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Cannarozzi AL, Biscaglia G, Parente P, Latiano TP, Gentile A, Ciardiello D, Massimino L, Di Brina ALP, Guerra M, Tavano F, Ungaro F, Bossa F, Perri F, Latiano A, Palmieri O. Artificial intelligence and whole slide imaging, a new tool for the microsatellite instability prediction in colorectal cancer: Friend or foe? Crit Rev Oncol Hematol 2025; 210:104694. [PMID: 40064251 DOI: 10.1016/j.critrevonc.2025.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 03/03/2025] [Accepted: 03/05/2025] [Indexed: 03/18/2025] Open
Abstract
Colorectal cancer (CRC) is the third most common and second most deadly cancer worldwide. Despite advances in screening and treatment, CRC is heterogeneous and the response to therapy varies significantly, limiting personalized treatment options. Certain molecular biomarkers, including microsatellite instability (MSI), are critical in planning personalized treatment, although only a subset of patients may benefit. Currently, the primary methods for assessing MSI status include immunohistochemistry (IHC) for DNA mismatch repair proteins (MMRs), polymerase chain reaction (PCR)-based molecular testing, or next-generation sequencing (NGS). However, these techniques have limitations, are expensive and time-consuming, and often result in inter-method inconsistencies. Deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H) are critical predictive biomarkers of response to immune checkpoint inhibitor (ICI) therapy and MSI testing is recommended to identify patients who may benefit. There is a pressing need for a more robust, reliable, and cost-effective approach that accurately assesses MSI status. Recent advances in computational pathology, in particular the development of technologies that digitally scan whole slide images (WSI) at high resolution, as well as new approaches to artificial intelligence (AI) in medicine, are increasingly gaining ground. This review aims to provide an overview of the latest findings on WSI and advances in AI methods for predicting MSI status, summarize their applications in CRC, and discuss their strengths and limitations in daily clinical practice.
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Affiliation(s)
- Anna Lucia Cannarozzi
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Giuseppe Biscaglia
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo 71013, Italy.
| | - Tiziana Pia Latiano
- Oncology Unit, Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo 71013, Italy.
| | - Annamaria Gentile
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Davide Ciardiello
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Milan.
| | - Luca Massimino
- Gastroenterology and Digestive Endoscopy Department, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Anna Laura Pia Di Brina
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Maria Guerra
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Francesca Tavano
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Federica Ungaro
- Gastroenterology and Digestive Endoscopy Department, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Fabrizio Bossa
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Francesco Perri
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Anna Latiano
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Orazio Palmieri
- Division of Gastroenterology, Fondazione IRCCS - Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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Liu H, Li G, Shen C, Qi X, Liu Y, Hua D, Mao Y, Zhang T. B7-H3-mediated deubiquitination stabilizing CYP1B1 expression promotes chemotherapy resistance in colorectal cancer. Biochim Biophys Acta Mol Basis Dis 2025; 1871:167771. [PMID: 40057208 DOI: 10.1016/j.bbadis.2025.167771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/12/2025] [Accepted: 02/27/2025] [Indexed: 04/15/2025]
Abstract
Colorectal cancer (CRC) is the second‑leading cause of cancer-related mortality worldwide. It is frequently characterized by chemotherapy resistance,which is a predominant factor contributing to unfavorable patient prognosis. B7-H3 is a novel tumor marker and a potential immunotherapy target. High B7-H3 expression in colorectal cancer is associated with adverse prognosis. In this study, we noted increased B7-H3 expression in colorectal cancer tumor tissues. Both in vivo and in vitro experiments demonstrated that increased B7-H3 expression promotes resistance to chemotherapy in CRC. Furthermore, our findings suggest that B7-H3 mediates CRC resistance by modulating CYP1B1 expression. Mechanistic investigations indicated that B7-H3 inhibited the ubiquitination of CYP1B1, stabilized its expression,and consequently enhanced chemotherapeutic resistance in CRC. In summary, our results underscore the significance of the B7-H3-CYP1B1 interaction as a crucial therapeutic target for overcoming chemotherapy resistance in CRC.
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Affiliation(s)
- Huan Liu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Guifang Li
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Chenjie Shen
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Xiaowei Qi
- Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Yankui Liu
- Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Dong Hua
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Yong Mao
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
| | - Ting Zhang
- Institute of Cancer, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China; Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth PL6 8BU, Devon, UK.
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Wei X, Qin R, Yin L, Iqbal MA, Shaibu Z, Li G, Wu T. Investigating the role of the Pon1-rs854560 (L55M) SNP in colorectal Cancer susceptibility. J Cancer Res Clin Oncol 2025; 151:170. [PMID: 40389753 PMCID: PMC12089196 DOI: 10.1007/s00432-025-06226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2025] [Accepted: 05/07/2025] [Indexed: 05/21/2025]
Abstract
BACKGROUND Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with both genetic and environmental risk factors. The PON1 rs854560 (L55M) polymorphism has been implicated in cancer susceptibility through its role in oxidative stress regulation, but its association with CRC remains unclear, particularly in Asian populations. AIM This study aimed to investigate the association between the PON1 rs854560 polymorphism and CRC susceptibility in a Chinese cohort, while assessing its impact on PON1 expression and enzymatic activity. METHOD A case-control study was conducted on 1,003 CRC patients and 1,303 healthy controls. The impact of the Pon1-rs854560 SNP was assessed by comparing the genotypes of individuals diagnosed with CRC to those of controls without the disease. RESULTS Genotype distribution showed slight differences between the case and control groups. The frequency of the AA genotype was slightly lower in the case group (91.72%) than in the control group (93.71%). The AT genotype was observed at similar frequencies in both groups (8.28% in the case group and 6.14% in the control group). Notably, the TT genotype was absent in the case group but present in 0.15% of the control group. Genotype combination analysis suggested that individuals carrying the AT + TT genotype (8.28%) had a higher susceptibility to CRC compared to those with the AA + AT genotype (100%). Allele frequency analysis revealed a slightly higher frequency of allele T in the case group (8.28%) than in the control group (6.45%). Additionally, lower PON1 mRNA and protein expression were associated with CRC progression, including features such as poorer differentiation, deeper tumor invasion, and vascular, nerve, and lymphatic metastasis. CONCLUSION The PON1 rs854560 polymorphism influences CRC risk in Chinese individuals, likely through reduced PON1 expression and detoxification capacity. These findings highlight its potential as a genetic biomarker for CRC susceptibility and suggest PON1's role in tumor progression. Further studies should validate these associations in diverse populations and explore therapeutic strategies targeting PON1 activity.
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Affiliation(s)
- Xi Wei
- Department of Pathology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, China
| | - Rong Qin
- Department of Medical Oncology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, China
| | - Liang Yin
- Department of Breast Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, China
| | | | - Zakari Shaibu
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Guorui Li
- Department of Pathology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, China
| | - Ting Wu
- Department of Pathology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212000, China.
