Early Detection Of Malignancy Research Articles

P.084 Early malignant transformation of intracranial epidermoid cysts: a case report and systematic review

Background: Intracranial epidermoid cysts (IEC) are benign congenital intracranial lesions that rarely undergo malignant transformation. We report a case of IEC evolving into squamous cell carcinoma (SCC) 1-year post-resection. Further, we conducted a systematic review on cases of early malignant transformations of IECs. Methods: MEDLINE, EMBASE, and Scopus were searched from inception until December 2023 for studies reporting malignant transformations of IECs within 2 years of diagnosis. Results: A 48-year-old female underwent surgical resection of a cerebellopontine angle (CPA) IEC in May 2022. She re-presented in July 2023 with headaches, nausea, vomiting, right facial weakness, and rapid cyst progression. Repeat surgical resection revealed a high-grade SCC. Our systematic review identified 19 (10 females, 9 males) additional IEC cases undergoing malignant transformation within 2 years. The mean age at presentation was 57.6 years, most common location was CPA (n=13, 68.4%) and mean time between IEC to malignant transformation was 10.6 months. Eighteen (94.7%) cases transformed to SCC, of which 2 had leptomeningeal carcinomatosis, and 1 transformed to glioblastoma. Conclusions: While malignant transformations of IECs are rare, regular postoperative follow-up is crucial for early malignancy detection and treatment initiation. Further study is warranted to evaluate factors contributing to accelerated malignant progression of IECs.

Environmental and Metabolic Risk Factors Linked to Gallbladder Dysplasia.

Gallbladder disorders encompass a spectrum from congenital anomalies to inflammatory and neoplastic conditions, frequently requiring surgical intervention. Epithelial abnormalities like adenoma and metaplasia have the potential to progress to carcinoma, emphasizing the importance of histopathological assessment for early detection of malignancy. Gallbladder cancer (GBC) may be incidentally discovered during cholecystectomy for presumed benign conditions, underscoring the need for a thorough examination. However, the lack of clarity regarding the molecular mechanisms of GBC has impeded diagnostic and therapeutic advancements. Timely detection is crucial due to GBC's aggressive nature and poor prognosis. Chronic inflammation plays a central role in carcinogenesis, causing DNA damage and oncogenic alterations due to persistent insults. Inflammatory cytokines and microRNAs are among the various mediators contributing to this process. Gallbladder calcifications, particularly stippled ones, may signal malignancy and warrant preemptive removal. Molecular pathways involving mutations in oncogenes and tumor suppressor genes drive GBC pathogenesis, with proposed sequences such as gallstone-induced inflammation leading to carcinoma formation. Understanding these mechanisms, alongside evaluating mucin characteristics and gene mutations, can deepen comprehension of GBC's pathophysiology. This, in turn, facilitates the identification of high-risk individuals and the development of improved treatment strategies, ultimately enhancing patient outcomes. Thus, in this review, our aim has been to underscore the primary mechanisms underlying the development of gallbladder dysplasia and neoplasia.

Diagnostic performance of artificial intelligence in interpreting thyroid nodules on ultrasound images: a multicenter retrospective study.

