Tumor Markers CA Research Articles

Biomarker Metabolite Discovery for Pancreatic Cancer using Machine Learning

Pancreatic cancer is one of the deadliest cancers in the world. This cancer is caused by multiple factors and mostly detected at late stadium. Biomarker is a marker that can identify some diseases very specific. For pancreatic cancer, biomarker has been recognized using blood sample known as liquid biopsy, breath, pancreatic secret, and tumor marker CA19-9. Those biomarkers are invasive, so we want to identify the disease using a very convenient method. Metabolite is product from cell metabolism. Metabolites can become a biomarker especially from difficult diseases. In this paper, we want to find biomarker from metabolite using machine learning and enrichment. Metabolites data was obtained from Metabolomic workbench, while the detection and identification is done using in silico. From 106 samples, control and cancer, we found 61 metabolites and analyze them. We got 8 metabolites that play important role in pancreatic cancer and found out 2 of them are the most impactful. From that we found that ethanol is one of the best candidate of biomarker that we provide for pancreatic detection cancer. However, the simulation need to be improved to find another biomarker that provide a better marker for prognosis.

Case Report: Choledocholithiasis as Risk Factor for Klatskin Tumor: A Rare Cholangiocarcinoma

Background: Klatskin tumor is a rare liver cancer that involves the bile ducts. Its incidence begins to increase over time and is usually only diagnosed in patients who are already at an advanced stage. The annual incidence of klatskin tumors is not more than 1:100,000. Klatskin tumor is suspected based on signs of biliary obstruction, ultrasonography showing a stricture or bile mass, cholangiography with ERCP and MRCP, abnormal liver function tests, and elevated tumor marker CA 19-9. Case Report: A 65-year-old man presented to the hospital with complaints of yellowing of the eyes and body that began one month ago, as well as a lump in the right upper abdomen that had grown larger over the previous five months. Physical examination revealed yellow eyes, and a palpable lump in the upper quadrant of the patient's abdomen. The patient defecates looked like putty and urinates looked like tea. The diagnosis leaded to a klatskin tumor because the results of MRCP showed a mass in the hilar region of the liver that extended to the proximal common bile duct, which described the appearance of a klatskin tumor. There were an increasing CA 19-9 level and liver function tests. Conclusion: Patient has been diagnosed with klatskin tumors, has choledocholithiasis risk factor, supported by appropriate MRCP images and increasing CA 19-9 level

High level of tumor marker CA19-9 returned to normal after cholecystectomy in calculous cholecystitis patients

Background High serum CA19-9 is usually caused by pancreaticobiliary malignancies, but it has also been found in a tiny minority of calculous cholecystitis patients. Aims To clarify the relationship between calculous cholecystitis and serum CA19-9. Methods Clinical data of calculous cholecystitis patients with high serum CA19-9 (high group, n = 20) and normal serum CA19-9 (normal group, n = 40) who underwent cholecystectomy were analyzed. Serum CA19-9 of high group were followed-up and gallbladder specimens were analyzed by immunohistochemistry. Results Serum CA19-9 in the high group ranged from 105 to 1635 U/ml, of which 30% exceeded 1000 U/ml. Follow-up results showed that 20 patient’s serum CA19-9 returned to normal after cholecystectomy, including 4 closely followed-up patients whose serum CA19-9 recovered within one month. Immunohistochemical results revealed that CA19-9 was mildly positive only in mucosal epithelial cells in the normal group, but positive in mucosal epithelial cells, vascular endothelial cells, and intercellular substances in the high group, accounting for high serum CA19-9. Conclusion Serum CA19-9 is proved to be associated with calculous cholecystitis for the first time, so that clinicians should consider calculous cholecystitis associated CA19-9 elevation in the clinic practice besides other CA19-9 related diseases.

Letter to the Editor Re: Yamamoto R, Sugiura T, Ashida R, Ohgi K, Yamada M, Otsuka S, and Uesaka K. Prognostic value of carbohydrate antigen 19-9 and the surgical margin in extrahepatic cholangiocarcinoma. Ann Gastroenterol Surg. 2022; 6:307-315.

