Diagnosis Of Malignant Tumors Research Articles

Cancer incidence and stage at diagnosis in children and adolescents in the Community of Madrid, 2015-2018.

Cancer is the leading cause of death in children aged 1-14 and the second in 15-19-year-old adolescents in Spain. The Paediatric Population-Based Cancer Registry of the Community of Madrid was created to monitor its incidence and survival. This study presents the incidence of childhood and adolescent cancer (0-19 years) in Madrid at a population level by sex, age group, type of tumour and stage at diagnosis. This study was a retrospective analysis of the total number of cases registered in the Paediatric Population-Based Cancer Registry of the Community of Madrid. The registry employs passive and active case finding: by cross-referencing hospital discharge data, primary healthcare data, mortality data and administrative information; and by validation of all potential incident cases through a review of electronic medical charts. All new diagnoses of malignant neoplasms, non-malignant neoplasms of the Central Nervous System, and uncertain and insitu neoplasms of the bladder, identified in 2015-2018 in individuals under age 20 residing in Madrid, were included. Patient information was collected along with tumour characteristics, including stage at diagnosis according to the Toronto Childhood Cancer Stage Guidelines. Age-specific and age-standardised incidence rates were computed with 95% confidence intervals (CI). A total of 1002 tumours were registered in 5,269,524 person-years, yielding an age-standardised rate of 192.7 (95% CI 184.3, 201.4) cases per million person-years. Male/female rate ratio was 1.1. The most common cancers across all ages comprised CNS tumours, leukaemias and lymphomas (primarily Hodgkin): 45.5 (95% CI 39.9, 51.7), 41.1 (95% CI 35.7, 47.1) and 35.8 (95% CI 30.9, 41.3) cases per million person-years, respectively. The proportion of metastatic tumours at diagnosis was similar for ages 0-14 (18.6%) and 15-19 (18.7%). This study provides a comprehensive understanding of childhood and adolescent cancer incidence in Madrid. The registry provides high-quality data and consolidates epidemiological surveillance of cancer in the region.

Validation of American College of Radiology Bone Reporting and Data System (Bone-RADS) Version 2023 for diagnosis of malignant tumors of appendicular bone on conventional radiographs

PurposeTo evaluate the diagnostic performance of the American College of Radiology(ACR) Bone Reporting and Data System (Bone-RADS) in diagnosis of malignant tumors of the appendicular bone on conventional radiographs. MethodsPrimary and secondary tumors of appendicular bone in patients who underwent radiographic and MRI examinations were classified into benign, intermediate, and malignant using a reference standard of histopathology, imaging follow-up, or clinical-radiologic consensus. Two radiologists assessed five radiographic features (margin, periosteal reaction, endosteal erosion, pathologic fracture, and extra-osseous mass), scored point total (points from radiographic features and a history of cancer), and assigned Bone-RADS categories. The diagnostic performance of Bone-RADS and interreader agreements were calculated. ResultsA total of 778 patients (507 benign, 45 intermediate, and 226 malignant tumors) were included. Bone-RADS showed high discrimination performance, with areas under the receiver-operating characteristics curve of 0.940–0.957 for point total and 0.895–0.900 for categorization. Bone-RADS had high sensitivity (95.2 %–99.1 %) and negative predictive value (NPV) (96.4 %–99.5 %), but relatively low specificity (65.0 %–68.6 %) and positive predictive value (PPV) (53.7 %–61.9 %). Interreader agreements were good to excellent for Bone-RADS point total (ICC = 0.850), categorization (k = 0.739), and most of the radiographic features (k = 0.621–0.822), except for endosteal erosion (k = 0.537) and extra-osseous mass (k = 0.234). ConclusionIn diagnosis of malignant bone tumors, ACR Bone-RADS showed high discrimination performance, with high sensitivity and NPV, but relatively low specificity and PPV. Nevertheless, relatively low interobserver agreement in some radiographic features and the consensus-based points system in Bone-RADS warrant further research and possible updates.