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Narayanan KB. Enzyme-Based Anti-Inflammatory Therapeutics for Inflammatory Diseases. Pharmaceutics 2025; 17:606. [PMID: 40430897 PMCID: PMC12115089 DOI: 10.3390/pharmaceutics17050606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2025] [Revised: 04/21/2025] [Accepted: 04/26/2025] [Indexed: 05/29/2025] Open
Abstract
Inflammation is a multifaceted biological response of the immune system against various harmful stimuli, including pathogens (such as bacteria and viruses), cellular damage, toxins, and natural/synthetic irritants. This protective mechanism is essential for eliminating the cause of injury, removing damaged cells, and initiating the repair process. While inflammation is a fundamental component of the body's defense and healing process, its dysregulation can lead to pathological consequences, contributing to various acute and chronic diseases, such as autoimmune disorders, cancer, metabolic syndromes, cardiovascular diseases, neurodegenerative conditions, and other systemic complications. Generally, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs), antihistamines, biologics, and colchicine are used as pharmacological agents in the management of inflammatory diseases. However, these conventional treatments often have limitations, including adverse side effects, long-term toxicity, and drug resistance. In contrast, enzyme-based therapeutics have emerged as a promising alternative due to their high specificity, catalytic efficiency, and ability to modulate inflammatory pathways with reduced side effects. These enzymes function by scavenging reactive oxygen species (ROS), inhibiting cytokine transcription, degrading circulating cytokines, and blocking cytokine release by targeting exocytosis-related receptors. Additionally, their role in tissue repair and regeneration further enhances their therapeutic potential. Most natural anti-inflammatory enzymes belong to the oxidoreductase class, including catalase and superoxide dismutase, as well as hydrolases such as trypsin, chymotrypsin, nattokinase, bromelain, papain, serratiopeptidase, collagenase, hyaluronidase, and lysozyme. Engineered enzymes, such as Tobacco Etch Virus (TEV) protease and botulinum neurotoxin type A (BoNT/A), have also demonstrated significant potential in targeted anti-inflammatory therapies. Recent advancements in enzyme engineering, nanotechnology-based enzyme delivery, and biopharmaceutical formulations have further expanded their applicability in treating inflammatory diseases. This review provides a comprehensive overview of both natural and engineered enzymes, along with their formulations, used as anti-inflammatory therapeutics. It highlights improvements in stability, efficacy, and specificity, as well as minimized immunogenicity, while discussing their mechanisms of action and clinical applications and potential future developments in enzyme-based biomedical therapeutics.
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Affiliation(s)
- Kannan Badri Narayanan
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan 38541, Gyeongbuk, Republic of Korea; or
- Research Institute of Cell Culture, Yeungnam University, 280 Daehak-Ro, Gyeongsan 38541, Gyeongbuk, Republic of Korea
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Albers B, Auer R, Selby K, Clack L. Organized Colorectal Cancer Screening Programs in Switzerland - Quo Vadis? Int J Public Health 2025; 70:1608183. [PMID: 40302766 PMCID: PMC12038373 DOI: 10.3389/ijph.2025.1608183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 04/02/2025] [Indexed: 05/02/2025] Open
Abstract
Objectives Colorectal cancer (CRC) is among the most commonly diagnosed cancers in Switzerland. Supported by a solid evidence base for CRC screening, cantons have increasingly established organized screening programs. This report summarizes and discusses the state of this program landscape using findings from the Swiss Improving Organized Colorectal Cancer Screening: An Implementation Science Study. Methods Semi-structured interviews were conducted with clinical or administrative leads for Swiss CRC screening programs to understand key characteristics, including host organization, enrollment pathways, screening modalities, and program deliverers. Results Eleven out of 13 existing or planned programs in 2021 participated, eight of which have been developed since 2020. All programs offer mail invitations to citizens 50-69 years old and fecal immunochemical testing, though positivity thresholds vary. Access to colonoscopy and the role of healthcare providers vary between programs. Conclusion Cantonal influences on designing and implementing preventive services allow programs to adapt to local conditions. However, they also challenge opportunities for cross-program learning, efficiencies, and equity. Strengthening the infrastructure connecting programs for shared knowledge building and program improvement will be vital for sustaining Swiss organized CRC screening.
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Affiliation(s)
- Bianca Albers
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
| | - Reto Auer
- Institute of Primary Healthcare (BIHAM), University of Bern, Bern, Switzerland
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Kevin Selby
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Lauren Clack
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Shang A, Yu P, Li L, He G, Xu J. Tumor‑stroma ratio as a clinical prognostic factor in colorectal carcinoma: A meta‑analysis of 7,934 patients. Oncol Lett 2025; 29:190. [PMID: 40041409 PMCID: PMC11877013 DOI: 10.3892/ol.2025.14936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 01/29/2025] [Indexed: 03/06/2025] Open
Abstract
The tumor-stroma ratio (TSR) has been regarded as an important factor associated with tumor metastasis, based on the 'seed and soil' theory, which may have guiding significance for the selection of chemotherapy regimens. Therefore, a high TSR may be a new risk factor for tumor recurrence in patients with stage II colorectal cancer (CRC). The present study aimed to evaluate the prognostic value of TSR in CRC, especially for the computer-calculated TSR. A comprehensive literature retrieval was performed using the PubMed, Web of Science, Embase and Cochrane Library databases to identify relevant studies published up to December 13, 2023. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to estimate the prognostic value of the TSR in CRC. A total of 21 studies published between 2007 and 2023 were included in the present meta-analysis. The combined analysis demonstrated that a high TSR was significantly associated with worse overall survival (OS; HR=1.84; 95% CI, 1.44-2.34; P<0.001), disease-free survival (DFS; HR=1.85; 95% CI, 1.27-2.68; P<0.001), cancer-specific survival (CSS; H=1.97; 95% CI, 1.46-2.65; P<0.001) and recurrence free survival (RFS; HR=1.55; 95% CI, 1.25-1.92; P<0.001) in patients with CRC. Moreover, an elevated computer-calculated TSR was also associated with poor OS (HR=1.89; 95% CI, 1.48-2.40; P<0.001) and DFS (HR=1.85; 95% CI, 1.27-2.68; P<0.001). However, a high TSR was not associated with poor OS in patients with stage I CRC (HR=1.01; 95% CI, 0.48-2.14; P=0.97). In conclusion, the results of the present meta-analysis indicate that a high TSR is associated with poor OS, DFS, CSS and RFS in patients with CRC, especially for those with stage II-III. In addition, TSR calculated by computer using whole-slide images may also be an effective prognostic marker for OS and DFS in patients with CRC.
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Affiliation(s)
- An Shang
- Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
| | - Pengcheng Yu
- Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
| | - Liping Li
- Department of Pneumology, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
| | - Ge He
- Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
| | - Junyi Xu
- Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China
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Shanmugam K, Rajaguru H. Enhanced Superpixel-Guided ResNet Framework with Optimized Deep-Weighted Averaging-Based Feature Fusion for Lung Cancer Detection in Histopathological Images. Diagnostics (Basel) 2025; 15:805. [PMID: 40218155 PMCID: PMC11989018 DOI: 10.3390/diagnostics15070805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 03/06/2025] [Accepted: 03/11/2025] [Indexed: 04/14/2025] Open
Abstract
Background/Objectives: Lung cancer is a leading cause of cancer-related mortalities, with early diagnosis crucial for survival. While biopsy is the gold standard, manual histopathological analysis is time-consuming. This research enhances lung cancer diagnosis through deep learning-based feature extraction, fusion, optimization, and classification for improved accuracy and efficiency. Methods: The study begins with image preprocessing using an adaptive fuzzy filter, followed by segmentation with a modified simple linear iterative clustering (SLIC) algorithm. The segmented images are input into deep learning architectures, specifically ResNet-50 (RN-50), ResNet-101 (RN-101), and ResNet-152 (RN-152), for feature extraction. The extracted features are fused using a deep-weighted averaging-based feature fusion (DWAFF) technique, producing ResNet-X (RN-X)-fused features. To further refine these features, particle swarm optimization (PSO) and red deer optimization (RDO) techniques are employed within the selective feature pooling layer. The optimized features are classified using various machine learning classifiers, including support vector machine (SVM), decision tree (DT), random forest (RF), K-nearest neighbor (KNN), SoftMax discriminant classifier (SDC), Bayesian linear discriminant analysis classifier (BLDC), and multilayer perceptron (MLP). A performance evaluation is performed using K-fold cross-validation with K values of 2, 4, 5, 8, and 10. Results: The proposed DWAFF technique, combined with feature selection using RDO and classification with MLP, achieved the highest classification accuracy of 98.68% when using K = 10 for cross-validation. The RN-X features demonstrated superior performance compared to individual ResNet variants, and the integration of segmentation and optimization significantly enhanced classification accuracy. Conclusions: The proposed methodology automates lung cancer classification using deep learning, feature fusion, optimization, and advanced classification techniques. Segmentation and feature selection enhance performance, improving diagnostic accuracy. Future work may explore further optimizations and hybrid models.
