Early-stage Cancer Research Articles

Comprehensive analysis of risk factors associated with submucosal invasion in patients with early-stage gastric cancer

BACKGROUND Submucosal invasion in early-stage gastric cancer (GC) is a critical determinant of prognosis and treatment strategy, significantly influencing the risk of lymph node metastasis and recurrence. Identifying risk factors associated with submucosal invasion is essential for optimizing patient management and improving outcomes. AIM To comprehensively analyze clinical, imaging, and endoscopic characteristics to identify predictors of submucosal invasion in patients with early-stage differentiated GC. METHODS A retrospective study was conducted at our institution from January 2019 to January 2023, including 268 patients diagnosed with early-stage differentiated GC who underwent surgical resection or endoscopic submucosal dissection. Data were collected on demographic, clinical, imaging, and endoscopic characteristics, with endoscopic images reviewed independently by two gastroenterologists. Statistical analysis included univariate and multivariate logistic regression to identify significant predictors of submucosal invasion, and receiver operating characteristic (ROC) curve analysis to evaluate the predictive value of continuous variables. RESULTS A total of 268 patients were included, with 178 males and 90 females, and a mean age of 61.5 ± 9.8 years. Univariate analysis showed that male gender, history of alcohol consumption, smoking, and computed tomography-detected gastric wall thickening were more prevalent in patients with submucosal invasion. Significant endoscopic predictors included tumor location in the upper two-thirds of the stomach, depressed morphology, marginal elevation, and high color differences on white-light endoscopy (WLE) and linked color imaging (LCI). Multivariate analysis identified upper stomach location [odds ratio (OR): 5.268], depressed type (OR: 5.841), marginal elevation (OR: 4.132), and LCI color difference ≥ 18.1 (OR: 4.479) as significant predictors. ROC analysis showed moderate predictive value for lesion diameter, WLE, and LCI color differences (area under the curve: 0.630, 0.799, and 0.760, respectively). CONCLUSION Depressed-type lesions, marginal elevation, location in the upper two-thirds of the stomach, and significant color differences on LCI are high-risk indicators for submucosal invasion. These findings suggest that such lesions warrant more aggressive intervention to prevent disease progression and improve patient outcomes.

Plasma mutation profile of precursor lesions and colorectal cancer using the Oncomine Colon cfDNA Assay

BackgroundColorectal cancer (CRC) is the second leading cause of cancer death worldwide. Early detection of precursor lesions or early-stage cancer could hamper cancer development or improve survival rates. Liquid biopsy, which detects tumor biomarkers, such as mutations, in blood, is a promising avenue for cancer screening.AimTo assess the presence of genetic variants in plasma cell-free tumor DNA from patients with precursor lesions and colorectal cancer using the commercial Oncomine Colon cfDNA Assay.Material and methodsCell-free DNA (cfDNA) samples from the plasma of 52 Brazilian patients were analyzed. Eight patients did not have any significant lesions (five normal colonoscopies and three hyperplastic polyps), 24 exhibited precursor lesions (13 nonadvanced adenomas, 10 advanced adenomas, and one sessile serrated lesion), and 20 patients with cancer (CRC). The mutation profile of 14 CRC-associated genes were determined by next-generation sequencing (NGS) using the Oncomine Colon cfDNA Assay in the Ion Torrent PGM/S5 sequencer.ResultsThirty-three variants were detected in eight genes (TP53, PIK3CA, FBXW7, APC, BRAF, GNAS, KRAS, and SMAD4). No variants were detected in the AKT1, CTNNB1, EGFR, ERBB2, MAP2K1 and NRAS genes. All variants were considered pathogenic and classified as missense or truncating. The TP53 gene harbored the most variants (48.48%), followed by the KRAS gene (15.15%) and the APC gene (9.09%). It was possible to detect the presence of at least one pathogenic variant in cfDNA in 60% of CRC patients (12/20) and 25% of precursor lesions (6/24), which included variants in three patients with nonadvanced adenoma (3/13 – 23.08%) and three with advanced adenomas (3/10 – 30%). No variants were detected in the eight patients with normal findings during colonoscopy. The detection of mutations showed a sensitivity of 60% and a specificity of 100% for detecting CRC and a sensitivity of 50% and a specificity of 100% for detecting advanced lesions.ConclusionThe detection of plasma NGS-identified mutations could assist in early screening and diagnostic of CRC in a noninvasive manner.