Thyroid nodules are commonly identified through ultrasound imaging, which plays a crucial role in the early detection of malignancy. The diagnostic accuracy, however, is significantly influenced by the expertise of radiologists, the quality of equipment, and image acquisition techniques. This variability underscores the critical need for computational tools that support diagnosis. This retrospective study evaluates an artificial intelligence (AI)-driven system for thyroid nodule assessment, integrating clinical practices from multiple prominent Thai medical centers. We included patients who underwent thyroid ultrasonography complemented by ultrasound-guided fine needle aspiration (FNA) between January 2015 and March 2021. Participants formed a consecutive series, enhancing the study's validity. A comparative analysis was conducted between the AI model's diagnostic performance and that of both an experienced radiologist and a third-year radiology resident, using a dataset of 600 ultrasound images from three distinguished Thai medical institutions, each verified with cytological findings. The AI system demonstrated superior diagnostic performance, with an overall sensitivity of 80% [95% confidence interval (CI): 59.3-93.2%] and specificity of 71.4% (95% CI: 53.7-85.4%). At Siriraj Hospital, the AI achieved a sensitivity of 90.0% (95% CI: 55.5-99.8%), specificity of 100.0% (95% CI: 69.2-100%), positive prediction value (PPV) of 100.0%, negative prediction value (NPV) of 90.9%, and an overall accuracy of 95.0%, indicating the benefits of AI's extensive training across diverse datasets. The experienced radiologist's sensitivity was 40.0% (95% CI: 21.1-61.3%), while the specificity was 80.0% (95% CIs: 63.6-91.6%), respectively, showing that the AI significantly outperformed the radiologist in terms of sensitivity (P=0.043) while maintaining comparable specificity. The inter-observer variability analysis indicated a moderate agreement (K=0.53) between the radiologist and the resident, contrasting with fair agreement (K=0.37/0.33) when each was compared with the AI system. Notably, 95% CIs for these diagnostic indexes highlight the AI system's consistent performance across different settings. The findings advocate for the integration of AI into clinical settings to enhance the diagnostic accuracy of radiologists in assessing thyroid nodules. The AI system, designed as a supportive tool rather than a replacement, promises to revolutionize thyroid nodule diagnosis and management by providing a high level of diagnostic precision.

Application of enzyme-linked immunosorbent assay in cancer detection

The enzyme-linked immunosorbent assay (ELISA) has emerged as an indispensable method in the realm of cancer detection., serving as a significant factor in the timely identification, prediction, and surveillance of many forms of cancer. ELISA as a highly sensitive immunological assay, utilizes the binding affinity between antibodies and antigens to detect and quantify cancer-associated biomolecules, such as tumor markers, oncogenic proteins, and specific antibodies. The recently adopted methodology facilitates the identification of cancer-associated biomarkers in various types of samples, such as plasma, urine, and tissue extracts. In the context of cancer diagnosis, ELISA aids in the early detection of malignancies by detecting cancer-specific biomarkers at low concentrations, allowing for timely intervention and improved patient outcomes. This research provides a concise overview of the multifaceted applications of ELISA in the field of oncology, especially in electrochemical ELISA and gold nanoparticle–based ELISA. It discusses the diverse biomarkers employed, and elucidates its significance in cancer research and clinical practice.

Biomarkers for Early Cancer Detection: A Landscape View of Recent Advancements, Spotlighting Pancreatic and Liver Cancers.

Cancer is one of the leading causes of death worldwide. Early cancer detection is critical because it can significantly improve treatment outcomes, thus saving lives, reducing suffering, and lessening psychological and economic burdens. Cancer biomarkers provide varied information about cancer, from early detection of malignancy to decisions on treatment and subsequent monitoring. A large variety of molecular, histologic, radiographic, or physiological entities or features are among the common types of cancer biomarkers. Sizeable recent methodological progress and insights have promoted significant developments in the field of early cancer detection biomarkers. Here we provide an overview of recent advances in the knowledge related to biomolecules and cellular entities used for early cancer detection. We examine data from the CAS Content Collection, the largest human-curated collection of published scientific information, as well as from the biomarker datasets at Excelra, and analyze the publication landscape of recent research. We also discuss the evolution of key concepts and cancer biomarkers development pipelines, with a particular focus on pancreatic and liver cancers, which are known to be remarkably difficult to detect early and to have particularly high morbidity and mortality. The objective of the paper is to provide a broad overview of the evolving landscape of current knowledge on cancer biomarkers and to outline challenges and evaluate growth opportunities, in order to further efforts in solving the problems that remain. The merit of this review stems from the extensive, wide-ranging coverage of the most up-to-date scientific information, allowing unique, unmatched breadth of landscape analysis and in-depth insights.

Detecting thyrotropin receptor mRNA from peripheral blood of patients with differentiated thyroid cancer rules out non-aggressive cases.

