Detection Of Early Lesions Research Articles

New Horizons and Prospects in Oral Cancer Detection

ABSTRACT Recent advancements in oral cancer detection prioritize non-invasive and minimally invasive techniques for efficient and accurate screening. This review outlines progress in methods such as narrow band imaging, fluorescence imaging, and optical coherence tomography, showing promise in early lesion detection. Biomarker detection in saliva and targeted nanoparticles enhance early diagnosis, while machine learning improves diagnostic accuracy. However, clinical validation and large-scale studies are needed for widespread adoption.

Community-based early detection of oral precancerous lesion, accessibility and utilization of oral healthcare services among Irular tribes residing at union territory of Pondicherry.

The present study was conducted to estimate the prevalence of oral carcinoma and precancerous lesion, oral healthcare seeking behaviour and identify accessible areas of tobacco cessation centres and oral healthcare facilities among Irular adult tribes residing in Pondicherry. 1. To estimate the prevalence of oral carcinomas and precancerous lesion by using toluidine blue solution. 2. To determine their oral healthcare seeking behaviour in terms of utilizing oral healthcare facilities. 3. To identify accessible tobacco cessation centres and oral healthcare centres for prevention of oral cancer. A cross-sectional study is designed to identify oral carcinomas, oral health-care seeking behaviour among Irular tribes of Pondicherry. 1% toluidine blue solution prepared for detection of oral precancerous lesion. Data was collected using a questionnaire and clinical examination. The collected data was subjected to statistical analysis. Out of 587 study population, oral mucosal lesion among the study population was 46 (7.8%) leukoplakia and 18 (3.1%) candidiasis. Positive health seeking behaviour 24 (41.7%) was observed. The study concluded that low prevalence of oral precancerous lesion and oral healthcare seeking behaviour is poor.

Endoscopic loco-regional treatment in controlling pancreatic neuroendocrine tumors (PNETs) behavior: a case series and literature review.

Pancreatic neuroendocrine tumors (PNETs) are considered rare pancreatic neoplasms, and it is a challenging disease entity due to its indolent behavior and is difficult to manage. Diagnostic challenge is usually found in the imaging-based approach, such as transabdominal ultrasound, abdominal CT scan, and abdominal MRI. Surgery is still the main key player in controlling the disease. The main problems in clinical practice are the early detection of small PNETs lesion and non-functional PNET (NF-PNET) cases. Most cases usually come with large tumor size or metastatic disease. Endoscopic ultrasound (EUS) has been well-known as the most sensitive tool for early detection of pancreatic malignancy. It has now also been developed for managing pancreatic cancer, such as tumor ablation therapy. We presented four variety of PNETs cases (one patient with non-functioning PNETs and three patients with functioning PNETs) who have been successfully treated with EUS-guided radiofrequency ablation (RFA) with good control of tumor growth during follow-up. One patient with a large-size insulinoma could have the tumor controlled gradually after several EUS-RFA sessions. No adverse events or major complications were observed during and after the EUS-RFA procedure. EUS has been shown as a promising tool not only for more accurate diagnosis but also for tumor growth control. However, it would need further comparison studies between EUS and surgical approaches to make a better treatment strategy.

Differences Between Edges and Centers of Melanomas Using Vibrational Optical Coherence Tomography: The Effects of Critical Lesion Size

Vibrational Optical Coherence Tomography (VOCT) is a new technique to noninvasively characterize skin cancers. We have previously shown that skin cancers exhibit new mechanovibrational peaks at 80, 130, and 250-260 Hz. The 80 Hz peak appears to represent new cells including Cancer Associated Fibroblasts (CAFs) while the new 130 and 250-260 Hz peaks reflect thin blood vessels and fibrotic tissue, respectively. Epithelial cell derived cancers are characterized by the formation of CAFs that are stiffer than normal fibroblasts, induce deposition of new thin vasomimictry vessels, and influence fibrotic tissue formation by expression of lysyl oxidases. The results of this study suggest that small lesions less than 0.13 mm in diameter are found in clear margins of skin cancers while lesions greater than 0.21 mm in diameter are characteristic of cancerous tissue based on histopathology. The results of this study suggest that early detection of MEL lesions as small as 0.06 mm can be achieved noninvasively using VOCT. VOCT may provide a method of screening patients for skin cancer in remote areas where Dermatologists are unavailable through use of telemedicine.