Epidemiology of Early-onset Colorectal Cancer in a Safety-net Hospital System in Texas

Goals: We aimed to characterize risk factors for early versus advanced-stage early-onset colorectal cancer (eoCRC) at our safety-net hospital system. Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Rates of CRC diagnosis in young adults (age below 50) have been rising despite an overall decrease in CRC. CRC in this group is often detected late due to screening historically being for persons 50 years and older. Etiologies for the increase in rates of eoCRC remain unclear, as do the risk factors for advanced-stage, defined as stage III or IV, at presentation. Study: We conducted a retrospective cohort study of 556 adults younger than 50 years of age with an ICD-10 diagnosis of malignant neoplasm of the colon or rectum within a 10-year span. Data collected included demographics, age at diagnosis, time to diagnosis, and cancer stage at diagnosis. Multivariable analysis was used to determine factors associated with advanced-stage CRC. Results: A total of 279 patients met the inclusion criteria. Most were Hispanic (67.03%), followed by non-Hispanic Black (NHB, 24.01%). Most had advanced-stage CRC at diagnosis (85.7%, n=239), despite 67.7% (n=189) being diagnosed within 3 months of symptom onset. When compared with non-Hispanic White (NHW) patients, NHB (OR: 2.02, CI: 0.59-6.96) and Hispanic (OR: 1.68, CI: 0.57-4.95) patients had higher odds of advance-stage CRC, albeit not statistically significant. Conclusions: Most patients were diagnosed with advanced-stage disease. NHB and Hispanic patients had a nonstatistically significant higher odds of presenting at advanced-stage CRC compared with NHW patients. System-wide quality improvement interventions may be needed to screen for eoCRC in safety-net hospital systems.

REHABILITATION AFTER SURVIVING OCULAR ONCOLOGY. LITERATURE REVIEW

New drugs and methods of early diagnosis of malignant tumors of the visual organ have appeared in the last decades. Nevertheless, the problem of untimely diagnosis and treatment of these diseases remains in practical ophthalmology, which leads to more radical and less organ-preserving methods of treatment and, as a consequence, to the deterioration of cosmetic and functional results in subsequent eye prosthetics.Aim. To analyze and discuss the literature on the following topics: ocular prosthetics and ophthalmic oncology using available databases.Material and methods. Optimization of domestic and foreign scientific papers using eLibrary, PubMed, ScienceDirect and Google Scholar databases.Results. The 52 most relevant sources of domestic and foreign literature were analyzed.Conclusions. Having analyzed the literature data in domestic and foreign sources, we can conclude that the world medical community has not fully disclosed the issue of eye prosthetics in patients after oncological treatment. More research and practical recommendations are needed in this area. The use of a staggered prosthetic method, as well as the shape of the eye prosthesis, taking into account the individual characteristics of the conjunctival cavity, will help to achieve the best results.

Development of ultrasound-based clinical, radiomics and deep learning fusion models for the diagnosis of benign and malignant soft tissue tumors.

The aim of this study is to develop an ultrasound-based fusion model of clinical, radiomics and deep learning (CRDL) for accurate diagnosis of benign and malignant soft tissue tumors (STTs). In this retrospective study, ultrasound images and clinical data of patients with STTs from two hospitals were collected between January 2021 and December 2023. Radiomics features and deep learning features were extracted from the ultrasound images, and the optimal features were selected to construct fusion models using support vector machines. The predictive performance of the model was evaluated based on three aspects: discrimination, calibration and clinical usefulness. The DeLong test was used to compare whether there was a significant difference in AUC between the models. Finally, two radiologists who were unaware of the clinical information performed an independent diagnosis and a model-assisted diagnosis of the tumor to compare the performance of the two diagnoses. A training cohort of 516 patients from Hospital-1 and an external validation cohort of 78 patients from Hospital-2 were included in the study. The Pre-FM CRDL showed the best performance in predicting STTs, with area under the curve (AUC) of 0.911 (95%CI: 0.894-0.928) and 0.948 (95%CI: 0.906-0.990) for training cohort and external validation cohort, respectively. The DeLong test showed that the Pre-FM CRDL significantly outperformed the clinical models (P< 0.05). In addition, the Pre-FM CRDL can improve the diagnostic accuracy of radiologists. This study demonstrates the high clinical applicability of the fusion model in the differential diagnosis of STTs.