Low-cost and label-free blue light cystoscopy through digital staining of white light cystoscopy videos

BackgroundBladder cancer is the 10th most common malignancy and carries the highest treatment cost among all cancers. The elevated cost stems from its high recurrence rate, which necessitates frequent surveillance. White light cystoscopy (WLC), the standard of care surveillance tool to examine the bladder for lesions, has limited sensitivity for early-stage bladder cancer. Blue light cystoscopy (BLC) utilizes a fluorescent dye to induce contrast in cancerous regions, improving the sensitivity of detection by 43%. Nevertheless, the added equipment cost and lengthy dwell time of the dye limits the availability of BLC.MethodsHere, we report the first demonstration of digital staining as a promising strategy to convert WLC images collected with standard-of-care clinical equipment into accurate BLC-like images, providing enhanced sensitivity for WLC without the associated labor or equipment cost.ResultsBy introducing key pre-processing steps to circumvent color and brightness variations in clinical datasets needed for successful model performance, the results achieve a staining accuracy of 80.58% and show excellent qualitative and quantitative agreement of the digitally stained WLC (dsWLC) images with ground truth BLC images, including color consistency.ConclusionsIn short, dsWLC can affordably provide the fluorescent contrast needed to improve the detection sensitivity of bladder cancer, thereby increasing the accessibility of BLC contrast for bladder cancer surveillance. The broader implications of this work suggest digital staining is a cost-effective alternative to contrast-based endoscopy for other clinical scenarios outside of urology that can democratize access to better healthcare.

Symptom Burden and Quality of Life in Long-Term Survivors with Head and Neck Cancer.

Objectives: In this study, long-term survivors of head and neck cancer (HNC) were evaluated regarding their symptom burden and quality of life (QoL). Methods: This prospective study was performed during the regular follow-up consultations at one of Germany's largest tertiary referral centers for HNC. The assessment included demographic, clinical, and oncological data, as well as the MIDOS(2) and the University of Washington Quality of Life Questionnaire (UW QoL) questionnaires. Patients were subdivided based on their disease stage, that is, early cancer stages (UICC I/II) and advanced cancer stages UICC (III/IV). Results: Between January 1, 2019 and December 31, 2019, 212 HNC patients with a mean follow-up of 46.36 ± 43.64 months were included (120 patients UICC stage I/II (22.5% female, mean age 61.93 ± 12.38 years) versus 92 patients UICC stage III/IV (25.0% female, mean age 63.73 ± 11.74 years)). For all patients evaluated (UICC I/II versus III/IV), the three most common symptoms were tiredness (47.5 vs 60.9%, P = .073, r = .123), anxiety (35.8 vs 32.6%, P = .624, phi = .034) and drowsiness (35.0 vs 44.6%, P = .157, phi = .097). Patients diagnosed with UICC III/IV stages reported loss of appetite significantly more frequently and with a high level of severity (15.0 vs 32.6%, P = .002, phi = .157; 0.23 ± 0.60 vs 0.47 ± 0.78, P = .003, r = .203). The overall symptom burden was low with a severity sum score (min 0-max 30) of 3.04 ± 3.29 versus 3.58 ± 3.38 (P = .143, r = .100). All patients rated their QoL as good (65.67 ± 20.93 vs 59.56 ± 22.00, P = .043, r = .139). Conclusion: The overall symptom burden of long-term survivors of HNC is encouragingly low.Trial registration: The study was registered in the German Registry for Clinical Studies (application No.: 00017122). Date of registration: 15.08.2019. https://drks.de/search/de/trial/DRKS00017122.

Does Colonoscopy as a First Screening Test Still Make Sense?-Counterpoint.

