Cancer Investigation最新文献

Background: The most deadly disease in skin cancers family is melanoma. The color resemblance among melanoma-affected and healthy areas pose significant challenges in early detection.

Objective: An automated localization and segmentation of skin lesions at earlier stages remains challenging. To tackle these issues, a new method is proposed in this research for detecting malignant melanoma.

Method: This proposed strategy comprises five stages namely augmentation, preprocessing, segmentation, feature extraction, and classification. Initially, data augmentation is performed, then median filtering and image enhancement are applied to input image during preprocessing. Subsequently, IBIRCH algorithm is employed for segmentation. Furthermore, color and shape features, statistical features and improved local texton XOR pattern are extracted. Finally, ensemble model (proposed Bi-LSTM, CNN and DBN) is proposed which receives features and intermediate score obtained from each model undergoes improved score level fusion and yields final classification output.

Results: The proposed model is evaluated against traditional models and the suggested model achieved superior accuracy of 97.59% and 95.32% on datasets 1 and 2, respectively.

Conclusion: The improved performance of proposed model not only outperforms traditional approaches but also paves way for reliable automated early-stage melanoma diagnosis and so reduces life risk of patients due to this early detection.

This study aimed to examine the association between taste changes and vulnerability in elderly cancer patients undergoing chemotherapy. A cross-sectional study was conducted among older cancer patients undergoing chemotherapy in Wuxi, China. The Chemotherapy-induced Taste Alteration Scale (CiTAS) was used to measure taste alteration. The Vulnerable Elders Survey (VES) was used to measure vulnerability status. The univariate, correlation, and hierarchical regression analyses were applied to assess the association between taste changes and vulnerability. Of 200 older cancer patients, 123 (61.5%) participants were non-vulnerable. The univariate analysis revealed significant distribution differences of vulnerability in education level, smell abnormalities, drinking history, chemotherapy cycle, and taste changes. The level of taste changes was positively correlated with vulnerability (r = 0.401, p < 0.01). Results of the regression analysis indicated that vulnerability in older cancer patients was significantly associated with higher odds of "phantogeusia and parageusia" (OR = 4.505, p < 0.001). Taste changes may be an important influencing factor of vulnerability in older cancer patients.

Introduction: This study aims to explore the clinical characteristics and prognosis of patients with melanoma (MM), which are composed mainly of acral and mucosal MM accompanied by multiple primary tumors.

Methods: A total of 87 patients diagnosed with single primary MM and 87 patients diagnosed with multiple primary malignant tumors were included. Nonmelanoma malignancy tumor type, genetic testing, and the survival data were collected. Pearson's chi-square test, Fisher's exact test, log-rank test, univariate and multivariate Cox's regression analysis were applied.

Results: The most common nonmelanoma malignancies in all patients involved the digestive system; breast cancer, thyroid cancer, lung cancer, and prostate cancer; and breast cancer was more common in patients with acral MM. Mutations in BRAF V600, NRAS, KIT, and TP53 were the most common. Univariate analysis revealed that mutations in KIT and elevated levels of lactate dehydrogenase (LDH) were potential factors that influenced OS. Multivariate analysis revealed that mutations in NRAS and increased LDH levels were related to worse survival and that survival was prolonged in patients with MM as the first primary tumor.

Conclusion: This study preliminarily describes the clinical features and prognosis of patients with melanomas, while the further study with larger sample size is needed.

Background: Slow transit constipation (STC) is a potential risk of the onset of colorectal cancer (CRC). Thus, the purpose of this work is to focus on the co-pathogenic targets between STC and CRC, meanwhile evaluating their prognostic value for CRC.

Methods: The miRNA and mRNA data of STC and CRC were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. The prognostic signature was constructed based on hub genes, which identified using differential expression analysis and LASSO Cox regression analysis. The hub genes were validated employing multiple public databases. Enrichment analysis was employed to elucidate their functions. Survival analysis was performed using Kaplan-Meier method. Transcription factor binding sites were predicted and verified using FIMO and ChIP-seq database, respectively.