Optimization of upper respiratory tract cancer diagnosis method based on exhaled breath gas analysis

Introduction. Head and neck tumors comprise about 7 % of all malignant neoplasms. In the head and neck area, tumors are usually located on the tongue (25–40 %) and floor of mouth (15–20 %). In the majority of cases, diagnosis, especially at early disease stages, is based on clinical and histopathological evaluation of tumor process. However, recently development and implementation of non-invasive techniques of early diagnosis of upper respiratory tract tumors through detection of pathognomonic volatile tumor markers in the exhaled air has become topical.Aim. To evaluate diagnostic accuracy of sensory gas analysis device and artificial neural network for examination of exhaled gas samples from patients with oropharyngeal, laryngeal, laryngopharyngeal cancer and to establish the optimal conditions for sampling.Materials and methods. The study included 28 patients with oropharyngeal, laryngeal, laryngopharyngeal cancers and 25 healthy volunteers. The proposed technique is based on analysis of samples of exhaled gas from the studied individuals using a diagnostic device developed by the authors. The device detects volatile compounds in the exhaled air using a set of semiconductor sensors with subsequent analysis by a neural network. The exhaled air was sampled using two methods: in the morning in the fasted state before daily hygienic procedures and physical activity (prepared samples) and in the context of everyday life, nutrition and hygiene without restrictions before sampling (non-prepared samples).Results. Based on the signals from the sensors, the neural network classified and detected patients with malignant tumors. Accuracy of the prepared samples from healthy volunteers and patients with oropharyngeal, laryngeal, laryngopharyngeal cancers was 79.17 %, of non-prepared – 84.09 %.Conclusion. High diagnostic accuracy of the developed technique of non-invasive diagnosis of malignant tumors of the oropharyngeal, laryngeal, laryngopharyngeal areas using exhaled air samples which does not require special preparation of the studied samples was demonstrated.

089. TACE for Residive Malignant Peripheral Nerve Sheath Tumor and Leiomyosarcoma: Case Series

Background: Malignant peripheral nerve sheath tumors (MPNST) are malignant, locally aggressive soft tissue sarcomas (STS) of the peripheral nerve or nerve sheath cells. Leiomyosarcomas are malignant tumors originating from the smooth muscle. Transarterial chemoembolization (TACE) is an interventional treatment to deliver chemoembolic materials. Case: First case is a 50-year-old male visited Oncology Surgery Polyclinic due to the presence of a tumor on his left forearm that was progressively increasing in size during the past two months. The MRI was done, the diagnosis of a residive malignant peripheral nerve sheath tumor was made. Second case is a 40-year-old female visited the Oncology Surgery Polyclinic due to the presence of a tumor on her right breast that was progressively increasing in size and the diagnosis of a Leiomyosarcoma at the right breast was made. Transarterial chemoembolization (TACE) was performed to both of the cases. Conclusion: MPNST and Leiomyosarcoma are malignant tumor that can be treated with doxorubicin chemotherapy through the TACE procedure.

Pancancer analysis of the interactions between CTNNB1 and infiltrating immune cell populations.

Recently, evidence has indicated that CTNNB1 is important in a variety of malignancies. However, how CTNNB1 interacts with immune cell infiltration remains to be further investigated. In this study, we focused on the correlations between CTNNB1 and tumorigenesis, tumor progression, mutation, phosphorylation, and prognosis via gene expression profiling interaction analysis; TIMER 2.0, cBioPortal, GTEx, CPTAC, and GEPIA2 database analyses; and R software. CTNNB1 mutations are most found in uterine endometrioid carcinoma and hepatocellular carcinoma. However, no CTNNB1 mutations were found to be associated with a poor prognosis. In addition, CTNNB1 DNA methylation levels were higher in normal tissues than in tumor tissues in cancer except for breast invasive carcinoma, which had higher methylation levels in tumor tissues. The phosphorylation level of the S675 and S191 sites of CTNNB1 was greater in the primary tumor tissues in the clear cell renal cell carcinoma, liver hepatocellular carcinoma, lung adenocarcinoma, pancreatic adenocarcinoma, and breast cancer datasets but not in the glioblastoma multiform dataset. As for, with respect to immune infiltration, CD8 + T-cell infiltration was negatively correlated with the expression of CTNNB1 in thymoma and uterine corpus endometrial carcinoma. The CTNNB1 level was found to be positively associated with the infiltration index of the corresponding fibroblasts in the TCGA tumors of colon adenocarcinoma, human papillomavirus-negative head and neck squamous cell carcinoma, mesothelioma, testicular germ cell tumor, and thymoma. We also identified the top CTNNB1-correlated genes in the TCGA projects and analyzed the expression correlation between CTNNB1 and selected target genes, including PPP4R2, RHOA, and SPRED1. Additionally, pathway enrichment suggested that NUMB is involved in the Wnt pathway. This study highlights the predictive role of CTNNB1 across cancers, suggesting that CTNNB1 might serve as a potential biomarker for the diagnosis and prognosis evaluation of various malignant tumors.

