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Objective: This single institutional study compared neoadjuvant concurrent chemo-radiotherapy (NACCRT) and neoadjuvant chemotherapy (NACT) followed by surgery in locally advanced middle and lower-1/3 carcinoma esophagus patients in terms of toxicity, clinical response, operative complications, disease downstaging, resection rates, pathological response, recurrence, and survival. Materials and Methods: This randomized prospective comparative study comprised 40 consecutive patients divided equally between two study arms NACCRT (n = 20; 41.4 Gy radiation dose; carboplatin area under the curve (AUC) 2/paclitaxel 50 mg/m2; 5 cycles) and NACT (n = 20; carboplatin AUC 5/paclitaxel 175 mg/m2; 2 cycles) from March 2014 to December 2016. Follow-up was done for 4 years. Chi-square test, Fischer's-exact test were used for comparative analysis and Kaplan-Meier analysis for survival. Results: Statistically significant esophagitis in NACCRT and peripheral-neuropathy in NACT was observed (P < 0.001). NACCRT recorded more postoperative complications, higher complete resection (R0) rates, and pathologically complete response (pCR). Tumor downstaging was significant in both study groups (n < 0.001). Four-year median disease-free survival (DFS) and overall survival (OS) were 28.50 months and 38 months in NACCRT versus 28 months and 35.5 months in NACT, respectively. In both NACCRT and NACT, pCR cases showed improved median DFS and OS compared to pathological partial response (pPR) (n < 0.001). Conclusion: This study demonstrated significant activity and tolerable toxicity of taxane-based therapy in NACCRT and NACT. Both groups recorded no survival benefit over each other, although pCR cases resulted in statistically significant survival advantage compared to clinical partial response. NACCRT resulted in lesser toxicity, numerically higher R0-resection, pCRs, median DFS, and OS compared to NACT. [ABSTRACT FROM AUTHOR]

Objective: Cancer is a major health problem worldwide including Asian--Pacific region. The region hosts over 4.5 billion people, over 60% of the world population and very divergent socioeconomically. The major cancers in the region in male include lung, stomach, liver, colorectal and esophagus and in female breast, lung, cervix, colorectal, and stomach. Over 60% of cancer patients need radiotherapy alone or in combination with surgery and/or chemotherapy, and therefore, radiotherapy is the main and essential modality of cancer treatment. Radiation oncology medical physicists play a pivotal role in efficient implementation of radiotherapy. This study was aimed to assess the status of cancer treatment by radiotherapy and the requirement of radiation oncology medical physicists in the region. Materials and Methods: To access the status and requirement of radiotherapy machines, availability of radiation oncology physicists in the region of Asia Oceania Federation of Organizations for Medical Physics (AFOMP), we have carried out a survey by sending questioners to AFOMP National Medical Physics Organizations (NMO). We received response from 21 countries, 100% response, regarding availability of teletherapy units, number of medical physicists working in radiotherapy and related information. Using GLOBOCAN cancer incidence data and considering 62.5% of cancer patients need radiotherapy treatment and up to 500 cancer patients can be treated in a year on one teletherapy machine, the gap between the available and required teletherapy machine to treat all the cancer patients requiring radiotherapy is estimated. Further, we estimated the gap between radiotherapy medical physicists available and required as per International Atomic Energy Agency and European Society for Therapeutic Radiology and Oncology guidelines. Results: It was observed that availability of teletherapy machines in AFOMP region is 0.21--14.0 teletherapy machine/million population and radiotherapy medical physicist are 0.82--2.43/teletherapy unit. [ABSTRACT FROM AUTHOR]

Objective: The study is a retrospective comparison of the usefulness of salvage surgery between a group of previously radiotherapy-treated patients (RTPs) and a group of patients who previously underwent partial surgery with both local and ± nodal recurrence. Study Design: Retrospective study. Setting: Multi-center academic hospital. Materials and Methods: The former group was comprised 30 previously RTPs, whereas the latter group consisted of 20 patients after partial laryngeal surgery with optional subsequent adjuvant radiotherapy (PSPs). Treatment efficacy was compared in both groups in relation to overall survival (OS) and the locoregional control rate (LCR). Local and ± nodal recurrence was considered primary treatment failure. All patients underwent total laryngectomy. Results: The updated 5-year OS in the PSPs was 31%, while the percentage of the updated 5-year LCR was 42%. In the RTPs the updated 5-year OS was 21%, and the percentage of 5-year LCR was 38%. No statistically significant differences were found in terms of the comparison of OS or the comparison of LCR results in both groups ( P = 0.427, P = 0.704, respectively). Conclusions: Based on the analysis, it was found that irrespective of the initial treatment, salvage surgery was associated with decreased survival and cure rates (by 50%) compared to the group of patients with advanced laryngeal cancer who underwent primary total laryngectomy. [ABSTRACT FROM AUTHOR]

Aim: In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib. Materials and Methods: Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR's) and prognostic nutritional index (PNI's) optimum cut-off value. The relationship between OS with PNI and NLR was investigated. Results: Fifty-two patient's data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19--0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29--1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17--0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18--0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21--0.80 P = 0.01) were the only independent factors for longer OS. Conclusion: Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib. [ABSTRACT FROM AUTHOR]

Objective: Bevacizumab (BEV) is a humanized monoclonal antibody of vascular endothelial growth factor receptors and, as a result of clinical trials, was approved for the treatment of recurrent ovarian cancer (ROC). The aim of this study was to assess the clinical utility of BEV in patients with ROC in real-world practice beyond clinical trials. Materials and Methods: In this single-center retrospective cohort study, we evaluated the medical data of all patients with ROC who were treated with BEV between October 2013 and March 2020. Results: A total of 76 females were evaluated. Forty-nine (64.5%) patients were platinum sensitive and 27 (35.5%) patients were platinum resistant. BEV was used in combination with chemotherapy agents in all patients, and the most preferred combinations were gemcitabine/carboplatin (GC) (78.9%) and carboplatin/paclitaxel (14.5%). In all patients, the BEV dose was 7.5 mg/kg every 3 weeks. The median progression-free survival (PFS) was 11.1 months (95% confidence interval [CI]: 9.6--12.6), and the median overall survival (OS) was 22.3 months (95% CI: 17.5--27.2). In multivariate analysis, serous histological type (P = 0.01), maintenance BEV administration (P = 0.001), and combination of GC-BEV (P < 0.001) were associated with better PFS, while serous histological type (P = 0.016) and good performance status (P = 0.006) were associated with prolonged OS. Conclusions: Low-dose (7.5 mg/kg) BEV was found to be effective in the second-line treatment of patients with ROC in our real-life study. In addition, the combination of BEV with GC was shown to be a viable option, especially in the treatment selection of platinum-resistant patients. [ABSTRACT FROM AUTHOR]

Aim: We propose a novel metric called ψ -- score to rank the Intensity Modulated Proton Therapy (IMPT) beams in the order of their optimality and robustness. The beams ranked based on this metric were accordingly chosen for IMPT optimization. The objective of this work is to study the effectiveness of the proposed method in various clinical cases. Methods and Materials: We have used Pinnacle TPS (Philips Medical System V 16.2) for performing the optimization. To validate our approach, we have applied it in four clinical cases: Lung, Pancreas, Prostate+Node and Prostate. Basically, for all clinical cases, four set of plans were created using Multi field optimization (MFO) and Robust Optimization (RO) with same clinical objectives, namely (1) Conventional angle plan without Robust Optimization (CA Plan), (2) Suitable angle Plan without Robust Optimization (SA Plan), (3) Conventional angle plan with Robust Optimization (CA-RO Plan), (4) Suitable angle Plan with Robust Optimization (SA-RO Plan). Initial plan was generated with 20 equiangular beams starting from the gantry angle of 0°. In the corresponding SA Plan and SA-RO Plan, the beam angles were obtained using the guidance provided by ψ -- score. Results: All CA plans were compared against the SA plans in terms of Dose distribution, Dose volume histogram (DVH) and percentage of dose difference. The results obtained from the clinical cases indicate that the plan quality is considerably improved without significantly compromising the robustness when the beam angles are optimized using the proposed method. It takes approximately 10--15 min to find the suitable beam angles without Robust Optimization (RO), while it takes approximately 20-30 min to find the suitable beam angles with RO. However, the inclusion of RO in BAO did not result in a change in the final beam angles for anatomies other than lung. Conclusion: The results obtained in different anatomic sites demonstrate the usefulness of our approach in improving the plan quality by determining optimal beam angles in IMPT. [ABSTRACT FROM AUTHOR]

