Cancer Antigen Research Articles

Molecular Biomarkers in Borderline Ovarian Tumors: Towards Personalized Treatment and Prognostic Assessment

Borderline Ovarian Tumours (BOTs) are a heterogenous group of ovarian neoplasms which have increased mitotic activity but lack stromal invasion. We performed a narrative review of the literature, aiming to identify prognostic molecular biomarkers that can potentially be used for treatment personalisation. We identified and discussed BRAF/KRAS, Cancer Antigen 125 (Ca 125), Calprotectin, p16ink4a, and Microsatellite instability (MSI) as the most studied biomarkers related to BOTs. Overall, BRAF and KRAS mutations are associated with earlier-stage and favourable prognosis; KRASmt may indicate extraovarian disease in serous BOT (sBOT). Ca125, the only currently clinically used biomarker, can be assessed pre-operatively and has an established role in post-operative surveillance, especially when it is raised pre-operatively or a high potential for malignant transformation is suspected post-operatively. p16ink4a expression trends could also indicate the malignant transformation of the tumour. Calprotectin has an inferior specificity to Ca125 and is not yet established as a biomarker, whilst there is very limited evidence available for MSI. As new evidence is coming along with artificial intelligence platforms, these biomarkers can be integrated and used towards the development of a precision model for treatment stratification and counselling in women diagnosed with BOTs.

An Unusual Case of Intrahepatic Stone Masquerading as Cholangiocarcinoma

ABSTRACT A cancer of the biliary tree, cholangiocarcinoma (CCA) often presents with painless jaundice, right upper quadrant abdominal pain, and unintended weight loss. Serologic testing to include cancer antigen 19-9 (CA 19-9) is elevated in CCA but can also be elevated in inflammatory processes in the biliary system. Diagnosis is difficult and even with advanced imaging techniques false-positives may occur. We present a case of a patient with elevated CA 19-9 and biliary stricture concerning for CCA but was due to hepatic stone. It demonstrates the challenge of correctly diagnosing CCA and an instance of nonmalignant elevation of CA 19-9.

A Clinicopathological Study of Surface Epithelial Tumors of the Ovary: A Retrospective Analysis at a Tertiary Care Center in Jeddah, Saudi Arabia.

Background Ovarian cancer is a prevalent gynecological cancer in women and one of the most common cancers globally. Factors such as the use of oral contraceptives, multiparity, and breastfeeding offer protection, while obesity, nulliparity, smoking, and genetic changes increase the risk. Ovarian cancer is asymptomatic in the early stages, typically becomes symptomatic in advanced stages, and can be divided into various histologic subtypes. This study aimed to determine the incidence of epithelial ovarian tumors according to their type and clinical presentation. Aim The study was conducted to determine the incidence of epithelial ovarian tumors according to their type and clinical presentation among women in a tertiary care center in Jeddah, Saudi Arabia. This is important becausevery few studies have been conducted in Saudi Arabia regarding the incidence of surface epithelial ovarian tumors. Methodology This retrospective cohort study utilized histopathological analysis to categorize ovarian neoplasms. Data on sociodemographic characteristics, histopathological findings, and clinical features were collected and analyzed from the tertiary care center to understand the distribution of surface epithelial ovarian tumors. The data were cleaned in Microsoft Excel (Microsoft Corp., Redmond, US) and analyzed using IBM SPSS Statistics version 29.0.0 (IBM Corp., Armonk, US). Results Our comprehensive study examined 252 women with ovarian tumors, revealing a predominant age group of 41-50 years (n=63, 25.0%), with the majority being married (n=193, 76.6%). Benign tumors were the most common (n=139, 55.2%), followed by malignant (n=87, 34.5%) and borderline (n=25, 9.9 %) tumors. The initial symptoms frequently included abdominal pain (n=105, 41.7%) and abdominal masses (n=65, 25.8%). Most tumors were primary (n=110, 43.7%). Protective factors such as breastfeeding/parity were significant (n=99, 39.3%), while nulliparity was a notable risk factor (n=31, 12.3%). The most elevated tumor marker was cancer antigen 125 (CA-125) (n=93, 36.9%). Treatment often involved total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) (n=92, 36.5%), with some requiring additional chemotherapy (n=36, 14.3%). Conclusion Our study demonstrated that surface epithelial tumors, particularly serous epithelial tumors, were the most common ovarian neoplasms, with abdominal pain being a frequent initial symptom. Effective management often included surgery and chemotherapy. Breastfeeding and parity were significant protective factors and CA-125 was a prevalent tumor marker.

