Cancer Management and Research最新文献

Purpose: To investigate the impact of Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) on hippocampal radiation dosage and psychological status in patients newly diagnosed with nasopharyngeal carcinoma (NPC).

Patients and methods: A retrospective analysis was conducted on 269 NPC patients who received initial treatment between January 2013 and April 2022. Patients were categorized into the IMRT group and the VMAT group based on the radiotherapy technique employed. The differences in hippocampal doses for NPC patients at different stages between the two groups were analyzed. The Hospital Anxiety and Depression Scale (HADS) was used to assess patients' anxiety and depression states. Before radiotherapy, patients with anxiety scores (HADS-A) between 0 and 10 points were included to analyze the differences in anxiety occurrence rates between IMRT and VMAT techniques. Similarly, patients with depression scores (HADS-D) between 0 and 10 points were included to analyze the differences in depression occurrence rates between the two radiotherapy techniques.

Results: In patients with T1-2 stage, those treated with IMRT had significantly higher hippocampal doses compared to those treated with VMAT. Furthermore, after radiotherapy, the occurrence rates of anxiety (HADS-A ≥ 11) and depression (HADS-D ≥ 11) in the IMRT group were 27.3% and 19.5%, respectively, while in the VMAT group, they were 9.5% and 7.4%, both showing significant statistical differences (P=0.010, P=0.035). However, there was no significant correlation between the radiotherapy technique and anxiety or depression occurrence rates in patients with T3-4 stage. Additionally, age and gender exhibited certain influences on psychological status.

Conclusion: In the absence of hippocampal protection, opting for a VMAT treatment plan over IMRT may potentially reduce the incidence of anxiety and depression. This perspective offers new insights for optimizing treatment strategies and improving quality of life.

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths worldwide. Mutations within the TP53 gene represent critical molecular events in NSCLC, contributing to the tumorigenesis in the pulmonary epithelial tissues. TP53 is a widely researched prognostic indicator in NSCLC, and pathological investigations have revealed a weak to mild negative predictive effect for TP53. Mutated p53 protein may have some pro-oncogenic impact, and the variations may change tumor inhibitors into oncogenes. The diverse mutational spectrum of TP53 in NSCLC with different mutations is linked to varied treatment responses. In contrast, first-line chemotherapeutics to this progress are limited, however, randomized trials with new chemotherapeutics have shown significant survival benefits. This review highlighted the critical influence of TP53 gene mutations on pathological-sensitivity and overall survival outcomes in NSCLC. Further research is needed to explore TP53 mutation-specific pathways and their effects on NSCLC progression and treatment effectiveness.

Introduction: Superior orbital fissure syndrome (SOFS) is a rare condition that involves damage to multiple structures within the superior orbital fissure, often caused by trauma, inflammation, or tumors. Lung adenocarcinoma, known for its propensity to metastasize, can lead to orbital metastases, which can manifest as SOFS. This case underscores the diagnostic and therapeutic challenges associated with such rare metastatic presentations.

Case presentation: A 60-year-old woman with a history of left lung adenocarcinoma presented with left eyelid ptosis and fixed eye position following hair dyeing. Despite initial treatments and imaging, her condition persisted. Subsequent imaging and thorough clinical evaluation revealed metastasis to the left superior orbital fissure. The patient was treated with volumetric modulated arc therapy (VMAT), leading to significant clinical improvement and reduction of the orbital mass.

Conclusion: This case highlights the critical role of comprehensive diagnostic evaluation and communication between specialists in managing rare metastatic conditions. It also demonstrates the efficacy of localized radiotherapy in treating such uncommon presentations of lung cancer metastasis.

Background: Cancer immunotherapy is an advanced therapeutic approach that harnesses the body's immune system to target and eliminate tumor cells. Traditional Chinese medicine (TCM), with a history rooted in centuries of clinical practice, plays a crucial role in enhancing immune responses, alleviating cancer-related symptoms, and reducing the risks of infections and complications in cancer patients.

Methodology: This review systematically examines the current literature on TCM-based formulations in cancer immunotherapy. It explores the mechanisms by which TCM augments immune responses, particularly focusing on how these formulations influence both innate and adaptive immunity. Various TCM herbs and compounds, their active ingredients, and their application in cancer prevention and treatment were analyzed through an integrated review of preclinical studies, clinical trials, and molecular mechanistic investigations.

Results: TCM formulations contribute to cancer therapy by modulating the body's internal environment to improve immune defense. They enhance the immune system's ability to detect and destroy cancer cells, promote apoptosis in tumor cells, inhibit tumor growth and metastasis, and augment the effectiveness of conventional cancer treatments. The review highlights specific TCM herbs and formulations that have demonstrated significant anti-cancer properties, including their ability to strengthen immune responses and provide synergistic effects with existing cancer therapies.