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Guo H, Zhang D, Li Z, Liu S, Wang R. Global burden of gallbladder cancer in 2022 and predictions to 2042. Dig Liver Dis 2025:S1590-8658(25)00243-9. [PMID: 40082101 DOI: 10.1016/j.dld.2025.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 12/18/2024] [Accepted: 02/17/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND & AIMS This study aims to provide updated estimate on the global burden of Gallbladder cancer (GBC) in 2022 and to predict the trends through the year 2042. METHODS Data were extracted from GLOBOCAN 2022 database. Incidence and mortality rates were calculated by sex, country, world region and Human Development Index (HDI). Trends up to the year 2042 were predicted based on global demographic projections by HDI. RESULTS Worldwide, there were 122,469 new GBC cases and 89,045 deaths identified in 2022. While the highest absolute number was observed in South Central Asia and Eastern Asia, particularly India and China, countries in South America, particularly Bolivia, showed the highest age-standardised rate. Medium HDI countries showed more than double the incidence and mortality rates compared to low HDI countries. Over half of GBC cases and deaths occurred in individuals aged 50-74 years. Predictions indicate a 65.3 % increase in new cases and a 67.6 % increase in deaths by 2042, with High HDI countries and Low HDI countries experiencing the largest absolute and percentage increases, respectively. CONCLUSIONS The global burden of GBC is substantial, especially concentrated in South Central Asia, Eastern Asia and South America. With significant increase of burden over the next 20 years, there is an urgent need for effective cancer control strategies in regions exhibiting great GBC burden.
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Affiliation(s)
- Hanfeng Guo
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410013, Hunan Province, China
| | - Decai Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410013, Hunan Province, China
| | - Zhaoqi Li
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410013, Hunan Province, China
| | - Shaojun Liu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410013, Hunan Province, China
| | - Rui Wang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha 410013, Hunan Province, China.
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Sano S, Akiyoshi T, Yamamoto N, Noguchi T, Sakamoto T, Matsui S, Mukai T, Yamaguchi T, Taketomi A, Fukunaga Y, Miyazaki N, Kawachi H. Prognostic Significance of Desmoplastic Reaction After Neoadjuvant Chemoradiotherapy in Advanced Rectal Cancer. Dis Colon Rectum 2025; 68:327-337. [PMID: 39625404 DOI: 10.1097/dcr.0000000000003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2025]
Abstract
BACKGROUND Desmoplastic reaction is recognized as a prognostic factor in colorectal cancer. However, its significance in locally advanced rectal cancer after neoadjuvant chemoradiotherapy remains underexplored. OBJECTIVE To assess the prognostic value of desmoplastic reaction in specimens from patients with advanced rectal cancer after chemoradiotherapy. DESIGN This was a retrospective study. SETTINGS This study was conducted at a single comprehensive cancer center. PATIENTS The study included 255 patients with advanced rectal cancer who underwent fluoropyrimidine-based chemoradiotherapy followed by total mesorectal excision from 2005 to 2014. Desmoplastic reaction was classified into mature, intermediate, and immature categories based on histological analysis. MAIN OUTCOME MEASURES The primary outcomes were recurrence-free survival and overall survival. RESULTS Desmoplastic reaction was classified as mature (69.0%), intermediate (5.5%), or immature (25.5%). The mature group had a higher percentage of good responders (34.1%) compared with the intermediate (0%) and immature (4.6%) groups ( p < 0.0001). The mature group correlated with better outcomes, with a higher 5-year recurrence-free survival (85.4%) and overall survival (93.0%) as compared with intermediate (45.1% and 76.2%, respectively) and immature (65.8% and 88.8%, respectively) groups. In the multivariable analysis, intermediate/immature desmoplastic reaction was significantly associated with poorer recurrence-free survival ( p = 0.03). Among poor responders, intermediate/immature desmoplastic reaction was associated with poorer recurrence-free survival ( p = 0.03). Adjuvant chemotherapy did not significantly improve the 5-year recurrence-free survival rate for the mature group (adjuvant chemotherapy vs no chemotherapy, 86.4% vs 84.8%; p = 0.64), with worse trends observed in the intermediate/immature combined group (55.9% vs 69.4%, respectively, p = 0.27). LIMITATIONS The limitations include the subjective nature of the desmoplastic reaction assessment and the retrospective design of the study. CONCLUSIONS Desmoplastic reaction in surgical specimens after chemoradiotherapy is associated with responses to chemoradiotherapy and serves as a significant prognostic factor in advanced rectal cancer, particularly for those responding poorly to chemoradiotherapy. See Video Abstract . IMPORTANCIA PRONSTICA DE LA REACCIN DESMOPLSICA TRAS LA QUIMIORRADIOTERAPIA NEOADYUVANTE EN EL CNCER RECTAL AVANZADO ANTECEDENTES:La reacción desmoplásica se reconoce como un factor pronóstico en el cáncer colorrectal. Sin embargo, su importancia en el cáncer rectal localmente avanzado después de la quimiorradioterapia neoadyuvante sigue sin explorarse.OBJETIVO:Evaluar el valor pronóstico de la reacción desmoplásica en muestras de pacientes con cáncer rectal avanzado después de la quimiorradioterapia.DISEÑO:Este es un estudio retrospectivo.ESCENARIO:Este estudio se llevó a cabo en un solo centro oncológico integral.PACIENTES:El estudio incluyó a 255 pacientes con cáncer rectal avanzado que se sometieron a quimiorradioterapia basada en fluoropirimidina seguida de una escisión mesorrectal total entre 2005 y 2014. La reacción desmoplásica se clasificó en categorías madura, intermedia e inmadura según el análisis histológico.RESULTADOS PRINCIPALES:Los resultados primarios fueron la supervivencia sin recurrencia y la supervivencia general. RESULTADOS: La reacción desmoplásica se clasificó como madura (69,0%), intermedia (5,5%) o inmadura (25,5%). El grupo maduro tuvo un mayor porcentaje de buenos respondedores (34,1%) en comparación con los grupos intermedio (0%) e inmaduro (4,6%) (p < 0,0001). El grupo maduro se correlacionó con mejores resultados, con una mayor supervivencia libre de recurrencia a 5 años (85,4%) y supervivencia general (93,0%) en comparación con los grupos intermedio (45,1% y 76,2%, respectivamente) e inmaduro (65,8% y 88,8%, respectivamente). En el análisis multivariable, la reacción desmoplásica intermedia/inmadura se asoció significativamente con una peor supervivencia libre de recurrencia ( p = 0,03). Entre los malos respondedores, la reacción desmoplásica intermedia/inmadura se asoció con una peor supervivencia libre de recurrencia (p = 0,03). La quimioterapia adyuvante no mejoró significativamente la tasa de supervivencia sin recurrencia a 5 años para el grupo maduro (quimioterapia adyuvante vs. ninguna quimioterapia, 86,4% vs. 84,8%; p = 0,64), observándose tendencias peores en el grupo combinado intermedio/inmaduro (55,9% vs. 69,4%, respectivamente, p = 0,27).LIMITACIONES:Las limitaciones incluyen la naturaleza subjetiva de la evaluación de la reacción desmoplásica y el diseño retrospectivo del estudio.CONCLUSIONES:La reacción desmoplásica en muestras quirúrgicas después de la quimiorradioterapia se asocia con respuestas a la quimiorradioterapia y sirve como un factor pronóstico significativo en el cáncer rectal avanzado, particularmente para aquellos que responden mal a la quimiorradioterapia. (Traducción-Yesenia Rojas-Khalil ).