Colonoscopy has been widely regarded as the gold standard for its high diagnostic accuracy and preventive potential. However, its invasive nature, high cost, and suboptimal participation rates limit its utility at the population level. Non-invasive screening tests, notably the fecal immunochemical test (FIT) and multitarget stool DNA tests, present promising alternatives that may improve screening participation and reduce barriers to participation. Among these, FIT has demonstrated a consistent advantage in enhancing participation, which subsequently contributes to better long-term outcomes in CRC prevention. FIT-based two-step screening offers several practical advantages, including cost-effectiveness, non-invasiveness, and greater flexibility. Moreover, the quantitative nature of FIT allows for adjustable sensitivity thresholds and the ability of risk stratification, making it adaptable across diverse populations and scenarios. Through serial testing, FIT can increase cumulative detection rates over time. This approach facilitates the identification of high-risk individuals, allowing for more judicious use of colonoscopy resources and reducing unnecessary invasive procedures, especially among low-risk populations. Notably, evidence indicates that participation to FIT-based screening is consistently higher than to colonoscopy, which enhances the detection of early-stage cancers and advanced adenomas in the long run. Given the constraints of limited endoscopic capacity, the aging population, and the recent lowering of the recommended screening age due to the rising incidence of early-onset CRC, FIT emerges as a practical, flexible solution. The role of two-step FIT screening in improving participation and enabling risk-stratified, personalized approaches to CRC prevention is pivotal, advocating for its expanded integration into future screening paradigms.

Computer-aided analysis reveals metallothionein-positive cancer-associated fibroblasts promote angiogenesis in gastric adenocarcinoma

Gastric adenocarcinoma (GC), along with its tumor microenvironment (TME), poses great challenges for clinical treatment strategies. Single-cell sequencing has become an important tool for analyzing TME heterogeneity, cell subpopulation, and gene expression patterns. 56 GC single-cell sequencing samples were analyzed, focusing on TME by delineating cancer cells, cancer-associated fibroblasts (CAFs), and macrophages. The spatial transcriptome was used to clarify the distribution characteristics of each cellular component in the tissue slice. Despite the widespread genetic mutations observed in cancer cells, certain recurrent alterations were identified in specific chromosomal regions. The heterogeneity among GC cells is profound, four cancer cell subpopulations were identified through drug sensitivity profiling. Subtype 4, although only present in some samples, demonstrates the strongest stemness and metabolic activity, possibly indicative of an early-stage cancer subpopulation. Their drug sensitivity profiles may hold promise for guiding clinical intervention. In addition, robust spatial co-localization patterns were observed between CAFs, M2 macrophages, and endothelial cells. CAFs were further categorized into six subgroups, among which a novel subgroup termed metallothionein(mt)-positive CAF (mtCAF), characterized by elevated expression of metallothionein 1X (MT1X) and subsequent vascular endothelial growth factor A (VEGFA) secretion, was identified. Immunohistochemistry preliminary confirmed the presence of this unique CAF subgroup. Additionally, M2d macrophages, besides exhibiting high VEGFA expression, also demonstrated various growth factors such as Aamphiregulin (AREG). The M2d-mtCAF axis may play an important role in GC angiogenesis. This study not only enhances our understanding of the TME heterogeneity in GC but also sheds light on the interaction between CAFs and tumor-associated macrophages (TAMs) in tumor angiogenesis.

Feasibility of a Remote Patient Video Education Intervention to Improve Care Coordination for Rural Cancer Patients.