Development of a novel molecular probe for visualizing mesothelin on the tumor via positron emission tomography.

Mesothelin (MSLN) is an antigen that is overexpressed in various cancers, and its interaction with tumor-associated cancer antigen 125 plays a multifaceted role in tumor metastasis. The serum MSLN expression level can be detected using enzyme-linked immunosorbent assay; however, non-invasive visualization of its expression at the tumor site is currently lacking. Therefore, the aim of this study was to develop a molecular probe for imaging MSLN expression through positron emission tomography (PET). VHH 269-H4 was obtained via immunization of llama using a fragment of MSLN from residue 360 to residue 597. S-2-(4-isothiocyanatobenzyl)-1,4,7-triazacyclononane-1,4,7-triacetic acid (p-SCN-Bn-NOTA) was conjugated to VHH 269-H4 to yield precursor NOTA 269-H4 for radiolabeling. The chelator-to-VHH ratio was determined by mass spectrometry. The binding kinetics of VHH 269-H4 and NOTA 269-H4 were measured by surface plasmon resonance. Flow cytometry was carried out using the anti-mesothelin monoclonal antibody Anetumab to select MSLN-positive and MSLN-negative cell lines. After radiolabeling, the radiochemical purity and in vitro stability were tested by radio-thin-layer chromatography and size exclusion chromatography, respectively. A saturation binding assay was conducted to measure the dissociation constant (Kd) of [68Ga]Ga-NOTA-269-H4. By mircoPET/CT imaging and biodistribution studies, the in vivo performances of the novel tracer were investigated in NCG mice bearing OVCAR-8, SKOV-3, or patient-derived xenografts. VHH 269-H4 targeting MSLN was obtained with a Kd value of 0.3 nM. After conjugation, approximately 27% and 3.2% of VHH were coupled to one and two NOTA chelators, respectively. This yielded precursor NOTA 269-H4 with a Kd value of 1.1 nM. The radiochemistry was accomplished with moderate radiochemical yields (34 ± 14%, n = 9, decay-corrected). [68Ga]Ga-NOTA-269-H4 was obtained with high radiochemical purity (> 99%), and was stable after 90min incubation at room temperature. The binding affinity of the radioligand towards MSLN was kept in the nanomolar range. Flow cytometry revealed that OVCAR-8 cells possess a high level of MSLN expression, while MSLN expression on SKOV-3 cells was negligible. Consistently, in microPET/CT imaging, [68Ga]Ga-NOTA-269-H4 demonstrated clear tumor visualization using NCG mice bearing OVCAR-8 xenografts, but no radioactivity accumulation was observed in SKOV-3 xenografts, suggesting a high specificity of the tracer in vivo. In biodistribution studies, [68Ga]Ga-NOTA-269-H4 displayed radioactivity accumulation of 2.93 ± 0.39%ID/g in OVCAR-8 xenografts at 30min post-injection, and the highest tumor-to-blood ratio (~ 3) was achieved at 90min post-injection. In NCG mice bearing patient-derived xenografts, [68Ga]Ga-NOTA-269-H4 was able to noninvasively detect MSLN expression via microPET/CT imaging. To our knowledge, our studies achieved the first-time to non-invasively detect MSLN expression clearly using a single domain antibody fragment. To sum up, [68Ga]Ga-NOTA-269-H4 is a highly promising PET probe to visualize MSLN expression in vivo and holds great potential to monitor MSLN expression during tumor development.

Usefulness of urinary biomarker-based risk score and multiparametric MRI for clinically significant prostate cancer detection in biopsy-naïve patients.