Metastatic Mesothelioma of the Tunica Vaginalis Presenting as Scrotal and Abdominal Nodules: A Case Report and Review of the Literature.

Mesothelioma of the tunica vaginalis testis (MMTVT) is a rare neoplasm comprising <3% of all cases of malignant mesothelioma (MM). MMTVT derives from the tunica vaginalis testis, an outpouching of the mesothelial-lined abdominal peritoneum that detaches from the abdominal cavity after the descent of the testis. Similar to pleural mesothelioma, asbestos exposure is a known risk factor. However, MMTVT has a better prognosis than pleural mesothelioma. Cutaneous metastases from MMTVT are exceedingly rare. Herein, we describe a case of a 67-year-old man with a history of asbestos exposure presenting with scrotal pain and indurated plaques on his lower abdomen and scrotum. Histologic sections showed a sheet-like dermal proliferation comprising epithelioid cells with necrosis and increased mitotic activity. The clinical and histologic differential diagnosis was broad, including metastatic carcinoma, melanoma, sarcoma, germ cell tumor, hematologic malignancy, neuroendocrine carcinoma, and malignant mesothelioma. By immunohistochemistry, the neoplastic cells were positive for WT1, D2-40, and AE1/AE3, with rare positivity for calretinin, consistent with a diagnosis of mesothelioma. Additional immunohistochemical studies provided no support for the other diagnostic considerations listed above. BAP1 showed retained nuclear expression (normal) by immunohistochemistry. A DNA sequencing panel identified copy number losses in CDKN2A, MTAP, CDKN2B, and NF2, which are frequently identified genetic alterations in malignant mesothelioma. Subsequent testicular imaging demonstrated a diffusely thickened scrotal wall with an enlarged left testicle. Overall, this represents a case of malignant mesothelioma presenting with cutaneous metastases to the scrotum and lower abdomen, with clinical and imaging features suggestive of primary MMTVT. The International Mesothelioma Interest Group recommends using at least 2 mesothelial markers, such as calretinin, WT1, CK5/6 or D2-40, and 2 epithelial markers, such as claudin-4, CEA, MOC-31, as well as a broad-spectrum cytokeratin stain (AE1/AE3) as part of an initial immunohistochemical panel. Metastatic mesothelioma should be included in the differential diagnosis of malignant epithelioid dermal tumors with unusual staining patterns.

Diagnosis and Management of Malignant Epithelial Nail Unit Tumors.

Background: Malignant epithelial nail unit tumors pose significant diagnostic and therapeutic challenges due to their clinical presentation often mimicking benign conditions and due to the need to preserve as much nail unit function as possible during surgery. Early detection is crucial, even if none of these tumors represent a life-threatening disease. Objectives: This review focus on squamous cell carcinoma, verrucous carcinoma, eccrine porocarcinoma, onychocytic carcinoma, basal cell carcinoma, malignant onychopapilloma, malignant onycholemmal cyst and onycholemmal carcinoma. Methods: Existing literature on the aforementioned tumors has been revised and synthesized. Results: Clinical presentation, pathology, diagnostic procedures, risk factors and the challenges associated with surgical management have been described in detail. Conclusions: Malignant epithelial tumors of the nail unit require careful evaluation and management due to their complex presentation. Early detection and an informed surgical approach are essential to improve patient outcomes and minimize complications.

