creator and few by illness phase.

Conclusions

Friends and family are most active in creating campaigns near the beginning of a child's cancer journey. Campaigners share information both to update and to convince donors to support them. Future work should explore the consequences of parents engaging in MCF.