Detection of Gastrointestinal Lesions using Deep Learning

In the context of gastrointestinal health, this paper focuses on the identification of lesions and six stages of it using deep learning techniques. Gastrointestinal lesions can be challenging to diagnose accurately, often leading to delayed treatment and potential health complications. Like challenges in medical diagnosis, where early detection is crucial, this paper aims to provide a robust solution for early lesion identification. We leverage advanced algorithms such as modified ResNet34 a Convolutional Neural Network architecture and Pytorch, for effective filtering processes. The proposed predictive analytics framework incorporates machine learning techniques to minimize error rates. Our model processes gastrointestinal image data, facilitating accurate lesion identification. Through extensive experimentation, our model demonstrates promising results in early lesion detection, facilitating timely clinical intervention and improved patient outcomes. The utilization of Visual Studio Code enhances our development process, ensuring a seamless implementation of our deep learning methodology. Overall, our project aims to enhance diagnostic accuracy, paving the way for improved clinical monitoring and ultimately contributing to a healthier and more secure lifestyle for individuals with gastrointestinal concerns.

Abstract 1071: Circulation of rare events in the liquid biopsy for early detection of lung mass lesions

Abstract Lung cancer screening with low-dose CT scans (LDCT) has reduced mortality for patients with high-risk smoking histories. However, this method of screening remains imperfect. High rates of false positive scans expose patients to additional morbidity as they pursue subsequent diagnostic evaluation. Real-world application of screening LDCT remains low. Finally, current screening guidelines exclude those without smoking histories, a population which comprises up to a quarter of lung cancer patients. We sought to explore the utility of liquid biopsy (LBx) in lung cancer patients and its use in early cancer screening and diagnosis. Using the third generation High-Definition Single Cell Assay (HDSCA3.0) workflow, we analyzed 99 peripheral blood samples divided into three cohorts: Normal Donors (ND, n=50) who were healthy volunteers with no known pathology, Screening CT patients (CT, n=25) who underwent standard LDCT screening with resultant Lung-RADS 1-2, Biopsy patients (BX, n=24) who had abnormal CT scans requiring tissue biopsy. The ND group was used to characterize baseline epithelial, mesenchymal, endothelial, and immune cells, alongside acellular events (oncosomes). For the CT and BX patients, demographic information including age, gender, and average BMI was roughly equivalent, however average pack-years smoked differed owing to 10 (42%) patients in the BX group who had no prior smoking history. A total of 14 (58%) BX patients were diagnosed with primary lung cancer (BX+), of which 11(75%) were adenocarcinoma, 2 (19%) were squamous cell carcinoma and 1 (6%) was small cell. Across the cohorts we observed intra- and interpatient heterogeneity of rare events including multiple phenotypic rare cell populations and oncosomes. The comparison of the rare event enumerations between the ND, CT, BX+, and BX- cohorts revealed a greater incidence of total events, total rare cells and oncosomes, as well as specific cellular phenotypes in the CT and BX cohorts compared to the ND cohort. LBx analytes were detected at a significant elevation in the BX samples compared to the CT samples, but there was no significant difference between BX+ and BX- samples. The data supports the utility of the LBx in distinguishing patients with an alveolar mass lesion from those without, providing a mechanism for screening prior to LDCT to better inform clinical workup and avoid unnecessary radiation exposure and biopsy. Citation Format: Anya Shah, Karen Resnick, Jeremy Mason, Peter Kuhn, Jorge Nieva, Stephanie Shishido. Circulation of rare events in the liquid biopsy for early detection of lung mass lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1071.