MTOR inhibitor in the treatment of TFE-positive advanced maligmnant PEComa of the uterus: a case report and literature review.

The pre- and intra-operative diagnoses of malignant uterine vascular perivascular epithelioid cell tumors (PEComas) can be challenging, for which the literature is limited. Some cases have been shown to have TSC gene mutations or rearrangements of the MiT factor family, resulting in variable responses to mTOR inhibitors. We report a case of a TFE-positive malignant PEComa of the uterus with pulmonary metastases that responded favorably to the mTOR inhibitor, everolimus. A 52-year-old female underwent a total hysterectomy 5 years ago for suspected sub-serosal or broad ligament fibroids. The intraoperative pathologic diagnosis was leiomyosarcoma of the uterus and the postoperative diagnosis was malignant PEComa of the uterus. The patient declined genetic testing and further treatment. In December 2020 the patient presented with a pelvic mass and underwent open abdominal mass resection and pelvic adhesiolysis. The pathologic findings confirmed recurrent malignant PEComa of the uterus. The pulmonary lesions gradually progressed during the follow-up period, so treatment with everolimus was initiated. Close follow-up evaluation for nearly 3 years showed disease remission without recurrence or progression. The patient described herein had a TFE-positive uterine malignant PEComa with lung metastasis and responded well to the mTOR inhibitor, everolimus. Close follow-up in the last 3 years showed remission without recurrence or progression.

Malignant melanotic nerve sheath tumor

Malignant melanotic nerve sheath tumor, previously known as melanotic schwannoma, is a rare variant of peripheral nerve sheath tumor composed of melanin-producing Schwann cells and clinically misdiagnosed as melanoma. Malignant melanotic nerve sheath tumor is a rare tumor with uncertain biological behavior and variable treatment recommendations. Despite the histological features that seem benign, with a low proliferation index, the clinical course of this tumor often becomes malignant, with a high frequency of local relapses and the presence of tumor metastasis signs. Distinctive features of malignant melanotic tumor of the nerve sheath are a relatively young age of patients, the presence of the Carney complex signs and psammomatous bodies in the tumor. The article presents a case of malignant melanotic tumor of the nerve sheath localized in the neck with a recurrent course. In the described clinical observation, the patient underwent surgical treatment twice. Microscopic and immunohistochemical analysis of postoperative materials gave a positive result for melanoma markers and showed the absence of psammoma bodies and low mitotic activity. The clinical course of the disease was malignant, with the appearance of a relapse in the postoperative scar. Diagnosis of malignant melanotic tumor of the nerve sheath is a complex task, both from the radiological and pathological points of view. Communication between the surgeon, radiologist and pathologist, understanding the anatomical relationships of the lesion and careful attention to the histological findings are critical to making the correct diagnosis.

Challenges in treating coexisting scrotal apocrine carcinoma and gastric cancer: insights from an elderly patient: a case report and literature review

BackgroundApocrine carcinoma associated with Paget’s disease is a rare malignancy that typically manifests in elderly individuals, predominantly affecting the geriatric population. It commonly arises in regions rich in apocrine glands and often exhibits an insidious onset, potentially requiring several years to be diagnosed.Case presentationAn 80-year-old male was simultaneously diagnosed with scrotal apocrine carcinoma (showing Paget changes) and early-stage gastric cancer. Whole-genome exome sequencing confirmed these as independent malignancies with minimal genetic overlap, indicating that they were two primary tumors. The patient initially underwent successful surgery but experienced recurrence and metastasis. Treatment with capecitabine and paclitaxel showed promising responses, highlighting similarities between breast and apocrine carcinomas. Challenges were noted in the use of genetic testing and drug susceptibility assessments for treatment guidance. Notably, HER-2 expression in metastatic lesions, a trait of apocrine carcinoma, has remained unexplored due to negative HER-2 FISH results and a lack of available targeted therapies in China.ConclusionElderly patients often exhibit a lesser degree of aggressiveness toward treatment following a diagnosis of malignant tumors. It is imperative to carefully consider how to strike a balance between effective treatment and maintaining a satisfactory quality of life for these patients. This case underscores the complexity of treating coexisting rare cancers in older adults and emphasizes the need for personalized treatments and continued innovation in cancer therapy. The insights gained offer significant value in understanding and managing such rare cancer cases.

