Computed-Tomography staging of Breast Cancer and its role in Patient Management in a resource-limited setting: A retrospective study from Fiji

@#Breast cancer is now the leading cause of mortality from cancer in Women in Fiji. State of the art diagnostic measures such as MRI, PET scanning and advanced tumour markers are unavailable in many LMIC countries including Fiji, but CT is becoming more widely available. The aim of the study was to determine the association between CT/anatomical staging and prognosis in a resource-limited setting, and its role in planning appropriate treatment strategies. This was a retrospective, analytical study of the data from the Colonial War Memorial Hospital Oncology department tumour register recorded between 2013 and 2018. The mean age of the breast cancer patients with confirmed diagnosis was 54.93 years with SD of 12.4 years. There was a 40% 3 year mortality rate. CT reports were available for 196 patients. Poor prognosis was very closely associated with Tumour size (p=0.002, OR 0.26 (0.10-0.63)), Nodes (p<0.001, OR 0.25 (0.13-0.48.)) and Metastases (p<0.001, OR 0.13 (0.07- 0.25)).The lungs were the most frequent site of metastases. CT staging enables accurate TNM classification, which is closely associated with prognosis. In the absence of advanced cytopathological and imaging modalities CT staging has an important part to play in planning appropriate treatment.

Xist noncoding RNA could act as a tumor suppressor gene in patients with classical Hodgkin's disease

Background: Xist is a long noncoding RNA involved in the X chromosome inactivation in females. It may act as an onco-suppressor gene in hematologic malignancies, and its activity is strongly dependent from SATB1 gene expression. However, its potential role in Hodgkin's disease (HD) onset and progression is unknown. Materials and Methods: Three gene expression microarray datasets were analyzed for the expression of Xist and SATB1 in patients with classical HD, namely, GDS4222 (130 patients and 54,000 gene features), GSE39134 (29 patients and 54,000 features), and E-MEXP-507 (29 patients and 27,648 probes). The first two were oligonucleotide arrays (platform: Affymetrix gene chip HG-U133-Plus2), whereas the latter was a cDNA two-channel array (platform: OncoChip. v2). Summary and time-dependent receiver operating characteristic (ROC) analysis were applied to obtain a summary measure (summary area under the ROC curve [sAUC]) of association between gene expression and unfavorable patient outcome in each probe set. Results: Xist was overexpressed among females in each data set. A slight overexpression was associated with a good prognosis both in males (sAUC = 0.75, 95% confidence interval [CI]: 0.70–0.80) and at a lesser extent, in females (sAUC = 0.64, 95% CI: 0.59–0.69). However, this finding was limited to the analysis of the biggest database (GDS4222). No association was found between Xist and SATB1 expression. Conclusions: A reactivation of Xist might act as an onco-suppressor gene in male patients with HD, which seems independent from SATB1 expression. The possibility that Xist could contribute to the better survival of female patients should also be investigated

Application of deep learning in cancer prognosis prediction model / 生物医学工程学杂志

In recent years, deep learning has provided a new method for cancer prognosis analysis. The literatures related to the application of deep learning in the prognosis of cancer are summarized and their advantages and disadvantages are analyzed, which can be provided for in-depth research. Based on this, this paper systematically reviewed the latest research progress of deep learning in the construction of cancer prognosis model, and made an analysis on the strengths and weaknesses of relevant methods. Firstly, the construction idea and performance evaluation index of deep learning cancer prognosis model were clarified. Secondly, the basic network structure was introduced, and the data type, data amount, and specific network structures and their merits and demerits were discussed. Then, the mainstream method of establishing deep learning cancer prognosis model was verified and the experimental results were analyzed. Finally, the challenges and future research directions in this field were summarized and expected. Compared with the previous models, the deep learning cancer prognosis model can better improve the prognosis prediction ability of cancer patients. In the future, we should continue to explore the research of deep learning in cancer recurrence rate, cancer treatment program and drug efficacy evaluation, and fully explore the application value and potential of deep learning in cancer prognosis model, so as to establish an efficient and accurate cancer prognosis model and realize the goal of precision medicine.

Expression of KIF20A and its clinical significance in colorectal cancer / 中国肿瘤临床

Objective: To explore the expression of KIF20A (kinesin family member 20A) in colorectal cancer (CRC) tissues and adjacent normal tissues, and to analyze the relationship between KIF20A expression level and clinicopathological factors in CRC patients. Meth-ods: Data from The Cancer Genome Atlas (TCGA) database were used to analyze KIF20A mRNA expression in CRC tissues and adjacent normal tissues. A total of 105 paraffin samples were obtained from CRC patients who had undergone surgery at Huai He Hospital of Henan University, from January 2011 to December 2012. Immunohistochemical staining (IHC) was performed to examine KIF20A pro-tein expression in tumor samples for which complete clinical and pathological data were available. Statistical analyses were applied to analyze the association between KIF20A expression and the clinical data, as well as with survival outcomes. Results: Bioinformatics analysis showed that the mRNA expression level of KIF20A was upregulated in CRC tissues and normal tissues (P<0.001). IHC revealed significantly higher expression of KIF20A in CRC tissues from 67 patients (64%) and lower or undetectable expression in 38 patients (36%). The difference was statistically significant (P<0.05). Overexpression of KIF20A in CRC tissues was significantly associated with depth of invasion, lymphatic node metastasis, distant metastasis, and TNM stage (all P<0.05). Kaplan-Meier survival analysis showed that patients with high levels of KIF20A expression had poor prognosis compared to patients with low levels of KIF20A expression. Cox proportional hazard regression analysis revealed that KIF20A was an independent prognostic factor in patients with CRC. Conclusions:KIF20A is upregulated in CRC tissues and could serve as a novel prognostic biomarker for CRC patients.