Accuracy of positron emission tomography-computed tomography in the assessment of metabolically negative axillary lymph nodes in breast cancer

Background Breast cancer is a significant public health concern, and early detection of breast lesions is crucial for improved patient outcomes. Accurate assessment of axillary lymph node involvement in breast cancer is vital for staging and treatment decisions. The purpose of this study was to assess to what extent positron emission tomography (PET)-computed tomography (CT) can be used in the assessment of negative axillary lymph nodes in breast cancer and to determine if pathological variability can affect the result of the PET-CT. Patients and methods This prospective study was carried out on 50 female patients with locally advanced breast cancer and with negative PET-CT scans for active axillary lymph nodes. All studied cases underwent postoperative pathological examination to be compared with preoperative PET-CT results. Results Of the studied cases, 84% showed negative axillary lymph node involvement. PET/CT exhibited high sensitivity (95.24%) and specificity (87.5%) in predicting positive nodes, with an axillary maximum standardized uptake value cutoff value of 4.22 (area under the curve=0.923). Logistic regression revealed a significant association between higher T stage and positive lymph nodes (P<0.05). Conclusion PET/CT demonstrates strong predictive accuracy in detecting metabolically negative axillary lymph nodes in breast cancer patients.

Analysis of dermoscopy images of multi-class for early detection of skin lesions by hybrid systems based on integrating features of CNN models.

Skin cancer is one of the most fatal skin lesions, capable of leading to fatality if not detected in its early stages. The characteristics of skin lesions are similar in many of the early stages of skin lesions. The AI in categorizing diverse types of skin lesions significantly contributes to and helps dermatologists to preserve patients' lives. This study introduces a novel approach that capitalizes on the strengths of hybrid systems of Convolutional Neural Network (CNN) models to extract intricate features from dermoscopy images with Random Forest (Rf) and Feed Forward Neural Networks (FFNN) networks, leading to the development of hybrid systems that have superior capabilities early detection of all types of skin lesions. By integrating multiple CNN features, the proposed methods aim to improve the robustness and discriminatory capabilities of the AI system. The dermoscopy images were optimized for the ISIC2019 dataset. Then, the area of the lesions was segmented and isolated from the rest of the image by a Gradient Vector Flow (GVF) algorithm. The first strategy for dermoscopy image analysis for early diagnosis of skin lesions is by the CNN-RF and CNN-FFNN hybrid models. CNN models (DenseNet121, MobileNet, and VGG19) receive a region of interest (skin lesions) and produce highly representative feature maps for each lesion. The second strategy to analyze the area of skin lesions and diagnose their type by means of CNN-RF and CNN-FFNN hybrid models based on the features of the combined CNN models. Hybrid models based on combined CNN features have achieved promising results for diagnosing dermoscopy images of the ISIC 2019 dataset and distinguishing skin cancers from other skin lesions. The Dense-Net121-MobileNet-RF hybrid model achieved an AUC of 95.7%, an accuracy of 97.7%, a precision of 93.65%, a sensitivity of 91.93%, and a specificity of 99.49%.

A Detailed Comparison regarding the of Knowledge Level of Final Year Dental Students of Isfahan Azad University with Other Statistical Communities in Other Studies, in Relation to Squamous Cell Cancer of the Oral Cavity


 
 
 Introduction: Oral squamous cell cancer (OSCC) constitutes 90% of oral cancers, the most important factors of which are smoking tobacco and drinking alcohol. Early detection of cancerous and precancerous lesions and subsequent referrals are the most important factors in reducing OSCC mortality. The purpose of this study is to compare the knowledge level of senior dental students of Isfahan Azad University regarding etiology, prognosis and treatment of OSCC lesions with three other statistical communities in other statistical populations( dental students in different years of studying, the graduates , and the doctors).
 Methods: The present study was conducted in the academic year 2021-2022 on 82 senior students of the Faculty of Dentistry in Islamic Azad University, Isfahan Branch (Khorasgan) using census sampling method. The type of study was cross-sectional and descriptive-analytical. A researcher-made questionnaire, whose validity and reliability was calculated was distributed to the students by the researcher in person. Data analyses were done and statistical tests were examined at a significance level of 0.05. Finally, other studies with the same statistical communities were also examined through Google scholar, Scopus, Sid, Proquest and PubMed databases and the results (general and detailed) were compared with the present study.
 Results: Of 82 students participating in the study, 47/9% were females, 80/5% were unmarried, and 74/4% were native people. The average score of awareness regarding the etiology dimension was 2/5 out of 3, while in the prognosis and treatment level, it was estimated as 3/44 out of 7. In addition, a significant difference was not observed between the average knowledge of students in both etiology and treatment dimensions, and the variables of gender, marital status, and residence status .
 Conclusion: The results of the present study showed that the knowledge level of senior students in the Faculty of Dentistry in Islamic Azad University, Isfahan (Khorasgan) Branch, as in many statistical communities in other studies, is far from the ideal level. In order to improve these conditions, it is suggested that students have more contact with patients and oral lesions during the course of their studies. Moreover, more retraining courses (virtual or face-to-face) are recommended in the field of malignant and premalignant oral lesions.
 