This study aimed to investigate the accuracy of multiparametric magnetic resonance imaging (mpMRI), genetic urinary test (GUT), and prostate cancer prevention trial risk calculator version 2.0 (PCPTRC2) for the clinically significant prostate cancer (csPCa) diagnostic in biopsy-naïve patients. In a single center study between 2021 and 2024 participants underwent prostate mpMRI, GUT, and ultrasound (US) guided biopsy. The csPCa risk was calculated using PCPTRC2. After conducting a digital rectal examination (DRE), a GUT was performed. It incorporated the RNA levels of prostate cancer antigen 3 (PCA3) and transmembrane serine protease 2 (TMPRSS2) gene and ETS-related gene (ERG) fusion genes (T: E), along with the patient's age and PSA density. The McNemar test compared detection rates between modalities. 208 (mean age 62.9 years +/- 8.2) men were included prospectively. A positive GUT score was found in 67.8% and PIRADS ≥3 in 81.7% of all cases. The combination of GUT with mpMRI showed significantly higher sensitivity (99.1%) than GUT and mpMRI alone, 84.4% and 93.8%, respectively (p ≤ 0.05). Similarly, very high sensitivity (99.0%) was achieved by combining mpMRI with PCPTCR2. Nevertheless, mpMRI plus GUT combination exceeded mpMRI plus PCPTCR2 by allowing to save a higher fraction of unnecessary biopsies, 25% and 2.4%, respectively. GUT and mpMRI combination would allow saving a substantial fraction of unnecessary biopsies with minimal risk of missing csPCa cases.

Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update.

To provide updated guidance regarding neoadjuvant chemotherapy (NACT) and primary cytoreductive surgery (PCS) among patients with stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (epithelial ovarian cancer [EOC]). A multidisciplinary Expert Panel convened and updated the systematic review. Sixty-one studies form the evidence base. Patients with suspected stage III-IV EOC should be evaluated by a gynecologic oncologist, with cancer antigen 125, computed tomography of the abdomen and pelvis, and chest imaging included. All patients with EOC should be offered germline genetic and somatic testing at diagnosis. For patients with newly diagnosed advanced EOC who are fit for surgery and have a high likelihood of achieving complete cytoreduction, PCS is recommended. For patients fit for PCS but deemed unlikely to have complete cytoreduction, NACT is recommended. Patients with newly diagnosed advanced EOC and a high perioperative risk profile should receive NACT. Before NACT, patients should have histologic confirmation of invasive ovarian cancer. For NACT, a platinum-taxane doublet is recommended. Interval cytoreductive surgery (ICS) should be performed after ≤four cycles of NACT for patients with a response to chemotherapy or stable disease. For patients with stage III disease, good performance status, and adequate renal function treated with NACT, hyperthermic intraperitoneal chemotherapy may be offered during ICS. After ICS, chemotherapy should continue to complete a six-cycle treatment plan with the optional addition of bevacizumab. Patients with EOC should be offered US Food and Drug Administration-approved maintenance treatments. Patients with progressive disease on NACT should have diagnosis reconfirmed via tissue biopsy. Patients without previous comprehensive genetic or molecular profiling should be offered testing. Treatment options include alternative chemotherapy regimens, clinical trials, and/or initiation of end-of-life care.Additional information is available at www.asco.org/gynecologic-cancer-guidelines.This guideline has been endorsed by the Society of Gynecologic Oncology.

CA-125 as a Biomarker in Renal Medullary Carcinoma: Integrated Molecular Profiling, Functional Characterization, and Prospective Clinical Validation.

Renal medullary carcinoma (RMC) is a highly aggressive malignancy defined by the loss of the SMARCB1 tumor suppressor. It mainly affects young individuals of African descent with sickle cell trait, and it is resistant to conventional therapies used for other renal cell carcinomas. This study aimed to identify potential biomarkers for early detection and disease monitoring of RMC. Integrated profiling of primary untreated RMC tumor tissues and paired adjacent kidney controls was performed using RNA-sequencing (RNA-seq) and histone Chromatin Immunoprecipitation Sequencing (ChIP-seq). The expression of serum cancer antigen 125 (CA-125), was prospectively evaluated in 47 patients with RMC. Functional studies were conducted in RMC cell lines to assess the effects of SMARCB1 re-expression. MUC16, encoding for CA-125, was identified as one of the top upregulated genes in RMC tissues, with concomitant enrichment of active histone marks H3K4me3 and H3K27ac at its promoter. Elevated serum CA-125 levels were found in 31 of 47 (66%) RMC patients and correlated significantly with metastatic tumor burden (p = 0.03). Functional studies in RMC cell lines demonstrated that SMARCB1 re-expression significantly reduced MUC16 expression. The correlation between serum CA-125 levels and metastatic burden suggests that CA-125 is a clinically relevant biomarker for RMC. These findings support further exploration of CA-125 for disease monitoring and targeted therapeutics in RMC.