Early diagnosis of thyroid cancer is hampered by the inability of fine-needle aspiration biopsy (FNAB) to accurately classify ∼30% of cases while preoperative cancer staging detects lymph nodal involvement in only half of cases. Liquid biopsy may present an accurate, non-invasive alternative for preoperative thyroid nodule assessment. Thyrotropin receptor (TSHR) mRNA, a surrogate marker for circulating cancer cells (CTC), may be an option for early detection of malignancy from peripheral blood, but requires methodological improvements. We aimed to investigate if TSHR mRNA can be detected in low sample volumes by employing an ultrasensitive method - droplet digital PCR (ddPCR). Less than 5mL of blood was collected from 47 patients with thyroid nodules (25 benign and 22 malignant). RNA was isolated from the fraction of mononuclear cells where CTCs segregate. Samples were analysed for the presence of TSHR mRNA by ddPCR. Thyrotropin receptor mRNA was detectable in 4mL sample volumes, with the test having good specificity (80%) but modest diagnostic accuracy (68.1%). Combining TSHR mRNA with ultrasound features and FNAB diagnosis, the test reaches high rule-out performances (sensitivity = 90% and NPV = 88.2%). Strikingly, TSHR mRNA correctly classified all samples with thyroid capsule invasion, lymph node metastasis and extrathyroidal extension. If aggressiveness is defined using these parameters, TSHR mRNA test reaches 100% sensitivity and 100% NPV for detecting high-risk cases. Employing ddPCR for TSHR mRNA improves its measurement by enabling detection in sample volumes common for laboratory testing. The test displays high prognostic performance, showing potential in preoperative risk assessment.

A simple and label-free proximity-catalytic hairpin reaction-based method for sensitive and miRNA analysis

Aberrant expression of microRNAs (miRNAs) has been shown to be linked to several crucial biological processes, including as carcinogenesis, metastasis, and progression. The advancement of innovative miRNA detection technologies can enhance the early detection of malignancies by merging with conventional diagnostic methods, such as ultrasound technology. Herein, we reported a simple, sensitive, and label-free miRNA detection method by integrating the proximity-catalytic hairpin assembly (proximity-CHA) and DNAzyme-assisted signal amplification. Compared with traditional CHA, in which the signal amplification efficiency is greatly limited by the concentration of hairpin probes, the proposed method possesses a greatly improved signal amplification efficiency. The target facilitated the non-enzymatic CHA-driven sequential formation of DNAzyme nanostructures, resulting in the effective DNAzyme-facilitated cleavage of a substrate modified with a fluorophore and quencher, leading to the production of an intensified fluorescence signal. The proximity-CHA-DNAzyme system possesses appealing analytical characteristics, making it highly promising for the analysis of many analytes in clinical research domains.

Analysis of Biosensors and Their Frontier Application in the Medical Field

With the progress of science and technology, the application of biosensors is more and more widespread. At present, traditional medical detection has the disadvantages of long cycles, low accuracy, and a cumbersome process. Because biosensors perfectly meet the requirements of timeliness and accuracy in medical detection, they are increasingly used in the field of cutting-edge medicine, which greatly improves the efficiency of diagnosis and treatment, reduces the probability of misdiagnosis, and reduces the pressure on the medical system. It is crucial for the early detection of the illness, particularly for the early detection of malignancy. Biosensors have bright prospects and high value in the field of modern medicine. In this paper, the composition and operation principle of biosensors is introduced. The frontier applications of biosensors in some medical fields are analyzed, and their advantages and disadvantages are obtained. The future development of biosensors is prospected, aiming to provide a certain direction for its future development.

Up regulation of serum L fucose glycoprotein as a diagnostic biomarker for dysplasia in oral sub mucous fibrosis patients