Conclusion: TCM-derived formulations represent a promising addition to cancer immunotherapy. The mechanisms through which these formulations enhance anti-tumor immunity are multifaceted, involving modulation of immune cell activity, apoptosis induction, and suppression of tumor progression. As cancer immunotherapy evolves, the integration of TCM into conventional treatment regimens may offer enhanced therapeutic efficacy, reduced side effects, and improved overall outcomes for cancer patients. Further clinical research is needed to fully elucidate the therapeutic potential and safety of TCM-based immunotherapeutic strategies in cancer care.

Objective: Our research has pinpointed the gut microbiome's role in the progression of various pathological types of non-small cell lung cancer (NSCLC). Nonetheless, the characteristics of the gut microbiome and its metabolites across different clinical stages of NSCLC are yet to be fully understood. The current study seeks to explore the distinctive gut flora and metabolite profiles of NSCLC patients across varying TNM stages.

Methods: The research team gathered stool samples from 52 patients diagnosed with non-small cell lung cancer (NSCLC) and 29 healthy individuals. Subsequently, they performed 16S rRNA gene amplification sequencing and untargeted gas/liquid chromatography-mass spectrometry metabolomics analysis.

Results: The study revealed that the alpha-diversity of the gut microbiome in NSCLC patients at different stages did not exhibit statistically significant differences. Notably, Lachnospira and Blautia were more abundant in healthy controls. The distribution of gut microbial species in patients with varying stages of NSCLC was uneven, with Bacteroides and Bacteroidaceae being most prevalent in stage T2, and Prevotella dominating in stage T4. Levels of Ruminococcus gnavus were notably elevated in stages N3 and M. The genus levels of Klebsiella, Parabacteroides, and Tannerellaceae were higher in stage II patients. Rodentibacter was the bacterium with increased levels in stage III NSCLC patients. Further metabolomics studies revealed significantly elevated levels of quinic acid and 3-hydroxybenzoic acid in the healthy control group. In contrast, Stage I+II non-small cell lung cancer (NSCLC) patients exhibited reduced levels of L-cystathionine. Notably, quinic acid, phthalic acid, and L-lactic acid were observed to be increased in Stage III+IV NSCLC patients.

Conclusion: Compared to the analysis of a single microbial dataset, this study provides deeper functional insights by incorporating comprehensive metabolomic profiling. This approach demonstrates that both the gut microbiome and associated metabolites are altered in NSCLC patients across different clinical stages. Our findings may offer novel perspectives on the pathogenesis of NSCLC at various TNM stages. Further research is warranted to validate and clinically apply these potential biomarkers.

The chronic myeloid leukemia (CML) is easily diagnosed by laboratory examination, however, rare BCR-ABL1 mRNA transcripts variants, such as e1a3 present diagnosis and therapeutic challenges. This case report details the diagnosis and management of a CML patient with the e1a3 transcript by FISH and RT-PCR. Following initial diagnosis, the patient was treated with the tyrosine kinase inhibitor (TKI) Flumatinib. During the treatment, although the FCM-MRD of the bone marrow kept negative, the e1a3 expression detected by PCR always remained positive. After eighteen months, the patient experienced headaches, vomiting, and blurred vision. Subsequent bone marrow analysis and flow cytometry detection of cerebrospinal fluid indicated that the patient had entered the blast phase, progressing to acute myeloid leukemia (AML). Treatment was switched to the third-generation TKI olverembatinib, combined with chemotherapy, followed by allogeneic hematopoietic stem cell transplantation. The patient remains disease-free following olverembatinib maintenance therapy. This case underscores the importance of comprehensive diagnostic apporsches and the potential efficacy of third-generation TKIs and allo-HSCT in the treatment of e1a3-type CML.

Introduction: Breast cancer is a significant worldwide health issue, particularly in Jordan, where early detection via mammography is essential for effective disease management. Despite the little radiation risk associated with mammography, it is crucial to monitor radiation exposure to guarantee patient safety. This study intends to assess skin entrance exposure and compute the Mean Glandular Dose (MGD) in mammography units to determine adherence to established criteria and pinpoint areas for enhancement.

Methods: To assess MGD, the study utilized the American College of Radiologists (ACR) phantom alongside a RaySafe X2 MAM dosimeter. Measurements of entrance kerma and half-value layer (HVL) were taken across 25 mammography units in Jordan. The MGD was calculated according to the ACR's 2018 protocol, which provides a standardized approach to ensure accurate and comparable dose estimations. These measurements were then analyzed against the ACR's threshold of 3 mGy to assess compliance.

Results: The study found that the average MGD across all units was 2.3 mGy, with individual values ranging from 0.95 to 4.10 mGy. Although 67% of the units maintained MGD values within the ACR threshold, 33% exceeded the recommended limit of 3 mGy. Higher MGD values were particularly common in non-accredited facilities, where the average MGD reached 2.7 mGy, compared to 1.6 mGy in accredited units, suggesting gaps in quality control and adherence to best practices in non-accredited centers.