Introduction: This study was done to quantify the translational setup errors with cone-beam computed tomography (CBCT) in the image-guided radiation therapy (IGRT) treatment of head-and-neck cancer (HNC) patients. Aims: The objective was to quantify the setup errors by CBCT. Methodology: One hundred patients of HNC were enrolled from March 2020 to March 2021 for IGRT treatment. Pretreatment kV-CBCT images were obtained at the first 3 days of irradiations, and setup error corrections were done in the mediolateral (ML), superior-inferior (SI), and anterior-posterior (AP) directions. Subsequently, a weekly kV-CBCT was repeated for whole duration of radiotherapy for the next 6-7 weeks. Adequacy of planning target volume (PTV) margins was assessed by van Herk's formula. Results: Total 630 CBCT scans of 100 patients were analyzed. Setup errors greater than 3 mm and 5 mm were seen in 11.4% and 0.31% of the patients, respectively. Systematic errors and random errors before correction in ML, SI, and AP directions were 0.10 cm, 0.11 cm, and 0.12 cm and 0.24 cm, 0.20 cm, and 0.21 cm, respectively. Systematic errors and random errors after correction in ML, SI, and AP directions were 0.06 cm, 0.07 cm, and 0.07 cm and 0.13 cm, 0.10 cm, and 0.12 cm, respectively. Conclusion: CBCT at the first 3 fractions and then weekly during radiotherapy is effective to detect the setup errors. An isotropic PTV margin of 5 mm over clinical target volume is safe to account for setup errors, however, in the case of close organ at risk, or with IGRT, a PTV margin of 3 mm can be considered. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer (PC) is one of the most common cancer types in men. In addition to androgen‑deprivation therapy(ADT), new generation agents have provided survival advantages to patients with metastatic hormone‑sensitive PC (mHSPC). In this analysis, we aimed to determine the most effective approach for treating and suppressing mHSPC using network meta‑analysis (NMA). Materials and Methods: A total of 10 trials investigating different treatment modalities were conducted using NMA. The analysis was performed for all mHSPC cases as well as for low‑ and high‑volume and docetaxel‑naive subgroups. Results: In combination with ADT, abiraterone acetate (AA) in the general‑population and high‑volume‑disease subgroups, and enzalutamide in docetaxel‑naive and low‑volume‑disease subgroups have the highest probability of being the best treatment modalities in terms of overall survival. In addition, in the low‑volume and docetaxel‑naive settings, enzalutamide was superior to ADT (hazard ratio [HR] = 0.429, 95% CrI: 0.258–0.714 and HR = 0.533, 95% CrI: 0.375–0.756, respectively). In addition, in the high‑volume and general‑population settings (all trials and cases), AA was superior to ADT (HR = 1.568, 95% CrI: 1.378–1.773 and HR = 1.164, 95%CrI: 1.348–1.924, respectively). Conclusion: The volume status based on the CHAARTED trial should be taken into account to determine an appropriate treatment strategy for mHSPC. AA plus prednisone in high‑risk and high‑volume‑mHSPC patients and enzalutamide in low‑volume‑mHSPC patients could be favorable options in combination with ADT. Depending on the patient’s tolerance, in high‑volume mHSPC, docetaxel, or apalutamide in combination with ADT could be alternatives for AA, whereas in the low‑volume mHSPC, local radiotherapy plus ADT or ADT alone could be utilized in place of enzalutamide. [ABSTRACT FROM AUTHOR]

Background: Rectal cancer is one of the most common malignant pathologies worldwide. Currently, the standard treatment of this pathology consists of radio‑chemotherapy followed by low anterior resection with total mesorectal excision or abdominoperineal proctectomy for medium/low rectal cancer. Objectives: In recent years, another treatment strategy has been proposed, stemming from the finding that up to 40% of patients receiving neoadjuvant treatment had a complete pathological response. This method, also referred to as the watch and wait approach, implies delaying surgery and following a rigorous protocol for patients who have developed a complete response to neoadjuvant treatment with a good oncologic outcome. The objective of this study was to highlight the merits of this approach in selected patients. Case Reports: In this study, we present two patients with low‑rectal tumors who developed complete response post neoadjuvant therapy and for whom the watch and wait protocol has been applied over the past 4 years. Conclusion: Although the watch and wait protocol appears to be a feasible option in the management of patients with a complete clinical and pathological response post neoadjuvant therapy, more prospective studies and randomized trials comparing this approach with standard surgical treatment are required before establishing it as the standard of care for distal rectal cancer. Therefore, establishing universal criteria for the selection and assessment of the patients with a complete clinical response following neoadjuvant treatment is required. [ABSTRACT FROM AUTHOR]

Introduction: After surgery, radiotherapy is the most common technique to treat breast cancer. Over the past decades, the thermal effects of radiofrequency‑wave hyperthermia combined with radiotherapy have been used to increase radiosensitivity in cancer treatment. The cells have various radiation and thermal sensitivities at different stages of the mitotic cycle. Furthermore, ionizing radiation and the thermal effect of hyperthermia affect the cells’ mitotic cycle and can partly induce cell cycle arrest. However, the time interval between hyperthermia and radiotherapy, as an essential factor influencing hyperthermia effect on cancer cells’ cycle arrest, has not been studied before. In this study, we investigated the effect of hyperthermia on the MCF7 cancer cell cycle arrest in mitotic cycles at various selected time intervals after hyperthermia to find and propose appropriate time intervals between hyperthermia and radiotherapy. Method and Materials: In this experimental study, we used the MCF7 breast cancer cell line to investigate the effect of 13.56 MHz hyperthermia (at a temperature of 43°C for a period of 20 min) on their cell cycle arrest. We performed the flowcytometry assay to assess the changes in the mitotic phases of the cell population at different time intervals (1, 6, 24, and 48 h) after hyperthermia. Results: Our flowcytometry results indicated the 24‑h time interval has the most significant effect on the cell population at S and G2/M phases. Therefore, the 24‑h time interval can be proposed as the most appropriate time after hyperthermia for carrying out combinational radiotherapy procedure. Conclusion: Among various investigated time intervals examined in our research, the 24‑h time interval can be proposed as the most appropriate time between hyperthermia and radiotherapy for combinational therapy of breast cancer cells. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is one of the most common cancers worldwide. In recent years, numerous non‑chemotherapy agents have been developed for BC treatment, including targeted agents, new hormonal therapies, and immunotherapies. However, despite the widespread use of these agents, chemotherapies are still an important cornerstone in BC treatment. Similarly, serious de‑escalation studies in radiotherapy use have been conducted in recent years. These two treatment modalities, which we frequently use in the treatment of BC due to their effectiveness, may also have serious side effects. Case Presentation: In this article, I will present a case of multiple myeloma (MM) and myxofibrosarcoma (MFS) that occurred many years later in a patient who completed adjuvant chemotherapy and radiotherapy for BC. MM has developed due to previous chemotherapy and MFS has developed due to previous radiotherapy. Conclusion: We usually treat our cancer patients with chemotherapy or radiotherapy to prolong their lives. In addition to the benefits we provide, may negatively affect the lifetime and quality of life by causing the development of metachronous secondary cancers in some patients. In this case report, I will present the “ironic” side of oncology science and treatment. [ABSTRACT FROM AUTHOR]

Background: Microwave ablation (MWA) of lung tumors is a technique that is dependent on the ablationist’s level of expertise. The selection of the optimum puncture path and determination of appropriate ablative parameters is the key to the success and safe of the procedure. The objective of this study was to describe the clinical use of a novel three‑dimensional visualization ablation planning system (3D‑VAPS) for aided MWA of stage I non‑small cell lung cancer (NSCLC). Methods: This was a single‑arm, single‑center, retrospective study. From May 2020 to July 2022, 113 consented patients with stage I NSCLC received MWA treatment in 120 MWA sessions. The 3D‑VAPS was used to determine that: (1) the overlap between the gross tumor region and simulated ablation; (2) the proper posture and appropriate puncture site on the surface of the body; (3) the puncture path; and (4) presetting preliminarily ablative parameters. Patients were monitored with contrast‑enhanced CT scans at 1, 3, and 6 months, as well as every 6 months following that. The primary endpoints were technical success and a complete ablation rate. Local progression‑free survival (LPFS), overall survival (OS), and comorbidities were secondary study objectives. Results: The mean diameter of tumors was 1.9 ± 0.4 cm (range 0.9‑2.5 cm). The mean duration was 5.34 ± 1.28 min (range 3.0–10.0 min). The mean power output was 42.58 ± 4.23 (range 30.0-50.0W). The median follow‑up time was 19.0 months (6.0‑26.0 months). The technical success rate was 100%. Three‑month after the procedure, the complete ablation rate was 97.35%. 6, 9, 12, and 24 months LPFS rates were 100%, 98.23%, 98.23%, and 96.46%, respectively. One‑year and 2‑year OS rates were 100% and 100%. There were no patients who died both during the procedure and after the MWA of 30 days. The complications after MWA included pneumothorax (38.33%), pleural effusion (26.67%), intrapulmonary hemorrhage (31.67%), and pulmonary infection (2.50%). Conclusions: This research describes and confirms that 3D‑VAPS is a feasibility and safe method for MWA of stage I NSCLC treatment. 3D‑VAPS may be helpful to optimize the puncture path, assess reasonable ablative parameters, and minimize complications. [ABSTRACT FROM AUTHOR]

Objectives: This meta‑analysis aimed at determining the association between preoperative denosumab and the risk of local recurrence in patients with giant cell tumors of the bone. Methods and Materials: Web of Science, EMBASE, Cochrane Library, and PubMed were comprehensively searched on April 20th, 2022. Data from the included articles were analyzed using meta‑analysis. The bias of all included studies was evaluated according to ROBINS‑I. Also, subgroup and sensitivity analyses were performed. Results: Eight studies with 1270 cases (195 in the denosumab group and 1075 in the control group) were eventually included. Patients receiving denosumab before curettage had a higher risk of local recurrence than those who underwent curettage alone (odds ratio: 2.29, 95% confidence intervals: 1.44–3.64, P = 0.0005). The denosumab group showed a significantly higher risk of local recurrence in most subgroup analyses, except for those with preoperative denosumab duration ≤six months/doses (P = 0.66) and sample size ranging from 100 to 180 (P = 0.69). Conclusion: Denosumab before curettage may increase the risk of local recurrence in patients with giant cell tumor of the bone. Preoperative denosumab should be used with caution after weighing an increased risk of local recurrence against the clinical benefits and a duration time of less than six months before surgery is recommended. [ABSTRACT FROM AUTHOR]