 

STUDY OF ENDOMETRIAL PATHOLOGY IN ABNORMAL UTERINE BLEEDING

Objective: Endometrial pathology is becoming the most common issue that affects women of reproductive age group worldwide. AUB encompasses a wide variety of presentations, for example, frequent menstrual cycles, frequent and heavy cyclical bleeding, irregular bleeding, and postcoital bleeding. This study was done to evaluate the endometrial causes of AUB and to determine the specific pathology in different age groups.
 Methods: This study was a prospective cross-sectional study conducted on 200 patients from January 2023 to October 2023 in the department of pathology in a reputed teaching hospital and research centre. All the endometrial biopsies/curretages and hysterectomy specimens sent for Histopathological examination with history of AUB were included in the study.
 Results: Age of the patients with AUB ranged from 17 to 71 y in our study. Out of 200 cases, 90 cases (45%) were seen in Perimenopausal group followed by 68 cases (34 %) in Reproductive age group and 42 cases (21%) in Postmenopausal age group. Menorrhagia was the most common bleeding pattern seen in 54% pf patient with AUB. In 28% in reproductive age group, hormonal imbalance was observed in 13% of reproductive age group and 6% in perimenopausal age group. Atrophic endometrium was observed in 7.5% of women in post-menopausal age group. Chronic endometritis was seen 3% of reproductive age group.
 Conclusion: Abnormal uterine bleeding in women belonging to different age group show variable endometrial pattern on histopathological examination. They are valuable in early detection of pre-cancerous endometrial lesions as well as malignancy.

Pap smear in Early Detection of Cervical Precancerous Lesions in Erbil

Background and objectives: Cervical cancer remains common. This may be because Iraq has no cervical cancer screening or human papilloma virus vaccination program. The goal of the study is to figure out how well the Pap smear works as a way to find cervical precancerous lesions also identify the prevalence of cervical cancer among women and to identify the potential risk factors for cervical cancer. Methods: A prospective cross-sectional study conducted using closed end questionnaire tool for the purpose of data collection which started from 1st of October 2021 until 1st of September 2022. Convenient type of sampling was used in collecting data which include 470 women attending to cervical screening unit in Maternity Teaching Hospital, Erbil, Kurdistan Region /Iraq. The questionnaire composed of two main parts including the socio-demographic data of the patients such as age, gender, occupation, education level, religion, income status, age at the marriage, duration of marriage…etc. The result of pap smear and cone biopsy performed during colposcopy procedure to match the accuracy of pap smear. Results: The findings revealed that 36% of the women aged between 40-49 years, the majority (80%) of them were married at the age of 15-24 years, 30% of their marriage lasted from 4-14 years, and most (72.6%) of them were housewives. The result of sensitivity, accuracy, positive and negative predicted value was equal to 45.6%, 97.7%, 80%, 89.9% respectively. The kappa test was 0.52 which indicate agreement between screening and gold standard test is a diagnosis of cervical cancer is still colposcopy-guided biopsy, which is then staged on the basis of the clinical examination and the outcome of imaging procedures, most obtained results were statistically significant. Conclusion: Pap smear had a lower sensitivity, but a higher specificity in the current study. The most common complaint of the women was post-coital bleeding. Severe acute cervicitis was the most common finding for the Pap smear.

Time-frequency analysis reveals an association between the specific nuclear magnetic resonance (NMR) signal properties of serum samples and arteriosclerotic lesion progression in a diabetes mouse model.