Cancer patients residing in rural areas experience substantial barriers to care and suboptimal care coordination. To date, there is a paucity of interventions to improve care coordination for rural cancer patients. In this study, we conducted a pilot trial to assess the feasibility and efficacy of a remote, tablet-based patient video education intervention focused on cancer care coordination among rural patients in Hawaii. The pilot trial utilized a single-arm, pre-post intervention design. Our TED-talk style video education intervention included talks on cancer basics, care coordination, and self-advocacy. Eligible participants were rural patients newly diagnosed with early-stage cancer receiving adjuvant therapy. Validated instruments were administered at baseline and post-intervention to assess patients' perceptions of care coordination and self-advocacy. Acceptability and satisfaction were assessed using semi-structured interviews. Descriptive statistics were used to describe study outcomes. From January 2022 to December 2022, 19 patients enrolled on the study; the mean age was 52.2. Participants were racially diverse. A total of 71.4% of eligible patients completed all assessments. No changes were observed in the overall perceptions of care coordination. However, improved scores were observed for the care coordination instrument communication domain (Cohen's d = - 0.76, 95% CI: - 1.45, - 0.03). There was a trend for improved scores on navigation and self-advocacy. All participants reported high satisfaction with the intervention. Results support the feasibility, satisfaction, and acceptability of this intervention among rural cancer patients in Hawaii. Further study is needed to evaluate the intervention in other rural areas. Clinical Trial Registration: NCT05162404.Registration Date: 12/17/2021.

Cervical intraepithelial neoplasia and cervical cancer in Hunan Province, China, 2020-2023.

To describe the incidence and distribution of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC) for rural women aged 35-64 in Hunan Province, China, 2020-2023. Data were from the Hunan Provincial Cervical Cancer Screening Program in Rural Areas. Most rural women aged 35-64 in Hunan Province attend the program. All women diagnosed with CINs and CCs will be asked to register detailed information, including pelvic examination, diagnosis, age, education level, etc. CINs included low-grade squamous intraepithelial lesions (LSIL) (CIN1), high-grade squamous intraepithelial lesions (HSIL) (CIN2 and 3); CCs included adenocarcinoma in situ (AIS), early invasive cervical cancer (EICC) (stage Ia1 and Ia2) and invasive cervical cancer (ICC) (stage Ib and above). The incidence of CIN and CC is the number of cases per 1000 women. Chi-square tests (χ2 ) were used to examine if there were significant differences in proportions among different groups. A total of 4150700 women were included, and 67071 CINs and CCs were identified. The incidence of LSIL, HSIL, AIS, EICC and ICC were 10.63‰(95%CI: 10.53-10.73), 4.98‰(95%CI: 4.91-5.05), 0.06‰(95%CI: 0.06-0.07), 0.23‰(95%CI: 0.22-0.25), and 0.26‰(95%CI: 0.24-0.27), respectively. The proportion of previous pelvic examinations was relatively low in EICC (17.24%) and ICC (17.45%) (χ2 = 236.57, P <0.01), present abnormal examination was relatively high in AIS (51.33%), EICC (49.74%) and ICC (62.45%) (χ2 = 331.15, P <0.01). HPV16 was the most common high-risk type for LSIL (22.01%), HSIL (36.92%), AIS (46.01%), EICC (58.88%), and ICC (64.34%). The proportion of HSIL was relatively high in women aged 35-44 (27.03%), AIS was relatively high in women aged 45-54 (46.39%), EICC (44.24%), and ICC (48.58%) was relatively high in women aged 55-64. The proportion of ICC was relatively high in women with elementary school (38.68%), HSIL (15.10%) and AIS (17.49%) was relatively high in women with senior high school, AIS (1.52%), EICC (0.62%) and ICC (0.75%) was relatively low in women with university and above. (P <0.01). We have described the incidence and distribution of CIN and CC among rural women aged 35-64. These findings were clinically relevant and were useful for clinical counseling and early diagnosis of CC.

Molecular Engineering of Ultrabright Biomimetic NanoGhost for Site-Selective Tumor Imaging and Biodistribution.

