The Mutation Portraits of Oncogenes and Tumor Supressor Genes in Predicting the Overall Survival in Pancreatic Cancer: A Bayesian Network Meta-Analysis.

INTRODUCTION: In pancreatic cancer, the carcinogenesis can not be separated from genetics mutations. The portraits of genes alterations majorily including oncogenes (KRAS, HER2, PD-L1) and tumor supressor genes (P53, CDKN2A, SMAD4). Besides being notorious a screening marker, the genetic mutations were related to the prognosis of pancreatic cancer. The aim of this study is to determine the genetic mutations portrait in predicting the overall survival in pancreatic cancer. METHODS: The network meta analysis (NMA) was registered in PROSPERO (CRD42023397976) and conducted in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) in addition of NMA extension guidance. Comprehensive searches were done including all studies which reported the overall survival of pancreatic cancer subjects with KRAS, HER2, PD-L1, P53, CDKN2A, SMAD4. Data were collected and analysis will be done based on Bayesian method, Markov Chain Monte Carlo algorithm, using BUGSnet package in R studio. Transivity was controlled by methods and consistency of the NMA will be fitted by deviance information criterion. Data analysis in NMA were presented in Sucra plot, league table, and forest plot. RESULTS: Twenty-four studies were included in this NMA with 4613 total subjects. The NMA was conducted in random-effects, consistent, and convergence model. Relative to control, the genetic mutation of SMAD4 (HR 1.84; 95%CI 1.39-2.46), HER2 (HR 1.76; 95%CI 1.14-2.71), and KRAS (HR 1.7; 95%CI 1.19-2.48) were significant to have worse survival. The mutations of PD-L1, P53, and CDKN2A also showed poor survival, but not statistically significant compared to control. CONCLUSION: In pancreatic cancer, the mutation of SMAD4 predicted the worst overall survival, compared to control, also mutation of HER2, KRAS, PD-L1, P53, and CDKN2A.

Correlation of interleukin-6 and C-reactive protein levels in plasma with the stage and differentiation of colorectal cancer: A cross-sectional study in East Indonesia.

INTRODUCTION: Tumors most often develop due to inflammatory factors, including inflammatory cells that produce cytokines and cytotoxic mediators that can stimulate malignant transformation. Knowing that interleukin-6 (IL-6) and C-reactive protein (CRP) factor into the development of colorectal cancer (CRC), we aimed to assess IL-6 and CRP's relationship with the stage and differentiation of CRC. METHODS: In a sample of 46 patients with CRC, as confirmed by histopathological examination, plasma levels of IL-6 and CRP were measured from peripheral venous blood samples before surgery and examined using enzyme-linked immunosorbent assay. RESULTS: Most patients were male (63.0%) and at least 50 years old (73.9%). A positive correlation emerged between stage of CRC and both plasma IL-6 (r = 0.396, p = .003) and CRP (r = 0.376, p = .005) levels, which the Kruskal-Wallis test indicated were highest in stage IV (IL-6: median = 25.80, p = .019; CRP: median = 34.10, p = .040). Plasma IL-6 levels (median = 25.80, p = .019) were higher in well-differentiated CRC, whereas plasma CRP levels (median = 34.10, p = .040] were higher in poorly differentiated tissue. Linear plotting revealed a linear relationship between plasma IL-6 and plasma CRP levels in patients with CRC. CONCLUSION: Because the stage of CRC significantly correlates with plasma IL-6 and CRP levels, IL-6 and CRP can serve as diagnostic factors in assessing the progress and prognosis of CRC.

Relationship between BRAF V600E and KRAS mutations in stool for identifying colorectal cancer: A cross-sectional study.

BACKGROUND: With early diagnosis, colorectal cancer (CRC) is a curable disease. As studies in the past 15 years have shown, specific genetic changes occur in the neoplastic transformation of normal colonic epithelium to benign adenoma until becoming adenocarcinoma. Considering that dynamic, we aimed to determine how v-raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E and Kirsten rat sarcoma (KRAS) mutations relate to the location, histopathology, and degree of tumor differentiation in CRC. METHODS: With a cross-sectional design involving an observational analytical approach, we determined the relationship of BRAF V600E and KRAS mutations to the location, histopathology, and degree of tumor differentiation in CRC. RESULT: The sample contained 43 patients with CRC aged 21-80 years, with an average age of 56.0 ± 11.2 years, 46.5% of whom were male and 53.5% female, for a male-to-female ratio of 1.0-1.15. Most tumors were located in the right colon (n = 18, 41.9%), followed by the rectum (n = 14, 32.6%) and left colon (n = 18, 25.6%). Non-mucinous adenocarcinoma was more prevalent than mucinous adenocarcinoma, with 22 (51.2%) and 21 (48.8%) patients, respectively. Nineteen tumors were poorly differentiated (44.2%), 15 were moderately differentiated (34.9%), and nine were well-differentiated (20.9%). BRAF V600E mutations totaled six (14%), whereas non-BRAF V600E mutations totaled 37 (86.0%). BRAF V600E mutations significantly related to tumor location, degree of differentiation, and histopathology (p < .01). CONCLUSION: A significant relationship exists between BRAF V600E mutations in the stool of patients with CRC and location, histopathology, and degree of tumor differentiation.

Association of superoxide dismutase enzyme with staging and grade of differentiation colorectal cancer: A cross-sectional study.

INTRODUCTION: The increase of superoxide dismutase (SOD) level in colorectal cancer (CRC) patients based on the examination of staging and grade of differentiation still evidently represents a clinical problem. SOD level raises at a certain staging and reduce at a certain grade of differentiation. For that reason, this study aimed to assess the association between SOD and the variables analyzed in this study. MATERIALS AND METHODS: This study was observational study using a cross-sectional research design aimed to measure the association between SOD and staging as well as grade of differentiation in CRC incidence. The study was conducted in our institution from January until March 2018. RESULTS: Statistical analyses of the data derived from the laboratory indicated that age and histopathological examination (TNM staging) had statistically significant correlation with SOD1 level. This significant correlation was proven from results of the statistical analyses of each variable at p = 0.039 (age) and p = 0.001 (TNM staging) respectively. Subsequent tests concerning the correlation between age and TNM staging on SOD1 level revealed that the study samples in the category of 30-49 age years old showed statistically significant correlation with SOD1 level with p = 0.009. CONCLUSION: The increase of grade of differentiation was proportional to the increase of SOD1 level as antioxidant against cancer in CRC patients.