Diabetes causes arteriosclerosis, primarily due to persistent hyperglycemia, subsequently leading to various cardiovascular events. No method has been established for directly detecting and evaluating arteriosclerotic lesions from blood samples of diabetic patients, as the mechanism of arteriosclerotic lesion formation, which involves complex molecular biological processes, has not been elucidated. "NMR modal analysis" is a technology that enables visualization of specific nuclear magnetic resonance (NMR) signal properties of blood samples. We hypothesized that this technique could be used to identify changes in blood status associated with the progression of arteriosclerotic lesions in the context of diabetes. The study aimed to assess the possibility of early detection and evaluation of arteriosclerotic lesions by NMR modal analysis of serum samples from diabetes model mice. Diabetes model mice (BKS.Cg db/db) were bred in a clean room and fed a normal diet. Blood samples were collected and centrifuged. Carotid arteries were collected for histological examination by hematoxylin and eosin staining on weeks 10, 14, 18, 22, and 26. The serum was separated and subjected to NMR modal analysis and biochemical examination. Mice typically show hyperglycemia at an early stage (8 weeks old), and pathological findings of a previous study showed that more than half of mice had atheromatous plaques at 18 weeks old, and severe arteriosclerotic lesions were observed in almost all mice after 22 weeks. Partial least squares regression analysis was performed, which showed that the mice were clearly classified into two groups with positive and negative score values within 18 weeks of age. The findings of this study revealed that NMR modal properties of serum are associated with arteriosclerotic lesions. Thus, it may be worth exploring the possibility that the risk of cardiovascular events in diabetic patients could be assessed using serum samples.

The insufficiency of CT examination in early detection of central lung squamous cell carcinoma and squamous epithelial precancerous lesions

BackgroundCT examination for lung cancer has been carried out for more than 20 years and great achievements have been made in the early detection of lung cancer. However, in the clinical work, a large number of advanced central lung squamous cell carcinoma are still detected through bronchoscopy. Meanwhile, a part of CT-occult central lung squamous cell carcinoma and squamous epithelial precancerous lesions are also accidentally detected through bronchoscopy.MethodsThis study retrospectively collects the medical records of patients in the bronchoscopy room of the Endoscopy Department of Zhejiang Cancer Hospital from January 2014 to December 2018. The inclusion criteria for patients includes: 1.Patient medical records completed, 2.Without history of lung cancer before the diagnosis and first pathological diagnosis of primary lung cancer, 3.Have the lung CT data of the same period, 4.Have the bronchoscopy records and related pathological diagnosis, 5.The patients undergoing radical surgical treatment must have a complete postoperative pathological diagnosis. Finally, a total of 10,851 patients with primary lung cancer are included in the study, including 7175 males and 3676 females, aged 22–98 years. Firstly, 130 patients with CT-occult lesions are extracted and their clinical features are analyzed. Then, 604 cases of single central squamous cell carcinoma and 3569 cases of peripheral adenocarcinoma are extracted and compares in postoperative tumor diameter and lymph node metastasis.Results115 cases of CT-occult central lung squamous cell carcinoma and 15 cases of squamous epithelial precancerous lesions are found. In the total lung cancer, the proportion of CT-occult lesions is 130/10,851 (1.20%). Meanwhile, all these patients are middle-aged and elderly men with a history of heavy smoking. There are statistically significant differences in postoperative median tumor diameter (3.65 cm vs.1.70 cm, P < 0.0001) and lymph node metastasis rate (50.99% vs.13.06%, P < 0.0001) between 604 patients with operable single central lung squamous cell carcinoma and 3569 patients with operable peripheral lung adenocarcinoma. Of the 604 patients with squamous cell carcinoma, 96.52% (583/604) are male with a history of heavy smoking and aged 40–82 years with a median age of 64 years.ConclusionsThis study indicates that the current lung CT examination of lung cancer is indeed insufficiency for the early diagnosis of central squamous cell carcinoma and squamous epithelial precancerous lesions. Further bronchoscopy in middle-aged and elderly men with a history of heavy smoking can make up for the lack of routine lung CT examination.