We have read with great interest a manuscript that demonstrated margin status having a significant impact on OS in the group of patients with the lowest preoperative Ca19-9 value.1 In contrast, in two other groups with increased preoperative Ca19-9, the OS rate of the R0 and R1 resection did not differ. Here we would like to comment on the hidden message of this interesting paper referring to the data which is shown exceptionally in tables and figures but is not remarked on in the article. In the presence of minimal margins, R1 dramatically worsened the survival chances in the best prognosis group and did not have an impact on medium (B) or high-risk (C) groups. Paradoxically, R1-exhibiting patients in the low-risk A group were exhibiting not only inferior OS as compared to R0 patients of their own normal group (fig. 3A) but also as compared to R1 patients in normalization (fig. 3B) or non-normalization (fig. 3C) groups. It seems that the authors initially aimed for an ambitious and difficult objective: to explore tumor marker Ca19-9 reduction achieved during the surgical intervention to evaluate the completeness of resection and to predict the prognosis of EHCC. An analysis of Table 1 reveals interesting findings. The degree of Ca19-9 reduction as a result of tumor debulking surgery was more pronounced in two higher-risk groups (also designated as “B” and “C” in some tables) as compared to the low-risk (A) group. The postoperative decline of the Ca19-9 value in the normal group can be calculated as 1.6 times reduction (from 16 to 10 U/mL); whereas it exhibited a significantly better reduction—4.1 times in the highest risk group (C). Finally, the highest reduction of Ca19-9 was seen in the B group—it exhibited 8 times decline. Nevertheless, patients in the B and C groups exhibited inferior overall survival regardless of margin status. Obviously occult distant metastasis at a time of surgical intervention in groups B and C resulted in inferior survival outcomes. The distant recurrence parameters later in time are remarkably worse in groups B and C (table 2). We would like to offer the rate of change of Ca19-9 in the early postoperative period to evaluate the completeness of surgical intervention. A specific growth rate (SGR) with negative values at the early postoperative period requires only two time points. Interestingly SGR can be compared between patients with no exact time points of blood sampling. The rate of tumor marker decline during an early postoperative period can signal the presence of positive margins or occult metastasis.2, 4 Similarly, SGR calculation following surgical resection for patients in remission3, 4 can be helpful in finding patients at risk of recurrence early. The monitoring of completeness of resection in oncology has been a point of debate over the past several decades.5 The absolute value of Ca19-9 should be less specific and less sensitive in identifying recurrence as compared to SGR, at least in theory. We are grateful for the authors providing us with many takeaways and ideas. The authors claim no conflict of interest. All the comments of this letter are in accordance with the Helsinki Declaration of 1964 and later versions.

Research and analysis on computed tomography signs and clinical characteristics of chronic duodenal papilla mucositis and duodenal papillary carcinoma.

Objective: To investigate the computed tomography (CT) findings of chronic duodenal papilla mucositis and duodenal papillary carcinoma, and provide more imaging information for early diagnosis of duodenal malignant diseases.Methods: CT findings and clinical data of 40 patients with chronic duodenal papilla mucositis and 46 patients with duodenal papillary carcinoma were retrospectively analyzed. Observation and measuring of direct duodenal papilla signs (including size, shape, density, enhancement uniformity, etc.), indirect duodenal papilla signs (including pancreaticobiliary dilatation) and clinical indicators (including tumor markers CA19-9, CA125, CEA, blood routine white blood cell count, bilirubin, age, gender, etc.) were carried out according to CT as well as statistical analysis.Results: There were significant differences in duodenal papilla regular morphology, age and CA19-9 (p < .05), and significant differences in duodenal papilla maximum transverse diameter, diameter of common bile duct, diameter of pancreatic duct, total bilirubin, direct bilirubin, and jaundice in duodenal papillary carcinoma group (p < 0.01). There were no significant differences in duodenal papilla enhancement uniformity, plain CT value, arterial CT value, portal CT value, enhancement uniformity, presence or not of calculus at the lower end, gender, CEA, CA125, white blood cell count, and abdominal pain with fever (all p > .05).Conclusion: CT is helpful for the diagnosis of duodenal papilla disease, but the CT findings of patients with duodenal papillary carcinoma tend to be similar to findings of chronic duodenal papilla mucositis, which is easy to lead to misdiagnosis, so comprehensive diagnosis should be made according to the direct and indirect CT signs as well as laboratory and clinical manifestations of duodenal papilla, so as to improve the diagnosis of duodenal papillary carcinoma, and reduce missed diagnosis and misdiagnosis.