Glycoproteins, essential for cellular functions, contain monosaccharides like Levo-fucose, crucial for cell communication. Recent research highlights serum L-fucose as a potential biomarker for early detection of malignancies. Typically, serum L-fucose levels are low but rise with malignancy. This study evaluates serum L-fucose as an early biomarker in oral submucous fibrosis (OSMF) patients. AimAssess serum L-fucose's diagnostic potential for dysplasia in OSMF patients. ObjectivesDetermine the Association between Serum L Fucose Glycoprotein Levels and Dysplasia in OSF Patients.Evaluate the Diagnostic Accuracy of Serum L Fucose Glycoprotein as a Biomarker for OSF-Related Dysplasia. MethodologyOver a span of two years, this study encompassed 80 subjects, aged between 18 and 60 years, who were clinically and histopathologically identified as OSMF patients, with or without dysplastic alterations. From each participant, 5 ml of blood was collected. Following centrifugation to separate the serum, the samples were analyzed to determine the levels of Levo-fucose. Statistical analysisUsing SPSS (version 17.0), serum L-Fucose levels of the case group were compared to the control group using ANOVA. Frequencies were analyzed with the chi-square test, and Tukey’s Test was used for multiple comparisons. Significance was set at p < 0.01. ResultsThe analysis revealed a statistically significant disparity in the mean serum L-Fucose levels between the two groups (p < 0.01). Notably, Group II patients (those with OSMF and dysplasia) exhibited markedly elevated mean serum L-fucose levels. ConclusionElevated serum L-Fucose levels were observed in OSMF patients with dysplasia. Harmful habits, especially gutkha chewing, were linked to Oral Squamous Cell Carcinoma onset. Serum L-fucose can be a reliable marker for evaluating precancerous conditions.

Clinicopathological Study of Xeroderma Pigmentosa: A Series of Eight Cases

Abstract Background: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease, resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR)-induced DNA damage in the nucleotide excision repair pathway. This results in increased photosensitivity, UVR-induced damage to skin and eye, increased susceptibility to cutaneous and ocular cancers, and progressive neurodegeneration in some patients. Aims and Objective: The objective of the study was to describe the clinicopathological spectrum of eight cases of XP. Materials and Methods: An ambispective case series was conducted in a pediatric tertiary care hospital in eastern India during a 10-year period from 2013 to 2022. Results: All the children of our cohort were born of consanguineous marriage. The mean age of presentation was 1.2 years (range: 7 months–3 years), whereas three children presented during their infancy. The male-to-female ratio was 5:3. The most common findings were cutaneous (100%), followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme photosensitivity followed by abnormal skin pigmentation and subsequently progressive xerosis, atrophy, wrinkling, and poikiloderma over time. Six patients had varied degrees of ocular involvement, whereas three of them had severe manifestations including madarosis, tylosis, ectropion, lagophthalmos, phthisis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. Fifty percent (n = 4) of cases had cutaneous and ocular premalignant (actinic keratosis) and malignant lesions including melanoma and nonmelanoma skin cancer such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Neurological abnormalities (subnormal intelligence) were found in two cases. There was no evidence of sensory neural hearing loss, microcephaly, neuroregression, or neurodeficits. Conclusion: Although XP is associated with increased mortality and morbidity, early diagnosis followed by persistent vigorous photoprotection and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Besides genetic counseling, further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Overexpressed S100A7 in the progression of oral lichen planus: From moderate dysplasia to oral squamous cell carcinoma

The S100A7 protein plays an essential role in tumor progression and is found to be overexpressed or deregulated in oral mucosal dysplasia and several cancers. However, its expression in oral lichen planus remains unknown. Early detection of malignancy in lichen is a challenge

Evaluation of salivary biomarkers for early detection of oral cell carcinoma.

Objective: To do a comparative analysis of salivary levels LDH, amylase, total protein, CYFRA 21-1 and CA19-9 in oral SCC, PML and healthy individuals. Study Design: Retrospective study. Setting: Department of Oncology, Women Medical College Abbottabad. Period: January 2021 to January 2022. Material &amp; Methods: In a total of 200 patients. Study participants were divided into three groups. Group I (n=90) had cases diagnosed with oral SCC, Group II (n=60) cases with PML and Group III (n=50) had healthy controls. Saliva samples of patients with PML and SCC were collected before they were administered definitive therapy. ELISA was used for evaluation of CA19-9 and CYFRA 21-1, while standard kit method was used for evaluation of amylase, LDH and total protein level. Results: There was statistically significant association between oral lesions and alcohol (P=.0005), smoking (P=.0001) and tobacco chewing (P=.0005). In Group I, most common site of lesion was buccal mucosa (47%), while in Group II tongue (35%) was most commonly affected. 33.3% patients with SCC had lymphadenopathy. Level of total proteins, LDH and CYFRA 21-1 were higher, while amylase was lower in Group I and II compared to Group III. Level of CA19-9 was not significantly different in three study groups. ROC analysis showed that CYFRA21-1 had greater chance of identifying oral malignancies (P=.0001). Conclusion: The outcome shows that the concurrent evaluation of salivary biomarkers can help in early detection of malignancy.