A biomarker is a measurable indicator used to distinguish precisely/objectively either normal biological state/pathological condition/response to a specific therapeutic intervention. The use of novel molecular biomarkers within evidence-based medicine may improve the diagnosis/treatment of disease, improve health outcomes, and reduce the disease's socio-economic impact. Presently cancer biomarkers are the backbone of therapy, with greater efficacy and better survival rates. Cancer biomarkers are extensively used to treat cancer and monitor the disease's progress, drug response, relapses, and drug resistance. The highest percent of all biomarkers explored are in the domain of cancer. Extensive research using various methods/tissues is carried out for identifying biomarkers for early detection, which has been mostly unsuccessful. The quantitative/qualitative detection of various biomarkers in different tissues should ideally be done in accordance with qualification rules laid down by the Early Detection Research Network (EDRN), Program for the Assessment of Clinical Cancer Tests (PACCT), and National Academy of Clinical Biochemistry. Many biomarkers are presently under investigation, but lacunae lie in the biomarker's sensitivity and specificity. An ideal biomarker should be quantifiable, reliable, of considerable high/low expression, correlate with the outcome progression, cost-effective, and consistent across gender and ethnic groups. Further, we also highlight that these biomarkers' application remains questionable in childhood malignancies due to the lack of reference values in the pediatric population. The development of a cancer biomarker stands very challenging due to its complexity and sensitivity/resistance to the therapy. In past decades, the cross-talks between molecular pathways have been targeted to study the nature of cancer. To generate sensitive and specific biomarkers representing the pathogenesis of specific cancer, predicting the treatment responses and outcomes would necessitate inclusion of multiple biomarkers. [ABSTRACT FROM AUTHOR]

Background: Although chemotherapy is considered to be the golden standard, it does not come without a price. Toxicities and resistance are frequently limiting its effectiveness. Immunotherapy has emerged as a safer therapeutic alternative but still has a long way until it has proven to be of equal efficacy. A type of immunotherapy is dendritic cell (DC) vaccination. Aims and Objectives: We have developed a novel platform for the generation of autologous DCs that have been activated against peptides that are personalized for each patient individually. The aim of the study was to clinically evaluate this platform. Materials and Methods: Our platform and our algorithm for the determination of the immunogenic peptides has been tested. DC generation was verified both morphologically and by CD80/86 expression. Peptide antigenicity was determined using a number of T-cell epitope prediction algorithms. Response to therapy was evaluated using response evaluation criteria in solid tumors (RECIST) criteria by the doctors involved. Immune status was also evaluated before and after DC vaccination and correlated with circulated tumor cell count. Results: It was found that DC vaccine increased immune activation while correlated with decreased circulating tumor cell counts. Clinical evaluation by the determination of immune markers may be a superior tool than using RECIST criteria. Conclusion: Dendritic cell therapies could prove to be a valuable tool in cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most common cancer and the fifth cause of death in women worldwide. Exploring unique genes for cancers has been interesting. Patients and Methods: This study aimed to explore unique genes of five molecular subtypes of BC in women using penalized logistic regression models. For this purpose, microarray data of five independent GEO data sets were combined. This combination includes genetic information of 324 women with BC and 12 healthy women. Least absolute shrinkage and selection operator (LASSO) logistic regression and adaptive LASSO logistic regression were used to extract unique genes. The biological process of extracted genes was evaluated in an open-source GOnet web application. R software version 3.6.0 with the glmnet package was used for fitting the models. Results: Totally, 119 genes were extracted among 15 pairwise comparisons. Seventeen genes (14%) showed overlap between comparative groups. According to GO enrichment analysis, the biological process of extracted genes was enriched in negative and positive regulation biological processes, and molecular function tracking revealed that most genes are involved in kinase and transferring activities. On the other hand, we identified unique genes for each comparative group and the subsequent pathways for them. However, a significant pathway was not identified for genes in normal-like versus ERBB2 and luminal A, basal versus control, and lumina B versus luminal A groups. Conclusion: Most genes selected by LASSO logistic regression and adaptive LASSO logistic regression identified unique genes and related pathways for comparative subgroups of BC, which would be useful to comprehend the molecular differences between subgroups that would be considered for further research and therapeutic approaches in the future. [ABSTRACT FROM AUTHOR]

Small-cell lung cancer (SCLC) has a poor prognosis. For the last 30 years, first-line systemic treatment has remained unaltered. After the integration of ımmunotherapy, a new first-line gold standard, atezolizumab in combination with carboplatin plus etoposide, was approved in extensive-disease SCLC (ED-SCLC) in 2019. First-line randomized controlled studies that investigated anti-programmed cell death protein 1 (PD-1)/PD-1 ligand-1 (PD-L1) and anti-T-lymphocyte-associated protein 4 (CTLA-4) agents in combination with platinum plus etoposide (EP) were scoured. A total of six studies (two - anti-CTLA-4 and four - anti-PD1/PD-L1) were included and classic and network meta-analyses (NMAs) were performed. Fixed model for overall survival (OAS) in the PD-1- or PD-L1-treated subgroup yielded a hazard ratio (HR) of 0.746 with a 95% confidence interval (CI) =0.662-0.840 and in the CTLA-4-treated subgroup a HR of 0.941 with a 95% CI = 0.816-1.084 for the immune therapy + chemotherapy versus chemotherapy comparison (CTLA-4-based versus PD-1- or PD-L1-based groups' comparison of OAS effect Q = 6.05, df = 1, P = 0.014). NMA showed that all chemotherapy + immunotherapy combinations were equally potent and more efficient than PE in terms of OAS and progression-free survival (PFS). Rank probability plots demonstrated nivolumab + EP as the most probable effective treatment modality in terms of OAS and PFS. The usage of anti-PD1/PD-L1 immunotherapy agents results in significant OAS advantage, and anti-PD1/PD-L1 agents are superior to anti-CTLA-4 approach in combination with platinum plus etoposide regimen in ED-SCLC. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of cutaneous melanoma among the elderly has increased significantly. Unfavorable survival rates are associated with insufficient patient managements and poor prognostic features in the elderly. We aimed to compare elderly (=75 years) and younger (<75 years) patients with cutaneous melanoma to determine the differences and the prognostic significance of age. Materials and Methods: The retrospective data of 117 elderly and 232 younger patients with cutaneous melanoma were compared. Results: The median age of the elderly patients was 78 years (75-104), and 51.3% of the patients were female. Of the patients, 14.5% were in the metastatic stages. Clinicopathologic factors such as extremity melanomas (P = 0.01), Clark levels IV-V (P = 0.04), ulceration (P = 0.009), and neurotropism (P = 0.03) were significantly more common in elderly patients. However, BRAF mutation was significantly more common in younger patients (P = 0.003). Overall survival (OS) and recurrence-free survival (RFS) rates of both the groups were similar. Lymph node involvement (P < 0.005), distant metastasis (P < 0.005), and relapse of disease (P = 0.02) were associated with poor OS in elderly patients. Tumor-infiltrating lymphocytes was associated with prolonged RFS (P = 0.05), while extremity melanomas (P = 0.01), lymphovascular invasion (P = 0.006), and lymph node involvement (P < 0.005) had negative impact on RFS. Conclusions: Although elderly patients with cutaneous melanoma had different clinicopathologic features in our series, their survival rates are similar to those of younger patients, which shows that age alone is inadequate to determine the prognosis. Disease stage and a comprehensive geriatric assessment might assist to determine appropriate management. [ABSTRACT FROM AUTHOR]

Introduction: Medicinal plants are the major natural resources for the treatment of human ailments including cancer therapy. The current cancer treatments such as surgery, radiation, and chemotherapy affect normal cells too. Thus, treatments like synthesized nanoscale particles using plant extracts have proven to be potential anticancer agent. Aim of the Study: We hypothesize that the gold nanoparticles (AuNPs) synthesized using Elephantopus scaber hydro-methanolic extract may have anti-cancer activity along with their synergistic counterparts with adriamycin (ADR) on human breast cancer MCF-7: human breast cancer (A-549), human oral cancer (squamous cell carcinoma [SCC]-40), and COLO-205: human colon cancer cell lines. Materials and Methods: The phytosynthesized AuNPs were characterized for ultraviolet-visible (UV-Vis) spectroscopy, nanoparticle tracking analysis (NTA), X-ray diffraction, scanning electron microscopy, transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) analysis. The anticancer ability of the AuNPs against human MCF-7, A-549, SCC-40, and COLO-205 through sulforhodamine B assay has been studied. Results: The synthesis of AuNPs was confirmed with the UV-Vis spectrophotometer with a peak at 540 nm. The FTIR analysis showed polyphenolic groups were major found to be the reduction and capping agent for AuNPs. According to the results obtained, AuNPs showed good anti-proliferative activity with GI50 <10 µg/ml on MCF-7 cancer cell line. The synergistic effect of AuNPs + ADR was even better for all the four cell lines than that of the AuNPs alone. Conclusion: The green synthesis of AuNPs is a simple, eco-friendly, and cost-effective method with dominantly spherical morphology ranging from 20 to 40 nm confirmed by NTA and TEM analysis. The study reveals the potent therapeutic value of the AuNPs. [ABSTRACT FROM AUTHOR]

Context: Globally, cancer stands as the principle cause of mortality and immediate attention on its treatment options is required. Natural compounds stay at first priority in encountering novel therapeutics without adverse effects. Aim: The aim of the study is to extract flavonol quercetin from leafy vegetables of Anethum graveolens L. and Raphanus sativus L. and find out its potential in combination with drugs used for chemotherapy to reduce the adverse effects of drugs. Settings and Design: Observational study. Materials and Methods: Column chromatography is used for quercetin extraction and anticancer activity of quercetin + anastrozole and quercetin + capecitabine were determined by (4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay (MTT), apoptosis assay, cell cycle analysis, mitochondrial membrane potential, and caspase 3 expression. Statistical Analysis Used: Cytotoxic assay results were assessed by mean, standard deviation and ANOVA; and results were compared for determining its significance. Results: The results noted that quercetin at very less concentration (16 and 31 µg/ml on Michigan Cancer Foundation-7 and 43 and 46 µg/ml on COLO 320) in combination with anastrozole and capecitabine was able to control the growth of cells, increase cell death, arrest cell cycle, and induce mitochondrial depolarization and expression of caspase 3. Conclusions: The natural compound used in the present study is effective in treating breast and colon cancer at minimal concentrations in combination with the drugs. This combinational treatment appears to be reported for the first time in the present study. [ABSTRACT FROM AUTHOR]