Особенности ранней диагностики новообразований яичников

Aim: to identify clinical and anamnestic risk factors for ovarian masses (OM), as well as to clarify the significance of various diagnostic criteria in the early diagnosis of ovarian cancer (OC). Patients and Methods: a retrospective analysis of 50 cases of patients with OM was conducted. The following groups were formed: the main group (50 patients with OM) and the control group — practically healthy female subjects (32 patients). Retrospectively, depending on the results concerning histology of the removed surgical material, the main group was divided into 2 subgroups: subgroup 1 — 37 patients with benign OM, subgroup 2 — 13 patients with borderline and malignant OM. The patterns of the anamnesis, the level of the Ca-125 tumor marker, the values of the Risk of Malignancy Index (RMI), and the tumor histology structure were assessed. Results: during the study, it was found that in patients with OM, diseases of the gastrointestinal tract (GIT), urinary system (24%), pelvic inflammatory disease (PID), as well as menstrual disorders of various types and uterine fibroids (p&lt;0.05) are more common. The incidence of gynecologic cancer in the family history is also significantly higher in patients with OM vs. the control group (36% and 3%, respectively, p&lt;0.05). Elevated Ca-125 values were noted both in the group with benign ovarian masses and in the group with borderline and malignant ovarian tumors.it has been established that the main risk factors for the OC development are diseases of GIT (Odds Ratio (OR) 2,09) and urinary system (OR 1,53), genetic predisposition to cancer of the reproductive organs (OR 1,86), menstrual disorder (OR 1,86), uterine fibroids (OR 1,74) and a history of PID (OR 1,83). Conclusion: despite a large number of studies devoted to the problem of OC early diagnosis, there is still no reliable criterion with high sensitivity and specificity. Female patients with postmenopause and adverse ultrasound criteria should have high oncological alarm of doctors, even with low values of the Ca-125 oncological marker. KEYWORDS: ovarian tumors, neoplasms, ovarian cancer, risk factors, Ca-125, malignancy index RMI. FOR CITATION: Smirnova A.V., Malyshkina A.I., Khrushkova E.P. Characteristics in early diagnosis of ovarian masses. Russian Journal of Woman and Child Health. 2023;6(2):105–111 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-105-111.

Uterine tube cancer in the practice of an obstetrician-gynecologist

Fallopian tube cancer (FTC) is an actual problem in oncology. Despite the low frequency of FTC, it is quite easy to confuse it with other malignant diseases of the female genital organs, namely, ovarian and endometrial cancer. It is quite difficult to diagnose FTC in time, since the absence of specific symptoms determines the detection of malignant tumors of fallopian tubes only during surgical interventions for benign gynecological pathology or in case of suspicion of ovarian or endometrial cancer. The final diagnosis and primary origin of the tumor can be established only by postoperative histological study.The article presents a review of the literature of scientometric databases on the etiology, diagnosis, and treatment of FTC. Based on the analysis of data from the scientific literature, the problem of FTC as a rare and deceptive malignant disease with a rather aggressive course is highlighted, which causes the formation of oncological awareness among obstetricians-gynecologists regarding this type of cancer.According to the literature, it is established that FTC is diagnosed very rarely. Among all cases of malignant tumors of the female genital organs, the frequency of FTC is only 0.14–1.8 %. It was also established that it is possible to diagnose FTC in a time only in 0–21 % of cases, according to other data– up to 10 %.Due to the aggressive course of tubal cancer, the five-year survival rate ranges from 22 till 57 %. Intraoperatively, it is possible to detect malignant tumors of the fallopian tubes only in 50 % of cases. The article provides data on the possible causes of development, clinical symptoms that can be manifested by FTC, as well as methods of diagnosis and treatment of this cancer.FTC is a very deceptive oncological pathology, which can be caused by chronic inflammatory changes in the fallopian tubes, infertility, fallopian tube endometriosis, and BRCA1 and BRCA2 mutations. First of all, obstetrician-gynecologists should pay attention on abnormal uterine bleeding in the patient, purulent-bloody discharge, pain in the lower abdomen, the phenomenon of “watery tubal discharge”, since these pathological manifestations are typical for FTC. The tumor marker CA-125 and β-subunit of hCG have important meaning, the levels of which are increased by FTC.Significant similarity of clinical symptoms with ovarian and endometrial cancer leads to significant errors in establishing the correct diagnosis. Since malignant tumors of the fallopian tubes can metastasize to groups of lymphatic lymph nodes that are completely atypical for them, it is also necessary to carry out a differential diagnosis with breast cancer, because FTC can manifest itself in the form of axillary lymphadenopathy, and with stomach cancer, in which an isolated increase of the left supraclavicular lymph node (Virchow’s metastasis) can also be observed, which is also characteristic of fallopian tube carcinomas.