Lynch Syndrome – An Overview of the Worldwide Management of This Silent Killer Within Our Genes

"Lynch syndrome, also known as hereditary non-polyposis cancer syndrome, represents the most common autosomal dominant genetic predisposition for the early onset development of several malignancies. Nearly three decades ago, the discovery of microsatellite instability, a distinctive feature of pathogenic variants within genes encoding mismatch repair proteins, marked a significant leap forward in understanding cancer biology and the underlying spectrum of cancers triggered by these mutations – typical of Lynch syndrome. In recent years, a new treatment paradigm, using immune checkpoint inhibitors, as well as preventive measures has drastically improved the survival rates. Identifying individuals with an inherent predisposition to cancer, through diagnostic protocols followed by personalized screening and treatment algorithms, holds the potential to mitigate premature cancer-related fatalities as well as preventable mortality. It is estimated that only a limited number of patients have been diagnosed, underscoring the importance of implementing specific screening programs for early detection of malignancies to which these patients are susceptible. This article aims to underline the importance of a national protocol tailored to guide a Western-inspired practice for Lynch syndrome patient management, the main aim of the Romanian Society for Lynch Syndrome, by providing an overview of similar initiatives throughout the world."

Natural history study of patients with familial platelet disorder with associated myeloid malignancy

AbstractDeleterious germ line RUNX1 variants cause the autosomal dominant familial platelet disorder with associated myeloid malignancy (FPDMM), characterized by thrombocytopenia, platelet dysfunction, and a predisposition to hematologic malignancies (HMs). We launched a FPDMM natural history study and, from January 2019 to December 2021, enrolled 214 participants, including 111 patients with 39 different RUNX1 variants from 45 unrelated families. Seventy of 77 patients had thrombocytopenia, 18 of 18 had abnormal platelet aggregometry, 16 of 35 had decreased platelet dense granules, and 28 of 55 had abnormal bleeding scores. Nonmalignant bone marrows showed increased numbers of megakaryocytes in 12 of 55 patients, dysmegakaryopoiesis in 42 of 55, and reduced cellularity for age in 30 of 55 adult and 17 of 21 pediatric cases. Of 111 patients, 19 were diagnosed with HMs, including myelodysplastic syndrome, acute myeloid leukemia, chronic myelomonocytic leukemia, acute lymphoblastic leukemia, and smoldering myeloma. Of those 19, 18 were relapsed or refractory to upfront therapy and referred for stem cell transplantation. In addition, 28 of 45 families had at least 1 member with HM. Moreover, 42 of 45 patients had allergic symptoms, and 24 of 30 had gastrointestinal (GI) symptoms. Our results highlight the importance of a multidisciplinary approach, early malignancy detection, and wider awareness of inherited disorders. This actively accruing, longitudinal study will genotype and phenotype more patients with FPDMM, which may lead to a better understanding of the disease pathogenesis and clinical course, which may then inform preventive and therapeutic interventions. This trial was registered at www.clinicaltrials.gov as #NCT03854318.