Optically active ultrabright imaging agents are shown to delineate tumor location with deep tissue visualization in pre noclinical tumor models. NanoGhosts (NGs) particles are reconstructed from the cell membrane and integrated with organic fluorophores to attain ultra-brightness for solid tumor imaging. Moreover, the integration of amphiphilic and lipophilic molecules reveals structural characteristics of NGs (≈70nm), which also alter their brightness. Upon intravenous administration (10 mgkg-1 single dose), these ultrabright NGs (778 MESF) enable the high-resolution of tumor site and real-time tracking of vital organs with high-contrast fluorescence signals. Engineered biomimetic NGs demonstrates better resolution and tissue penetration as compared to the clinically approved indocyanine green (ICG). High precision in tumor detection (0.5h) and strong tumor retention (24h which is further up to 30th day) without affecting healthy tissues ensure the future scope of NGs in early-stage cancer imaging. These findings suggest that these NGs mimic the biological characteristics of native cells, enabling them to evade immune clearance and target the solid tumor naturally.

Minimally invasive surgery versus open surgery in advanced stage endometrial cancer.

Staging surgery in early stage endometrial cancer has been shown to be feasible and safe with minimally invasive surgery (MIS) in many previous studies. However, there is limited literature on MIS's safety in advanced stages. This study aims to identify factors associated with survival in stage III endometrial cancer and investigate survival differences based on surgical approach. Patients with stage III endometrial cancer who underwent staging surgery from March 2002 to March 2023 were included in this study. Various clinicopathological features, disease-free survival (DFS), and overall survival (OS) were evaluated. Among the 79 patients included in this study, 20 patients underwent MIS (25.3%) and 59 patients underwent open surgery (74.7%). The open surgery group had a higher prevalence of aggressive histology, a higher median pretreatment CA-125 level, and a greater number of harvested lymph nodes compared to the MIS group. Five-year OS and DFS was higher in the open surgery group than in the MIS group (DFS: 67.9% vs. 59.9%, p = 0.046; OS: 74.3 vs. 50.6%, p = 0.008). In multivariate analysis, younger than 55 years old (OR, 2.778; 95% CI, 1.078-7.156; p = 0.034), and open surgery (OR, 3.671; 95% CI, 1.581-8.522; p = 0.002) was related to improved OS. Open staging surgery showed better survival outcomes when compared to MIS in stage III endometrial cancer patients in our study. For patients who are older than 55 years old and have aggressive histology in endometrial biopsy, considering open surgery may help improve their prognosis, even if preoperative MRI suggests early-stage endometrial cancer.

Minimally Invasive Surgery for the Management of Ovarian Cancer

OBJECTIVE: To examine perioperative and survival outcomes of patients with ovarian cancer managed by minimally invasive surgery compared with laparotomy in the context of 1) early-stage epithelial ovarian cancer, 2) primary cytoreduction for advanced disease, and 3) interval debulking after neoadjuvant chemotherapy. DATA SOURCES: A literature search was conducted PubMed, MEDLINE and ClinicalTrials.gov, Web of Science, Cochrane Library, and meeting abstract libraries (International Gynecological Cancer Society, Society of Gynecologic Oncology, American Society of Clinical Oncology) from 1994, the year of the first published laparoscopic clinical study in ovarian cancer, to May 2024. Studies that compared minimally invasive surgery with laparotomy for staging of ovarian cancer and reported perioperative or survival outcomes data were included. Single-arm studies, case studies, meeting abstracts, and studies involving borderline tumors, fertility-sparing surgery, or management of recurrent disease were excluded. METHODS OF STUDY SELECTION: Three authors independently screened citations for relevance and inclusion and exclusion criteria and assessed the risk of bias of individual studies using the methodologic index for nonrandomized studies criteria for nonrandomized studies. TABULTATION, INTEGRATION, AND RESULTS: From a total of 2,777 identified citations, 36 nonrandomized studies were included: 21 early-stage, five primary debulking for advanced stages, seven interval debulking after neoadjuvant chemotherapy, and three with heterogeneous populations. No randomized studies were identified. For early-stage cancer, nine studies found no difference in progression-free survival (risk ratio [RR] 1.05, 95% CI, 1.00–1.10, I 2=34.7%, P=.151), and 12 studies found no difference in overall survival (RR 1.00, 95% CI, 0.98–1.03, I 2=49.7%, P=.025). For primary debulking of advanced disease, rate of optimal debulking (five studies) (RR 1.11, 95% CI, 1.00–1.25, I 2=41.5%, P=.144) slightly favored minimally invasive techniques. For interval debulking, there was no difference in rates of optimal debulking (five studies) (RR 1.03, 95% CI, 0.96–1.11, I 2=54.6%, P&lt;.051) between the two surgical modalities. CONCLUSION: The inclusion of observational studies in this analysis with a fair amount of bias warrants caution in the interpretation of the findings. However, minimally invasive surgery may offer some perioperative advantages over laparotomy and may be an acceptable alternative for selected patients. For early-stage disease, there was no difference in survival outcomes between minimally invasive surgery and laparotomy. For those with advanced disease, rates of optimal debulking were similar. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022359051.