Prognostic impact of micro-rna expression in breast cancer: systematic review / Impacto prognóstico da expressão de micrornas no câncer de mama: revisão sistemática

Breast cancer is an important health problem worldwide and the identification of new prognostic markers is important in establishing the best treatment for each patient. MicroRNAs (miRNAs) are non-coding RNAs that regulate gene expression and that can be useful biomarkers for prognosis in breast cancer. The objective of this systematic review was to investigate tumor miRNA expression potentially associated with the prognostic factors of breast carcinomas. The search was done in the PubMed database; 1457 articles were initially found and 20 studies were included in the review. MiRNA-21 and miRNA-200b were the most commonly investigated in breast cancer prognosis. Lymph node metastasis was associated with the hyperexpression of miRNA-211, miRNA-301a and miRNA-370 and also associated with the hypoexpression of miRNA-124, miRNA-127, miRNA-129-5p, miRNA199-5p, miRNA-206, miRNA-218 and miRNA-339-5p. Distant metastasis was associated with miRNA-204 hypoexpression. Tumor size was associated with hyperexpression of miRNA-21 and miRNA-301a and also to the hypoexpression of miRNA-29b and miRNA129-5p. Lower survival rates were associated with the hyperexpression of miRNA-21, miRNA-301a and microRNA-711, and hypoexpression of miRNA-15a, miRNA-29b, miRNA-124, miRNA-129-5p, miRNA 199b -5p, miRNA-200b, miRNA-204, miRNA-206 and miRNA-218. On the other hand, higher survival rates were associated with the hyperexpression of miRNA-339-5p and miRNA-127 and also to the hypoexpression of miRNA-210. The results of this review emphasize the need to validate these findings in additional studies

O câncer de mama é um importante problema de saúde em todo o mundo e a identificação de novos marcadores prognósticos é necessária para estabelecer o melhor tratamento para cada paciente. MicroRNAs (miRNAs) são RNAs não codificadores reguladores da expressão gênica que têm sido evidenciados como biomarcadores úteis no prognóstico do câncer de mama. O objetivo desta revisão sistemática foi verificar o papel da expressão de miRNAs tumorais associados aos fatores prognósticos dos carcinomas de mama. A busca de estudos foi feita no banco de dados PubMed; 1.457 artigos foram inicialmente encontrados e 20 estudos foram incluídos na revisão. MiRNA-21 e miRNA-200b foram os mais comumente investigados em relação aoprognóstico do câncer de mama. A presença de metástase linfonodal foi significativamente associada à hiperexpressão de miRNA-211, miRNA-301a e miRNA-370 e também associada à hipoexpressão de miRNA-124, miRNA-127, miRNA-129-5p, miRNA199-5p, miRNA-206, miRNA-218 e miRNA- 339-5p. Metástase a distância foi associada à hipoexpressão de miRNA-204. O tamanho do tumor foi associado à hiperexpressão de miRNA-21 e miRNA-301a e também à hipoexpressão de miRNA-29b e miRNA129-5p. Em relação à sobrevida global, menores taxas de sobrevida foram associadas à hiperexpressão de miRNA-21, miRNA-301a e microRNA-711 e à hipoexpressão de miRNA- 15a, miRNA-29b, miRNA-124, miRNA-129-5p, miRNA 199b-5p, miRNA-200b, miRNA-204, miRNA-206 e miRNA-218. Por outro lado, maiores taxas de sobrevida foram associadas à hiperexpressão de miRNA-339-5p e miRNA-127 e também à hipoexpressão de miRNA-210. Os resultados desta revisão enfatizam a necessidade de validar esses achados em estudos adicionais

The role of vitamin D in cancer prevention / 中国天然药物

Vitamin D, also known as cholecalciferol, is the precursor to the active steroid hormone 1, 25-dihydroxyvitamin D3 (calcitriol; 1, 25(OH)2D3). The main physiological role for 1, 25(OH)2D3 is to regulate calcium and inorganic phosphate homeostasis for bone health. More recently, vitamin D has been investigated for its effects in the prevention and treatment of a variety of diseases such as cancer, autoimmune disorders, and cardiovascular disease. Preclinical data strongly support a role for vitamin D in the prevention of cancer through its anti-proliferative, pro-apoptotic, and anti-angiogenic effects on cells. Epidemiologic and clinical studies have shown mixed data on the correlation between serum vitamin D levels and cancer risk. This report seeks to outline results from the most recent preclinical and clinical studies investigating the potential role of vitamin D in cancer prevention.