A Clinico-Pathological Correlation of Breast Lumps in a Tertiary Care Centre

BACKGROUND&#x0D; Breast lump is one of the most prevalent ailments that women face. Mostly these lumps are benign, but breast malignancy is the most common form of cancer and is the second leading cause of malignancy deaths in women. Fibroadenoma is the most common benign breast mass and invasive ductal carcinoma is the most common malignancy. Delay in the detection causes the malignancy to progress to an advanced stage. Early detection of malignancies in initial stages is done using triple test to decrease mortality. Incidence of breast cancer can be reduced by 30% by the routine mammographic screening of healthy women. We wanted to correlate the clinical and pathological diagnosis in patients presenting with palpable breast lumps and assess the reliability of clinical examination as a pre-procedural diagnostic tool in this study.&#x0D; METHODS&#x0D; A prospective observational study was done in a total of 100 women. Detailed clinical history and examination were done and then compared to histopathological results. The final results were statistically analyzed.&#x0D; RESULTS&#x0D; The clinical examination exhibited a sensitivity of 97.96% and a specificity of 96.08% for the identification of cancer when the data were considered collectively. The clinical examination's positive predictive value was 95.84%, and its negative predictive value was 98.08%.&#x0D; CONCLUSIONS&#x0D; A significant correlation was also observed between the clinical diagnosis and final pathological diagnosis. So routine clinical examination would definitely be helpful in early diagnosis.

Artificial Intelligence–Triaged 3-Dimensional Pathology to Improve Detection of Esophageal Neoplasia While Reducing Pathologist Workloads

Early detection of esophageal neoplasia via evaluation of endoscopic surveillance biopsies is the key to maximizing survival for patients with Barrett’s esophagus, but it is hampered by the sampling limitations of conventional slide-based histopathology. Comprehensive evaluation of whole biopsies with 3-dimensional (3D) pathology may improve early detection of malignancies, but large 3D pathology data sets are tedious for pathologists to analyze. Here, we present a deep learning-based method to automatically identify the most critical 2-dimensional (2D) image sections within 3D pathology data sets for pathologists to review. Our method first generates a 3D heatmap of neoplastic risk for each biopsy, then classifies all 2D image sections within the 3D data set in order of neoplastic risk. In a clinical validation study, we diagnose esophageal biopsies with artificial intelligence–triaged 3D pathology (3 images per biopsy) vs standard slide-based histopathology (16 images per biopsy) and show that our method improves detection sensitivity while reducing pathologist workloads.

Evaluation of Testicular Growth Percentage Ratio after Orchidopexy in Different Age Group in Unilateral Palpable Undescended Testis

Background: Undescended testis (UDT) means absent of testis in the scrotum but present its normal path of descend. In recent decades, the recommended age for orchiopexy for undescended testis has decreased, in the expectation that this might improve subsequent fertility. Currently recommended age for Orchidopexy between 6-12 and 6-18 months. Whatever the underlying cause UDT deserves treatment early in life to prevent loss of spermatogenic potential and to allow early detection of malignancy. The accurate measurement of testicular size and determination of testicular volume has a great importance in assessing the testicular functional status in children. Ultrasonograpically measured testicular volume is standard and more accurate than obtained by non-radiological clinical method. Objective: To evaluate the testicular growth after orchidopexy in different age group in unilateral palpable undescended testis. Materials and Methods: This Quasi Experimental study was carried in the Department of Pediatric Surgery, BSMMU, Dhaka, Bangladesh without interrupting standard care practiced in the department during October 2020 to September 2022.A total of 30 pediatric patients with unilateral palpable undescended testis. Proper clinical history, physical examinations, and initial investigation reports were recorded in a standard data sheet. All the patients were categorized according to age at operation as ≤2years and &gt;2years. Unilateral palpable undescended testes from 6 months to 12 years were enrolled in this study. Ultrasonography of both inguino scrotal region were performed for every sample to see the length, width and location of testis. Ultrasonography was done before and after orchiopexy by single experienced radiologist. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: A total of 30 patients with unilateral palpable undescended testis underwent ........

One-step self-assembly of quantum dot-based spherical nucleic acid nanostructure for accurate monitoring of long noncoding RNA MALAT1 in living cells and tissues

