Non-cancer Group Research Articles

Outcomes and Adverse Effects of Transcatheter Aortic Valve Replacement (TAVR) in Cancer Patients: A Meta-Analysis.

Aortic valve disease and cancer are significant causes of mortality, especially in older populations. This meta-analysis addresses a critical question in the management of patients with both aortic valve disease and cancer. As these two conditions are major contributors to mortality, determining the best course of treatment can be complex. Traditionally, randomized controlled trials (RCTs) exclude cancer patients, leaving a gap in clinical evidence. This study steps in to fill that gap by pooling data from over 120,000 patients in 15 cohort studies, following PRISMA guidelines to evaluate the safety and effectiveness of transcatheter aortic valve replacement (TAVR) in cancer patients. The primary focus of the analysis was all-cause mortality, withsecondary outcomes including stroke, pacemaker implantation, acute kidney injury, major bleeding, and vascular complications. The results revealed no statistically significant differences between cancer and non-cancer groups in terms of mortality or complications. These findings suggest that TAVR can be a safe and effective option for patients with cancer, suggesting that deferring cardiovascular interventions in favor of cancer treatment may not always be necessary. However, the observational nature of the included studies does introduce potential biases, such as confounding factors and selection bias. The study highlights the need for more targeted research that focuses on specific types and stages of cancer to better understand how these factors may influence outcomes. Despite these limitations, the meta-analysis provides valuable insights and suggests that TAVR could be a viable treatment path for patients managing both cancer and aortic valve disease.

Substance Use in Adolescent and Young Adult Cancer Survivors: An Integrative Review.

The adolescent and young adult (AYA) ages are a time when individuals are susceptible to risky behaviors, including binge drinking, tobacco, marijuana, and illicit drug use. AYAs are at an increased risk for developing chronic health problems compared with their healthy peers, and substance use can pose additional risks. The purpose of this review is to compare substance use in AYAs with their healthy peers and identify contributing factors. A literature search was conducted of PubMed, Scopus, and OVID databases using keywords substance*, adolescent*, adolescence*, teens*, teenager*, young adult*, pediatric*, childhood*, cancer*, and oncology*. The initial search yielded 148 articles. Inclusion criteria specified English language and articles from January 1, 2013, to December 31, 2023. Studies were excluded if they did not include participants aged <18 years and without a noncancer comparison group. Five relevant articles were included after review and appraisal. Substance use was examined by substance use type and contributing factors, including caregiver-AYA relations, age, and depression/coping. Findings were mixed for substance use, including tobacco and alcohol use. Findings indicate no consistent pattern-substance use was both more and less common in AYAs than in their noncancer peers, or substance use did not differ between AYAs and their noncancer peers. With mixed results, each study identified some level of substance use in AYAs. Given this knowledge, when treating AYAs, providers should be diligent about screening for substance use during each visit. AYAs should be educated about the risk of substance use, especially as a vulnerable, at-risk population.

Efficacy comparison of five antidepressants in treating anxiety and depression in cancer and non-cancer patients.

Cancer patients have a heightened susceptibility to anxiety and depressive disorders, which significantly impact the effectiveness of cancer treatments and long-term quality of life. This study aimed to compare the efficacy of different antidepressants in cancer and non-cancer patients. A total of 610 patients diagnosed with depressive episodes and/or anxiety disorders were retrospectively included and divided into a cancer group and a non-cancer control group. Antidepressants used included escitalopram, duloxetine, sertraline, venlafaxine, and vortioxetine, combined with trazodone or not. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) scores were used to evaluate the efficacy after 4 weeks and 8 weeks of systematic antidepressants treatment. Compared to the non-cancer group, the cancer group had higher proportions of females, older individuals, and patients with poor sleep quality, while reporting fewer somatic symptoms at baseline (all p < 0.05). PHQ-9 and GAD-7 scores in cancer patients treated with antidepressants were significantly lower than baseline at week 4 and week 8 (all p < 0.05). The sertraline group demonstrated significantly less improvement in GAD-7 scores at week 4 and in both GAD-7 and PHQ-9 scores at week 8 compared to the escitalopram group, while duloxetine, venlafaxine, and vortioxetine showed comparable efficacy to escitalopram. Antidepressants combined with trazodone showed significant improvement in PHQ-9 scores at week 4 compared to those without trazodone. The gynecological cancer group showed significantly more improvement in GAD-7 and PHQ-9 scores at week 4 and 8 compared to breast cancer patients. Antidepressant treatment in cancer patients with anxiety and depression is as effective as in non-cancer patients. The efficacy of escitalopram is comparable to duloxetine, venlafaxine, and vortioxetine, all of which outperformed sertraline in cancer patients.