Genetic, Environmental and Clinical Factors Related to Treatment Failure of Cervical Precancerous Lesions in a Cohort of Brazilian Women.

Aims: To ascertain the risk of pre-cancerous treatment failure considering selected genetic, environmental, and clinical characteristics among Brazilian women. Study Design: A prospective study developed in a cohort of women treated for Cervical Intraepithelial Neoplasia (CIN) lesion. Place and Duration of Study: Gynecology Oncology day clinic of Brazilian National Cancer Institute, between October 2004 and May 2006. Methodology: We included 285 women (age range 18-75 years) with CIN submitted to lesion excision. All patients were interviewed at admission to identify epidemiological and clinical characteristics, having blood samples collected, and a colposcopic examination performed. TP53 polymorphism was ascertained using PCR-RFLP. After treatment, the study population was followed up with Pap-tests during two years. Treatment failure was evaluated using histological confirmation of any altered tissue. Kaplan-Meyer curves and Cox Proportional Risk Model were used for data analysis. Results: Frequencies of TP53 polymorphisms were: Arg72Pro genotype(Arg/Pro)- 177(62.1%); Arg72 genotype(Arg/Arg)-55(19.3%); Pro genotype (Pro/Pro)-53(18.6%). Women with endocervical margins involvement showed an HR 7.01(1.73-28.44). Current smoking was statistically related to CIN treatment failure (HR:3.90,95%CI:1.28-11.91). Comparatively to Arg/Arg, the risks for treatment failure were: HR 1.51(95%CI:0.23-9.80) for Arg/Pro women; and HR:1.41 (95%CI:0.31-6.52) for Pro/Pro. Conclusion: Surgical margins involvement and current tobacco smoking presented independent risks for CIN treatment failure among the studied population. Pro/Pro genotype seems to be associated with CIN treatment failure.

Education, tobacco smoking, alcohol consumption, and IL-2 and IL-6 gene polymorphisms in the survival of head and neck cancer

The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95 percent confidence intervals (95 percentCI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6 percent). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95 percentCI = 0.15-1.81) and T/T (HR = 0.22; 95 percentCI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95 percentCI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95 percentCI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95 percentCI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95 percentCI = 0.26-1.78) and larynx cancer (HR = 0.93; 95 percentCI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.

An approach for assessment of tumour volume from mammography in locally advanced breast cancer

Tumor size is an important independent indicator in patients with carcinoma of the breast. Repeated size measurements during primary systemic therapy produce detailed information about response that could be used to select the most effective treatment regimen and to estimate the patient’s prognosis. Measurement of tumor burden with ultrasonography and computed tomography is being used with increasing frequency to assess the effectiveness of cytotoxic anticancer drugs. Standardization of assessment and results reporting are important steps that aim at increasing the amount of usable therapeutic information at the physician’s disposal. The purpose of our study is to calculate the tumor volume by mammography after demagnification and compare the tumor volume measured from this method with ultrasonography volumes.

Expression of Poly ADP-Ribose Polymerase-1 in Human Breast Cancer Tissue and Its Relationship with Prognosis Related Factors / 中国康复理论与实践

@#Objective To investigate the expression of poly ADP-ribose polymerase-1(PARP-1) in human breast cancer tissue and its relationship with patient's prognosis related factors.Methods The expression of PARP-1 in breast cancer tissues and their adjacent non-cancerous tissues from resection in 66 operated cases were detected using RT-PCR and immunofluorecence staining(IFS).The relationship between the expression of PARP-1 and the prognosis related factors was analyzed.Results Compared with that of the adjacent non-cancerous tissues,the expression of PARP-1 mRNA increased in 94.9%(62/66) patients,while the expression of PARP-1 protein increased in 90.9%(60/66) ones.The label index(LI) and the expression index(EI) of PARP-1 gene increased especially in the cases in later clinical stage,with poor tumor differentiation grade,of pure breast carcinomas or infiltrative breast carcinomas and of metastasis.Conclusion The expression of PARP-1 in human breast cancer tissue on the level of transcription and translation increases,which may be positively related with the patient's prognosis.

Correlation Between Expression of Vascular Endothelial Growth Factor of Serum and Tumor Tissues and Clinical Prognosis in Patients with Breast Cancer / 中国普外基础与临床杂志

Objective To investigate the correlation between expression of vascular endothelial growth factor(VEGF) of serum and tumor tissues and the clinical prognosis in patients with breast cancer. Methods The expressions of VEGF level of serum and tumor tissues in 44 patients with invasive duct breast cancer, 13 with benign breast diseases and 40 healthy controls. Serum VEGF level was measured by ELISA method. The protein expression of tissue VEGF, ER and C-erbB-2 were evaluated by immunohistochemistry LSAB method. Results Serum VEGF level and tissue VEGF expression in breast cancer were higher than those in benign breast diseases (P0.05). VEGF expression was correlated with lymph node metastasis (P 0.05). Conclusion There is positively correlation between serum VEGF level and tissue VEGF expression, and between VEGF expression and clinic prognosis. Serum VEGF level may be one of important index of prognosis estimation in patients with breast cancer.