The use of thermovision in the detection of asymptomatic facial inflammation – Pilot study

Abstract Introduction: Asymptomatic inflammatory foci resulting from chronic dental infections or the presence of foreign bodies, e.g., in the sinuses, leading to serious local and systemic complications. These conditions, despite the absence of symptoms, are a source of bacterial, toxic, allergic, and neurogenic effects. Despite the developed radiological diagnostics in the form of pantomographic images and cone beam computed tomography (CBCT), thermal imaging is increasingly mentioned as an auxiliary tool in detecting and treating inflammatory foci of the craniofacial region. It is due that thermal imaging can bring indirectly metabolic information about studied tissues and thus allow the detection of early inflammatory lesions yet not invisible on X-ray diagnostics. The purpose of the study was to apply and validate a protocol for identifying asymptomatic inflammatory foci in the maxillofacial area using thermal imaging. Material and methods: Patients referred to the institute were examined for the presence of inflammatory foci. Analysis of radiographs revealed asymptomatic foci in the maxillary sinus, which were associated with the presence of a displaced foreign body. Thermographic examinations were performed using a FLIR T540 thermal imaging camera. Results: The obtained results showed a significant temperature difference between the suspected and opposite sinus. It was also confirmed that after the foreign body was removed from the sinus the temperature showed a dynamic decrease in time. Conclusions: According to the study, thermography has the potential to become an essential diagnostic tool for inflammation of odontogenic origin. It offers non-invasiveness, safety, real-time imaging, painless and completely safe.

New-onset diabetes is a predictive risk factor for pancreatic lesions in high-risk individuals: An observational cohort study.

Pancreatic cancer (PC) is the third cause of cancer-related deaths. Early detection and interception of premalignant pancreatic lesions represent a promising strategy to improve outcomes. We evaluated risk factors of focal pancreatic lesions (FPLs) in asymptomatic individuals at hereditary high risk for PC. This is an observational single-institution cohort study conducted over a period of 5 years. Surveillance was performed through imaging studies (EUS or magnetic resonance imaging/magnetic resonance cholangiopancreatography) and serum biomarkers. We collected demographic characteristics and used univariate and multivariate logistic regression models to evaluate associations between potential risk factors and odd ratios (ORs) for FPL development. A total of 205 patients completed baseline screening. Patients were followed up to 53 months. We detected FPL in 37 patients (18%) at baseline; 2 patients had lesions progression during follow-up period, 1 of them to PC. Furthermore, 13 patients developed new FPLs during the follow-up period. Univariate and multivariate analyses revealed that new-onset diabetes (NOD) is strongly associated with the presence of FPL (OR, 10.94 [95% confidence interval, 3.01-51.79; P < 0.001]; OR, 9.98 [95% confidence interval, 2.15-46.33; P = 0.003]). Follow-up data analysis revealed that NOD is also predictive of lesions progression or development of new lesions during screening (26.7% vs. 2.6%; P = 0.005). In a PC high-risk cohort, NOD is significantly associated with presence of FPL at baseline and predictive of lesions progression or new lesions during surveillance.

PAP-test: Possibilities and Limitations

Cervical cancer (CC) progresses slowly, and the cytological screening increases the likelihood of early detection of precancerous lesions. Cytology of the cervix is one of the primary methods of effective CC diagnosis, which, thanks to early detection and timely treatment, leads to a stable decrease in morbidity and mortality from invasive CC. The results of many studies have shown that the specificity of the conventional Pap smear test is approximately 80–100%, its sensitivity ranges from 30% to 80%, and the rate of inadequacy of this method is from 5% to 25%. With traditional smear preparation, only a small percentage of collected cells end up on the slide, while abnormal cells may be discarded and not analyzed. When viewing the slide, cells that have dried and clumped together may interfere with the visualization of atypical cells. To overcome these limitations, in 1996, as an alternative to the traditional Pap test, liquid cytology was presented – the technology of preparing slides on which the cells are placed in a single layer. This technology outperformed the conventional Pap test with improved fixation, reduced obscuring factors, and standardized cell transfer. In liquid cytology samples are collected by fully immersing the cytobrush in a vial containing a preservative liquid, whereby the cells are preserved and fixed simultaneously, unlike conventional smears where the sample is applied to a glass slide and fixed separately. Today, two main methods of preparation based on liquid cytology are known: ThinPrep and SurePath. The results of cytology are described according to the Bethesda system. The Bethesda classification is widely accepted because it corresponds to the clinical presentation, reproduces the nature of the lesions, and is therefore treatmentoriented with a desirable follow-up procedure. The indisputable advantage of the Pap test by liquid cytology is the ability to perform both cytological and molecular studies, in particular HPV, in one sample. This capability facilitated the implementation of a two-step strategy when HPV testing is used as a triage test for ASC-US or low-grade squamous intraepithelial lesion cytology, or when cytology is used to triage HPV-positive women.