Prognosis of premenopausal women with low-risk endometrial cancer but elevated CA125 levels.

Women with low-risk endometrial cancer, as defined by the Korean Gynecologic Oncology Group (KGOG) criteria, have a low risk of lymph node metastasis and an excellent prognosis without lymphadenectomy. However, it is unclear whether lymphadenectomy should be performed in premenopausal women who meet the KGOG criteria other than elevated cancer antigen 125 (CA125) levels, because the CA125 level can be elevated by benign conditions. We investigated the patterns of metastasis and recurrence to assess the value of lymphadenectomy in this population. Premenopausal women with endometrial cancer meeting the KGOG criteria, except for those with elevated CA125 levels, were eligible. The characteristics of the eligible women were collected from seven institutes in the Republic of Korea by reviewing their medical records. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Seventy-three patients were included. Of 62 women who underwent lymphadenectomy, only two (3.2%) had lymph node metastasis. Eighteen women (24.7%) received adjuvant therapy. At a median follow-up of 59 months, the 5-year RFS was 88.8%. Five women (7%) experienced recurrence, two had lymph node recurrence, and three had non-nodal recurrence. RFS was similar between the women who did and did not undergo lymphadenectomy (P=0.737). Premenopausal women who had elevated CA125 levels but met all other KGOG criteria showed a low risk of lymph node metastasis and recurrence as well as a good prognosis. Therefore, lymphadenectomy can be omitted in this population.

Synthetic cells in tissue engineering.

Tissue functions rely on complex structural, biochemical, and biomechanical cues that guide cellular behavior and organization. Synthetic cells, a promising new class of biomaterials, hold significant potential for mimicking these tissue properties using simplified, nonliving building blocks. Advanced synthetic cell models have already shown utility in biotechnology and immunology, including applications in cancer targeting and antigen presentation. Recent bottom-up approaches have also enabled synthetic cells to assemble into 3D structures with controlled intercellular interactions, creating tissue-like architectures. Despite these advancements, challenges remain in replicating multicellular behaviors and dynamic mechanical environments. Here, we review recent advancements in synthetic cell-based tissue formation and introduce a three-pillar framework to streamline the development of synthetic tissues. This approach, focusing on synthetic extracellular matrix integration, synthetic cell self-organization, and adaptive biomechanics, could enable scalable synthetic tissues engineering for regenerative medicine and drug development.

Bone marrow metastasis of ovarian cancer: A two‑center retrospective study and literature review.

Bone marrow metastasis (BMM) causes pancytopenia and disseminated intravascular coagulation (DIC), resulting in rapid mortality. The incidence of this disease is likely underestimated, with confirmed BMM occurring at approximately twice the rates expected clinically. The present study describes two detailed cases and includes a literature review of BMM caused by ovarian cancer. The existing medical records of patients admitted to Oita University Hospital (Yufu, Japan) and Saitama Medical University International Medical Center (Hidaka, Japan) were retrospectively analyzed and a literature review regarding BMM associated with ovarian cancer was conducted. The literature review of BMM of ovarian cancer, including the present cases, revealed that patient ages ranged between 37 and 71 years, with tumor histology described in 5 out of 8 cases. Notably, 3 previous cases involved rare histological types (small cell carcinoma, carcinosarcoma and mucinous carcinoid), whereas the present identified cases involved common types. The first case involved a patient who developed isolated BMM/carcinomatosis during maintenance therapy with olaparib for recurrent high-grade ovarian serous carcinoma. The patient initially presented with elevated cancer antigen 125 levels and decreased blood counts. Following the onset of BMM, the patient's lactate dehydrogenase level was elevated to 2,712 U/l. The second patient was diagnosed with BMM/carcinomatosis, concurrent with an initial diagnosis of ovarian clear cell carcinoma. Both patients subsequently developed pancytopenia and DIC, resulting in mortality. To the best of our knowledge, the present study is the first retrospective study of BMM of ovarian cancer. For early diagnosis, BMM should be considered in the differential diagnosis when a reduction in blood counts is accompanied by an elevation in serum tumor markers, regardless of histological type.

Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression.