Early rhythm control of atrial fibrillation in cancer survivors: a nationwide population-based cohort study

Abstract Background Though early rhythm control (ERC) in patients with atrial fibrillation (AF) is effective in reducing stroke, the benefit of ERC has not been well-elucidated in cancer survivors. This study aimed to compare the risk of ischemic stroke between ERC and usual care in cancer survivors with AF and cancer. Methods This nationwide observational study was conducted using the Korean National Health Insurance Service database. Patients aged 20 years or older with newly diagnosed AF between 2009 and 2018 were included. Patients who received rhythm control therapy within 1-year of AF diagnosis were defined as the ERC group, while the remaining patients were defined as the usual care group. The risk of ischemic stroke in the ERC group compared to the usual care group was evaluated in long-term cancer survivors (cancer diagnosis ≥5 years) and the non-cancer group. Results A total of 591,692 patients were included in the study (18,747 patients [3.2 %] with cancer, mean age 65.7±14.6 years, 53.7% men, mean CHA2DS2-VASc score 3.3±2.0). The proportion of patients receiving ERC was slightly higher in cancer survivors compared to the non-cancer group (28.0% vs 25.3%, p&amp;lt;0.001). During a mean 4-year follow-up, incident stroke occurred in 52,500 patients (1,338 in cancer survivors, 51,182 in non-cancer). The ERC group showed a lower risk of stroke than the usual care group, regardless of the presence of cancer history(Figure); adjusted hazard ratio [95% confidence interval] 0.67 [0.58-0.76] in cancer survivors, 0.76 [0.74-0.78] in the non-cancer group (p-for-interaction=0.125). The effect of ERC on the risk of ischemic stroke in cancer group was consistent across all subgroups, including different cancer types or use of chemotherapy. Conclusion ERC was associated with a lower risk of ischemic stroke among long-term cancer survivors. An integrated approach incorporating appropriate rhythm control strategies should be considered for cancer survivors with newly diagnosed AF.

Short-term mortality among very elderly cancer patients in the intensive care unit: A retrospective cohort study based on the Medical Information Mart for Intensive Care IV database.