Objectives: This meta-analysis aimed at determining the association between preoperative denosumab and the risk of local recurrence in patients with giant cell tumors of the bone. Methods and Materials: Web of Science, EMBASE, Cochrane Library, and PubMed were comprehensively searched on April 20th, 2022. Data from the included articles were analyzed using meta-analysis. The bias of all included studies was evaluated according to ROBINS-I. Also, subgroup and sensitivity analyses were performed. Results: Eight studies with 1270 cases (195 in the denosumab group and 1075 in the control group) were eventually included. Patients receiving denosumab before curettage had a higher risk of local recurrence than those who underwent curettage alone (odds ratio: 2.29, 95% confidence intervals: 1.44–3.64, P = 0.0005). The denosumab group showed a significantly higher risk of local recurrence in most subgroup analyses, except for those with preoperative denosumab duration ≤six months/doses (P = 0.66) and sample size ranging from 100 to 180 (P = 0.69). Conclusion: Denosumab before curettage may increase the risk of local recurrence in patients with giant cell tumor of the bone. Preoperative denosumab should be used with caution after weighing an increased risk of local recurrence against the clinical benefits and a duration time of less than six months before surgery is recommended. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to investigate the correlation between periodontal disease and oral cancer risk by meta-analysis.Methods: We searched the electronic databases of PubMed and Wanfang to include the articles related to periodontal disease and oral cancer risk. The association between periodontal disease and oral cancer risk was assessed by odds ratio (OR) and its corresponding 95% confidence interval (95% CI). The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. All the data analysis was done by STATA12.0 software (Stata Corporation, College Station, TX, USA).Results: Eleven case-control studies were included in our present meta-analysis. We found significant statistical heterogeneity was existed in our present meta-analysis (I2 = 99.8%, P < 0.05). Hence, the data were pooled by random effect model. The pooled results indicated a significant correlation between periodontal disease and oral cancer risk was found with OR = 3.21 and the 95% CI = 2.25-4.16 (P < 0.05). The Begg's funnel plot was obvious asymmetric indicating significant publication bias. Moreover, further Egger's line regression test also indicated significant publications (t = 3.35, P < 0.05).Conclusion: Our present meta-analysis indicated that periodontal disease can increase the oral cancer risk by nearly 2-fold. [ABSTRACT FROM AUTHOR]

Objectives: This meta-analysis aimed at evaluating the efficacy of dual-time-point (DTP) F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) in diagnosing pulmonary nodules.Methods: Using computer and manual search, the current research about the efficacy of DTP F-FDG PET/CT in diagnosing pulmonary nodules was collected. According to the evaluation criteria of Quality Assessment of Diagnostic Accuracy Studies Scale, the data from 13 studies were analyzed by Meta-DiSc software, and the sensitivity (Sen), specificity (Spe), diagnostic odds ratios (DOR), positive likelihood ratios (LR+), and negative likelihood ratios (LR-) were summarized.Results: A total of 13 articles were included in this study, involving 962 patients. The meta-analysis showed that the rough Sen of DTP PET/CT was 0.80 (95% confidence interval [CI] 0.76-0.84, I2 = 83.2%), the summary Spe was 0.75 (95% CI 0.71-0.79, I2 = 89.3%), the summary LR + and LR- were 2.57 (95% CI 1.54-4.29) and 0.28 (95% CI 0.16-0.5), respectively, and DOR was 10.01 (95% CI 3.83-26.18).Conclusion: DTP F-FDG PET/CT has similar Sen and Spe, with single-time-point PET/CT in diagnosing pulmonary nodules. Further high-quality research is required to explore the potential value of DTP F-FDG PET/CT. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), and HBV/HCV double infection and hepatocellular carcinoma risk in Chinese population.Materials and Methods: The databases of PubMed and CNKI were electronic searched by reviewers according to the searching words of HBV, HCV, and hepatocellular carcinoma. The related case-control studies or cohort studies were included. The association between virus infection and hepatocellular carcinoma risk was demonstrated by odds ratio (OR) and 95% confidence interval (95% CI). The data were pooled by fixed or random effects model according to the statistical heterogeneity. The publication bias was assessed by Begg's funnel plot and Egger's linear regression test.Results: Finally, 13 publications were included in this meta-analysis. For significant statistical heterogeneity (I2 = 99.8%,P = 0.00), the OR was pooled by random effects model. The pooled results showed that HBV infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 58.01, 95% CI: 44.27-71.75); statistical heterogeneity analysis showed that significant heterogeneity existed in evaluation of HCV infection and hepatocellular carcinoma risk across the included 13 studies I2 = 77.78%, P = 0.00). The OR was pooled by random effects model. The pooled results showed that HCV infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 2.34, 95% CI: 1.20-3.47); significant heterogeneity did not exist in evaluation HBV/HCV double infection and hepatocellular carcinoma risk for the included 13 studies (I2 = 0.00%,P = 0.80). The OR was pooled by fixed effects model. The pooled results showed that HBV/HCV double infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 11.39, 95% CI: 4.58-18.20). No publication bias was found in the aspects of HBV, HCV, and HBV/HCV double infection and hepatocellular carcinoma.Conclusion: For Chinese population, HBV, HCV or HBV/HCV double infection can significantly increase the risk of developing hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the clinical efficacy of elemene versus DDP intrapleural injection in the treatment of malignant pleural effusion caused by lung cancer by meta-analysis.Materials and Methods: PubMed (1960 ~ 2016.4), EMBASE (1980 ~ 2016.4), and CNKI (1979 ~ 2016.4) databases were searched to identify the clinical studies of elemene intrapleural injection in the treatment of lung cancer malignant pleural effusion. The odds ratio (OR) was used to evaluate the clinical efficacy of elemene in the treatment of pleural effusion compared to cisplatin (DDP).Results: Seven hundred and Thirty-two subjects with 14 studies were finally included in this meta-analysis. Meta-analysis demonstrated that the objective response rate in elemene group was much higher than that in DDP group (OR = 1.34, 95% confidence interval: 1.07 ~ 1.69, P < 0.05). The Begg's funnel plot and Egger's line regression test showed no statistical publication bias.Conclusion: High clinical efficacy of elemene in the treatment of lung cancer malignant pleural effusion was found compared to DDP. [ABSTRACT FROM AUTHOR]

Genotoxicity in lymphocytes of cancer patients undergoing radiotherapy can lead to lymphocytopenia. Lymphocytopenia induced by radiotherapy is one of the most unfavorable prognostic biological markers in cancer patients, since it has been accepted to be associated with poor prognosis in terms of both survival time and response to cancer therapy. Therefore, reduction in lymphocytopenia may increase treatment efficiency. Research endeavors with synthetic radioprotectors in the past have met with little success primarily due to toxicity-related problems. These disadvantages have led to interest on the use of some plants and phytochemicals as radioprotector. The aim of this paper is to review protective role of some plants and phytochemicals against genotoxicity-induced by ionizing radiation in human blood lymphocytes. Therefore, current review may help the future researches to decrease lymphocytopenia in radiotherapeutic clinical trials. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the clinical efficacy and safety of high-dose imatinib (IM) for chronic myeloid leukemia (CML) patients by pooled published studies.Methods: Through searching the databases of PubMed, EMBASE, ASCO, ESMO, CNKI, and Wanfang, we collected open published clinical controlled trials-related high-dose IM treatment of CML. The pooled complete cytogenetic response (CCyR) and hematologic toxicities were calculated by the statistical software.Results: Seven studies were included in this study with 1137 cases received high-dose IM treatment and 958 cases received regular-dose IM treatment. The pooled results showed that patients received high-dose IM had higher CCyR compared with regular-dose with the odds ratio (OR) of 1.75 (95% confidence interval [95% CI]: 1.44-2.1, P < 0.05) and 1.58 (95% CI: 1.38-1.81, P < 0.05) in 6 and 12 months. However, the hematologic toxicities risk of neutropenia (OR = 1.76, 95% CI: 1.22-2.54) and thrombopenia (OR = 1.88, 95% CI: 1.42-2.50) were much higher in the high-dose group.Conclusion: High-dose IM for CML treatment was superior to standard-dose IM in the aspects of CCyR, but the risk of developing neutropenia and thrombopenia was much higher. [ABSTRACT FROM AUTHOR]

Aim: Various phosphonate ligands labeled with β--emitting radionuclides have shown good efficacy for bone pain palliation. In this study, a new agent for bone pain palliation has been developed.Materials and Methods: Samarium-153-(4-[((bis(phosphonomethyl))carbamoyl)methyl]-7,10-bis (carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl) acetic acid (153Sm-BPAMD) complex was prepared using BPAMD ligand and samarium-153 chloride. The effect of various parameters on the labeling yield of 153Sm-BPAMD including ligand concentration, pH, temperature, and reaction time were studied. Production of 153Sm was performed at a research reactor using 152Sm (n, γ)153Sm nuclear reaction. The radiochemical purity of the radiolabeled complex was checked by instant thin layer chromatography. Stability studies of the complex in the final preparation and the presence of human serum were performed up to 48 h. Partition coefficient and hydroxyapatite (HA) binding of the complex were investigated and biodistribution studies using single photon emission computed tomography (SPECT) and scarification were performed after injection of the complex to wild-type mice.Results: 153Sm-BPAMD was prepared in a high radiochemical purity >98% and specific activity of 267 GBq/mmol at the optimal conditions. The complex demonstrated significant stability at the room temperature and in human serum at least for 48 h. HA binding assay demonstrated that at the amount of more than 5 mg, approximately, all radiolabeled complex was bind to HA. At the pH 7.4, log Po/w was - 1.86 ± 0.02. Both SPECT and scarification showed major accumulation of the labeled compound in the bone tissue.Conclusions: The results show that 153Sm-BPAMD has interesting characteristics as an agent for bone pain palliation, however, further biological studies in other mammals are still needed. [ABSTRACT FROM AUTHOR]