Simple and sensitive measurement of long non-coding RNA (lncRNA) is critical for early detection of malignancies. Herein, we demonstrate one-step self-assembly of quantum dot (QD)-based spherical nucleic acid (SNA) nanostructure for accurate monitoring of lncRNAs in living cells and tissues. When target lncRNA is present, it binds with a dumbbell probe to expose the complementary domain of Cy5-labeled primer, which subsequently induces cascade primer exchange reaction to produce abundant Cy5-labeled initiators. The Cy5-labeled initiators subsequently hybridize with hairpin probes on the QD surface to activate isothermal circular strand-displacement polymerization reaction, generating the QD-DNA-Cy5 nanostructures and inducing efficient Förster resonance energy transfer (FRET) between donor QD and acceptor Cy5. The obtained FRET signals are accurately quantified by single-molecule imaging. Notably, the single QD-based SNA nanostructure functions not only as a signal transmitter but also as a protector against non-specific amplification. Moreover, this assay utilizes only one DNA polymerase to achieve two-stage amplification, avoiding careful modulation of multiple enzymes. The self-assembly of QD nanosensor can be accomplished in single-step and single-tube manners at room temperature, eliminating precise temperature control and labor-intensive reaction protocols. This QD nanosensor achieves high sensitivity with a limit of detection (LOD) of 65.25 aM, and it is capable of quantifying lncRNA expression at single-cell level, differentiate tumor cells from normal cells, and distinguish breast cancer patients from healthy individuals, providing a versatile paradigm for biomedical research and early clinic diagnostics.

CAN KI-67 PREDICT MALIGNANT AND PRE-MALIGNANT ORAL LESION? : AN EXPERIENCE IN A TERTIARY CARE HOSPITAL IN THE CENTRAL INDIA.

Background: Oral cancer ranks the sixth commonest cancer worldwide and the third most common cancer in India. Ki67 index has been suggested to play an important role in early diagnosis and prognosis of potentially malignant disorders. This study aims to understand prognostic role of Ki 67 expression in different categories of oral mucosal neoplastic lesions in Central India, where tobacco chewing is endemic. This could help in early categorization and effective management of patients. Aims: To study the Ki67 expression in terms of Index of Positivity and Intensity score in oral mucosal neoplastic lesions. Setting and Design: Department of Pathology, Tertiary Care Hospital Observational &amp; Prospective study Methods &amp; Material: The expression of Ki-67was studied in parafn- embedded tissue sections of histopathology proven pre- malignant and malignant lesions of oral cavity in ninety four cases. Results: Association of Ki67 Expression Intensity score with the type of lesion was found to be signicant in premalignant and malignant lesions predominantly (p= &lt;0.001).Similarly, Ki67 Index of positivity score was highly statistically signicant (p= &lt;0.001) in association with the type of lesion. Conclusions: the expression of Ki-67 correlates well with the disease progression from dysplasia to carcinoma of the oral cavity. It is therefore a marker of malignant transformation and carcinogenesis in oral premalignant lesions and in future it may serve as a prognostic tool in the early detection of malignancy

De Novo Malignancy After Adult-to-Adult Living Donor Liver Transplantation: A Single-Center Long-Term Experience

The incidence of de novo malignancy (DNM) after liver transplantation (LT) is reported to be 3.1% to 14.4%. It is a known cause of death in long-term recipients. This study aimed to clarify the clinical features and risk factors of DNM. Recipients who underwent adult-to-adult living-donor LT (LDLT) and survived for >6 months were investigated. The medical records were retrospectively reviewed. This study was approved by the institutional review board. In total, 180 patients were included. The indications for LDLT were hepatocellular disease (n=62), metabolic liver disease (n=50), cholestatic disease (n=46), acute liver failure (n=12), and others (n=10). The median age at LDLT was 48 (18-71) years, and the follow-up period was 15 (0-29) years. De novo malignancy was diagnosed in 24 recipients (28 sites), including the digestive tract (n=9), genitourinary (n=5), gynecologic (n=5), lung (n=4), hematological (n=3), and others (n=2). The median duration from LDLT to DNM was 7 (0-19) years. Four patients were lost to follow-up due to advanced-stage cancer. R0 (curative treatment) for non-hematological DNM was achieved in 19 lesions (95%). The 10- and 20-year DNM incidence rates were 11% and 20%, respectively. The 20-year survival rates of DNM (59.6%) and non-DNM (59.9%) patients were not significantly different. De novo malignancy was significantly higher in patients with primary sclerosing cholangitis than in others (P < .05). Even in DNM recipients, early detection of malignancy and R0 treatment promises long-term outcomes comparable to those of non-DNM recipients.