The objective of this study is to examine the epidemiological characteristics of very elderly patients (aged over 80 years) with cancer admitted to the intensive care unit (ICU), and to elucidate the association between Acute Physiology Score III (APS-III) and 28-day mortality. A retrospective analysis was conducted using data extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients aged 80 years and above were assigned to three groups: non-cancer group, non-metastatic cancer group, and metastatic cancer group, based on their cancer diagnosis and its extent, Kaplan-Meier curves were constructed among these patient groups. Furthermore, patients were divided into a survival group and a non-survival group based on their 28-day survival status after ICU admission. Univariate and multivariate logistic regression analyses were performed to detect the risk factors for 28-day mortality among these patients. Additionally, this investigation sought to establish a dose-response relationship by exploring the graded association between APS-III scores and the 28-day mortalities among patients diagnosed with cancer. A total of 42,037 medical records were screened, from which 11,461 elderly patients aged over 80 years were included, comprising 1020 (8.90%) with non-metastatic cancer, 537 (4.68%) with metastatic cancer, and 9904 (86.41%) without cancer. Significant differences in 28-day mortality were observed between both the non-metastatic and metastatic cancer groups compared to the non-cancer group (20.98% and 22.35% vs. 15.75%, p < 0.001). However, no statistically significant difference was detected in the 28-day mortality rate when comparing the non-metastatic cancer group directly with the metastatic cancer group (20.98% vs. 22.35%, p = 0.576). Univariate analysis revealed significant differences (p < 0.001) in age, gender, BMI, aCCI excluding cancer point, ventilation, presence of cancer, and status of metastatic cancer between the survival and non-survival groups. In the multivariate logistic regression, the odds ratio (OR) for ventilation was found to be 2.154 (95% CI: 1.799-2.578), cancer conferred an OR of 1.499 (95% CI: 1.137-1.975), metastatic cancer showed an OR of 1.171 (95% CI: 0.745-1.841), APS-III showed an OR of 1.038 (95% CI: 1.034-1.042). A dose-response relationship was observed, demonstrating that when the APS-III score exceeded 80 points, the 28-day mortality rate surpassed 50% among the very elderly cancer patients in ICU. More than one-tenth of critically ill very elderly patients admitted to the ICU are diagnosed with cancer. Among ICU patients, those with cancer face a short-term mortality risk approximately 1.5 times higher than those without a cancer diagnosis. Interestingly, while our findings do not indicate an escalated mortality risk due to metastasis within the cancer patient cohort, the presence of cancer itself remains a significant factor influencing ICU mortality rates in this very elderly population.

When cancer patients encountered COVID-19: clinical characteristics and outcome in China.

Cancer patients were more likely to be affected by the coronavirus disease 2019 (COVID-19) pandemic. Therefore, we analyzed the clinical characteristics and outcomes in cancer patients who were infected with COVID-19 to determine if they were more vulnerable to COVID-19 than non-cancer patients. This retrospective study involved 150 cancer patients and 300 non-cancer patients with a laboratory-confirmed diagnosis of COVID-19 at the Cancer Hospital of the Chinese Academy of Medical Sciences, at the end of 2022. Multivariable analysis was carried out on the factors associated with COVID-19 severity in cancer patients. Compared to the non-cancer group, the cancer group saw a notably higher number of hospitalizations and fatalities. Multivariate analysis showed that COVID-19 severity was correlated with male gender (OR: 5.60, 95% CI, 1.89-16.57), and recovery duration was longer than 10 days (OR: 3.19, 95% CI, 1.09-9.32) in the cancer group. However, the severity of COVID-19 was not made worse by the administration of systemic anticancer treatments prior to the outbreak. During the COVID-19 Omicron epidemic, there seemed to be some association between various antitumor therapies, treatment intervals, and COVID-19 severity. The findings of this study can potentially help allay cancer patients` fears regarding COVID-19 infection and enable them to continue with crucial therapeutic processes for the treatment of cancer.

Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre-Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden.

Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.

Discrimination of Lung Cancer and Benign Lung Diseases Using BALF Exosome DNA Methylation Profile.

Benign lung diseases are common and often do not require specific treatment, but they pose challenges in the distinguishing of them from lung cancer during low-dose computed tomography (LDCT). This study presents a comprehensive methylation analysis using real-time PCR for minimally invasive diagnoses of lung cancer via employing BALF exosome DNA. A panel of seven epigenetic biomarkers was identified, exhibiting specific methylation patterns in lung cancer BALF exosome DNA. This panel achieved an area under the curve (AUC) of 0.97, with sensitivity and specificity rates of 88.24% and 97.14%, respectively. Each biomarker showed significantly higher mean methylation levels (MMLs) in both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) compared to non-cancer groups, with fold changes from 1.7 to 13.36. The MMLs of the biomarkers were found to be moderately elevated with increasing patient age and smoking history, regardless of sex. A strong correlation was found between the MMLs and NSCLC stage progression, with detection sensitivities of 79% for early stages and 92% for advanced stages. In the validation cohort, the model demonstrated an AUC of 0.95, with 94% sensitivity and specificity. Sensitivity for early-stage NSCLC detection improved from 88.00% to 92.00% when smoking history was included as an additional risk factor.