Background: The most-cited articles. (MCAs) are likely those that impressed other researchers and had profound influence on clinical practice or future developments in the related scientific field.Aim: This study was conducted to explore a bibliometric approach to assess in where the cutaneous malignant melanoma. (CMM) related MCAs have been published.Materials and Methods: We identified journals for publications with the word "melanoma" in the title by using the ISI Web of Knowledge Database between 2000 and 2010. The term MCAs arbitrarily defined as equal or more than 100 citations.Results: A total of 425 MCAs were published in 93 journals, led by the Cancer Research. (n = 58) and Journal of Clinical Oncology. (n = 53). Journal categories with the MCAs were the Oncology with 232 articles, followed by the Medicine with 138. articles. The median number of citations was 147. The total numbers of citations were most prominent for the journal Nature and the New England Journal of Medicine. (NEJM) (median 385 and 354, respectively). Total number of citations was the highest for the Science.categorized journals. (median 211). Articles categorized as Dermatology and Melanoma was the least (median 132.5). The median number of citations per year was 14.91. The most valuable cited articles of per year were also published in the journal Nature. (median 59.67) and the NEJM. (median 48.67). The number of citation was the highest for the Science-categorized journals. (median 25.92).Conclusion: Majority of the MCAs on CMM were published in non-dermatology/melanoma specialized journals. [ABSTRACT FROM AUTHOR]

Deuterium is a stable isotope of hydrogen. Natural water contains nearly 150 ppm Deuterium. Water containing less than natural abundance of deuterium, is known as Deuterium Depleted Water (DDW). Recent literature survey indicates that DDW of 25 ppm to 120 ppm has many positive health applications like anti-cancer/tumor, anti- diabetic, nonspecific immune defense of the body, anti-ageing, and Radio-protective effects. International papers reveal that insulin resistance has been treated with DDW. These are available in international markets to the common public on prescription by authorized persons. Reports of few clinical trials involving human beings have also been published. DDW is being used abroad for more than a decade for treatment of cancer (adjuvant therapy) fight against side effects of chemotherapy and radiotherapy, fighting ageing for skin treatment, removing the DNA errors and getting rid of hereditary diseases like diabetes, heart diseases, thalassemia, etc. Some of the experts feel that continuous consumption of DDW for 3 months daily as per the prescribed dose increases survival rates of cancer patients and rejuvenates healthy people by eradicating DNA error. Dr. Gabor Somlyai, a molecular biologist from Hungary, has been studying biological effect of Deuterium depletion since 1990. He had published all his findings on the subject in the form of a book named "Let's defeat cancer - the biological effect of Deuterium depletion". There are many experiments that have been carried out and human clinical trials are still carried out in parts in Hungary with DDW of different concentrations varying between 20 ppm to120 ppm. The most important discovery is that healthy cells quickly adapt to the lower deuterium concentration, whereas tumor cells are unable to do so. As mentioned in the literature, presence of natural concentration of deuterium is vital for cell proliferation and that the cell division is triggered by the change of the D/H ratio (the ratio of D/H temporarily increases during the process of cell division). Basically hydrogen gets pumped out from the cell during cell division, therefore, deuterium concentration increases within the cell. As a result when D concentrations decreases in the body by deuterium depletion, cell division gets hindered and this effect is more prominent in tumor cell (rate of proliferation is high for tumor cell compare to normal cell) compare to the normal cells. This, in the majority of cases, resulted in the destruction of the malignant cells, a decrease in tumor mass or its total regression. It is also noted that, Pharmaceutical firm like, HYD pharma, Hungary has already received GMP certification for DDW production facility for clinical trials and will soon apply for ethical approval to start phase 2 clinical trial in chronic lymphocytic leukemia. Based on his findings, various concentrations of DDW are used for therapy and prevention as a dietary supplement e.g. in Hungary as PREVENTA®105, anti-cancer veterinary drug (VETERA® DDW-25 A.U.V), cosmetic product for rejuvenating skin (YUVAN DDW-) etc. Similar products of 25, 50, 90, 120 ppm DDW are also marketed in Japan, UK and USA. Romanian heavy water plants are generating and supplying DDW of various concentrations up to 80 ppm. M/s Cambridge Isotope Laboratories, USA M/s Sigma- Aldrich, USA have catalogued DDW of 2-3 ppm for R&D purpose. Clinical trials by Russian researchers indicate that use of DDW in breast cancer patients removed the toxicity of chemotherapy. Heavy water Board (HWB) in its various Heavy Water Plants produce heavy water and generate DDW (30ppm-120ppm) in large quantities. HWB being the largest producer of heavy water, also shares the capability of producing large quantities of deuterium depleted water and can supply the same at various concentrations ranging between 30ppm to 120ppm. HWB has supplied samples of DDW to Tata Memorial Hospital/ACTREC for taking up studies for validation of reported information on DDW. With huge positivity ACTREC is putting effort in this direction and some good result and benefit to the society is soon expected. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric malignancies constitute about 3% of all cancer cases. With better understanding of cancer biology and regimens, cure is possible in majority of cases. Uttarakhand state is situated in Shivalik foothill of sub Himalayan region and has major population at hilly terrain. Cancer research Institute, being the single referral cancer center caters majority of state cases. Material and Method: A retrospective audit was done for all diagnosed pediatric cancer (0-20 years) enlisted with institute during 2013-2015, using electronic medical database [UCOST] and paper files. Data was analysed for demographic profile and diagnosis spectrum. Confirmation was done by morphology and/or Flowcytometry for leukemia, immunohistochemistry for lymphomas. For solid tumors, biopsy confirmation was requisite for confirmation. Result: from 2013 to 2015, a total of 241 pediatric cases were enlisted with confirmed diagnosis of malignancy. Pattern of referral showed male dominance with 66 %. Among subgroup analysis, acute leukemia constituted 34 % of all pediatric cancers followed by lymphoma, brain tumor and germ cell tumor [14.7%, 8.2%, and 6.4% respectively]. Median age of diagnosis of acute leukemia was 10 years with male dominance [male: Female= 3.5:1]. Acute myeloid leukemia was noted in relatively older age group with median age of 12 years. Among lymphomas, median age for non-Hodgkin group was 12 years and for Hodgkin lymphoma was 11 years. On analysis of solid tumors, brain tumor was most frequent subgroup with median age of 10 years and male to female ratio of 13/7. Cancers involving bone (Osteosarcoma, Ewing's sarcoma) constituted second largest solid tumor group followed by Germ cell tumor. While male dominance was noted in all subgroups, Germ cell tumor subgroup showed majority as female enlistment [14/15]. Median age of diagnosis for germ cell tumor was noted as 16 years. Soft tissue sarcoma was diagnosed amongst 9 cases with clear male dominance and median age of presentation as 14.5 years. While wilms tumor and retinoblastoma were noted among 7 and 3 cases showing reduced enlistment, unusually high incidence of rectal cancer was noted [7 cases, median age 17.5 years]. Occurrences of nasopharyngeal carcinoma, hepatoblastoma and neuroblastoma were noted as 2 cases each. Conclusion: Being the single referral center of state, audit of pediatric malignancies can be considered as parallel to state incidence. However hilly terrain and sparse health facility available might be a cause of referral bias or decline. This audit represents an interesting childhood cancer pattern from sub Himalayan region. [ABSTRACT FROM AUTHOR]