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Affiliation(s)
- Shuhei Sano
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Akiyoshi
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noriko Yamamoto
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tatsuki Noguchi
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Sakamoto
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shimpei Matsui
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiki Mukai
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiro Yamaguchi
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yosuke Fukunaga
- Department of Colorectal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoki Miyazaki
- Division of Clinical Research Planning and Strategy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroshi Kawachi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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10
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STRATA Collaborative. ACCORD study: a national multi-centre study of the watch and wait approach in patients with rectal cancer in Aotearoa New Zealand. ANZ J Surg 2025; 95:440-449. [PMID: 40071714 DOI: 10.1111/ans.19415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 12/21/2024] [Accepted: 01/10/2025] [Indexed: 03/27/2025]
Abstract
AIM The adoption of a watch and wait (W&W) approach in patients with rectal cancer, and a complete clinical response (cCR) following neoadjuvant therapy, is increasing worldwide. Despite this, pragmatic unbiased outcome data is limited. This study aimed to investigate national outcomes associated with W&W in Aotearoa New Zealand (AoNZ). METHODS A national retrospective study of patients with adenocarcinoma of the rectum managed with a W&W approach between January 2015 and December 2022 in AoNZ was performed by STRATA, a student and trainee led collaborative network. The Cancer Registry and the New Zealand Ministry of Health National Minimum Data Set were linked to identify patients who had rectal cancer and who were treated with neoadjuvant therapy but not rectal resection. Research teams across 17 AoNZ hospitals then screened these patients for inclusion and data collection. RESULTS One thousand five hundred and eighteen patients were screened across 17 hospitals, 133 met inclusion criteria. Median age was 71 years. Median follow-up was 2.2 years. The 2-year cumulative incidence of local regrowth was 18.2% (95% CI 10.7%-25.1%), of which 92% was present in the bowel wall, and 68% underwent surgery, all with curative intent. The 2-year cumulative distant metastasis rate was 8.8% (95% CI 3.0%-14.2%) and the 2-year overall survival was 94.8% (95% CI 90.4%-99.4%). CONCLUSION This nationwide study of a W&W approach has clinical outcomes similar to the international literature. This data will help guide further implementation of a W&W approach in the management of patients with rectal cancer and inform both clinicians and patients.
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Dey S, Ghosh M, Dev A. Signalling and molecular pathways, overexpressed receptors of colorectal cancer and effective therapeutic targeting using biogenic silver nanoparticles. Gene 2025; 936:149099. [PMID: 39557372 DOI: 10.1016/j.gene.2024.149099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 10/18/2024] [Accepted: 11/13/2024] [Indexed: 11/20/2024]
Abstract
Increasing morbidity and mortality in CRC is a potential threat to human health. The major challenges for better treatment outcomes are the heterogeneity of CRC cases, complicated molecular pathway cross-talks, the influence of gut dysbiosis in CRC, and the lack of multimodal target-specific drug delivery. The overexpression of many receptors in CRC cells may pave the path for targeting them with multiple ligands. The design of a more target-specific drug-delivery device with multiple ligand-functionalized, green-synthesized silver nanoparticles is highly promising and may also deliver other approved chemotherapeutic agents. This review presents the various aspects of colorectal cancer and over-expressed receptors that can be targeted with appropriate ligands to enhance the specific drug delivery potency of green synthesised silver nanoparticles. This review aims to broaden further research into this multi-ligand functionalised, safer and effective silver nano drug delivery system.
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Affiliation(s)
- Sandip Dey
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Jharkhand, India
| | - Manik Ghosh
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Jharkhand, India
| | - Abhimanyu Dev
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Jharkhand, India.
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12
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Gorría T, Sierra-Boada M, Rojas M, Figueras C, Marin S, Madurga S, Cascante M, Maurel J. Metabolic Singularities in Microsatellite-Stable Colorectal Cancer: Identifying Key Players in Immunosuppression to Improve the Immunotherapy Response. Cancers (Basel) 2025; 17:498. [PMID: 39941865 PMCID: PMC11815897 DOI: 10.3390/cancers17030498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 01/26/2025] [Accepted: 01/28/2025] [Indexed: 02/16/2025] Open
Abstract
Although immune checkpoint inhibitor (ICI) therapy is currently the standard of care in microsatellite-unstable (MSI) metastatic colorectal cancer (CRC), ICI therapy, alone or in combination with other therapies, is not a treatment approach in microsatellite-stable (MSS) CRC, which is present in 95% of patients. In this review, we focus on metabolic singularities-at the transcriptomic (either bulk or single cell), proteomic, and post-translational modification levels-that induce immunosuppression in cancer and specifically in MSS CRC. First, we evaluate the current efficacy of ICIs in limited and metastatic disease in MSS CRC. Second, we discuss the latest findings on the potential biomarkers for evaluating ICI efficacy in MSS CRC using strict REMARK criteria. Third, we review the current evidence on metabolic patterns in CRC tumors and immune cell metabolism to advance our understanding of metabolic crosstalk and to pave the way for the development of combination strategies to enhance ICI efficacy.
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Affiliation(s)
- Teresa Gorría
- Medical Oncology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (T.G.); (M.R.); (C.F.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Agustí Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
- Medicine Department, University of Barcelona, 08036 Barcelona, Spain
| | - Marina Sierra-Boada
- Medical Oncology Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
| | - Mariam Rojas
- Medical Oncology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (T.G.); (M.R.); (C.F.)
| | - Carolina Figueras
- Medical Oncology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (T.G.); (M.R.); (C.F.)
| | - Silvia Marin
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, 08036 Barcelona, Spain;
- Institute of Biomedicine of University of Barcelona (IBUB), 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Sergio Madurga
- Department of Material Science and Physical Chemistry, Research Institute of Theoretical and Computational Chemistry (IQTCUB), University of Barcelona, 08028 Barcelona, Spain;
| | - Marta Cascante
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, 08036 Barcelona, Spain;
- Institute of Biomedicine of University of Barcelona (IBUB), 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Joan Maurel
- Medical Oncology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (T.G.); (M.R.); (C.F.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Agustí Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
- Medicine Department, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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Durgawale TP, Rajashakar V, Gupta JK, Banu SS, Galla SH, Singh J, Rao AA, Prasad PD, Chaudhari PB, Mortuza MR, Sweilam SH, Asiri M, Amin MA, Utpal BK, Mohammad BD. Phytochemical-Based Drug Discovery for Breast Cancer: Combining Virtual Screening and Molecular Dynamics to Identify Novel Therapeutics. Chem Biodivers 2025:e202402864. [PMID: 39868843 DOI: 10.1002/cbdv.202402864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Revised: 01/24/2025] [Accepted: 01/27/2025] [Indexed: 01/28/2025]
Abstract
Maternal embryonic leucine zipper kinase (MELK), a pivotal signaling protein, plays a crucial role in various physiological processes, such as cell growth, survival, and differentiation. There is currently a growing interest in MELK as a promising therapeutic target for multiple cancers, including triple-negative breast cancer (TNBC). Exploring MELK as a target offers a prospective strategy to impede cancer progression and enhance the efficacy of conventional anticancer therapies. In this study, we employed a multistep docking procedure to evaluate the anticancer potential of phyto-compounds from the NPACT and PhytoHub databases targeting the MELK protein. A collection of 23 740 compounds underwent hierarchical multistep docking, accompanied by an analysis of binding interactions. The extensive analysis identified five compounds (PHUB000697, PHUB002010, NPACT00373, PHUB002005, and PHUB001739) as potent inhibitors of the MELK protein, exhibiting docking scores lower than -11 Kcal/mol, that is, -12.90, -12.00, -11.23, -11.19, and -11.09 Kcal/mol, respectively. PHUB000697 exhibited very crucial interactions with Gly20, Lys40, Cys89, and Glu93 (2.74 Å). To evaluate the stability of protein-ligand interactions in dynamic states, 100 ns molecular dynamics (MD) simulations were conducted using the entire trajectory, revealing a substantial binding affinity for all identified compounds toward the MELK protein. Consequently, these five compounds emerge as promising candidates for future drug development targeting the MELK protein in treating TNBC. However, experimental assessment is essential to understand the molecular interaction mechanisms better. We are aiming to report a few in vitro and in vivo studies on these compounds to validate the computational results.