Clinicopathological analysis of small intestinal metastasis from extra-abdominal/extra-pelvic malignancy.

The metastatic tumors in the small intestine secondary to extra-abdominal/extra-pelvic malignancy are extremely rare. However, the small intestine metastases are extremely prone to misdiagnosis and missed diagnosis due to the lack of specific clinical manifestations and examination methods, thus delaying its treatment. Therefore, in order to improve clinical diagnosis and treatment capabilities, it is necessary to summarize its clinical pathological characteristics and prognosis. To summarize the clinicopathological characteristics of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy, and to improve the clinical capability of diagnosis and treatment for rare metastatic tumors in the small intestine. The clinical data of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy were retrieved and summarized, who admitted to and treated in the Air Force Medical Center, Chinese People's Liberation Army. Then descriptive statistics were performed on the general conditions, primary tumors, secondary tumors in the small intestine, diagnosis and treatment processes, and prognosis. Totally 11 patients (9 males and 2 females) were enrolled in this study, including 8 cases (72.3%) of primary lung cancer, 1 case (9.1%) of malignant lymphoma of the thyroid, 1 case (9.1%) of cutaneous malignant melanoma, and 1 case (9.1%) of testicular cancer. The median age at the diagnosis of primary tumors was 57.9 years old, the median age at the diagnosis of metastatic tumors in the small intestine was 58.81 years old, and the average duration from initial diagnosis of primary tumors to definite diagnosis of small intestinal metastases was 9 months (0-36 months). Moreover, small intestinal metastases was identified at the diagnosis of primary tumors in 4 cases. The small intestinal metastases were distributed in the jejunum and ileum, with such clinical manifestations as hematochezia (5, 45.4%) and abdominal pain, vomiting and other obstruction (4, 36.4%). In addition, 2 patients had no obvious symptoms at the diagnosis of small intestinal metastases, and 5 patients underwent radical resection of small intestinal malignancies and recovered well after surgery. A total of 3 patients did not receive subsequent treatment due to advanced conditions. Small intestinal metastases of extra-abdominal/extra-pelvic malignancy is rare with high malignancy and great difficulty in diagnosis and treatment. Clinically, patients with extra-abdominal/extra-pelvic malignancy should be alert to the occurrence of this disease, and their prognosis may be improved through active surgery combined with standard targeted therapy.

DICER-1 Mutation Associated Sarcoma of Thyroid in An Adult Male

Abstract Introduction/Objective DICER-1 is an autosomal dominant tumor predisposition syndrome caused by germline DICER1 mutations. In the thyroid, it is associated with an early-onset multinodular goiter (MNG) and low-grade thyroid carcinomas. The aggressive variants thyroblastoma and poorly differentiated carcinoma are however seen in the pediatric age group. We report a case of DICER-1-associated (rhabdomyo) sarcoma without primitive components in an adult male. Methods/Case Report A 44-year-old healthy male with a family history of MNG, presented with a large left neck mass confirmed on imaging with largest 6.4cm, and extension into the mediastinum. FNA showed a malignant spindle cell- rich neoplasm with negative expression for Keratins, TTF-1, PAX-8, Calcitonin, INSM- 1 and SOX-10. The CEA and calcitonin were normal. The lymphoma was excluded by flow cytometry. The patient underwent a left thyroidectomy with central and left selective neck dissection. On gross examination, the left lobe of the thyroid was replaced by a tan- white, partially encapsulated solid mass. Microscopic examination revealed nests and sheets of ovoid to spindle- shaped cells with eosinophilic cytoplasm in fascicles with hypocellular areas with loose stroma. Foci of rhabdomyoblastic differentiation with straps cells, positive for desmin and myogenin were identified. Brisk mitotic activity and tumor necrosis were present. No primitive thyroid epithelium or blastemal component was identified. Tumor cells were negative for S100, SOX10 CD34, CD31, SMA, calponin, CD99, NKX2.2, SS18-SSX which excluded malignant peripheral nerve sheath tumor, angiosarcoma, leiomyosarcoma, Ewing’s sarcoma, and synovial sarcoma. Next-generation sequencing showed a DICER1 c.4517G&amp;gt;A (p.W1506) and c.5437G&amp;gt;C (p.E1813Q) mutation, both variants reported as germ-line variants. A final diagnosis of DICER-1-associated rhabdomyosarcoma was rendered. The patient underwent rehabilitation at another facility and lost to follow-up. Results (if a Case Study enter NA) NA Conclusion The case highlights the expanding spectrum of DICER-1-associated malignant tumors and the importance of keeping it in the differential diagnosis of unusual malignant tumors of the thyroid even in adults.