Urinary system tumors often cause negative psychological symptoms, such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis. While epirubicin (EPI) is recommended by the European Association of Urology and can improve prognosis, its long-term use can cause toxic side effects, reduce treatment compliance, and increase psychological burden. Therefore, an appropriate intervention mode is necessary. To explore the clinical value of EPI combined with mindfulness intervention in patients with urinary system tumors and depression. This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023. Patients were divided into conventional (n = 55) and joint intervention (n = 55) groups. The conventional group received mitomycin and routine nursing, while the joint intervention group received EPI and mindfulness intervention. Both groups underwent three cycles of chemotherapy. Immune function (CD4+ cells, CD8+ cells, CD4+/CD8+ ratio), tumor marker levels [urinary bladder cancer antigen (UBC), bladder tumor antigen (BTA) and nuclear matrix protein 22 (NMP22)], quality of life questionnaire-core 30 (QLQ-C30), 17-item Hamilton depression scale (HAMD-17), and cancer-related fatigue [cancer fatigue scale (CFS)] were assessed. Adverse reactions and nursing satisfaction were recorded and evaluated. Post-intervention, CD4+, CD8+, and CD4+/CD8+ levels increased in both groups, with the joint intervention group showing more significant improvement (P < 0.05). Tumor marker levels (NMP22, BTA, and UBC) were lower in the joint intervention group compared to the conventional group (P < 0.05). The joint intervention group also showed a greater reduction in HAMD-17 scores (9.38 ± 3.12 vs 15.45 ± 4.86, P < 0.05), higher QLQ-C30 scores, and lower CFS scores (both P < 0.05). Additionally, the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction (P < 0.05). EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

Liquid-Based Diagnostic Panels for Prostate Cancer: The Synergistic Role of Soluble PD-L1, PD-1, and mRNA Biomarkers.

This study aimed to evaluate the diagnostic potential of soluble Programmed Death Ligand 1 (sPD-L1) and Programmed Death 1 (sPD-1) molecules in plasma, along with urinary mRNA biomarkers-Prostate-Specific Membrane Antigen (PSMA), Prostate Cancer Antigen 3 (PCA3), and androgen receptor (AR) genes-for identifying clinically significant prostate cancer (PCa), defined as pathological stage 3. In a cohort of 68 PCa patients, sPD-L1 and sPD-1 levels were quantified using ELISA, while mRNA transcripts were measured by RT-qPCR. Results highlight the potential of integrating these liquid-based biomarkers. In particular, the combination of sPD-L1, sPD-1, and AR demonstrated the most significant improvement in diagnostic performance, increasing the area under the curve (AUC) from 0.65 to 0.81 and sensitivity from 60% to 88%, compared to AR alone. PSMA demonstrated an AUC of 0.82 and a specificity of 52.8%, which improved to an AUC of 0.85 and a specificity of 94.4% with the inclusion of sPD-L1 and sPD-1. Similarly, PCA3 achieved an AUC of 0.75 and a specificity of 53.8%, increasing to an AUC of 0.78 and a specificity of 76.9% when combined with these biomarkers. Incorporating sPD-L1 into a three-gene panel further elevated the AUC from 0.74 to 0.94. These findings underscore the value of multimodal liquid-based diagnostic panels in improving the management of clinically significant PCa.

Glutaraldehyde functionalized reduced graphene oxide based resistive sensors for detection of PCA3.

Prostate cancer antigen 3 (PCA3) has emerged as a critical biomarker for the early detection of prostate cancer, complementing the traditional prostate-specific antigen (PSA) testing. This research presents a novel resistive sensor based on reduced graphene oxide (RGO) functionalized with glutaraldehyde (GA)/complementary single-stranded DNA (ss-DNA) for the detection of the PCA3 RNA. The device was meticulously characterized at each fabrication step to confirm the successful integration of the various layers on the sensor device, utilizing atomic force microscopy (AFM) which confirmed the increase in the thickness of the sensor from ∼1.4 nm (only RGO) to ∼25 nm for the RGO-GA/ss-DNA/PCA3 device. Field emission scanning electron microscopy exhibited a change in the surface morphology after each step of device fabrication and testing. Fourier-transform infrared (FTIR) spectroscopy was conducted to confirm the presence of functional groups in each component of the sensor. The fabricated resistive sensor demonstrated mean response ranging from 1.203 to 59.44% for 0.1 to 100 ng mL-1 PCA3 RNA. Notably, the device exhibited stability over a period of two weeks and displayed high selectivity for PCA3. The developed RGO-GA/ss-DNA/PCA3 sensor was tested with RNA extracted from multiple prostate cancer cell lines and other cancer cell lines and demonstrated response only to RNA extracted from LNCaP as it was the only cell line expression of PCA3. The findings from the developed sensor were cross-validated with the observations of a semi quantitative polymerase chain reaction (qPCR), and were found to be closely matched.