Conclusion: This study emphasizes the critical role of accreditation and adherence to quality standards in maintaining safe and effective mammography practices. While most mammography units in Jordan meet the ACR's recommended MGD limits, the elevated dose levels in some non-accredited facilities highlight the need for more rigorous implementation of accreditation standards. Improving compliance with established guidelines will enhance breast cancer screening effectiveness, ultimately supporting better early detection and outcomes for breast cancer in Jordan.

Purpose: (Tumor-educated platelets) TEPs have emerged as active players in all steps of tumorigenesis, confrontation of platelets with tumor cells via transfer of tumor-associated biomolecules and results in the sequestration of such biomolecules. The current study was aimed to examine whether TEPs lncRNA-STARD4-AS1 and ELOA-AS1 might be potential biomarkers for NSCLC.

Materials and methods: TEPs were obtained by low-speed centrifugation. Quantitative real-time PCR was used to determine the expression level of TEPs-STARD4-AS1, ELOA-AS1 in the training cohort and the validation cohort. ROC curve was generated to evaluate their diagnostic value. Correlations between TEPs-STARD4-AS1, ELOA-AS1 and clinical parameters were further analyzed.

Results: Our results showed that the level of TEPs-STARD4-AS1 and ELOA-AS1 significantly upregulated in patients with NSCLC compared with healthy controls in the two cohorts. By ROC analysis, we found that TEPs-STARD4-AS1, ELOA-AS1 could offer valuable diagnostic performance for NSCLC patients (AUC_STARD4-AS1 = 0.800/0.774, and AUC_ELOA-AS1 = 0.754/0.718 for diagnosing adenocarcinoma and squamous cell carcinoma cases from controls, respectively). The combination of TEP-STARD4-AS1 and ELOA-AS1 improved the diagnostic efficiency of NSCLC. Clinicopathological analysis further revealed that TEPs-STARD4-AS1 level significantly correlated with tumor-node-metastasis (TNM) stage (p = 0.011), while TEPs-ELOA-AS1 expression significantly correlated with tumor-node-metastasis (TNM) stage and (p = 0.019) distant metastasis (p = 0.004).

Conclusion: Our data suggested that TEPs-STARD4-AS1 and ELOA-AS1 are promising non-invasive circulating diagnostic markers for NSCLC.

Introduction: The development and progression of Hepatocellular Carcinoma (HCC) is more relevant to immune regulation. Therefore, there is an urgent need to find immune-related molecular markers that can predict the prognosis and immune status of HCC.

Methods: RNA-seq and clinical HCC data from the Cancer Genome Atlas (TCGA) were analyzed for differential expression of microRNA (miRNAs), mRNAs, and lncRNAs. MiRNAs associated with immune scores were identified by Spearman analysis and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. MiRNAs and mRNAs were screened for prognosticity using COX regression. Kaplan-Meier survival analysis, risk scores, and correlation with clinical features were performed. Immune infiltration, Tumor Immune Dysfunction and Exclusion (TIDE), and chemotherapy prediction analyses were performed for high and low risk groups. Finally, prognostic mRNA expression was validated in cell lines.

Results: Five prognostic miRNAs (hsa-miR-145-3p, hsa-miR-150-3p, hsa-miR-153-3p, hsa-miR-223-3p, hsa-miR-424-3p) were identified in the study. A risk score model based on these prognostic miRNAs accurately predicted overall survival and was validated in GSE31384. Six mRNAs (KCTD17, MAFG, RAB10, SFPQ, TRMT6, UBE2D2) were further identified as prognostic. A risk model including these mRNAs also accurately predicted overall survival, and higher risk scores were associated with lower survival. Univariate and multivariate Cox regression analyses confirmed that both miRNA and mRNA risk scores were independent prognostic factors. The TIDE results showed lower TIDE scores and T-cell exclusion scores in the low risk score group. Chemotherapeutic drug sensitivity analysis revealed that the high-risk group was more sensitive to multiple chemotherapeutic agents. In addition, real-time quantitative PCR (RT-qPCR) results of the cell lines supported the results of the public database analysis.

Conclusion: This study validated immune-related prognostic miRNAs and mRNAs and identified risk signatures for HCC, potentially advancing HCC prognosis and treatment.

Intestinal flora is a complex micro-ecosystem in human body, which is called the second genome of human body. Intestinal flora imbalance plays an important role in the occurrence and development of gastric cancer through circulation, metabolism and immunity. Gastric cancer is associated with dysbacteriosis. Traditional Chinese medicine (TCM) compounds in Buyang Yiwei Decoction can reduce the clinical signs and symptoms of gastric cancer by regulating intestinal microbiota, alleviate the adverse reactions of gastric cancer after radiotherapy and chemotherapy, and improve the quality of life of patients. This article reviews whether Buyang Yiwei Decoction can reduce the risk of gastric cancer or play a therapeutic role in gastric cancer by improving the intestinal microbiota.