Diagnostic value of an enhanced MRI combined with serum CEA, CA19-9, CA125 and CA72-4 in the liver metastasis of colorectal cancer

ObjectiveThis paper aims to explore the diagnostic value of enhanced magnetic resonance imaging (MRI) combined with a carcinoembryonic antigen (CEA) and carbohydrate antigen in terms of the liver metastasis of colorectal cancer.MethodsA total of 167 colorectal cancer patients with liver metastasis and 167 colorectal cancer patients without liver metastasis were selected as the subjects. An automatic electrochemiluminescence analyser was then used to detect the tumour markers CEA, CA19-9, CA125 and CA72-4. The consistency between the MRI examination and clinical pathological examination was also analysed, and the sensitivity, specificity and positive and negative predictive values of various combined detection methods were compared.ResultsThe abnormal rates of CEA, CA19-9, CA125 and CA72-4 in the two groups were statistically significant (P < 0.05), while the results of the enhanced MRI and clinicopathological examination for liver metastasis in patients with colon cancer were largely consistent (Kappa coefficient = 0.788, P < 0.000). However, the two methods were inconsistent. The false positive rate of the enhanced MRI examination was 15.3%, while the false negative rate was 6.0%. The specificity (94.61%), positive predictive value (92.68%) and positive likelihood ratio (12.67%) were the highest for the MRI combined with serial CEA, while the sensitivity (98.80%) and negative predictive value (97.22%) were the highest with the MRI combined with parallel CEA, and this combination returned the lowest negative likelihood ratio (0.03).ConclusionThe combination of MRI and CEA excludes non-metastatic patients and identifies colorectal liver metastasis cancer patients. Overall, it has a higher diagnostic value.

Extrapelvic Endometriosis Mimicking Peritoneal Surface Malignancy: Case Report and a Review of Literature.

Extrapelvic endometriosis is a rare presentation of endometriosis with atypical clinical symptoms. It can mimic peritoneal surface malignancy, as well as some abdominal infectious diseases. A 29-year-old Moroccan woman presented with abdominal pain, progressive abdominal distention, and an intermittent inflammatory syndrome. Imaging revealed multiple, progressively growing abdominal cysts. She had elevated tumor markers CA125 and CA19.9. Despite thorough investigation, several differential diagnoses persisted for a long time. Definitive pathological diagnosis could only be established after debulking surgery. Literature review on malignant and benign conditions causing multicystic abdominal distention is provided. When definitive diagnosis is not established, but suspicion for peritoneal malignancy remains, a debulking procedure can be undertaken. Organ preservation can be pursued whenever benign disease is still considered. In case of malignancy, short-term (curative) debulking procedure with or without hyperthermic intraperitoneal chemotherapy (HIPEC) can be proposed.

Opportunities and clinical significance of preoperative diagnosis of infiltrative endometriosis

Aim. To optimize preoperative diagnosis of infiltrative forms of genital endometriosis.&#x0D; Materials and methods. We analyzed the results of the preoperative examination and surgical treatment of 667 patients from 22 to 49 years old (31.4 [27.3; 34.2]) with external endometriosis presented with pelvic pain, dysmenorrhea, dyspareunia (n=580), and primary or secondary infertility (n=215). The duration of the disease ranged from 1 to 16 years. Seventy-eight (11.69%) patients had a history of surgery for external endometriosis. The serum concentration of the CA-125 tumor marker was measured by immunochemiluminescence assay. Colonoscopy was performed in 655 cases, and cystoscopy in 66 cases. In addition, pelvic ultrasound was performed for all patients. Pelvic magnetic resonance imaging (MRI) was performed with an intravenous bolus injection of a contrast agent.&#x0D; Results. Patients with endometrioid ovarian cysts (n=564) and "minor" forms of endometriosis (n=44) predominated. Endometrioid infiltrates occurred in 59 (8.84%) patients. In the group of patients with infiltrates, 18.64% had a history of surgery for endometriosis; 5.7% had a recurrence. Patients with retrocervical endometriosis and endometriosis of uterosacral ligaments predominated among females with infiltrative forms. No statistically significant differences in CA-125 concentration between patients with and without infiltrates were observed. The infiltrate was revealed, and its topography was described in 49 (83.05%) patients using ultrasound and 56 (94.81%) patients using MRI. All patients with dysuria had ultrasound, MRI, colonoscopy and cystoscopy.&#x0D; Conclusion. The combined use of pelvic ultrasound and MRI provides high accuracy in diagnosing infiltrative endometriosis.