The Effect of Systemic Immune-Inflammatory Index (SII) and Prognostic Nutritional Index (PNI) in Early Gastric Cancer.

In recent years, the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) have been considered potential predictors of survival outcomes in various solid tumors, including gastric cancer. However, there is a notable lack of research focusing on their prognostic implications specifically in the early stage of gastric cancer. This study aims to investigate the prognostic indicators of early gastric cancer (EGC), including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, PNI, and lymph node metastasis (LNM). In this retrospective analysis, we examined 490 patients diagnosed with EGC (pT1Nx). The peripheral blood indices of interest were SII, PNI, PLR, and NLR. The receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to determine optimal cutoff values and prognostic efficacy for each parameter. Additionally, Kaplan-Meier survival curves and multivariate Cox regression models were utilized to delineate independent prognostic factors. The optimal cutoff values for SII and PNI were determined as 613.05 and 42.21, respectively. Patients in the low SII (SII-L) group demonstrated significantly higher 5-year Disease-Free Survival (DFS) and Overall Survival (OS) rates of 94.7% and 96.2%, compared to the high SII (SII-H) group (DFS: 78.7%; OS: 81.9%), with both differences proving statistically significant (P < 0.001, P < 0.001). Similarly, patients in the high PNI (PNI-H) group showed superior 5-year DFS (93.3%) and OS rates (95.1%) versus the low PNI (PNI-L) group (DFS: 71.4%; OS: 74.3%), also demonstrating statistical significance (P < 0.001, P < 0.001). Multivariate analysis identified SII, PNI, and LNM as independent prognostic factors for EGC. A combined analysis of SII, PNI, and LNM yielded a C-index of 0.723 (P = 0.008). SII, PNI, and LNM are effective markers for predicting the survival outcomes of patients undergoing radical gastrectomy for EGC.

Risk factors for the recurrence in patients with early endometrioid endometrial cancer achieving complete remission for fertility-sparing hormonal treatment

ObjectiveThis study aimed to assess the recurrence risk factors in patients with early-stage endometrioid endometrial cancer (EC) who achieved a complete response (CR) through fertility-sparing hormonal treatment (FST). MethodsWe retrospectively analyzed patients who received FST for presumed stage IA and grade 1 endometrioid EC at two institutions. Medroxyprogesterone (MPA)- and levonorgestrel-releasing intrauterine devices (LNG-IUD) were used concurrently. Maintenance therapy involved maintaining the LNG-IUDs in situ for those who did not attempt to conceive immediately after achieving CR. Cox regression analysis was used to identify clinicopathological variables for recurrence-free survival (RFS) following CR. ResultsAmong 178 patients with endometrioid EC who received FST, 142 (79.8 %) achieved CR. The median time to achieve CR and the median FST duration were 10 months (range 1–34) and 14 months (range 3–49), respectively. During the median follow-up period of 44 months (range 6–143), 59.9 % (85/142) of patients had recurrence, with a median RFS of 14 months (range 1–123) after CR. In multivariable analysis, age > 35-years (hazard ratio (HR) 1.892, 95 % confidence interval (CI) 1.224–2.923; P < 0.05) and pregnancy after the first CR (HR 0.203, 95 % CI 0.093–0.444; P < 0.05) were significantly associated with RFS. ConclusionsOlder age and non-pregnancy status may be risk factors for recurrence after CR. Therefore, patients with these conditions should undergo stringent follow-up, including imaging and histological examinations, to detect recurrence after CR.