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Affiliation(s)
| | - V Rajashakar
- Department of Pharmaceutical Chemistry, Anurag Pharmacy College, Ananthagiri, Suryapet, Telangana, India
| | - Jeetendra Kumar Gupta
- Department of Pharmacology, Institute of Pharmaceutical Research, GLA University, Mathura, Mathura, Uttar Pradesh, India
| | - S Shakila Banu
- Department of Pharmacognosy, Periyar College of Pharmaceutical Sciences, Tiruchirappalli, Tamil Nadu, India
| | - Sri Hari Galla
- Medicinal Chemistry Department, University of Louisville, Louisville, Kentucky, USA
| | - Jyoti Singh
- School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - A Anka Rao
- KL College of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Guntur, Andhra Pradesh, India
| | - P Dharani Prasad
- Department of Pharmacology, Mohan Babu University MB School of Pharmaceutical Sciences, (Erstwhile Sree Vidyaniketan College of Pharmacy), Tirupati, India
| | | | | | - Sherouk Hussein Sweilam
- Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Pharmacognosy, Faculty of Pharmacy, Egyptian Russian University, Badr City, Cairo, Egypt
| | - Mohammed Asiri
- Department of Clinical Laboratory Sciences, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - Md Al Amin
- Department of Pharmacy, Faculty of Health and Life Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Biswajit Kumar Utpal
- Department of Pharmacy, Faculty of Health and Life Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Badrud Duza Mohammad
- Department of Pharmaceutical Chemistry, Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
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14
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Zhao X, Xiu J, Yang H, Han W, Jin Y. Network Pharmacology and Bioinformatics Study of Six Medicinal Food Homologous Plants Against Colorectal Cancer. Int J Mol Sci 2025; 26:930. [PMID: 39940699 PMCID: PMC11817456 DOI: 10.3390/ijms26030930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 01/16/2025] [Accepted: 01/20/2025] [Indexed: 02/16/2025] Open
Abstract
Integrating network pharmacological analysis and bioinformatic techniques, this study systematically investigated the molecular mechanisms of six medicinal food homologous plants (Astragalus membranaceus, Ganoderma lucidum, Dioscorea opposite, Curcuma longa, Glycyrrhiza uralensis, and Pueraria lobata) against colorectal cancer. Through screening the TCMSP database, 303 active compounds and 453 drug targets were identified. By integrating differential expression gene analysis with WGCNA on the GSE41258 dataset from the GEO database, 49 potential therapeutic targets were identified. GO and KEGG enrichment analyses demonstrated that these targets are primarily involved in drug response, fatty acid metabolism, and key cancer-related pathways. Cross-validation using three machine learning algorithms-LASSO regression, SVM-RFE, and Random Forest-pinpointed four critical target genes: CA1, CCND1, CXCL2, and EIF6. Further, CIBERSORT immune infiltration analysis revealed strong associations between these core genes and the tumor immune microenvironment in colorectal cancer patients, notably in modulating M0 macrophage infiltration and mast cell activity. Molecular docking analyses confirmed robust binding interactions between active compounds and core target proteins. This study systematically elucidated the molecular mechanisms of six medicinal food homologous plants against colorectal cancer, providing scientific evidence for their rational clinical application.
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Affiliation(s)
- Xinyue Zhao
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Science, Jilin University, Changchun 130012, China; (X.Z.); (J.X.); (H.Y.)
- Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Jian Xiu
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Science, Jilin University, Changchun 130012, China; (X.Z.); (J.X.); (H.Y.)
| | - Hengzheng Yang
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Science, Jilin University, Changchun 130012, China; (X.Z.); (J.X.); (H.Y.)
| | - Weiwei Han
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Science, Jilin University, Changchun 130012, China; (X.Z.); (J.X.); (H.Y.)
- Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Yue Jin
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Science, Jilin University, Changchun 130012, China; (X.Z.); (J.X.); (H.Y.)
- Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin University, Changchun 130012, China
- National Engineering Laboratory of AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
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Galasso L, Termite F, Mignini I, Esposto G, Borriello R, Vitale F, Nicoletti A, Paratore M, Ainora ME, Gasbarrini A, Zocco MA. Unraveling the Role of Fusobacterium nucleatum in Colorectal Cancer: Molecular Mechanisms and Pathogenic Insights. Cancers (Basel) 2025; 17:368. [PMID: 39941737 PMCID: PMC11816155 DOI: 10.3390/cancers17030368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2024] [Revised: 01/16/2025] [Accepted: 01/20/2025] [Indexed: 02/16/2025] Open
Abstract
Fusobacterium nucleatum, a gram-negative anaerobic bacterium, has emerged as a significant player in colorectal cancer (CRC) pathogenesis. The bacterium causes a persistent inflammatory reaction in the colorectal mucosa by stimulating the release of pro-inflammatory cytokines like IL-1β, IL-6, and TNF-α, creating an environment conducive to cancer progression. F. nucleatum binds to and penetrates epithelial cells through adhesins such as FadA, impairing cell junctions and encouraging epithelial-to-mesenchymal transition (EMT), which is associated with cancer advancement. Additionally, the bacterium modulates the host immune system, suppressing immune cell activity and creating conditions favorable for tumor growth. Its interactions with the gut microbiome contribute to dysbiosis, further influencing carcinogenic pathways. Evidence indicates that F. nucleatum can inflict DNA damage either directly via reactive oxygen species or indirectly by creating a pro-inflammatory environment. Additionally, it triggers oncogenic pathways, especially the Wnt/β-catenin signaling pathway, which promotes tumor cell growth and longevity. Moreover, F. nucleatum alters the tumor microenvironment, impacting cancer cell behavior, metastasis, and therapeutic responses. The purpose of this review is to elucidate the molecular mechanisms by which F. nucleatum contributes to CRC. Understanding these mechanisms is crucial for the development of targeted therapies and diagnostic strategies for CRC associated with F. nucleatum.
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Affiliation(s)
- Linda Galasso
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Fabrizio Termite
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
| | - Irene Mignini
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Giorgio Esposto
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Raffaele Borriello
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Federica Vitale
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
| | - Alberto Nicoletti
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
| | - Mattia Paratore
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Maria Elena Ainora
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Antonio Gasbarrini
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Maria Assunta Zocco
- Internal Medicine, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy; (L.G.); (F.T.); (I.M.); (G.E.); (R.B.); (F.V.); (A.N.); (M.P.); (M.E.A.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A.Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
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Zhang S, Gong F, Liu J, You S, Liu T, Yang J, Hu J. Effects of acteoside from Cistanche tubulosa on the plasma metabolome of cancer-related fatigue mice inoculated with colon cancer cells. Front Pharmacol 2025; 15:1370264. [PMID: 39872045 PMCID: PMC11769790 DOI: 10.3389/fphar.2024.1370264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 12/17/2024] [Indexed: 01/29/2025] Open
Abstract
Objective To elucidate the metabolic mechanisms by which acteoside (ACT) isolated from Cistanche tubulosa alleviates cancer-related fatigue (CRF) in a murine model of colon cancer with cachexia. Methods BALB/c mice inoculated with C26 colon cancer cells were treated with paclitaxel (PTX, 10 mg/kg) and ACT (100 mg/kg) alone or in combination for 21 days. Fatigue-associated behaviors, tumor inhibition rate, and skeletal muscle morphology assessed by hematoxylin-eosin (H&E) staining and electron microscopy were evaluated. Finally, liquid chromatography-mass spectrometry (LC/MS) was employed to investigate alterations in the plasma metabolic profile of tumor-bearing mice with CRF in response to ACT treatment, and the affinity between metabolite-associated proteins and ACT was verified by Surface plasmon resonance (SPR) assay. Results Our study demonstrated the presence of CRF in the colon cancer mouse model, with the severity of fatigue increasing alongside tumor growth. Administration of ACT ameliorated both tumor burden and PTX-induced muscle fatigue-like behavior. LC/MS analysis identified a panel of differentially regulated metabolites, including trans-aconitine, citric acid, 3-coumaric acid, ephedrine, thymine, cytosine, indole-3-acetic acid, and pantothenol-9. These metabolites were primarily enriched in pathways associated with valine biosynthesis, tyrosine metabolism, tryptophan metabolism, and biosynthesis of pyridine alkaloids. Furthermore, several key enzymes, including CYP3A4, CYP19A1, CYP2E1, TNF, BCL-2, RYR2, and ATP2A1, were identified as potential targets underlying the anti-CRF effects of ACT. Conclusion This study suggests that ACT derived from C. tubulosa harbors protective properties against cancer-related fatigue mediated by tumor cells.