Results: We identified four common key differentially expressed miRNAs of STC and CRC, including hsa-miR-340, hsa-miR-30b, hsa-miR-20b, and hsa-miR-29c (p-value <0.05), and their targets were involved in the CRC's metabolic processes (all p-values <0.05). We developed a prognostic signature based on nine hub genes, and patient prognosis could be predicted employing Risk score = 0.099063054* NOG + 0.074815408* PLD5 + 0.003499667* NOVA1 + 0.051762032*DTNA + 0.050495722* GPR26 + 0.045057094* TNFAIP8L3 + 0.097209257* SLC29A4+ (-0.246941474)* CCNJL + 0.039294168* TRABD2B. High-risk patients exhibited significantly poorer prognosis (p-value <0.05). The hub genes CCNJL, NOVA1, PLD5, and SLC29A4 were significantly down-regulated targets of hsa-miR-340 in the CRC samples (p-value <0.05). Functional analyses suggested their involvement in immune-related processes (all p-values <0.05). Our exploration of upstream regulators revealed six and one reliable transcription factors for CCNJL and SLC29A4, respectively.

Conclusion: This study delved into common biomarkers between STC and CRC, and developed a reliable prognostic signature for CRC.

Background: Enfortumab vedotin, an anti-nectin-4 antibody-drug conjugate, is a key treatment for advanced urothelial cancer. However, hyperglycemia, a major adverse event, varies in incidence and can progress to diabetic ketoacidosis. We conducted a systematic review and meta-analysis to quantify the risk of hyperglycemia with enfortumab vedotin.

Material and methods: We searched studies published through September 30, 2024. Eligible clinical trials evaluated enfortumab vedotin as a monotherapy or combined with pembrolizumab. Pooled incidence and relative risk of hyperglycemia were calculated using random- or fixed-effects models.

Results: Seven studies with 2,138 patients were included in our analysis. The summary incidence of all-grade hyperglycemia was 10.3% (95% CI: 8.6-12.2%), and high-grade hyperglycemia occurred in 5.7% (95% CI: 4.5-7.1%) of patients. No significant difference was observed between monotherapy and combination therapy (p = 0.16). Enfortumab vedotin significantly increased the risk of all-grade (RR = 16.97, 95% CI: 6.22-48.25, p < 0.001) and high-grade hyperglycemia (RR = 34.78, 95% CI: 4.77-253.43, p < 0.001).

Conclusion: Enfortumab vedotin is associated with a significantly increased risk of all-grade and high-grade hyperglycemia in urothelial cancer. Its combination with pembrolizumab does not appear to elevate this risk further. Routine glucose monitoring and early intervention should be implemented, particularly in high-risk patients.

This study investigated the 3-year development of chemotherapy-induced peripheral neuropathy (CIPN) in post-menopausal women diagnosed with early breast cancer (EBC) using vibration perception threshold (VPT) measurements and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (CIPN18). 90 patients (aged 50-70) and 30 healthy subjects were included in the study. VPT measurements and CIPN18 questionnaires were performed post-chemotherapy (median 72 (IQR: 53-93) days post chemotherapy) as well as at the 12 and 36-month follow-up. Post-chemotherapy data showed impaired VPT measurements when comparing our study population to controls, but spontaneous improvement occurred, and by the 36-month follow-up, VPT measurements normalized when compared to controls. Mean CIPN18 scores improved, though the improvement was not statistically significant. Spearman's rho between VPT measurements and CIPN18 questionnaires showed weak to moderate correlations during follow-up. However, further analyses using a Generalized Additive Model confirmed the absence of a significant correlation between VPT measurements and CIPN18 questionnaires. Our data highlight limitations in the relationship between VPT measurements and CIPN. However, VPT measurements may have potential as an objective supplement to general assessment of patients.

This study was conducted to determine the effect of radiotherapy (RT) on heart functions in the early period in patients with breast cancer. The hemodynamic parameters showing heart functions of patients were recorded by impedance cardiography (ICG), a noninvasive method for monitoring heart function before and after RT. Some hemodynamic parameters of patients compared to before RT increased significantly after RT. Hemodynamic parameters that increased significantly following RT, compared with baseline: cardiac index (CI) (l/min/m²), before radiotherapy 3.21 ± 0.71, after radiotherapy 3.75 ± 1.01; stroke volume index (SVI) (ml/min/m²), before radiotherapy 37.32 ± 8.87, after radiotherapy 44.49 ± 10.85; thoracic fluid volume (TFC) (kohm^-1), before radiotherapy 35.43 ± 7.70, after radiotherapy 39.52 ± 10.37. The findings suggested that short-term effects of RT on hemodynamic parameters in breast cancer patients were not due to deterioration in heart functions, but could be due to radiodermatitis, which can be seen in patients up to 42 days after RT. As a part of the treatment plan of patients receiving RT, it may be recommended to determine changes in heart functions with ICG and to plan new studies in which patients will be followed for a longer period.