for Paper presentation at Indian Cancer Congress 2017 Full Name : Dr. Shefali. H.Karve Academic Qualification: M.D.Pathology Institution Name: HCG, Bangalore Address: No.5, Bull temple road, Basavanagudi, Bangalore-560004. Mail id: shefalikarve@gmail. com Abstract title: Comparison of MSI detection in Colorectal Adenocarcinomas by IHC & molecular methods. Co-author: Dr. Veena R.S., Head of Histopathology Dept. Hcg, Bangalore. Abstract Body : Colorectal cancer is the third most common cancer and is one of the leading causes of cancer related death. It develops either sporadically(85%) or as part of a hereditary cancer syndrome(<10%) or against a background of IBD. The adenoma carcinoma sequence underlies the development of CRC in most patients and 2 other distinct pathways have been identified - MSI & CIN. Discovery of these pathways led to the paradigm of CRC as a genetically heterogenous disease. Approximately 15% of CRC display high level of microsatellite instability (MSI-H) due to either a germline mutation in one of the genes responsible for DNA mismatch repair (Lynch syndrome) or somatic inactivation of the same pathway, most commonly through hypermethylation of the MLH-1 gene (Sporadic MSI-H). MSI refers to the hypermutable state of cells caused by impaired DNA mismatch repair(MMR). It consists of insertion & deletion mutations in stretches of short tandem DNA repeats (microsatellites) as well as nucleotide substitutes throughout the genome. Mutations in the DNA mismatch repair genes(MLH1, MSH2, MSH6 & PMS2) result in a failure to repair errors in repetitive sequences, leading to MSI. MSI-H CRCS respond poorly to 5-FU based chemotherapy, but they maybe efficiently treated with camptothecin derivatives. Novel therapies that stimulate the immune system have been evaluated in mismatchrepair deficient tumors, including those related to Lynch Syndrome. The dense immune infiltration and cytokine-rich environment in mismatch repair-deficient tumors may improve clinical outcomes. A critical pathway responsible for mediating tumor induced immune suppression is the PD-1 mediated checkpoint pathway. Objectives of the study: 1) Frequency of MSI in the study population. 2) To study the expression of MSI markers- MLH1, MSH-2, PMS-2 & MSH-6 in colorectal carcinomas by IHC. 3) Correlation between MSI expression & histopathological features of CRC. 4) Correlation between IHC studies and molecular studies for MSI detection. Materials and methods: ? Study place : Department of Pathology, HCG cancer center, Bangalore. ? Study population: Colorectal cancer specimens of received in pathology department. ? Study design : Prospective and Retrospective ? Sample size: 54 cases ? Study duration : April 2016 to December 2017. ? Inclusion criteria: - According to Bethesda criteria. ? Exclusion criteria: - Metastatic colorectal carcinoma. Methodology : ? Surgically resected colorectal specimens from patients diagnosed with adenocarcinoma will be received and representative sections given and further processed. ? These will be stained with H&E and morphological features analyzed and tumor will be staged. ? Further those cases which fulfil the inclusion criteria will be subjected to IHC testing for the 4 MSI markers : MLH1, PMS2, MSH2 and MSH6, in the Semiautomated Intellipath system from Biocare Medicals(USA). ? The above will further also be subjected to Flourescence - based multiplex microsatellite PCR. The PCR products will further be analyzed by Genetic Analyzer machine. Statistical analysis: ? Descriptive statistics ( frequency, %, Mean, Median and Standard deviation[SD]) will be used to describe data such as patient demographics and tumor-specific variables. ? Statistical analysis will be done to assess any significant correlation of MSI with stage, age, location of tumor and histopathological features and correlation between IHC studies and molecular studies by chisquare test. ? SPSS Software, version 23(2015) will be used for the analysis. Results and conclusions are awaited. [ABSTRACT FROM AUTHOR]

Researchers suggested that the prevention of colon cancer might occur through intervention of synbiotics (prebiotic+probiotic) that allow certain substantial changes in the gut micro biota. The pro and prebiotic supplementation helps to improve the host health. Inulin is one such prebiotic used for the enhancement of naïve probiotic bacterial population. This paper explains the impact of inulin (PRE) extracted from taproots of common chicory (Cichorium intybus L.), Lactobacillus salivarius (L. salivarius) FP25, (PRO), and synbiotic (SYN; inulin + L. salivarius FP25) preparation on Azoxymethane mediated CC induced rat model with respect to changes in microbial load, microbial enzymes. The results suggested that the PRE and SYN supplementation effectively reduced the selected pathogenic bacteria (Salmonella spp., and Escherichia coli), microbial enzymes and increased the probiotic load. The intervention of SYN significantly reduced the colonic ACF in CC model. The study results revealed that the supplementation of SYN diet (inulin and L. salivarius FP25) protects the AOM-mediated colon cancer induced host. [ABSTRACT FROM AUTHOR]

In India most of the patients of gastric cancer report to the surgeon at a relatively advanced stage. Very few patients present in early stage ( stage I & IIa) who can be treated and cured by radical surgical procedures. But a very large number of patients ( nearly 80%) present in either locally advanced ( stage IIb to IIIb ) or with metastasis ( stage IV ). . Many of them have vomiting, electrolyte imbalance, anaemia and low general condition to tolerate chemotherapy. As a result curative surgery is not possible in these cases and hardly 50% of these advanced gastric cancer patients can be subjected to chemotherapy as neoadjuvant. Often these patients are subjected to safe and shorter surgical procedures like Anterior gastro-jejunostomy or a feeding jejunostomy for nutritional purpose leaving behind the main disease. As the growth is not excised bleeding from it persists and anaemia is not corrected in spite of repeated blood transfusions, thereby hampering proper chemotherapy in proper dose, drug and at regular intervals. Many of these cases become refractory to chemotherapy and gradually turn to stage IV . Some of these lead to penetration into pancreas and celiac nerves and even perforations at the growth site. The overall survival of these patients are approx. 6-8 months . This is a ongoing study to see the effectiveness of palliative gastrectomy ( partial, subtotal or total) in locally advanced conditions. Here most of the time the fixed nodes of D2 /D3 regions are left behind and the adhesions from the pancreas and adjacent structures are released by R1 resection. All these patients are subjected to palliative chemotherapy after surgery, which are tolerated well without much side effects and the overall survivals are found be extended to 15-18 months . Moreover the chances of penetration and perforation are avoided. The most important contraindications to gastrectomy in this group are ascites and widespread peritoneal dissemination. This paper presentation is intended to share the experience of palliative gastrectomies in more than 300 cases performed in last 25 yrs. in locally advanced gastric cancers and highlight the effectiveness of such ventures, which involves lot of surgical skill and risk as well . Hence all patients of gastric cancers on whom a radical surgery is not possible, every attempt should be made for at least a palliative gastrectomy with or without nodal clearance. The usual practice of anterior gastrojejunostomy or a feeding enterostomy are often not helpful and therefore should be discouraged. ………………………………………………………………………………………………………………………… I declare that there is no conflict of interest involved. [ABSTRACT FROM AUTHOR]

Approximately 50% of autosomal dominant polycystic kidney disease (ADPKD) patients have gross hematuria, but few cases of bladder cancer complications are known. We report a case of a 49-year-old female ADPKD patient with bladder cancer, who was presented to our hospital 4 months after the onset of gross hematuria. A computed tomography (CT) scan showed a bladder mass, enlarged pelvic and left inguinal lymph nodes, multiple liver cysts, and a polycystic kidney. Based on family history, CT scan results, and lymph node biopsy, we diagnosed the patient with uroplakin III-negative bladder cancer with squamous metaplasia and ADPKD. The patient was treated with systemic chemotherapy but died 2 months after the definitive diagnosis. The delayed diagnosis was disastrous, and malignancy should be considered in the differential diagnosis when symptoms suggestive of malignancy such as hematuria appear. Particularly, uroplakin III-negative advanced bladder cancer has a poor prognosis and requires early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Cell block preparation is routine practice in cytopathology these days because of its pivotal role in increasing diagnostic yield and ancillary studies. In the present era of personalized medicine in oncology, ancillary techniques such as immunohistochemistry (IHC) and molecular analysis are gaining more importance. Methods: A retrospective study was conducted in the Department of Pathology, over 6 months, which included 144 cases of Fine Needle Aspiration Cytology (FNAC) of abdominopelvic masses and 105 cases of ascitic fluids. Cell blocks and conventional smears were prepared simultaneously in all cases. IHC was applied on cell blocks and analyzed. Results: IHC was performed on cell blocks in 76 cases of FNA and 53 cases of ascitic fluids. Based on IHC, liver lesions (50 cases) were categorized into metastatic carcinomas with a suggested primary site (45.0%), hepatocellular carcinoma (12.2%), neuroendocrine tumors (16.3%), and malignant melanoma (2%). Using MOC-31 and WT-1, ascitic fluid samples were categorized into benign and malignant. Forty-one out of 53 cases of fluids were diagnosed as metastatic adenocarcinomas with the ovary as the most common primary site. Conclusion: A panel of IHC markers, though not specific alone when applied to cell blocks in a careful clinical and morphological context leads to a rapid and accurate diagnosis. This in turn obviates the need for biopsy in severely ill patients. An astute pathologist can provide accurate results with judicious use of IHC on cell blocks and may bring a sigh of relief for many cancer patients by averting the need for biopsy. [ABSTRACT FROM AUTHOR]

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly aggressive hematologic neoplasm and classified under acute myeloid leukemia. Here, we describe the clinicopathological features of three cases of BPDCN: two with classical and one uncommon immunophenotype. A-35-year-old female (case 1) presented with complaint of nasal mass and generalized lymphadenopathy. Biopsy from axillary lymph node showed infiltration by cells with scant cytoplasm which were immunopositive for LCA, CD4, CD43, and ALK1. Flowcytometry showed positivity for CD45, CD4, CD33, and CD123 while negative for rest all markers. The other two cases have classical immunophenotype. In clinical practice, nasal mass with lymphadenopathy suggests natural killer T-cell/peripheral T-cell lymphoma. Again immunohistochemical positivity for CD4, CD43, and ALK while negativity for CD3 suggests anaplastic large cell lymphoma. In this case, morphology and extensive bone marrow involvement raise the suspicion. Fowcytometry positivity for HLADR, CD123, and CD33 helps in making diagnosis. [ABSTRACT FROM AUTHOR]