Assessment of tumor markers CA 19-9, CEA, CA 125, and CA 242 for the early diagnosis and prognosis prediction of gallbladder cancer.

Gallbladder cancer (GBC) is one of the leading and aggressive cancers in this region of India. It is very difficult to diagnose in the early stage, as it lacks typical early signs and symptoms; thus, the diagnosis is often in the advanced stage, which ultimately leads to a poor 5-year survival outcome. Tumor markers including carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), CA 125, CA 242, and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC. To compare tumor marker levels between GBC and benign GB diseases (GBDs) and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC. Patients of either sex aged ≥ 18 years, with suspected GBC (GB polyp, irregular thick GB wall, GB mass, porcelain GB) on the basis of radiological imaging were included in this study. GB wall thickness using ultrasonography and tumor markers CEA, CA 125, CA 19-9, and CA 242 in all patients were recorded. All cases after surgical intervention were divided into two groups, GBC and benign GBD, according to histopathological examination findings. The cases were followed up and clinical findings, radiological findings, and levels of tumor markers were assessed. A total of 200 patients were included in this study, of whom 80 patients had GBC and 120 patients had benign GBD. The median (interquartile range) age was 52.0 (41.0-60.0) years and the majority of patients (132, 66.0%) were women. Tumor markers including CA 19-9, CA 125, CEA, and CA 242 were significantly elevated in patients with GBC (P < 0.001). There was a significant reduction in tumor markers at 3 and 6 mo from baseline (P < 0.001). The mean survival of patients with normal and elevated levels of tumor markers CA 125, CA 19-9, and CEA was comparable; however lymph node metastasis and CA 242 expression level were independent prognostic factors. Serum levels of tumor markers including CA 19-9, CA 125, CEA, and CA 242 were significantly associated with GBC. However, no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival. Tumor marker assessment during follow-up may represent a treatment response.

Difference Levels Of Cea And Ca 125 Tumor Marker Between Lung Carcinoma With Bone Metastases And Lung Carcinoma Without Bone Metastases At Rsup Sanglah Denpasar

Lung carcinoma is one of the most common malignancies metastasized to bone, as much as 30-40% of lung malignancies metastasize to bone in the course of the disease. Carcinoembryonic Antigen (CEA) and Cancer Antigen 125 (CA 125) are tumor markers often used to assess lung malignancy. Eventhough the character of tumor markers are less sensitive and specific, some evidence address an increase in these tumor markers in the case of lung malignancies which metastasize to bone. The purpose of this study is to prove an increase in the levels of tumor markers CEA and CA 125 in lung carcinoma with bone metastases compare to lung carcinoma without bone metastases. A cross sectional study consecutively by reviewing lung carcinoma with bone metastases and without bone metastases in patient’s medical record between 2013-2021 at RSUP Sanglah Denpasar. Of 50 lung carcinoma patients (25 patients with bone metastases and 25 patients without bone metastases), levels CEA and CA 125 tumor markers were processed using SPSS. The results showed levels of CEA were significantly higher in lung carcinoma with bone metastases (p=0,028), but levels of CA 125 were not significantly higher in lung carcinoma with bone metastases (p=0,796). The results of the study concluded that levels of CEA could be used as a valuable marker to assess lung malignancy which metastasized to bone in clinical application.&#x0D; Keywords: Tumor Marker Levels, CEA, CA 125, Lung Carcinoma, Bone Metastases

Circulating caspase-cleaved cytokeratin 18 correlates with tumour burden and response to therapy in patients with colorectal cancer liver metastasis