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Affiliation(s)
- Shilei Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Central Laboratory, School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Fukai Gong
- Department of Pharmacy, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jiali Liu
- Department of Pharmacognosy, School of Pharmacy, Xinjiang Medical University, Urumqi, China
| | - Shuping You
- Department of Basic Nursing, School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Tao Liu
- Department of Toxicology, School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Jianhua Yang
- Department of Pharmacy, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Junping Hu
- Department of Pharmacognosy, School of Pharmacy, Xinjiang Medical University, Urumqi, China
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Sung H, Siegel RL, Laversanne M, Jiang C, Morgan E, Zahwe M, Cao Y, Bray F, Jemal A. Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data. Lancet Oncol 2025; 26:51-63. [PMID: 39674189 PMCID: PMC11695264 DOI: 10.1016/s1470-2045(24)00600-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 10/17/2024] [Accepted: 10/18/2024] [Indexed: 12/16/2024]
Abstract
BACKGROUND Previous studies have shown that colorectal cancer incidence is increasing among younger adults (aged <50 years) in multiple high-income western countries in contrast with stabilising or decreasing trends in incidence in older adults (aged ≥50 years). This study aimed to investigate contemporary colorectal cancer incidence trends in younger adults versus older adults. METHODS Colorectal cancer incidence data, including year of diagnosis, sex, and 5-year age group for 50 countries and territories, were extracted from the WHO-International Agency for Research on Cancer Cancer Incidence in Five Continents Plus database. The Human Development Index 2022 was retrieved from the United Nations Development Programme and grouped into very high (>0·80), high (0·70-0·79), medium (0·55-0·69), and low (<0·55) categories. Age-standardised incidence rates (ASR) per 100 000 person-years of early-onset (diagnosed between ages 25 to 49 years) and late-onset (diagnosed between ages 50 to 74 years) colorectal cancer (ICD 10th revision, C18-20), diagnosed between 1943-2003 and 2015-17, were calculated using the direct method and Segi-Doll world standard population). The primary study objective was to examine contemporary colorectal cancer incidence trends in younger adults versus older adults using data until 2017 from 50 countries and territories. Temporal trends were visualised and quantified with joinpoint regression, stratified by age at diagnosis (25-49 years or 50-74 years). Average annual percentage changes (AAPC) were estimated. FINDINGS In the most recent 5 years (2013-17 for all countries analysed, except for Japan [2011-15], Spain [2012-16], and Costa Rica [2012-16]), the incidence rate of early-onset colorectal cancer was highest in Australia (ASR 16·5 [95% CI 16·1-16·9]), the USA (Puerto Rico; 15·2 [14·2-16·2]), New Zealand (14·8 [14·0-15·6]), the USA (14·8 [14·7-14·9]), and South Korea (14·3 [14·0-14·5]) and lowest in Uganda (4·4 [3·6-5·2]) and India (3·5 [3·3-3·7]). The highest incidence rates among older adults were found in the Netherlands (168·4 [166·9-170·0]) and Denmark (158·3 [155·8-160·9]) and the lowest were in Uganda (45·9 [38·5-51·4]) and India (23·5 [22·8-24·3]). In terms of AAPC, in the most recent 10 years, incidence rates of early-onset colorectal cancer were stable in 23 countries, but increased in 27 countries with the greatest annual increases in New Zealand (AAPC 3·97% [95% CI 2·44-5·52]), Chile (3·96% [1·26-6·74]), Puerto Rico (3·81% [2·68-4·96]), and England (3·59% [3·12-4·06]). 14 of the 27 countries and territories showed either stable (Argentina, France, Ireland, Norway, and Puerto Rico) or decreasing (Australia, Canada, Germany, Israel, New Zealand, Slovenia, England, Scotland, and the USA) trends in older adults. For the 13 countries with increasing trends in both age groups, the average annual percentage increase in younger compared to older adults was higher in Chile, Japan, Sweden, the Netherlands, Croatia, and Finland; lower in Thailand, France (Martinique), Denmark, and Costa Rica; and similar in Türkiye, Ecuador, and Belarus. The rise in early-onset colorectal cancer was faster among men than women in Chile, Puerto Rico, Argentina, Ecuador, Thailand, Sweden, Israel, and Croatia, whereas faster increase among women compared to men was in England, Norway, Australia, Türkiye, Costa Rica, and Scotland. INTERPRETATION Early-onset colorectal cancer incidence rates are rising in 27 of 50 countries and territories examined, with the rise either exclusive to early-onset disease or faster than the increase in older adults in 20 of the 27 countries. The findings underscore the need for intensified efforts to identify factors driving these trends and increase awareness to help facilitate early detection. FUNDING Intramural Research Program of the American Cancer Society, Cancer Grand Challenges, and National Institutes of Health.
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Affiliation(s)
- Hyuna Sung
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA.
| | - Rebecca L Siegel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Chenxi Jiang
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Eileen Morgan
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mariam Zahwe
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA; Division of Gastroenterology, John T Milliken Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Alvin J Siteman Cancer Center, St Louis, MO, USA
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
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Ebrahimi P, Khaleghi S, Vali M, Delavari S, Khafri S, Karami M, Shojaie L, Nikbakht H. Utilization of a Joint Point Regression Model for Predicting Mortality Rates of Common Cancers in Babol City. Cancer Rep (Hoboken) 2025; 8:e70107. [PMID: 39838878 PMCID: PMC11751474 DOI: 10.1002/cnr2.70107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 10/11/2024] [Accepted: 12/18/2024] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Cancer is a major cause of mortality. Timely information about cancer mortality trends is essential for prioritizing health programs. AIMS This study aims to use a Joint point regression model to predict the mortality rates of the top 10 common cancers in Babol City. METHODS This cross-sectional study considered all registered cancer-related deaths from 2013 to 2021 in the Babol University of Medical Sciences' death registration and classification system. Crude and age-standardized rates and cancer trends were calculated and predicted for the next 5 years, overall and by type of cancer and gender. RESULTS Over these 9years, 2417 deaths from the 10 common cancers were recorded. We observed an increase in mortality rates with a slope of 12.05% from 2013 to 2016, and a gentler slope of 3.2% from 2016 to 2021. Cancer mortality rates are predicted to increase by 6.43% in the next 5 years without intervention. Detailed analysis indicates that breast cancer will have the highest mortality rate during 2022-2026, rising by 13.6% annually. Predictions based on gender indicate that, breast cancer mortality will increase by 13.6% annually for women. Also, stomach cancer mortality rates will increase by 0.15% in men annually. CONCLUSION Cancer mortality in Babol remains a significant public health issue with an increasing trend. Nevertheless, these rising mortality rates require urgent interventions, including cancer prevention programs, increased access to medical services, and improved quality of life.