Background: Association with variety of etiological agents is one of the characteristic features of oral squamous cell carcinoma (OSCC). We hypothesized the existence of tobacco consumption habit-based heterogeneity in the immunohistochemical expression of carcinogenesis relevant molecular markers in OSCC. Hence, the present study was conducted to investigate the carcinogenesis relevant three commonly expressed markers (Ki-67, CD105, and α-smooth muscle acting [SMA]) in various forms of tobacco consumption habits in OSCC patients. Materials and Methods: A total of 217 patients of OSCC were included in the study, and based on the habit, they were broadly categorized into tobacco lime (TL), TL and areca nut (TLAN), and areca nut (AN). Further, categorization was done on the basis of absence or presence of additional habit of smoking. Immunohistochemistry (IHC) was performed using Ki-67, CD105, and α-SMA markers on formalin-fixed paraffin-embedded tissues. Results: TLAN (62.21%) was the most common habit noted in OSCC patient followed by TL (20.73%) and AN (15.20%). The additional habit of smoking was observed in 31.11% and 25.92% of TL and TLAN habits of OSCC patients, respectively. All the three markers (Ki-67, CD105, and α-SMA) showed statistically significant differences in the habit group such as TL, TLAN, and AN (P < 0.001). Although the expression of all the three markers was increased in TL as compared with TLAN, differences were not statistically significant. When these markers were compared in with and without smoking category, only TLAN with smoking and TLAN without smoking showed statistically significant differences in the expression of all three markers. Conclusions: Ki-67 CD105 and α-SMA immunohistochemical expression in OSCC corresponds with different forms of tobacco consumption habits. Habit-related unique carcinogenesis events are reflected at IHC level thus providing proof of concept for future studies. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate peroxiredoxin 3 (PRDX3) expression in gastric cancer tissue and its effects on cisplatin resistance in gastric cancer cells and its possible mechanism. Methods: PRDX3 expression in human gastric cancer tissue microarrays was detected via immunohistochemistry. The PRDX3 small interfering RNA (siPRDX3 group) and the negative control siNC (siNC group) were transfected into AGS and MKN-74 cell lines, respectively, whereas a blank control group was set up. Each group was treated with different cisplatin concentrations (0, 5, 10, 15, 20, 25, and 30 μg/ml), and the half-inhibitory concentration (IC50) of each group of the two cell lines was calculated using the CCK8 assay. The corresponding IC50 concentration of the siPRDX3 group in the two cell lines was used to treat cells of each group. Flow cytometry was used to detect cell apoptosis, and Western blotting was used to detect the expression levels of cleaved caspase-3 and Bax in each group. Results: PRDX3 was overexpressed in gastric adenocarcinoma tissue compared with adjacent noncancer tissue (P = 0.0053). After cisplatin treatment, the IC50 in the siPRDX3 group of AGS cells (5.91 ± 0.18 μg/ml) and the siPRDX3 group of MKN-74 cells (3.48 ± 0.30 μg/ml) was significantly lower than in the corresponding siNC groups (10.01 ± 0.99 and 6.39 ± 0.70 μg/ml; P = 0.0022 and 0.0027, respectively). AGS cells (38.81% ± 1.69%) and MKN-74 cells (25.03% ± 2.80%) in the siPRDX3 group showed significantly higher apoptosis rates than in the corresponding siNC groups (23.17% ± 1.43% and 16.7% ± 1.39%; P = 0.0003 and 0.0099, respectively). The expression levels of cleaved caspase-3 and Bax were significantly higher in the siPRDX3 group of both cell lines than in the siNC group (P < 0.0001). Conclusion: PRDX3 increases the gastric cancer cell resistance to cisplatin by reducing apoptosis and thus may serve as a target to overcome cisplatin resistance. [ABSTRACT FROM AUTHOR]

Background: This study investigated the reconstruction effect of skin-preserving breast cancer modified radical mastectomy combined with one-stage breast prosthesis implantation in female patients to analyze relevant factors and observe the effect of prosthesis reconstruction on short-term breast satisfaction, psycho-social functions, and quality of life (QOL) in patients with breast cancer after the operation. Methods: Patients were divided into two groups based on the reconstruction effect (an excellent effect group and a good and general effect group). Patients' short-term cosmetic effect on the breast after breast cancer modified radical mastectomy combined with one-stage breast prosthesis implantation was prospectively followed up to analyze influencing factors. At post-operative 6 months, the breast satisfaction dimension, psycho-social dimension, upper limb breast health dimension, and surgical satisfaction dimension in the prosthesis reconstruction module in the BREAST-Q scale were used for follow-up evaluation. Results: The excellent rate of prosthesis reconstruction was 91.3%. A significant correlation was observed among the reconstruction effect, implant volume, and number of children born by the patient (P < 0.05). The correlation with age, BMI (body mass index), operation time, nipple and areola retention, operation method, and incision was not statistically significant (P > 0.05). At post-operative 6 months, the Breast-Q score was significantly different in the overall breast satisfaction dimension and outcome satisfaction dimension between the two groups (P < 0.05). Conclusion: Breast cancer modified radical mastectomy combined with one-stage breast prosthesis implantation can not only fulfill patients' physical aesthetic needs but also positively affect their psychosocial behavior to improve post-operative QOL. [ABSTRACT FROM AUTHOR]

Introduction: Judicious use of antibiotics and stringent adherence to practice guidelines is the need of the hour as antibiotic resistance is a rampant problem. Despite several reports in the literature describing the optimal duration of antibiotics, there is no consensus. A "one for all" protocol may be impractical and hence the guidelines need to be tweaked to take into consideration local factors. We designed a protocol for prophylactic antibiotics in clean-contaminated head and neck cancer squamous cell carcinoma (HNSCC) surgeries to prevent unchecked abuse and evaluated its feasibility. Materials and Methods: Two hundred consecutive patients who underwent a clean-contaminated surgery for HNSCC between January 2017 and December 2019 were included. Single-dose intravenous amoxicillin-clavulanate at induction followed by three doses of amoxicillin-clavulanate, metronidazole, and amikacin in the postoperative period was used. Adherence to the antibiotic protocol was assessed from a prospectively maintained database. Results: The mean age was 55.99 ± 11.71 years. The protocol was effective in 70% of the patients with an acceptable surgical site infection (SSI) rate of 12%. Flap-related complications (9.5%) and oro-cutaneous fistula (5%) were common causes of prolonged antibiotics. On univariate analysis, blood transfusion (P =.014), clinical stage at presentation (P =.028), patients undergoing reconstruction (P =.001), longer operative time (P =.009), and pathological T stage (P = 0.03) were at higher chance of deviating from the protocol. On multivariate analysis, age more than 50 years (OR: 2.14, 95% CI: (1.01, 4.52); P value = 0.047) and reconstruction (OR: 3.36, 95% CI: (1.21, 9.32); P value = 0.020) were found to be significant. Conclusions: A three-dose perioperative antibiotic prophylaxis in clean-contaminated HNSCC surgeries is feasible. Similar protocols should be developed and validated at other major centers to limit the unnecessary use of antibiotics and prevent the emergence of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Aims: To investigate the predictive value of hepatic venous pressure gradient (HVPG) and the efficacy and significance of early percutaneous transhepatic varices embolization (PTVE) for gastrointestinal bleeding after transcatheter arterial chemoembolization (TACE) for liver cancer. Methods and Materials: This retrospective study enrolled 60 patients diagnosed with stage B or stage C liver cancer, according to the Barcelona Clinic Liver Cancer (BCLC) staging system, between December 2019 and October 2021. TACE and HVPG measurement (>16 mmHg or >20 mmHg) were performed on all 60 patients, who were randomized into control and experimental (PTVE) groups. All patients were followed up for 12 months. Statistical Analysis Used: SPSS 20.0 software was used for data analysis. The two groups were compared with respect to the initial occurrence time of hemorrhage after TACE, recurrence time of hemorrhage, liver function, TACE frequency, TACE type, and tumor control. Results: The initial hemorrhage rates at one, three, six, and 12 months after TACE were 3.2%, 12.9%, 22.6%, and 48.4%, respectively, in the control group (n = 31) and 0%, 0%, 3.4%, and 10.3%, respectively, in the PTVE group (n = 29). Differences between the groups in terms of initial hemorrhage rate at six and 12 months postoperatively were significant (P < 0.05). The recurrence rates of hemorrhage at one, three, six, and 12 months after TACE were 11.1%, 22.2%, 22.2%, and 33.3%, respectively, in 27 patients in the control group. In eight patients in the PTVE group, the corresponding rates were 0%, 0%, 0%, and 25.0%. The differences between the groups in the recurrence rate of hemorrhage at the four time points were significant (P < 0.05). At six months postoperatively, liver function recovery and remission were noted in eight (25.8%) and 18 (66.7%) patients, respectively, in the control group; these events were noted in 10 (34.5%) and 19 patients (65.5%), respectively, in the PTVE group, and the difference between the groups was not significant (P > 0.05). In the control group, TACE was performed for a total of 94 times on 31 patients within 12 months, including conventional transcatheter arterial chemoembolization (C-TACE, 75.5%) and the drug-eluting bead TACE (DEB-TACE, 24.5%); the objective response rate (ORR) was 39.3%. In the PTVE group, TACE was performed for a total of 151 times on 29 patients within 12 months, with an average of 5.21 times on each patient, including the C-TACE (57.6%) and DEB-TACE (42.4%); the ORR was 60.1%. Differences in TACE frequency, proportion of C-TACE/DEB-TACE, and ORR were significant between the two groups (P < 0.05). Conclusion: HVPG can accurately evaluate gastrointestinal bleeding after TACE in patients with liver cancer. Early PTVE can significantly lower the risk of gastrointestinal bleeding and help TACE control tumor progression in patients with an HVPG >16 mmHg or >20 mmHg. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the clinical efficacy and prognostic analysis results of 8spheres polyvinyl alcohol (PVA) microspheres (8SM) with gelatin sponge (GS) particles for transcatheter arterial chemoembolization (TACE) in patients with stages A–B hepatocellular carcinoma (HCC). Methods: Data were collected from 172 patients who underwent TACE at Harbin Medical University Cancer Hospital from January 2014 to July 2020. Patients were divided into two groups: TACE group using 8SM plus lipiodol (8spheres PVA group, N = 89) and TACE group using GS particles plus lipiodol (the GS group, N = 83). Subsequently, we compared the liver function, blood count, alpha-fetoprotein (AFP), and other parameters of patients in each group before and after interventional embolization. We also calculated the patient's progression-free survival and overall survival in these groups. Results: The postoperative liver function indices, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the 8spheres PVA group, were worse than in the GS group. The postoperative median survival time was 19 ± 3.06 months and no significant difference in survival time was observed in GS group (26 ± 3.19 months) (P = 0.509). Multivariate analysis showed that targeted therapy (P = 0.051), maximum tumor diameter <5 cm (P = 0.018), age ≥60 years (P = 0.018), and AFP <120.5 μg/L (P = 0.007) significantly improved the overall survival rate of patients. Conclusion: Postoperative liver function indices of patients with HCC treated with GS particles were better than those treated with 8SM; thus, GS particles are more suitable for patients with poor liver function. [ABSTRACT FROM AUTHOR]