Background and aimsSystemic chemotherapy followed by hepatic resection is the treatment of choice for patients with colorectal cancer liver metastasis (CRCLM) but reliable biomarkers predicting response to therapy are needed. Spontaneous apoptosis of single tumour cells is common in CRCLM. We explored the potential of circulating apoptosis markers to predict treatment response. Materials and methodsFifty-eight patients with CRCLM or hepatocellular carcinoma (HCC) were included in this study. Tumour tissue and blood samples were obtained before and after initiation of chemotherapy. Immunohistochemistry and ELISA assays were utilized to quantify the apoptosis marker caspase-cleaved cytokeratin 18 (M30) in tissue and circulation. ResultsCRCLM tissues showed more apoptotic tumour cells than HCC, or healthy liver. This was associated with elevated levels of circulating M30 (median = 244 U/l vs. 37 U/l in healthy controls, p = 0.009) which correlated with tumour volume (r2 = 0.92). Patients with progressive disease during chemotherapy showed higher M30 levels before therapy than responders (745 U/l vs. 136 U/l, p = 0.016). The predictive potential of M30 was higher than that of the tumour markers CA19-9 or CEA (AUC: 0.93, 0.63, and 0.78, respectively). ConclusionsApoptotic tumour cells release cellular debris into the circulation, which provides information about tumour size and vitality.

The Analysis of E-Cadherin, N-Cadherin, Vimentin, HER-2, CEA, CA15-3 and SF Expression in the Diagnosis of Canine Mammary Tumors

Canine mammary tumors (CMTs) are one of the most common tumors in female dogs, and they are associated with a poor prognosis owing to their high rate of recurrence and metastasis rates, which make their diagnosis especially important in clinical veterinary medicine. In this study, the characteristics of tumors were observed in dogs suffering from CMTs, and clinical diagnosis and histopathology were used to identify tumors. Furthermore, the expression levels of tumor markers for CMTs were analyzed by enzyme-linked immunosorbent assay (ELISA) and quantitative PCR (qPCR). Upon clinical examination, dogs with CMTs displayed a distinct and irregular mass in the mammary gland, and X-ray (Latero-lateral and ventro-dorsal views) and ultrasonography of the abdomen revealed a moderately echogenic mass at the mammary gland with slightly stronger density than the surrounding tissue. A total of 30 tumors were identified by histopathology, 11 benign and 19 malignant. Changes in some indicators in dogs suffering from CMTs and healthy dogs suggested that there were multiple direct or paraneoplastic changes associated with tumors that could be detected/suspected by hematological examination, and ELISA revealed the HER-2 serum concentrations were significantly different between healthy animals and those with malignant tumors. qPCR indicated that tumor markers N-cadherin, Vimentin, HER-2, CEA, CA15-3 and SF were higher in dogs with malignant tumors than healthy dogs, with a low level of E-cadherin in malignant tumors. This study verified that serological tests and molecular biological tests were essential to the early diagnosis, treatment and prognosis of dogs with tumors.

The value of hsa_circ_0058514 in plasma extracellular vesicles for breast cancer.

The aim of this study was to investigate the diagnostic value of hsa_circ_0058514 in plasma extracellular vesicles (EVs) in BC patients and its predictive value for neoadjuvant chemotherapy. The expression of hsa_circ_0058514 in a large sample of BC plasma and healthy subjects' plasma was detected by qPCR, and the ROC curve was drawn to verify its diagnostic value as a plasma tumor marker. Furthermore, the association between the expression of hsa_circ_0058514 and clinicopathological characteristics before and after treatment was detected in the plasma of 40 pairs of BC patients undergoing neoadjuvant therapy. The expression level of hsa_circ_0058514 in the plasma of BC patients was significantly higher than that of healthy subjects. The ROC curve showed that plasma hsa_circ_0058514 ROC in differentiating non-metastatic BC and healthy people had better diagnostic efficiency than conventional tumor markers CA153, CA125, and CEA. In patients with neoadjuvant therapy, the decrease in plasma hsa_circ_0058514 value before and after treatment correlated with pathological MP grade (r = 0.444, p = 0.004) and imaging tumor regression value (r = 0.43, p = 0.005) positive correlation. The detection of hsa_circ_0058514 in both extracellular vesicles of BC cell culture medium and human plasma was demonstrated. Hsa_circ_0058514 is detected in the plasma from BC cells secreted in the form of vesicles. Hsa_circ_0058514 can be used as an early plasma biological indicator for the diagnosis of BC in clinical applications, with a higher risk of recurrence and metastasis, and as a predictor of the effect of neoadjuvant therapy to guide the clinical use of neoadjuvant therapy.