Clinical utility of quantitative ultrasonography parameters combined with serum cancer antigen 15‑3, human epidermal growth factor receptor 2 and soluble E‑cadherin in diagnosing mass‑type breast cancer.

Contrast-enhanced ultrasonography (CEUS), a newly developed imaging technique, holds certain value in differentiating benign from malignant tumors. Additionally, serum tumor markers also exhibit significant clinical importance in the diagnosis and monitoring of malignant tumors. Reports have indicated abnormal expression of HER-2, CA153 and sE-cad in breast cancer. Early diagnosis of breast cancer facilitates early clinical intervention and enhances the overall quality of life for patients. Therefore, this study aims to explore the clinical value of quantitative CEUS parameters combined with serum levels of CA153, HER-2 and sE-cad in diagnosing mass-type breast cancer. In total, 49 patients with breast cancer (breast cancer group) and 56 patients with benign breast tumors (benign group) were selected as the study participants, while 50 healthy women served as the control group. Ultrasonography was performed on the patients in the breast cancer and benign groups using diagnostic color Doppler ultrasonography. The serum CA15-3, HER-2 and sE-cad levels in all three study groups were measured using a fully automated electrochemiluminescence immunoassay. Pearson's correlation test was used to analyze the correlation between the quantitative ultrasonography parameters and serum CA15-3, HER-2 and sE-cad levels. Logistic multivariate regression analysis was performed to analyze the independent risk factors, and a receiver operating characteristic curve was plotted to assess the diagnostic value of these factors. The peak intensity (PI), wash-in slope (WIS), gradient (Grad) and local mean transit time (mTTI), along with the CA15-3, HER-2 and sE-cad levels in the breast cancer group were significantly higher, and the time to peak (TTP) was significantly lower, compared with those values in the benign and control groups. CA15-3, HER-2 and sE-cad were negatively correlated with TTP in the breast cancer group (all P<0.05) and positively correlated with PI, WIS, Grad and mTTI (all P<0.05). The area under the curve (AUC) values for CA15-3, HER-2, sE-cad, PI, WIS, Grad, mTTI and TTP for the diagnosis of malignant breast cancer were 0.640, 0.730, 0.687, 0.683, 0.692, 0.737, 0.697 and 0.671, respectively. The AUC for the combined diagnosis was 0.919, with a sensitivity of 0.857 and a specificity of 0.911, outperforming each index alone for a single diagnosis. Logistic multivariate regression analysis revealed that HER-2, TTP, PI, WI and Grad were independent risk factors for malignant breast cancer. In conclusion, combining the quantitative ultrasonography parameters with the CA15-3, HER-2 and sE-cad levels facilitated the differential diagnosis of benign and malignant breast lesions, and may provide a reference for clinical treatment in the future.

Elevated CA15‐3 Levels in Myeloid Disorders: Clinicopathological Correlation

Background: Serum tumor markers are beneficial to patients with advanced cancer because they help in early diagnosis, determining prognosis, predicting response to certain medications, and monitoring therapy. The prognostic value of cancer antigen 15‐3 (CA15‐3) serum‐level changes in breast cancer is very well established. The main cause behind the elevation of CA 15‐3 is metastatic breast carcinoma. In this study, we will run a record review to study comprehensively the clinical association between chronic myeloid disorders and CA15‐3 elevation.Method: In this retrospective study, we run CA15‐3 on 106 patients with different myeloid disorders diagnosed between 2008 and 2021 from several tertiary care centers in Saudi Arabia, Jeddah, majority of which (38 cases) were diagnosed with chronic myeloid leukemia (35.8%). Others had essential thrombocytosis (22.6%), chronic myeloproliferative neoplasm (20.8%), myelofibrosis (7.5%), acute myeloid leukemia (4.7%), myelodysplastic syndrome (4.7%), and polycythemia vera (3.8%).Result: An increase in CA15‐3 was seen in 50% of all cases. In particular, polycythemia vera showed an elevation in 100% of the cases (4 out of 4). Second in expressivity is myelodysplastic syndrome (80%, 4 out of 5 cases). Close in value is myelofibrosis (75%, 6 out of 8 cases). The least association is noted between CA15‐3 and essential thrombocytosis (16.7%, 4 out of 24 cases).Conclusion: When CA15‐3 levels are considered during the time of myeloid disorder diagnosis, it shows an independent predictive value. More research is needed to determine the utility of these serum biomarkers in myeloid disorders decision‐making. This is a thorough case series of chronic myeloid disorders inclusive of all myeloproliferative neoplasms besides myelodysplastic syndrome describing the association with CA15‐3.