Objective: Revealing microfibrillar-associated protein 4 (MFAP4)'s function and its clinical significance in hepatocellular carcinoma (HCC). Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting were used to evaluate MFAP4 mRNA and protein expression in paired HCC and paracarcinoma tissues, respectively. MFAP4 serum concentration was detected using enzyme-linked immunosorbent assays in healthy people (n = 30), cirrhosis (n = 15) and HCC patients (n = 80). MFAP4 protein expression was detected in two tissue microarrays (n = 60 and n = 90). Plasmids were transfected into human HCC cell line Bel-7402, and MFAP4 function was determined in vitro in cell experiments. Furthermore, tumorigenicity studies in nude mice served to assess the function of MFAP4 for HCC. Results: Both MFAP4 mRNA and protein expression were significantly downregulated in HCC tissue compared with paracarcinoma tissue (P < 0.05). Decreased MFAP4 expression in paracarcinoma tissue was associated with poor postoperative survival in HCC patients (P = 0.027). MFAP4 was also downregulated in HCC sera compared with healthy people (P < 0.05). In vitro, MFAP4 upregulation in Bel-7402 cells induced S phase arrest, promoted apoptosis, and inhibited migration and invasion. Western blotting indicated MFAP4 overexpression increased CDK4, CDK6, pRB, P27, and BCL-XS expression. Tumorigenicity study showed that the upregulation of MFAP4 inhibited the proliferation of Bel-7402 cells in nude mice. Conclusions: MFAP4 expression was significantly lower both in sera and tissue of HCC patients. MFAP4 can serve as molecular marker for HCC diagnosis and prognosis. Additionally, MFAP4 acted as an important HCC tumor suppressor by inducing S phase arrest, and promoting apoptosis, cell migration, and invasion. [ABSTRACT FROM AUTHOR]

Aim: To compare the clinical efficacy and safety of 2-micron laser and conventional trans-urethral resection of bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder tumor (NMIBT), providing evidence-based evidence for clinical treatment. Materials and Methods: PubMed, Embase, Cochrane Library, CMB, CNKI, and WanFang databases were searched since their inception until December 2021 for all eligible randomized controlled trials (RCTs) related to 2-micron laser and TURBT for treating NMIBT. Two researchers independently screened the literature, extracted outcome indicators, and assessed the risk of bias according to the inclusion and exclusion criteria. Binary and continuous variables were calculated by relative risk (RR) and mean difference (MD) with 95% confidence interval (95%CI), respectively. RevMan 5.4 and Stata 15.0 software were used for all statistical analysis. Results: A total of ten RCTs involving 1,163 patients were included: 596 cases in the 2-micron laser group and 567 cases in the TURBT group. The results of the meta-analysis revealed that 2-micron laser has advantages over the TURBT in operative duration (MD = −2.94, 95% confidence interval (CI) [−8.55, 2.68], P = 0.31), operative blood loss (MD = −19.93, 95%CI [−33.26, −6.60], P = 0.003), length of hospital stay (MD = −0.94, 95%CI [−1.38, −0.50], P < 0.001), post-operative bladder irrigation time (MD = −28.60, 95%CI [−50.60, −6.59], P = 0.01), period of catheterization days (MD = −1.07, 95%CI [−1.73, −0.40], P = 0.002), obturator nerve reflex (RR = −0.06, 95%CI [0.02, 0.15], P < 0.001), bladder perforation (RR = 0.14, 95%CI [0.06, 0.35], P < 0.001), and bladder irritation (RR = 0.30, 95%CI [0.20, 0.46], P < 0.001). There was no significant difference between the two surgical methods in post-operative urethral stricture and short-term recurrence of NMIBT. Conclusion: Compared with TURBT, 2-micron laser may be safer and more effective for NMIBT management. However, these conclusions need to be validated through more high-quality RCTs because of the quality limitations and publication bias of the included studies. [ABSTRACT FROM AUTHOR]

The human gut microbiota represents a complex ecosystem that is composed of bacteria, fungi, viruses, and archaea. It affects many physiological functions including metabolism, inflammation, and the immune response. The gut microbiota also plays a role in preventing infection. Chemotherapy disrupts an organism's microbiome, increasing the risk of microbial invasive infection; therefore, restoring the gut microbiota composition is one potential strategy to reduce this risk. The gut microbiome can develop colonization resistance, in which pathogenic bacteria and other competing microorganisms are destroyed through attacks on bacterial cell walls by bacteriocins, antimicrobial peptides, and other proteins produced by symbiotic bacteria. There is also a direct way. For example, Escherichia coli colonized in the human body competes with pathogenic Escherichia coli 0157 for proline, which shows that symbiotic bacteria compete with pathogens for resources and niches, thus improving the host's ability to resist pathogenic bacteria. Increased attention has been given to the impact of microecological changes in the digestive tract on tumor treatment. After 2019, the global pandemic of novel coronavirus disease 2019 (COVID-19), the development of novel tumor-targeting drugs, immune checkpoint inhibitors, and the increased prevalence of antimicrobial resistance have posed serious challenges and threats to public health. Currently, it is becoming increasingly important to manage the adverse effects and complications after chemotherapy. Gastrointestinal reactions are a common clinical presentation in patients with solid and hematologic tumors after chemotherapy, which increases the treatment risks of patients and affects treatment efficacy and prognosis. Gastrointestinal symptoms after chemotherapy range from nausea, vomiting, and anorexia to severe oral and intestinal mucositis, abdominal pain, diarrhea, and constipation, which are often closely associated with the dose and toxicity of chemotherapeutic drugs. It is particularly important to profile the gastrointestinal microecological flora and monitor the impact of antibiotics in older patients, low immune function, neutropenia, and bone marrow suppression, especially in complex clinical situations involving special pathogenic microbial infections (such as clostridioides difficile, multidrug-resistant Escherichia coli, carbapenem-resistant bacteria, and norovirus). [ABSTRACT FROM AUTHOR]

Aim: This paper discusses the retrospective analysis conducted to determine the significance of diagnostic biomarkers, carcinoembryonic antigens (CEA), cytokeratin fragment antigens 21-1 (CYFRA 21-1), neuron-specific enolases (NSE), and tumor-specific growth factors (TSGF) upon patients who suffered with non-small cell lung cancer (NSCLC).Materials and Methods: From June 2010 to December 2011, we analyzed the positive rates of biomarkers in 276 NSCLC patients. We assessed the relationship between biomarkers and clinical characteristics of sex, smoking history, and disease stage.Results: The median and positive rates of each serum biomarker were marked as 1.91-22.77 ng/ml and 35.86% (CEA), 2.0-6.77 ng/ml and 50% (CYFRA 21-1), 13.91-23.78 ng/ml and 62.31% (NSE), and 56-67 μ/ml and 10.14% (TSGF). The level of CEA in peripheral (2.43-23.76 ng/ml) was significantly higher than the level at central position (1.97-3.63 ng/ml) (P < 0.05).Conclusion: Although the positive CEA, CYFRA 21-1, NSE, and TSGF rates were observed at low values during the NSLCLC serum diagnosis, they still played an important role in diagnosing lung cancer. Significant levels of CEA, CYFRA 21-1, NSE, and TSGF were detected in the serum. The amounts found were useful for diagnosing NSCLC patients who depended on the currently limited biomarker development. [ABSTRACT FROM AUTHOR]

The family of human matrix metalloproteinases (MMPs) comprises several tightly regulated classes of proteases. These enzymes and their specific inhibitors play important roles in tumor progression and the metastatic process by facilitating extracellular matrix (ECM) degradation. As scientific understanding of the MMPs has advanced, therapeutic strategies focusing on blocking these enzymes by MMP inhibitors (MMPIs) have rapidly developed. This paper reviews MMPs in detail. Their perspectives in therapeutic intervention in cancer are also mentioned. [ABSTRACT FROM AUTHOR]

Aim: Apparent diffusion coefficient (ADC) value measurement of nodes in diffusion-weighted images (DWI) has been widely used for diagnosis and differential diagnosis of human tumors. We evaluated whether the ADC provided by DWI varies according to the state of estrogen receptors (ER) and progesterone receptors (PR) in breast cancer (BC). Materials and Methods: English and Chinese electronic databases were searched for potentially relevant studies followed by a comprehensive literature search. Summary standardized mean difference (SMD) with 95% confidence interval (CI) was used for ER and PR category of ADC value with the use of the Z test. Results: Final analysis from 6 eligible cohort studies between 2010 and 2012 were selected for inclusion. Overall estimates revealed that the mean ADC of ER-positive or PR-positive cancer was significantly lower than that of ER-negative or PR-negative breast cancer (ER- VS. ER+: SMD = 0.64, 95% CI: 0.02-1.27, P = 0.042; PR- VS. PR+: SMD = 0.45, 95% CI: 0.04-0.86, P = 0.032). Country-stratified analysis indicated the mean ADC of ER-positive cancer was significantly lower in China (SMD = 3.92, 95% CI: 2.22-5.62, P < 0.001). Further subgroup analysis by MRI machine type implied that ADC values may be a potential diagnostic indicator for PR levels in breast cancer only when using Non-Phillips 1.5T scanner (SMD = 0.88, 95% CI: 0.64-1.12, P < 0.001). Conclusion: ADC values vary significantly according to the ER and PR levels in BC patients, indicating that cancer heterogeneity affects imaging parameters. DWI could therefore be critical for clinical applications of ADC values. [ABSTRACT FROM AUTHOR]