PARP1-targeted fluorescence molecular endoscopy as novel tool for early detection of esophageal dysplasia and adenocarcinoma

BackgroundEsophageal cancer is one of the 10 most common cancers worldwide and its incidence is dramatically increasing. Despite some improvements, the current surveillance protocol with white light endoscopy and random untargeted biopsies collection (Seattle protocol) fails to diagnose dysplastic and cancerous lesions in up to 50% of patients. Therefore, new endoscopic imaging technologies in combination with tumor-specific molecular probes are needed to improve early detection. Herein, we investigated the use of the fluorescent Poly (ADP-ribose) Polymerase 1 (PARP1)-inhibitor PARPi-FL for early detection of dysplastic lesions in patient-derived organoids and transgenic mouse models, which closely mimic the transformation from non-malignant Barrett’s Esophagus (BE) to invasive esophageal adenocarcinoma (EAC).MethodsWe determined PARP1 expression via immunohistochemistry (IHC) in human biospecimens and mouse tissues. We also assessed PARPi-FL uptake in patient- and mouse-derived organoids. Following intravenous injection of 75 nmol PARPi-FL/mouse in L2-IL1B (n = 4) and L2-IL1B/IL8Tg mice (n = 12), we conducted fluorescence molecular endoscopy (FME) and/or imaged whole excised stomachs to assess PARPi-FL accumulation in dysplastic lesions. L2-IL1B/IL8Tg mice (n = 3) and wild-type (WT) mice (n = 2) without PARPi-FL injection served as controls. The imaging results were validated by confocal microscopy and IHC of excised tissues.ResultsIHC on patient and murine tissue revealed similar patterns of increasing PARP1 expression in presence of dysplasia and cancer. In human and murine organoids, PARPi-FL localized to PARP1-expressing epithelial cell nuclei after 10 min of incubation. Injection of PARPi-FL in transgenic mouse models of BE resulted in the successful detection of lesions via FME, with a mean target-to-background ratio > 2 independently from the disease stage. The localization of PARPi-FL in the lesions was confirmed by imaging of the excised stomachs and confocal microscopy. Without PARPi-FL injection, identification of lesions via FME in transgenic mice was not possible.ConclusionPARPi-FL imaging is a promising approach for clinically needed improved detection of dysplastic and malignant EAC lesions in patients with BE. Since PARPi-FL is currently evaluated in a phase 2 clinical trial for oral cancer detection after topical application, clinical translation for early detection of dysplasia and EAC in BE patients via FME screening appears feasible.

EVALUATION OF THE ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSIS OF BREAST LESIONS AND CORRELATION WITH HISTOPATHOLOGICAL EXAMINATION