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Affiliation(s)
- Pouyan Ebrahimi
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Sara Khaleghi
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Mohebat Vali
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Sahar Delavari
- Institute for the Developing Mind, Children's Hospital Los Angeles, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Soraya Khafri
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public HealthBabol University of Medical SciencesBabolIran
| | - Mohsen Karami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Department of Parasitology and MycologyBabol University of Medical SciencesBabolIran
| | - Layla Shojaie
- Division of GI/Liver, Department of Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Hossein‐Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public HealthBabol University of Medical SciencesBabolIran
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19
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Bulisani BM, Leite MADO, Waisberg J. Liver-first approach to the treatment of patients with synchronous colorectal liver metastases: a systematic review and meta-analysis. EINSTEIN-SAO PAULO 2024; 22:eRW0596. [PMID: 39661858 PMCID: PMC11634356 DOI: 10.31744/einstein_journal/2024rw0596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 04/08/2024] [Indexed: 12/13/2024] Open
Abstract
OBJECTIVE The optimal approach to the treatment of colorectal carcinoma and synchronous liver metastases remains controversial. The objective of this review was to analyze the outcomes of adopting the liver-first approach for the treatment of patients with colorectal cancer with synchronous hepatic metastases who initially underwent systemic chemotherapy and/or resection of the metastatic lesions and primary colorectal carcinoma. METHODS This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE, EMBASE, LILACS, and Cochrane Central Register of Controlled Trials databases were searched for the identification and retrieval of eligible studies. Studies that included details of using the liver-first approach for the treatment of synchronous liver metastases of colorectal cancer and its outcomes, including the patients' survival data, were included. Proportional meta-analysis was performed using the random-effects restricted maximum likelihood method to summarize the three- and five-year overall survival and recurrence rates of the patients. RESULTS Eight hundred and fifty-five articles describing the results of studies on the liver-first approach were identified. Three independent reviewers screened the titles and abstracts of the articles and excluded 750 articles. Thereafter, 29 retrospective and comparative studies that met the inclusion criteria were included. No randomized controlled trials were identified in the database search. CONCLUSION Neoadjuvant treatment with systemic chemotherapy for hepatic metastasis can prepare a patient for resection of liver metastases, offering the opportunity for potentially curative treatment of synchronous hepatic metastases initially considered unresectable. The decision regarding the resection of primary colorectal carcinoma and liver metastases should be based on individualized patient response. Prospero database registration ID: CRD42022337047 (www.crd.york.ac.uk/prospero).
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Affiliation(s)
- Bruno Mirandola Bulisani
- Centro Universitário FMABCSanto AndréSPBrazil Centro Universitário FMABC, Santo André, SP, Brazil.
| | | | - Jaques Waisberg
- Centro Universitário FMABCSanto AndréSPBrazil Centro Universitário FMABC, Santo André, SP, Brazil.
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20
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Yu Y, Huang L, Yan R, Jiang M, Li SJ, Fan WD. The efficacy and safety of neoadjuvant treatment with the PD-1 inhibitor for locally advanced colorectal cancer: a meta-analysis. Front Oncol 2024; 14:1416943. [PMID: 39687895 PMCID: PMC11646803 DOI: 10.3389/fonc.2024.1416943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 11/05/2024] [Indexed: 12/18/2024] Open
Abstract
Objective To systematically evaluate the efficacy and safety of PD-1 inhibitors in neoadjuvant therapy for locally advanced colorectal cancer (LACRC). Method Retrieved from PubMed, Embase, and the Cochrane Library, all relevant studies about PD-1 inhibitors for neoadjuvant treatment of LACRC were collected from inception to 31 December 2023. The efficacy was assessed by the rate of pathological complete response (PCR), clinical complete response (CCR), and major pathological response (MPR), and the safety was evaluated by the incidence of all adverse effects (TRAEs). Subgroup analysis was conducted by experimental design, types of PD-1 inhibitors, and disease types. Result A total of 803 patients were included in 21 studies. The results of the meta-analysis showed that the PCR rate of PD-1 inhibitors in the treatment of LACRC was 54% (95% CI: 43%-65%, P<0.05); the CCR of anti-PD-1 was 40% (95% CI: 26%-54%, P<0.05); the MPR was 66% (95% CI: 56%-76%, P<0.05); and the irAEs was 27% (95% CI: 17%-37%, P<0.05). Subgroup analysis showed that the PCRs in prospective studies and retrospective studies were 49% (95% CI: 32%-66%, P<0.05) and 57% (95% CI: 42%-73%, P<0.05), respectively. Among the 803 patients, 619 (77%) were diagnosed with rectal cancer (RC), and the PCR and MPR were 49% and 65%, respectively; 184 (23%) were diagnosed with colorectal cancer (CRC), and the PCR and MPR were both 67%. In our meta-analysis, types of PD-1 inhibitors, including sintilimab, toripalimab, camrelizumab, avelumab, pembrolizumab, and tislelizumab, and patients who received PD-1 inhibitors alone or in combination achieved good PCR rates. Conclusion Neoadjuvant therapy combined with a PD-1 inhibitor has a favorable PCR and relatively low incidences of irAEs for patients with LACRC, suggesting that this regimen including a PD-1 inhibitor is significantly effective and sufficiently safe.
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Affiliation(s)
- Yan Yu
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Huang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rong Yan
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Jiang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shuang-Jiao Li
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wang-Dong Fan
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
- West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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21
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Sun Y, Huang L, Shen X, Yang Z, Xu B, Bao C, Shi Y. Development and validation of a dynamic nomogram for individualized prediction of survival in patients with colon cancer. Sci Rep 2024; 14:28033. [PMID: 39543274 PMCID: PMC11564546 DOI: 10.1038/s41598-024-78783-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 11/04/2024] [Indexed: 11/17/2024] Open
Abstract
Current tools for predicting survival outcomes in colon cancer patients predominantly rely on clinical and pathologic characteristics. However, accumulating evidence demonstrates a significant correlation between nutritional status and patient outcomes. This study aimed to establish a new dynamic nomogram for individualized prediction of postoperative overall survival (OS). The clinicopathological and nutritional data of colon cancer patients undergoing radical resection were retrospectively collected and randomly divided into the primary and validation cohorts. Risk factors on OS rates were investigated by Cox analyses and, the nomogram was constructed using significant predictors. Among 1,024 patients, 341 deaths were observed after median follow-up of 54 months. Five independent prognostic factors, including nutritional status assessments, were incorporated into the nomogram. The C-index regarding 1-, 3-, and 5-year OS were 0.830, 0.859, and 0.757 in the primary cohort and 0.843, 0.870, and 0.773 in the validation cohort, respectively. Calibration curves for the probability of OS exhibited an optimal agreement. Decision curve analyses revealed the greater application value of the nomogram than the TNM staging system. Based on the nomogram, patients could be stratified into three scenarios with significant prognostic classification (P < 0.0001). In conclusion, we developed and validated an easy-to-use dynamic nomogram for predicting postoperative OS in colon cancer patients.
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Affiliation(s)
- Yuting Sun
- Department of Infectious Diseases, Jiangnan University MedicalCenter, 68 Zhongshan Road, Wuxi, 214000, Jiangsu, China
| | - Longchang Huang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Xiaoming Shen
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Zenghui Yang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Binghua Xu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Chuanqing Bao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China.
| | - Yifan Shi
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China.
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22
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Tan Z, Jiang L, Lu A, He X, Zuo Y, Yang J. Living with a permanent ostomy: a descriptive phenomenological study on postsurgical experiences in patients with colorectal cancer. BMJ Open 2024; 14:e087959. [PMID: 39532360 PMCID: PMC11574432 DOI: 10.1136/bmjopen-2024-087959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2024] Open
Abstract
OBJECTIVES To explore the postsurgery lived experiences of patients with colorectal cancer with a permanent ostomy for informing initiatives to improve patient care and future quantitative research. DESIGN A descriptive qualitative phenomenological study. SETTING We conducted this study in the Colorectal Cancer Division at the Cancer Center of West China Hospital, Sichuan University, a premier institution renowned for its comprehensive cancer care and research. PARTICIPANTS 12 patients who had undergone surgeries for colorectal cancer with a permanent ostomy. RESULTS Our interviews revealed profound adjustments in the lives of colorectal cancer survivors living with permanent ostomies. Participants articulated a transition to a 'new normal', characterised by extensive daily life adjustments, psychological adaptation and ongoing management challenges. Key themes identified included the adaptation to a reshaped daily routine and altered perceptions of quality of life. Many faced substantial challenges in stoma care, requiring significant learning and adaptation. Psychological adaptations were marked by a redefinition of body autonomy and personal identity, alongside a recalibration of social interactions and privacy. The need for robust professional guidance and a comprehensive social support system was universally emphasised. CONCLUSIONS Patients with colorectal cancer with permanent ostomies navigate significant changes in their lives postsurgery, undertaking a complex process of reconstructing and adapting to a new normalcy. They recalibrate their physical, psychological and social well-being, demonstrating resilience and adaptability in the face of these challenges. Their pervasive expression of needs for information and support may reflect gaps in the existing patient education and support measures and communication strategies. Healthcare professionals and policy-makers should adopt a patient-centred approach acknowledging the multifaceted nature of postsurgery recovery and adaptation by fostering open communication, tailoring personalised education and facilitating supportive community networks.