Lactylated histone H3K18 as a potential biomarker for the diagnosis and prediction of the severity of pancreatic cancer.

Lactylation plays an essential role in pancreatic cancer, but the precise role of lactylated histone in the diagnosis and prognosis of pancreatic cancer remains to be further clarified. Twenty-one patients diagnosed with pancreatic cancer were enrolled in this study, and the clinicopathologic characteristics were collected. Lactylation levels of total proteins and histone H3 Lysine-18 (H3K18) of tissues were determined by western blotting and laboratory indicators including serum levels of lactate, Cancer Antigen 19-9 (CA19-9), and Carcinoembryogenic Antigen (CEA) were obtained. Total protein lactylation was found in both pancreatic cancer tissues and para-carcinoma normal tissues, and was more potent in tumor tissues. H3K18la was also highly expressed tumor tissues. Furthermore, H3K18la protein expression correlated positively with serum lactate (r = 0.774, p < 0.001), CA19-9 (r = 0.744, p < 0.001), and CEA (r = 0.589, p < 0.01). The Area Under the Curve (AUC) of H3K18la for the diagnosis of pancreatic cancer was 0.848 in serum (p < 0.001). The present findings suggested that H3K18 may be used as a novel potential biomarker for the diagnosis and prognosis of pancreatic cancer patients.

Assessment of lipid peroxidation and total antioxidant capacity in patients with breast cancer.

Breast cancer (BC), a disease in which abnormal breast cells grow out of control and form tumors, is a prevalent life-threatening disease worldwide. Oxidative stress has been implicated in the development and progression of various cancers, including BC. Assessing lipid peroxidation and overall antioxidant status in BC offers valuable information on disease progression, patient prognosis, and the effectiveness of therapeutic options. A total of 150 women were categorized into three groups: normal, benign mass, and BC. Participants were selected and evaluated at the cancer clinic; fasting blood samples were collected, and total antioxidant capacity (TAC), oxidized low-density lipoprotein (Ox-LDL), cancer antigen (CA) 15-3, and carcinoembryonic antigen (CEA) were measured. Subsequently, statistical analysis was performed to compare the levels of these parameters in different groups and examine the analytical performance of TAC and Ox-LDL in BC. In patients with malignancy, the serum level of TAC was significantly decreased compared with the benign group (8.3 U/mL and 16.04 U/mL, respectively) (P < 0.001). Healthy controls exhibited higher levels of TAC (43.4 U/mL). The levels of Ox-LDL in BC were significantly increased in both malignant and benign groups (3,831 pg/mL and 1,234 pg/mL, respectively) compared with normal controls (682 pg/mL) (P < 0.001). CEA and CA15-3 were drastically increased in the BC groups compared with the control group. A significant area under the curve was observed in the receiver operating characteristic (ROC) curve analysis for TAC (0.975, P < 0.001) and Ox-LDL (0.986, P < 0.001). This study revealed that patients with BC had lower TAC and higher Ox-LDL serum levels, indicating elevated oxidative stress. These levels may serve as promising monitoring parameters in BC.

Efficacy of microwave ablation for intrahepatic cholangiocarcinoma: a systematic review and meta-analysis.