Introduction : Breast carcinoma is one of the most common carcinomas among the women. FNAC is part of a TRIPLE APPROACH for the diagnosis of breast lumps:a) Clinical examination, b) Imaging and c) Biopsy (FNAC and Core biopsy).FNAC is considered as valuable diagnostic techniques because of its simplicity, reliability, cost- effectivity and with minimal complications.&#x0D; Aims and Objectives : The aim of this study is to assess the accuracy of FNAC in diagnosis of breast lesions in correlation with histopathological findings.&#x0D; Material and Methedology : This is retrospective study for a period of one year of all the cases of breast lesions that were referred to pathology department for FNAC and These patients were subjected to Excisional biopsy/Incisional biopsy/Mastectomy.&#x0D; &#x0D; Result : In duration of 1 year of study, we received total 76 cases with complaint of breast lump. The frequency of benign breast lesions were higher in the range of 20-40 years and the frequency of malignant lesions were higher among the age group of 41-60 years. Out of 76 cases, 40 (52.6%) cases were of Fibroadenoma, 2 (2.6%) cases were of Abscess, 2 (2.6%) cases were of Fibrocystic disease, 2 (2.6%) cases were of lactating adenoma and 30 (39.5%) cases were of malignant lesion. Among total of 76 cases, 46 cases were non-malingant and 30 cases were malignant on cytological examination. 46 non-malignant cases diagnosed on FNAC were correlated with histopathology examination. 2 false negative cases were reported which were diagnosed as benign breast lesions turned out be malignant on histopathological examination. Out of 30 diagnosed malignant lesions on FNAC, all were consistent with histopathology examination. In our study, Incidence of Benign breast lesions is 57.9% and Malignant breast lesions is 39.5% respectively.&#x0D; Conclusion : Our study states that reporting and findings of FNAC were closely correlated with the histopathological diagnosis in accordance to NCI guidelines. FNAC has significant diagnostic value in differentiating the breast lumps for further operative management.Awareness of breast cancer is must and much needed in developing country like India which can be achieved by proper education, prevention, early detection and proper management of breast lesions.&#x0D; &#x0D;

Detection of Sialic Acid to Differentiate Cervical Cancer Cell Lines Using a Sambucus nigra Lectin Biosensor.

Pap smear screening is a widespread technique used to detect premalignant lesions of cervical cancer (CC); however, it lacks sensitivity, leading to identifying biomarkers that improve early diagnosis sensitivity. A characteristic of cancer is the aberrant sialylation that involves the abnormal expression of α2,6 sialic acid, a specific carbohydrate linked to glycoproteins and glycolipids on the cell surface, which has been reported in premalignant CC lesions. This work aimed to develop a method to differentiate CC cell lines and primary fibroblasts using a novel lectin-based biosensor to detect α2,6 sialic acid based on attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and chemometric. The biosensor was developed by conjugating gold nanoparticles (AuNPs) with 5 µg of Sambucus nigra (SNA) lectin as the biorecognition element. Sialic acid detection was associated with the signal amplification in the 1500-1350 cm-1 region observed by the surface-enhanced infrared absorption spectroscopy (SEIRA) effect from ATR-FTIR results. This region was further analyzed for the clustering of samples by applying principal component analysis (PCA) and confidence ellipses at a 95% interval. This work demonstrates the feasibility of employing SNA biosensors to discriminate between tumoral and non-tumoral cells, that have the potential for the early detection of premalignant lesions of CC.

Significance of PET/CT Imaging in Myeloma Assessment: Exploring Novel Applications beyond Osteolytic Lesion Detection and Treatment Response

In multiple myeloma (MM), specific cytokines produced by plasma cells disrupt the equilibrium between osteoblasts and osteoclasts. As a result, MM patients experience an increase in osteoclast activity and a decrease in osteoblast activity. This disparity is fundamental to the development of myeloma bone disease. Lytic lesions, which are a feature of MM, can result in pathologic fractures and excruciating pain. For many years, whole-body X-ray radiography has been the standard imaging method for identifying lytic lesions. However, its sensitivity is limited because it can only detect lesions once the bone mass has been reduced by 30% to 50%. Hence, utilizing advanced and sensitive imaging modalities, such as positron emission tomography (PET) fused with computed tomography (CT), is crucial for the early detection of osteolytic lesions. Among radiotracers used in PET imaging, 1⁸F-fluorodeoxyglucose ([18F]FDG) is the most commonly employed in the field of oncology. Currently, most guidelines include [18F]FDG PET/CT in the assessment of myeloma patients, particularly for detecting osteolytic lesions, evaluating treatment response, and assessing extramedullary and residual disease. Nonetheless, in recent years, new applications of PET/CT for evaluating myeloma have been investigated. These include assessing aspects such as bone turnover, dual-time-point imaging (early and delayed scans), the impact of chemotherapy on the brain (commonly known as ‘chemo brain’), innovative PET radiotracers, and the use of artificial intelligence technology. This article aims to provide a comprehensive review of both conventional and innovative uses of PET/CT in evaluating multiple myeloma.