Introduction: Ocular surface squamous neoplasia (OSSN) is a broad term encompassing pre-cancerous and cancerous conditions affecting the ocular surface. Given the non-specific clinical presentation, there is a need for reliable diagnostic tools that can be used in resource-limited settings. This study assessed the diagnostic accuracy of Impression Cytology (IC) in diagnosing OSSN, compared to histopathology, the gold standard.

Methods: A diagnostic accuracy study was conducted involving 40 patients suspected to have OSSN at Kenyatta National Hospital and Kikuyu Hospital. Patients were scheduled for IC followed by surgical excision and Histopathological examination. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated.

Results: There were 40 participants, 28 females and 12 males, with a mean age of 40.5 years (range 18-70). IC had a sensitivity of 100%, specificity of 82.1%, accuracy of 87.5%, positive predictive value of 70.6%, and negative predictive value of 100%.

Conclusion: IC is an effective, minimally invasive diagnostic tool for OSSN, demonstrating high sensitivity and negative predictive value. Its implementation in clinical settings could improve early detection and management of OSSN, particularly in regions with limited access to histopathological services.

Aim: To evaluate the safety and efficacy of administering capecitabine concurrent with brachytherapy in advanced-stage cervical cancer.

Methods: Eligible patients with FIGO stage IB2-IVA cervical cancer were enrolled in this phase II non-randomized trial. After external beam chemoradiotherapy (EBRT), patients received capecitabine alongside brachytherapy as radiosensitizer. The primary objective was to assess the tolerability of the combined regimen and its effect on one-year disease-free (DFS) and overall survival rates (OS).

Results: Of the 69 patients completed treatment, 18 were enrolled as intervention group and 51 served as controls. Both groups were matched in terms of comorbidities, stage, and response to EBRT. Overall, concurrent capecitabine administration during brachytherapy was safe. At one-year follow-up, one death was recorded in each group, with recurrence rates of 16.7% in the intervention group and 19.6% in the control group. One-year DFS was 82% (95% CI: 54%-98%) in the intervention group and 87% (95% CI: 72%-94%) in the control group, while one-year OS was 93% (95% CI: 53%-98%) and 97% (95% CI: 85%-99%), respectively (for both p < 0.05).

Conclusion: In conclusion, while capecitabine-augmented brachytherapy was demonstrated to be safe in patients with advanced cervical cancer, its addition did not yield significant improvements in DFS or OS.

Desmoid tumor (DT), also known as desmoid fibromatosis, is a rare, locally proliferative tumor characterized by an overgrowth of myofibroblastic cells. Due to the varied clinical presentation of DT, there are a multitude of treatment options. This study provides our institutional experience in characterizing and treating DT as well as patient outcomes. A retrospective review was performed for 49 patients diagnosed with DT. Patient demographics, tumor characteristics, treatment characteristics, and tumor recurrence were reported. We reported our institution's treatment trends over time, relative risk analysis for surgery, as well as univariate analysis for recurrence. Thirty-seven patients received surgery with an overall recurrence rate of 29.7% (11/37). In total, ten patients received medical therapy including tamoxifen/sulindac (n = 7), nirogacestat (n = 1), and sorafenib (n = 2). One patient has been followed with active surveillance. Relative risk for surgery and tumor recurrence was not significantly correlated with race, gender, location, or large tumor size > 5 cm. Four patients treated with medical therapy experienced tumor reduction and symptomatic improvement. Management of DT includes many surgical and non-surgical options. We noted a similar recurrence rate in patients who received surgical treatment to what has been reported in the literature roughly 33%. We also noted effective tumor control in patients receiving medical therapy. As such, surgery can be utilized in situations with well-demarcated DT which can be removed en bloc, while utilizing medical therapy for highly invasive tumors.