Analysis of metalothionein in patients with malignant liver tumors.

Malignant liver tumors are highly aggressive with a poor prognosis. Metalothionein (MT) is a low-molecular intracellular protein, whose primary function is to regulate the homeostasis of heavy metals in many organisms. There are only few studies focusing on the molecular mechanisms of MT expression. Recent studies show its significant relations to carcinogenesis, spontaneous mutagenesis and efficiency of antitumor medicine. In previous studies, the increase of MT levels in cancer patients was proven. The aim of this work is to study MT as well as to increase the efficiency of malignant liver tumor diagnosis. In our pilot study (2022-2023) we observed a group of 15 patients with hepatocellular carcinoma (diagnosis C220) and a group of 15 patients with hepatoblastoma (diagnosis C222). The control group included 20 healthy probands. We developed our own modified method for the analysis. Blood serum samples of the probands were denaturated (99 ˚C, 20 min). MT was determined by an electrochemical method. Obtained data were stored and processed in the laboratory information system QINSLAB. In denaturated blood serum samples, we obtained voltametric curves of MT. We determined concentrations of MT by evaluating the area under the curve (AUC). To differentiate normal and abnormal concentrations of MT, blood samples of healthy probands were used (N = 20), with the average MT levels of 2.0 ± 1.3 µg/L and median 1.9 µg/L. In patients diagnosed with HCC, the average MT levels were 9.1 ± 6.5 µg/L and median 9.0 µg/L. The receiver operating characteristic (ROC) analysis showed AUC 0.864 (95% CI 0.736-0.992), sensitivity 0.74 and specificity 0.75. In patients diagnosed with hepatoblastoma, the average MT concentrations measured were 11.5 ± 7.5 µg/L and the median was 10.9 µg/L. The ROC analysis displayed AUC 0.868 (95% CI 0.751-0.993), sensitivity 0.84 and specificity 0.86. The correlation analysis showed correlation between MT and carcinoembryonic antigen (CEA) (r = 0.99), uric acid (r = -0.86) and potassium ions (r = -0.94). In this pilot study, we observed the association of MT levels in healthy probands and malignant liver tumor patients. Many previous studies show that MT concentrations are increasing as the illness progresses. We assume that this increase is connected to the high metabolic activity of cancer cells. This study will continue with collecting a larger number of samples.

Classification of Breast Cancer Tumors from Histopathological Images through a Modified ResNet-50 Architecture

The diagnosis of malignant or benign breast cancer tumors from histopathological images is challenging due to human error, which may lead to the patient undergoing additional, often painful, procedures to collect new data. Utilizing a supervised, pre-trained ResNet-50 model as a second opinion for doctors can help eliminate the need for repeated procedures. One main challenge faced by doctors and machine learning models is image blurriness. Applying various data preprocessing and augmentation techniques, such as resizing, Gaussian blurring, histogram equalization, and color space conversions, can improve the model’s performance. The model achieved its best results with an accuracy of 95.61%, precision of 96%, recall of 94%, and an F1-score of 95%.