Metabolomics-based search for lung cancer markers among patients with different smoking status

Tobacco smoking is the main etiological factor of lung cancer (LC), which can also cause metabolome disruption. This study aimed to investigate whether the observed metabolic shift in LC patients was also associated with their smoking status. Untargeted metabolomics profiling was applied for the initial screening of changes in serum metabolic profile between LC and chronic obstructive pulmonary disease (COPD) patients, selected as a non-cancer group. Differences in metabolite profiles between current and former smokers were also tested. Then, targeted metabolomics methods were applied to verify and validate the proposed LC biomarkers. For untargeted metabolomics, a single extraction-dual separation workflow was applied. The samples were analyzed using a liquid chromatograph-high resolution quadrupole time-of-flight mass spectrometer. Next, the selected metabolites were quantified using liquid chromatography-triple-quadrupole mass spectrometry. The acquired data confirmed that patients’ stratification based on smoking status impacted the discriminating ability of the identified LC marker candidates. Analyzing a validation set of samples enabled us to determine if the putative LC markers were truly robust. It demonstrated significant differences in the case of four metabolites: allantoin, glutamic acid, succinic acid, and sphingosine-1-phosphate. Our research showed that studying the influence of strong environmental factors, such as tobacco smoking, should be considered in cancer marker research since it reduces the risk of false positives and improves understanding of the metabolite shifts in cancer patients.

Gut microbiota Parabacteroides distasonis enchances the efficacy of immunotherapy for bladder cancer by activating anti-tumor immune responses

ObjectiveBladder cancer(BCa) was a disease that seriously affects patients’ quality of life and prognosis. To address this issue, many researches suggested that the gut microbiota modulated tumor response to treatment; however, this had not been well-characterized in bladder cancer. In this study, our objective was to determine whether the diversity and composition of the gut microbiota or the density of specific bacterial genera influence the prognosis of patients with bladder cancer.MethodsWe collected fecal samples from a total of 50 bladder cancer patients and 22 matched non-cancer individuals for 16S rDNA sequencing to investigate the distribution of Parabacteroides in these two groups. Further we conducted follow-up with cancer patients to access the impact of different genera of microorganisms on patients survival. We conducted a Fecal Microbiota Transplantation (FMT) and mono-colonization experiment with Parabacteroides distasonis to explore its potential enhancement of the efficacy of anti-PD-1 immunotherapy in MB49 tumor-bearing mice. Immunohistochemistry, transcriptomics and molecular experiment analyses were employed to uncover the underlying mechanisms.ResultsThe 16S rDNA showed that abundance of the genus Parabacteroides was elevated in the non-cancer control group compared to bladder cancer group. The results of tumor growth curves showed that a combination therapy of P. distasonis and ICIs treatment significantly delayed tumor growth and increased the intratumoral densities ofboth CD4+T and CD8+T cells. The results of transcriptome analysis demonstrated that the pathways associated with antitumoral immune response were remarkably upregulated in the P. distasonis gavage group.ConclusionP. distasonis delivery combined with α-PD-1 mAb could be a new strategy to enhance the effect of anti-PD-1 immunotherapy. This effect might be achieved by activating immune and antitumor related pathways.