Clinical Characteristics and 8-year Survival Rate in Advanced Ovarian Cancer Following Neoadjuvant Chemotherapy: A Single Center Experience

Background: More than 75% of epithelial ovarian cancer (EOC) cases are diagnosed in advanced stages, which is associated with tumor recurrence and chemotherapy resistance. So far, to the best of our knowledge, a similar study has not been conducted in Iran to investigate the clinical characteristics and survival rate of these patients treated with neoadjuvant chemotherapy (NACT). Objectives: This study aimed to evaluate the clinical characteristics and survival of patients treated with NACT followed by cytoreductive surgery and the factors affecting survival. Methods: This retrospective cohort study was conducted on 147 advanced ovarian cancer cases who were treated with NACT referring to the Gynecology Oncology Department of Imam Khomeini Hospital in Tehran, Iran, between 2011 and 2021 and met the inclusion criteria for this study. The survival curve and Cox regression method were used to analyze the data. Results: The results revealed that 8.9% of advanced EOC (147/1,650) were treated with NACT and the average number of NACT courses was 4.12 periods. The survival rates of 1, 3, 5, and 8 years were 85.31%, 44.05%, 18.35%, and 13.77%, respectively. The mean and median of survival time were 47.7 and 36 months, respectively. Nearly 80% of the patients had stages 3C and 4A before receiving NACT. Based on the results of the adjusted Cox regression model, tumor marker level showed a significant relationship with survival rate (P=0.008), and also peritoneum involvement had a clinically significant impact on survival with a hazard ratio of 2.88. Conclusion: The results suggested that 8.9% of ovarian cancer cases were treated with NACT. It was also revealed that the average number of NACT courses was 4.12 periods and the 8-year survival rate was 13.77%. CA125 tumor marker level showed a significant relationship with survival rate, and peritoneum involvement had a clinically significant impact on survival.

Evaluation of risk factors and effective factors in determining the prognosis of ovarian cancer

Ovarian cancer is still one of the leading causes of death from reproductive system cancers. Despite recent advances in treating this cancer, ovarian cancer is the fourth cause of death in women. Knowing the risk factors of ovarian cancer and the factors affecting the prognosis of this tumor can be helpful. This study investigates risk factors and practical factors in determining the prognosis of ovarian cancer. In the present study, we searched through various databases such as Wiley Online Library, Google Scholar, PubMed, and Elsevier with the keywords Polycystic Ovarian, Ovarian Estrogen-Dependent Tumors Syndrome Chronic Inflammation, Prognosis of Ovarian Cancer, among published articles from 1996 to 2022. Based on these studies, we investigated the age of menstruation, age of menopause, number of pregnancies, family history of ovarian cancer and genital tract cancer, use of birth control pills, histological type of tumor, degree of cell differentiation, type of surgery, and post-surgery treatments, and examination of the serum level of tumor marker CA12, as well as the role of polycystic ovary syndrome in the development of ovarian cancer. In general, infertility was one of the most important risk factors and the serum level of tumor marker CA125 was one of the most important determinants of ovarian cancer prognosis.

Value of multi-detector computed tomography combined with serum tumor markers in diagnosis, preoperative, and prognostic evaluation of pancreatic cancer

BackgroundMulti-detector computed tomography (MDCT) and serum tumor markers are commonly used in the diagnosis of pancreatic cancer (PC). In this article, we focused on the evaluation of the clinical value of MDCT combined with serum tumor markers CA199, CA242, and CEA in diagnosis, preoperative, and prognostic evaluation of PC.MethodsEighty-five PC patients (PC group) and 39 patients with pancreatitis (control group) admitted to our hospital were selected for our present research study. MDCT, CA199, CA242, and CEA examination were examined in all patients, and their value in diagnosis, preoperative, and prognostic evaluation of PC was retrospectively analyzed.ResultsThere were 69 patients whose clinical staging results of MDCT were consistent with the postoperative pathological diagnosis. The coincidence rate was 70.00% in stage I, 62.96% in stage II, 72.72% in stage III, and 80.00% in stage IV, respectively, and the overall coincidence rate was 69.57%The levels of CA199, CA242, and CEA in PC group were remarkably higher than those in control group and were sharply correlated with clinical stage, differentiation degree, and distant metastasis. The sensitivity, accuracy, and negative predictive value of MDCT combined with serum CA199, CA242 and CEA in the diagnosis of PC were significantly improved compared with those of each single test. In PC group, the 2-year event-free survival rate of the group with high CA199, CA242, and CEA expression was remarkably lower than that of the low expression group.ConclusionMDCT combined with CA199, CA242, and CEA notably improved the diagnostic efficiency of PC and had guiding significance for preoperative and prognostic evaluation of PC.