A Prospective cohort study of functional outcomes after primary closure versus secondary intention healing with collagen dressing in partial glossectomy for early-stage tongue cancer

A Prospective cohort study of functional outcomes after primary closure versus secondary intention healing with collagen dressing in partial glossectomy for early-stage tongue cancer

The role of C1orf50 in breast cancer progression and prognosis.

Although the prognosis of breast cancer has significantly improved compared to other types of cancer, there are still some patients who expire due to recurrence or metastasis. Therefore, it is necessary to develop a method to identify patients with poor prognosis at the early stages of cancer. In the process of discovering new prognostic markers from genes of unknown function, we found that the expression of C1orf50 determines the prognosis of breast cancer patients, especially for those with Luminal A breast cancer. This study aims to elucidate the molecular role of C1orf50 in breast cancer progression. Bioinformatic analyses of the breast cancer dataset of TCGA, and in vitro analyses, reveal the molecular pathways influenced by C1orf50 expression. C1orf50 knockdown suppressed the cell cycle of breast cancer cells and weakened their ability to maintain the undifferentiated state and self-renewal capacity. Interestingly, upregulation of C1orf50 increased sensitivity to CDK4/6 inhibition. In addition, C1orf50 was found to be more abundant in breast cancer cells than in normal breast epithelium, suggesting C1orf50's involvement in breast cancer pathogenesis. Furthermore, the mRNA expression level of C1orf50 was positively correlated with the expression of PD-L1 and its related factors. These results suggest that C1orf50 promotes breast cancer progression through cell cycle upregulation, maintenance of cancer stemness, and immune evasion mechanisms. Our study uncovers the biological functions of C1orf50 in Luminal breast cancer progression, a finding not previously reported in any type of cancer.

Diagnosis of early-stage bladder cancer via unprocessed urine samples at the point of care.

Diagnostic kits for the optical detection of bladder cancer in urine can facilitate effective screening and surveillance. However, the heterogeneity of urine samples, owing to patients with bladder cancer often presenting with haematuria, interfere with the transduction of the optical signal. Here we describe the development and point-of-care performance of a device for the detection of bladder cancer that obviates the need for sample processing. The device leverages the enzymatic release of organogel particles carrying solvatochromic fluorophores in the presence of urinary hyaluronidases-a bladder cancer biomarker. Owing to buoyancy, the particles transfer from the urine sample into the organic phase, where the change in fluorescence can be measured via a smartphone without interference from blood proteins. In a double-blind study with 80 unprocessed urine samples from patients with bladder cancer (including samples with haematuria) or other genitourinary diseases and with 25 samples from healthy participants, our system distinguished the cancerous samples, including those with early-stage bladder cancer, with accuracies of about 90%. Obviating the need for sample pretreatment may facilitate the at-home detection of bladder cancer.

Detecting Collagen by Machine Learning Improved Photoacoustic Spectral Analysis for Breast Cancer Diagnostics: Feasibility Studies With Murine Models.

Collagen, a key structural component of the extracellular matrix, undergoes significant remodeling during carcinogenesis. However, the important role of collagen levels in breast cancer diagnostics still lacks effective invivo detection techniques to provide a deeper understanding. This study presents photoacoustic spectral analysis improved by machine learning as a promising non-invasive diagnostic method, focusing on exploring collagen as a salient biomarker. Murine model experiments revealed more profound associations of collagen with other cancer components than in normal tissues. Moreover, an optimal set of feature wavelengths was identified by a genetic algorithm for enhanced diagnostic performance, among which 75% were from collagen-dominated absorption wavebands. Using optimal spectra, the diagnostic algorithm achieved 72% accuracy, 66% sensitivity, and 78% specificity, surpassing full-range spectra by 6%, 4%, and 8%, respectively. The proposed photoacoustic methods examine the feasibility of offering valuable biochemical insights into existing techniques, showing great potential for early-stage cancer detection.