Investigating the Z-scan technique for quantifying circulating cell-free DNA (ccfDNA) extracted from blood plasma as a potential biomarker for various cancers

The Z-scan technique is a nonlinear optical method that has found applications in characterizing various materials, particularly those exhibiting nonlinear optical response (NLOR). This study applies the continuous wave (CW) Z-scan technique to examine the NLOR in terms of the nonlinear optical phase shifts (ΔΦ0 ) exhibited by the ccfDNA extracted from blood plasma samples collected from a group constituting 30 cancer-diagnosed patients and another group constituting 30 non-diagnosed individuals. The cancer group exhibited significantly higher ΔΦ0 versus incident power slopes compared to the non-cancer group (0.34 versus 0.12) providing a clear distinction between the two groups. The receiver operating characteristic (ROC) curve analysis of the results indicates a clear separation between cancer and non-cancer groups, along with a 94% accuracy rate of the data. The Z-scan results are corroborated by spectrophotometric analysis, revealing a consistent trend in the concentration values of ccfDNA samples extracted from both cancerous and non-cancerous samples, measuring 3.24 and 1.41 respectively. Additionally, more sensitive fluorometric analyses of the respective samples demonstrate significantly higher concentrations of ccfDNA in the cancer group, further affirming the correlation with the Z-scan results. The study suggests that the Z-scan technique holds promise as an effective method for cancer detection, potentially contributing to improved oncology diagnosis and prognosis in the future.

Exploring the Link between Head and Neck Cancer and the Elevated Risk of Acute Myocardial Infarction: A National Population-Based Cohort Study.

Enhanced screening protocols for cancer detection have increased survival in patients with head and neck cancer (HNC), which highlights the need to address the sequelae of therapy-induced cardiovascular complications. This study was conducted to assess the incidence and risk of acute myocardial infarction (AMI) in patients with HNC who have not undergone radiation or chemotherapy using a comprehensive, population-based cohort dataset. A total of 2976 individuals without cancer and 744 individuals with HNC were matched using the propensity score method. The findings indicated that the occurrence rates of AMI were comparable between the HNC (2.19) and non-cancer groups (2.39). Cox regression analysis did not demonstrate a significant increase in the risk of AMI in patients with HNC (hazard ratio: 0.93, 95% confidence interval: 0.50-1.73). No increased risk of AMI was observed in the HNC group compared to the non-cancer group, regardless of the time since the HNC diagnosis. Subgroup analyses showed no notable differences in the AMI risk between the groups when considering sex, age, comorbidities, and cancer type. This study showed that patients with HNC who have not been treated with radiation or chemotherapy did not exhibit an increased incidence or risk of AMI compared to individuals without cancer.

Investigating the role of TGF-β and BDNF in cancer-related depression: a primary cross-sectional study.

Cancer-related depression is a well-documented condition that significantly impacts long-term quality of life. Brain-derived neurotrophic factor (BDNF), a neurotrophin essential for neurogenesis and neuronal plasticity, has been implicated in various neuropsychological disorders including depression associated with cancer. Cytokines, on the other hand, play a crucial role in regulating depression, potentially by influencing BDNF expression. Transforming growth factor-β (TGF-β), a key immune regulator within the tumor microenvironment, has been found to elevate BDNF levels, establishing a link between peripheral immune responses and depression. The study aims to investigate the correlation of TGF-β and BDNF in cancer-related depression. This study involved a cohort of 153 gynecological patients, including 61 patients with gynecological cancer and 92 patients without cancer. Depression levels were assessed using the subscale of Hospital Anxiety and Depression Scale (HADS-D), and TGF-β and BDNF plasma levels were measured using enzyme-linked immunosorbent assay (ELISA). The study revealed elevated plasma TGF-β levels in patients with cancer (32.24 ± 22.93 ng/ml) compared to those without cancer (25.24 ± 19.72 ng/ml) (P = 0.046). Additionally, reduced levels of BDNF were observed in patients presenting depression symptoms (44.96 ± 41.06 pg/ml) compared to those without depression (133.5 ± 176.7 pg/ml) (P = 0.036). Importantly, a significant correlation between TGF-β and BDNF was found in patients without cancer but with depression (correlation coefficient = 0.893, **P < 0.01). Interestingly, cancer appeared to influence the association between TGF-β and BDNF in patients with depression, as evidenced by a significant difference in the correlation of TGF-β and BDNF between cancer and non-cancer groups (P = 0.041). These findings underscore the active involvement of TGF-β and BDNF crosstalk in the context of cancer-related depression.