Elderly age and tuberculosis: diagnostics difficulties and course features

ABSTRACT. The clinical observation of an elderly female patient, who was being treated at the Zaporizhzhia Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center, is presented, the features of the diagnostics and the course of the tuberculosis process is determined. The clinical case demonstrates the difficulty of timely tuberculosis diagnostics due to numerous comorbidities in an elderly woman. Most cases of tuberculosis in the elderly are associated with the reactivation of old specific foci, which can be explained by age-related changes in the immune system. In this case, the difficulty of the timely tuberculosis diagnostics was associated with non-specific symptoms of the active process and the absence of bacterial excretion 2 years ago in an elderly woman. As a result, a diagnosis of malignant neoplasm of the upper lobe of the left lung was mistakenly made. The outcomes of the disease led to the development of fibrocavernous tuberculosis with multidrug resistance. The woman had a good adherence to the treatment, which gave a positive result.

Age at Tumor Diagnosis in 14,636 Canine Cases from the Pathology-Based UNIPI Animal Cancer Registry, Italy: One Size Doesn't Fit All.

Cancer is the most common cause of death in adult dogs. All dogs would benefit from early diagnosis, but there are no specific guidelines regarding the schedule of cancer screening in companion animals. The aim of this study was to retrospectively evaluate the age at diagnosis in Italian oncological canine patients. A total of 14,636 canine histologically confirmed neoplastic cases were coded according to the Vet-ICD-O-canine-1 and stratified by malignancy, sex, neutering status, breed, cephalic index, body size, and tumor type. Differences in age distribution were analyzed and the influence of these variables on the time of first malignancy diagnosis was assessed using an event history analysis model. The median age at diagnosis for benign and malignant tumors was 9 and 10 years, respectively. Intact and purebred dogs were diagnosed earlier, but the median age differed significantly by breed. The earliest age at diagnosis was recorded for lymphomas and mast cell tumors. The model showed an accelerating effect of large size, brachy- and dolichocephaly, and sexual integrity in female dogs on the time of malignancy diagnosis. Our results confirm that a "one-size-fits-all" approach to cancer screening is not accurate in dogs and provide relevant data that may lead to the establishment of breed-based screening schedules.

Use of empegfilgrastim for primary prevention of febrile neutropenia in patients receiving myelosuppressive therapy. Experience of the Arkhangelsk Clinical Oncological Dispensary

Background. Granulocyte colony-stimulating factors (G-CSFs) are used in oncology practice for prevention of febrile neutropenia caused by cytotoxic chemotherapy. Despite the proven safety of G-CSFs use in randomized clinical trials and in real clinical practice, clinicians have questions about the tolerability of this group of drugs.Aim. To demonstrate the safety profile of a long-acting G-CSF produced in Russia which was used to prevent febrile neutropenia and maintain dose intensity of drug therapy in patients with various solid tumors undergoing chemotherapy at the Arkhangelsk Clinical Oncological Dispensary.Materials and methods. The retrospective analysis included patients with a confirmed diagnosis of malignant neoplasm who received various chemotherapy regimens that required the inclusion of G-CSF. For primary prevention of febrile neutropenia, patients were prescribed empegfilgrastim (Extimia®) at a dose of 7.5 mg subcutaneously once per course of chemotherapy.Results. Data of 151 patients were analyzed for the period from July 2021 to April 2023. The average age was 57 years (28–75). The group of elderly patients (over 65 years) consisted of 38 (25 %) patients. The majority of patients were diagnosed with breast cancer (56 (37 %) patients) and gastric cancer (37 (25 %) patients). The number of empegfilgrastim injections over the entire observation period was 773. Adverse reactions associated with the use of empegfilgrastim were registered in 13 (8.6 %) patients, the most common of which was grade 1–2 leukocytosis according to the CTCAE v.5 classification. One patient developed a serious adverse reaction: grade 4 neutropenia according to the CTCAE v.5 classification. A subgroup of patients with metastatic pancreatic cancer treated with FOLFIRINOX was analyzed separately to assess the relative dose intensity of the chemotherapy courses. Nine patients with metastatic pancreatic cancer received FOLFIRINOX therapy with a median of 8 (5–12) courses. A total of 69 chemotherapy cycles were administered to 9 patients with a median of 7.5 (2–13) cycles. The relative dose intensity of the chemotherapy courses was 83.71 ± 19.33.Conclusion. Empegfilgrastim has shown a favorable safety and tolerability profile in patients with various solid tumors in real-world clinical practice including the highly toxic FOLFIRINOX regimen.