BREAST CANCER SCREENING IN WOMEN AGED 45-65 IN SAMARKAND REGION, UZBEKISTAN: A CROSS-SECTIONAL ANALYSIS OF DATA FROM 2023

Objective: Breast cancer is a leading cause of cancer-related mortality among women globally, and early detection through screening significantly reduces morbidity and mortality. This study evaluates the outcomes of breast cancer screening programs in the Samarkand region of Uzbekistan in 2023, focusing on participation rates, detection rates, and stage distribution across 17 districts and cities. Methods: Data were collected on women aged 45–65, including annual screening targets, the number of screenings performed, diagnosed cases, and cancer stage distribution (early stages 1–2 vs. late stages 3–4). Statistical analysis was conducted to determine completion and detection rates, as well as regional disparities in screening outcomes. Results: The screening program achieved promising outcomes in participation and early-stage cancer detection, with substantial variability among districts. A higher proportion of cases were detected at stages 1–2, indicating effective early diagnosis in some areas. However, significant regional disparities in screening completion and detection highlight inequitable access to services. Novelty: This study provides a comprehensive regional analysis of breast cancer screening outcomes in Uzbekistan, emphasizing the importance of addressing disparities to improve equitable access to early diagnosis and treatment. These findings underscore the need for targeted public health interventions to enhance program effectiveness and reduce the burden of late-stage breast cancer

Role of Surveillance Colonoscopy With Mortality Event due to Colorectal Cancer and Cancer Stage Findings in Inflammatory Bowel Disease Patients

Background: Patients with Inflammatory bowel disease (IBD), both due to ulcerative colitis (UC) and Crohn’s disease (CD), are at higher risks of having colorectal cancer (CRC). Various guidelines have recommended surveillance using a colonoscopy. However, evidence of its usefulness for prognosis remains a subject of discussion. Aim: To determined the difference in mortality rate due to CRC and cancer stage between patients IBD who undergo routine surveillance and whoes do not. Methods: Studies performed searches on database of Science Direct, PUBMED, EBSCO, and Cochrane for research types of randomized controlled trials (RCTs), cohort, or case-controls that evaluate the role of surveillance on patients with IBD regarding to mortalities due to CRC and cancer stage findings. Data were then analyzed using the fixed/random effect model based on heterogeneity to evaluate the odds ratio (ORs) with a 95% confidence interval, calculated using the Mantel-Haenszel method. Results: Based on five observational studies that evaluated 3,215 patients with Inflammatory Bowel Disease by surveillance, compared with 4,465 control patients, it was found that patients undergoing surveillance have significantly lower mortality due to CRC (15.1%) than the control patients (23.8%) (OR 0.36 (95% CI: 0.24–0.52), p &lt; 0.00001). There are more patients with end-stage colorectal cancer without surveillance (37%) than those with surveillance (20%) (OR 0.28 (95% CI: 0.20–0.41), p &lt; 0.00001). Conclusion: Patients with inflammatory bowel disease who undergo routine colonoscopy surveillance will have a lower mortality rate and be found with earlier-stage cancer than patients who do not undergo routine colonoscopy examination.

A review of enhanced recovery after surgery concept in perioperative radical prostatectomy for prostate cancer.

Radical prostatectomy (RP) is the main treatment for early-stage localized prostate cancer. With the improvement of medical technology, radical prostatectomy is mainly performed under laparoscopy or robot assistance. With the continuous deepening of the Enhanced Recovery After Surgery (ERAS) concept in clinical practice, patients have increasingly high requirements for postoperative recovery. The ERAS concept is of great significance in the perioperative period and has been used in many surgical fields due to its ability to improve prognosis. ERAS has not yet been widely applied in urology and the research progress of other disciplines in ERAS has promoted its development in radical prostatectomy. This review summarizes the key elements of ERAS in the perioperative period of RP, aiming to demonstrate the superiority of ERAS and provide new references and inspirations for urologists.