Abstract 1062: Clinical validation: A blood-based biomarker for early lung cancer detection based on circulating DNA fragmentomics

Abstract PURPOSE: Screening for lung cancer using a biomarker blood test has the potential to overcome the currently low adherence rates in the US, offering patients a convenient and accessible option. Integrating routine blood draws into lung cancer screening could boost participation, mirroring the success of non-invasive tests in colorectal screening. Numerous proof-of-concept studies indicate that analyzing genome-wide cfDNA fragmentation patterns can effectively distinguish between individuals with and without lung cancer. We conducted a multi-institutional case-control study to train and validate a fragmentome based cfDNA classifier for lung cancer early detection. METHODS: The DELFI-L101 study (NCT04825834) is a prospective, multi-site, observational case-control study designed to develop and validate an early detection test for lung cancer. The DELFI (DNA Evaluation of Fragments for Early Interception) method utilizes low-pass whole genome sequencing, a cost-effective approach that examines cell-free DNA (cfDNA) fragmentation patterns associated with lung cancer. Enrolled participants were aged ≥50 y, smoking history of ≥20 pack-years, and had undergone or had planned chest CT imaging. Medical histories were documented, and blood samples were collected for DELFI analysis. A classifier, developed through supervised machine learning, was created to distinguish between samples from individuals with lung cancer and those without. Performance was assessed through repeated 10-fold cross-validation in the training set and then subsequently assessed in an independent split-study clinical validation set. The classifier was optimized for the sensitivity detection of lung cancer in the screening-eligible population. Performance was evaluated across patient and tumor characteristics, adjusting the stage distribution to match that of LDCT screening populations. RESULTS: In an analysis of 958 participants from both the lung cancer and non-cancer control groups, the sensitivity of the test remained consistent across various participant demographics, comorbidities, and tumor characteristics, increasing with higher group, T, and N stages. The stage weighted sensitivity for the screening population was 80% (95% CI: 75%-86%), with a specificity of 53% (95% CI: 43%-64%). At a prevalence of 0.7%, the negative predictive value was 99.7%. CONCLUSIONS: Clinical validation of the DELFI-based blood test demonstrates its potential to detect lung cancer within the screening eligible population. A negative result is associated with a high negative predictive value. Given the limited adoption of low-dose computed tomography (LDCT) screening, especially among socio-economically disadvantaged individuals, this clinically validated, blood-based cfDNA test could significantly increase LDCT screening participation. Citation Format: Peter Mazzone, Peter B. Bach, Lindsey B. Cotton, Caitlin A. Schonewolf. Clinical validation: A blood-based biomarker for early lung cancer detection based on circulating DNA fragmentomics [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 1062.

Psychiatric disorders in childhood cancer survivors: A retrospective matched cohort study of inpatient hospitalisations and community-based mental health services utilisation in Western Australia.

We examined the impact of long-term mental health outcomes on healthcare services utilisation among childhood cancer survivors in Western Australia using linked hospitalisations and community-based mental healthcare records from 1987 to 2019. The study cohort included 2977 childhood cancer survivors diagnosed with cancer at age < 18 years in Western Australia from 1982 to 2014 and a matched non-cancer control group of 24,994 individuals. Adjusted hazard ratios of recurrent events were estimated using the Andersen-Gill model. The cumulative burden of events over time was assessed using the method of mean cumulative count. The annual percentage change in events was estimated using the negative binomial regression model. The results showed higher community-based service contacts (rate/100 person-years: 30.2, 95% confidence interval = [29.7-30.7] vs 22.8, 95% confidence interval = [22.6-22.9]) and hospitalisations (rate/1000 person-years: 14.8, 95% confidence interval = [13.6-16.0] vs 12.7, 95% confidence interval = [12.3-13.1]) in childhood cancer survivors compared to the control group. Childhood cancer survivors had a significantly higher risk of any event (adjusted hazard ratio = 1.5, 95% confidence interval = [1.1-2.0]). The cumulative burden of events increased with time since diagnosis and across age groups. The annual percentage change for hospitalisations and service contacts significantly increased over time (p < 0.05). Substance abuse was the leading cause of hospitalisations, while mood/affective and anxiety disorders were common causes of service contacts. Risk factors associated with increased service events included cancer diagnosis at age < 5 years, leukaemia diagnosis, high socioeconomic deprivation, and an attained age of < 18 years. The elevated utilisation of healthcare services observed among childhood cancer survivors emphasises the need for periodic assessment of psychiatric disorders, particularly in high-risk survivors, to facilitate early management and optimise healthcare resources.