Data on overall survival (OS) and progression-free survival (PFS) after microwave ablation (MWA) for intrahepatic cholangiocarcinoma (ICC) are scarce. We conducted a systematic review of the safety and efficacy of MWA for ICC. The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting the outcomes of MWA for ICC. Meta-analyses of the pooled OS, PFS, technical success, technical efficacy, and complication rates were conducted. Pooled hazard ratios (HRs) of common variables were calculated to identify the factors associated with OS. The analysis encompassed 168 entries, among which 8 observational studies comprising 423 patients were deemed eligible. The pooled results were as follows: The median OS was 22.0 months [95% confidence interval (CI): 15.1-28.9], with the 1-, 3-, and 5-year OS rates being 83.7% (95% CI: 75.8-91.6%), 51.0% (95% CI: 41.1-60.9%), and 33.3% (95% CI: 14.1-52.4%), respectively. The median PFS was 12.5 months (95% CI: 8.3-16.7), and the 1-year PFS rate was 61.2% (95% CI: 36.5-85.9%). The technical success, technical efficacy, and major complication rates were 100% (95% CI: 99.5-100%), 99% (95% CI: 92.1-100%), and 2.8% (95% CI: 1.1-5.2%), respectively. A cancer antigen 19-9 (CA 19-9) level >37 U/mL was associated with a shorter OS (HR =1.4; 95% CI: 1.2-1.7; P=0.001). MWA is a safe and effective alternative to chemotherapy, radiotherapy, and radiofrequency ablation (RFA) treatments, especially for patients with a CA 19-9 level ≤37 U/mL, and potentially has advantages over RFA. However, further studies are required to validate these findings.

Beta-human chorionic gonadotropin, carbohydrate antigen 19-9, cancer antigen 125, and carcinoembryonic antigen as prognostic and predictive biological markers in bladder cancer

IntroductionWe evaluated the prognostic potential of the Beta-human chorionic gonadotropin (β-hCG), Carbohydrate Antigen 19-9 (CA19-9), Cancer Antigen 125 (CA125), and Carcinoembryonic Antigen (CEA) tumor markers for bladder cancer.MethodsWe analyzed the records of 369 patients who underwent radical cystectomy for urothelial cancer (UC) between October 2012 until December 2019. Levels of CA19-9, CA125, CEA, and β-hCG before radical cystectomy were measured in all patient samples, and serum biomarker cutoff values were used as normal and elevated values.Results and discussionThe proportion of abnormal β-hCG (P&amp;lt;0.001), CA19-9 (P&amp;lt;0.001), and CA125 (P=0.033) was significantly higher in locally advanced bladder UC than in organ-confined bladder UC. In patients with preoperative β-hCG and CA125 abnormality, there was poor prognosis of recurrence-free survival (RFS)(P=0.003, P=0.042) and overall survival (OS) (P=0.003, P=0.002). Using the Cox multivariate regression analysis, both β-hCG (HR: 3.88, 95% CI: 1.43–10.25) and CA125 (HR: 6.21, 95% CI: 1.34–32.16) were found to be significant independent factors for predicting OS and RFS. In addition, patients with a high number of increased tumor markers showed significantly worse OS ((P&amp;lt;0.001) and RFS (P=0.002) than patients with a low number of increased tumor markers. In conclusion, serum β-hCG and CA125 levels could potentially be used for UC prognosis in patients undergoing radical cystectomy. To assess their usefulness in evaluating long-term recurrence and survival, further treatment responses and large-scale additional studies are needed.

Circulating MiR-126 as a potential biomarker in Egyptian colorectal cancer patients: A case-control study.

Globally, colorectal cancer (CRC) is among the most prevalent malignant tumors. It is characterized by unlimited proliferation, invasion, and metastasis. MicroRNA-126 (miR-126) has been shown in many studies to play a significant role in CRC, but data regarding its role in CRC Egyptian patients are limited. This case-control study aimed to investigate the miR-126 as a potential marker in CRC Egyptian patients and to correlate its expression levels with CRC tumor, node, metastasis (TNM) stage, distant metastasis, and tumor size. The study included 50 adult Egyptian participants (30 patients with CRC, 10 patients with colorectal adenoma as a pathological control, and 10 healthy controls). MiR-126 expression levels were detected using Real-Time Quantitative PCR (qPCR) along with the endogenous reference gene hsa-miR-103a in all participants. MiR-126 expression was significantly decreased in CRC patients than both control groups. It was associated with advanced TNM stage (p = 0.001) and distant metastasis (p = 0.002). However, it was not correlated with tumor size (p = 0.980), carcinoembryonic antigen (CEA) (p = 0.397), and cancer antigen 19-9 (CA19-9) (p = 0.236). The best cut-off point of miR-126 to discriminate CRC from both controls was 0.7 and to discriminate metastatic CRC from non-metastatic CRC was 0.3. Our results suggest that miR-126 could be used as an early marker for CRC detection among Egyptian patients and a good prognostic indicator associated with metastasis.