Diagnostic performance of F-18 FDG PET/CT in recurrent adenocarcinoma gallbladder and its impact on post-recurrence survival.

To analyze diagnostic performance of F-18 FDG PET/CT in recurrent adenocarcinoma gallbladder (GBC) and to establish its possible impact on post-recurrence survival. FDG PET/CT studies of suspected recurrent GBC were retrospectively analyzed alongside tumor markers serum CEA and CA 19-9. Abnormal FDG-avid lesions and abnormal morphological lesions were considered positive for recurrence, and were categorized as isolated abdominal wall recurrence, loco-regional recurrence, and distant metastatic disease. Histopathology, definite progression on imaging and positive response to treatment was considered as reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were used as diagnostic performance parameters. Post-recurrence survival was calculated whenever appropriate follow-up was available, based on the abovementioned categories of sites of recurrence using survival curves and log-rank test. Out of 117 PET/CT studies, 93 (79.5%) were positive and 24 (20.5%) were negative for recurrence. 86 out of 93 were true positive and 23 of 24 were true negative. PET/CT demonstrated sensitivity, specificity, PPV, NPV and accuracy of 98.8%, 76.7%, 92.5%, 95.8% and 93.1%, respectively. Diagnostic performance of PET/CT was significantly better than combination tumor markers. Of 66 cases with available follow-up, isolated abdominal wall (port/scar site) recurrence and loco-regional recurrence demonstrated significantly higher post-recurrence survival as compared to distant metastasis; median survival being 39, 25 and 12 months, respectively. F-18 FDG PET/CT has better diagnostic performance than tumor markers combination. Isolated abdominal wall (port/scar site) recurrence and loco-regional recurrence on PET/CT demonstrated better survival than non-regional metastatic disease. These results suggest a possible role of PET/CT as a surveillance modality, as well as a guide to therapeutic decision-making in cases of recurrent GBC.

Clinical Study of Anti-PD-1 Immunotherapy Combined with Gemcitabine Chemotherapy in Multiline Treatment of Advanced Pancreatic Cancer.

Objective This study aimed to investigate the efficacy and safety of anti-PD-1 immunotherapy combined with gemcitabine chemotherapy in multiline treatment of advanced pancreatic cancer. Methods A retrospective analysis was performed on the clinical data of 32 patients with advanced pancreatic cancer treated with sintilimab regimen from January 2019 to December 2021 in our hospital. All patients were followed up until death or April 2022, in the form of outpatient, in-hospital review, or telephone follow-up. Follow-up content included routine blood, liver and kidney functions, tumor markers, plain or enhanced abdominal CT, and abdominal MRI examinations. Clinical efficacy was evaluated according to mRECIST criteria, and the severity of adverse effects was evaluated according to American Institute for Cancer Research (AICR) Standard Term for Adverse Events, Version 5.0. Results During treatment, the dosage of sintilimab was halved in 2 patients due to adverse reactions. All patients were treated with sintilimab for 1~10 times, with an average of 6 ± 4 times. The total response rate (ORR) and disease control rate (DCR) were 6.25% and 12.50% and 25.00% and 37.50%, respectively, after 1 and 3 months of treatment. The mean follow-up time of 32 patients was 1-12 months, and the median follow-up time was 4 ± 3 months. By the end point of follow-up, a total of 25 patients died, and the median progression-free survival (PFS) was 3.8 (95% CI (1.85-5.63)) months. The median overall survival (OS) was 5.1 months (95% CI (3.63~7.68). After treatment, the levels of tumor markers CA125, CEA and CA199 were partly decreased compared with those before treatment (all P < 0.001). After treatment, the blood routine indexes d-dimer, CRP (C-reactive protein), NLR (neutral granulocyte to lymphocyte ratio), and MLR (monocyte to lymphocyte ratio) decreased compared with those before treatment. In 32 patients with advanced pancreatic cancer, the adverse reactions with an incidence more than 10% included fatigue, rash, hypothyroidism, hyperuricemia, and renal insufficiency. Only 2 patients showed grade 3 fatigue symptom, and all the others showed no adverse reactions of grades 3~5. In this study, all patients' adverse reactions were relieved after symptomatic treatment. Conclusion Gemcitabine chemotherapy in multiline treatment of advanced pancreatic cancer with sintilimab can achieve certain clinical benefits without serious adverse reactions.