Overexpression of tuftelin and KLF-5 and its clinicopathological features in hepatitis B virus-related hepatocellular carcinoma

Objective: To analyze and evaluate the expressions and clinical value of tuftelin (TUFT1) and Krüppel-like factor 5 (KLF5) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) tissues. Method: KLF5 mRNA and TUFT1 mRNA transcriptional status in cancer and non-cancer groups were compared according to the Cancer Genome Atlas (TCGA) database. The differences and prognostic value between the groups were analyzed. Postoperative liver cancer and its paired pericancerous tissues, with the approval of the ethics committee, were collected to build tissue chips. The expression of KLF5 and TUFT1 and their intracellular localization were verified by immunohistochemistry. Tissue expression and clinicopathological characteristics were analyzed by immunoblotting. SPSS software was used to analyze the relationship between SPSS and patient prognosis. Results: The transcription level of TUFT1 or KLF5 mRNA was significantly higher in the HCC group than the non-cancer group (P < 0.001), according to TCGA data. Immunohistochemistry and Western blotting examination confirmed the overexpression of TUFT1 and KLF5 in human HCC tissues, which were mainly localized in the cytoplasm and cell membrane. The positivity rates of TUFT1 and KLF5 were 87.1% ( χ(2) = 18.563, P < 0.001) and 95.2% ( χ(2) = 96.435, P < 0.001) in HCC tissues, and both were significantly higher than those in the adjacent group. The expression intensity was higher in stage III-IV than stage I-II of the International Union Against Cancer standard (P < 0.01). The clinicopathological features showed that the abnormalities of the two were significantly related to HBV infection, tumor size, extrahepatic metastasis, TNM stage, and ascites. Univariate analysis was related to tumor size, HBV infection, and survival. Multivariate analysis was an independent prognostic factor for patients with HCC. Conclusion: TUFT1 and KLF5 may both be novel markers possessing clinical value in the diagnosis and prognosis of HBV-related HCC.

A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate

ObjectivesTo evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer. Materials and methodsThe study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA1 and PSA2) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values. ResultsPSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), P=.019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515–0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (P:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33−0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations. ConclusionPSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.

Urinary cancer detection by the target urine volatile organic compounds biosensor platform

Volatile organic compounds (VOCs) have grown due to their crucial role in transitioning from invasive to noninvasive cancer diagnostic methods. This study aimed to assess the feasibility of the metal oxide biosensor platform using urine VOCs for detecting genitourinary cancers. Five different commercially available semiconductor sensors were chosen to detect specific VOCs (methane, iso-butane, hydrogen, ethanol, hydrogen sulfide, ammonia, toluene, butane, propane, trimethylamine, and methyl-mercaptan). Changes in electrical resistance due to temperature variations from the voltage heater were examined to characterize VOC metabolism. Logistic regression and ROC analysis were employed to evaluate potential urine VOCs for genitourinary cancer determination. This study involved 64 participants which were categorized into a cancer and a non-cancer group. The genitourinary cancer (confirmed by tissue pathology) comprised 32 patients, including renal cell carcinoma (3.1%), transitional cell carcinoma (46.9%), and prostate cancer (50%). The non-cancer comprised 32 patients, with 9 healthy subjects and 23 individuals with other genitourinary diseases. Results indicated that VOC sensors for methane, iso-butane, hydrogen, and ethanol, at a voltage heater of 2000 mV, demonstrated a significant predictive capability for genitourinary cancer with P = 0.013. The ROC of these biomarkers also indicated statistical significance in predicting the occurrence of the disease (P < 0.05). This report suggested that methane, iso-butane, hydrogen, and ethanol VOCs exhibited potential for diagnosing genitourinary cancer. Developing gas metal oxide sensors tailored to these compounds, and monitoring changes in electrical resistance, could serve as an innovative tool for identifying this specific type of cancer.

Longitudinal assessment of chemotherapy-induced brain connectivity changes in cerebral white matter and its correlation with cognitive functioning using the GQI.

Breast cancer was the most prevalent type of cancer and had the highest incidence rate among women worldwide. The wide use of adjuvant chemotherapy might have a detrimental effect on the human brain and result in chemotherapy-related cognitive impairment (CICI) among breast cancer patients. Furthermore, prior to chemotherapy, patients reported cancer-related cognitive impairment (CRCI), which might be due to physiological factors or mood symptoms. The present longitudinal study aimed to investigate microstructural and macroscale white matter alterations by generalized q-sampling imaging (GQI). The participants were categorized into a pre-chemotherapy group (BB) if they were diagnosed with primary breast cancer and an age-matched noncancer control group (HC). Some participants returned for follow-up assessment. In the present follow up study, 28 matched pairs of BB/BBF (follow up after chemotherapy) individuals and 28 matched pairs of HC/HCF (follow up) individuals were included. We then used GQI and graph theoretical analysis (GTA) to detect microstructural alterations in the whole brain. In addition, we evaluated the relationship between longitudinal changes in GQI indices and neuropsychological tests as well as psychiatric comorbidity. The results showed that disruption of white matter integrity occurred in the default mode network (DMN) of patients after chemotherapy, such as in the corpus callosum (CC) and middle frontal gyrus (MFG). Furthermore, weaker connections between brain regions and lower segregation ability were observed in the post-chemotherapy group. Significant correlations were observed between neuropsychological tests and white matter tracts of the CC, MFG, posterior limb of the internal capsule (PLIC) and superior longitudinal fasciculus (SLF). The results provided evidence of white matter alterations in breast cancer patients, and they may serve as potential imaging markers of cognitive changes. In the future, the study may be beneficial to create and evaluate strategies designed to maintain or improve cognitive function in breast cancer patients undergoing chemotherapy.

Do Contemporary Cancer Survivors Experience Better Quality of Life? Evaluating a Decade of SEER Medicare Health Outcomes Survey Data.

A cancer diagnosis may have deleterious effects on health-related quality of life (HRQOL) as adults age. This study examined differences in HRQOL between cancer and matched noncancer Medicare beneficiaries over 65, within and across two time periods. We used novel matching methods on data from the Surveillance, Epidemiology and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) data resource. We matched SEER-MHOS respondents with cancer from a recent period (2015-2019) to respondents with cancer from an earlier period (2008-2012). We then matched these two cohorts, without replacement, to contemporary cohorts without cancer diagnoses. We estimated Veteran's RAND 12-Item Short Form Survey Physical Component Summary (PCS) and Mental Component Summary (MCS) scores for all cohorts. Our analysis found significantly higher mean MCS scores in the recent period for those with cancer relative to the recent noncancer control group. Breast and lung cancer presented positive and statistically significant trends. We found statistically insignificant differences in PCS scores between the two time periods. No cancer sites had different PCS scores over time compared with the comparison group. Mental health for those with cancer improved more between 2008 and 2019 than a matched noncancer comparison group. Physical health remained stable across time. These findings highlight the importance of including a matched noncancer group when evaluating HRQOL outcomes. SEER-MHOS respondents with cancer report stable PCS scores across 15 years of data and higher MCS scores relative to noncancer controls.