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Affiliation(s)
- Zuo Tan
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lili Jiang
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anqing Lu
- Department of Central Transportation, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiao He
- West China Medical Simulation Center, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Zuo
- West China School of Nursing, Sichuan University, Sichuan, China/Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China, Chengdu, Sichuan, China
| | - Jie Yang
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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23
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Yuan Z, Wang Y, Xu S, Zhang M, Tang J. Construction of a prognostic model for colon cancer by combining endoplasmic reticulum stress responsive genes. J Proteomics 2024; 309:105284. [PMID: 39159861 DOI: 10.1016/j.jprot.2024.105284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/31/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024]
Abstract
Endoplasmic reticulum stress may affect the occurrence and development of cancer. However, its effect on the prognosis of colon cancer (CC) patients is not clear yet. Herein, based on TCGA database, we screened 15 endoplasmic reticulum stress responsive genes (ERSRGs) associated with the prognosis of CC patients by Cox regression. By LASSO and multivariate Cox regression analyses, a prognostic risk assessment model involving 12 genes (DNAJB2, EIF4A1, YPEL4, COQ10A, IRX3, ASPHD1, NTRK2, TRIM39, XBP1, GRIN2B, LRRC59, and RORC) was built. The survival curves indicated that patients in the low-risk group had good prognosis. ROC curves demonstrated a good performance of this 12-gene prognostic model, and the Riskscore could be considered as an independent prognostic factor. Patients in low-risk group benefit more from immune checkpoint inhibitor and immune checkpoint blockade (ICB) treatment. Besides, the enrichment analysis suggested a remarkable difference in Ca2+ signaling in both groups. Finally, based on the cMAP database, we identified several potential drugs that could target high-risk groups, such as Dasatinib, GNF-2, Saracatinib, and WZ-1-84. To sum up, our research constructed an ERSRGs-characteristic prognostic model. The model is a promising biomarker for prediction of clinical outcomes and immune therapy response of CC patients. SIGNIFICANCE: Based on the transcriptomic data of colon cancer in the TCGA database, this study screens 12 endoplasmic reticulum stress-related genes (ERSRGs), including DNAJB2, EIF4A1, YPEL4, COQ10A, IRX3, ASPHD1, NTRK2, TRIM39, XBP1, asphD1, NTRK2. GRIN2B, LRRC59, and RORC, and a prognostic model was constructed. This model can be used as a predictor of prognosis and immunotherapy response in colon cancer patients. At the same time, model-based prediction of drugs can also be a potential option for colon cancer treatment in the future.
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Affiliation(s)
- Zhibin Yuan
- Department of General Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Yi Wang
- Department of General Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Song Xu
- Department of General Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Meng Zhang
- Department of General Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China.
| | - Jianjun Tang
- Department of General Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China.
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24
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Cao JP, Yan Y, Li XS, Zhu LX, Hu RK, Feng PF. Oroxylin A suppressed colorectal cancer metastasis by inhibiting the activation of the TGF-β/SMAD signal pathway. Sci Rep 2024; 14:24091. [PMID: 39406881 PMCID: PMC11480421 DOI: 10.1038/s41598-024-75457-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 10/04/2024] [Indexed: 10/19/2024] Open
Abstract
Metastatic colorectal cancer continues to have a high fatality rate, with approximately only 14% of patients surviving more than 5 years. To improve the survival rate of these patients, the development of new therapeutic drugs is a priority. In this study, we investigated the effects of Oroxylin A on the metastasis of human colorectal cancer cells and its potential molecular mechanism. This study utilised CCK8 assay, transwell assay, flow cytometry, western blot analysis, molecular docking, HE staining, immunofluorescence staining, and xenograft models. The proliferation, migration, and invasion of colon cancer cells were effectively suppressed by Oroxylin A in a dose-dependent manner. Oroxylin A has the potential to inhibit the process of epithelial‒mesenchymal transition (EMT) by upregulating the expression of E-cadherin, a marker associated with epithelial cells, while downregulating the levels of N-cadherin, Snail, vimentin, and slug, which are markers associated with mesenchymal cells. In addition, 200 mg/kg of Oroxylin A inhibited the growth of colorectal tumours. Molecular docking technology revealed that Oroxylin A can bind to TGFβ and inhibit the activation of the TGFβ-smad signalling pathway. The overexpression of TGFβ weakened the inhibitory effect of Oroxylin A on the proliferation, migration, and invasion of human colorectal cancer cells, as well as the promoting effect on apoptosis. Oroxylin A inhibited the activation of the TGF-smad signalling pathway and the EMT process, thereby suppressing the migration and invasion of human colorectal cancer cells.
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Affiliation(s)
- Ji-Ping Cao
- Department of Pharmacy, Afliated Hospital 2 of Nantong University, No. 666, Shengli Road, Nantong, 226001, China
| | - Yang Yan
- The Ninth Geological Brigade of Jiangxi Geological Bureau, Nanchang, China
| | - Xin-Shuai Li
- Department of Pharmacy, Afliated Hospital 2 of Nantong University, No. 666, Shengli Road, Nantong, 226001, China
| | - Long-Xun Zhu
- Department of Pharmacy, Afliated Hospital 2 of Nantong University, No. 666, Shengli Road, Nantong, 226001, China
| | - Rui-Kun Hu
- Personnel Department, Affiliated Maternity and Child Health Care Hospital of Nantong University, No.399, Shiji Road, Nantong, 226001, China.
| | - Pan-Feng Feng
- Department of Pharmacy, Afliated Hospital 2 of Nantong University, No. 666, Shengli Road, Nantong, 226001, China.
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25
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Liu Y, Ming H, Xu L, Li L, Liu Q, Zhao J, Zhong C, Li H. DNA methylation analysis of the SDC2, SEPT9 and VIM genes in fecal DNA for colorectal cancer diagnosis. BMC Cancer 2024; 24:1205. [PMID: 39350171 PMCID: PMC11440654 DOI: 10.1186/s12885-024-12990-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 09/24/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Colorectal cancer is one of the most common cancers worldwide. DNA methylation sites may serve as a new gene signature for colorectal cancer diagnosis. The search for representative DNA methylation sites is urgently needed. This study aimed to systematically identify a methylation gene panel for colorectal cancer diagnosis via tissue and fecal samples. METHODS A total of 181 fecal and 50 tumor tissue samples were collected. They were obtained from 83 colorectal cancer patients and 98 healthy subjects. These samples were evaluated for DNA methylation of 9 target genes via quantitative bisulfite next-generation sequencing. We employed the rank-sum test to screen the colorectal cancer-specific methylation sites in the tissue and fecal cohorts. A data model was subsequently constructed and validated via the dedicated validation dataset. RESULTS Compared with the fecal and negative control samples, the colorectal cancer tissue samples presented significantly higher methylation rates for all the selected gene sites. The methylation rates of the tissue and preoperative fecal samples showed the same high and low rates at the same sites. After screening, a panel of 29 loci in the SDC2, SEPT9, and VIM genes proved to be reliable biomarkers for colorectal cancer diagnosis in fecal samples. Logistic regression models were then constructed and validated using this panel. The sensitivity of the model was 91.43% (95% CI = [89.69, 93.17]), the specificity was 100% (95% CI = [100,100]), and the AUC value is 99.31% (95% CI = [99,99.62]). The diagnostic accuracy of the model for stage I and stage II colorectal cancer was 100% (11/11) and 91.3% (21/23), respectively. Overall, this study confirms that the gene locus panel and the model can be used to diagnose colorectal cancer effectively through feces. CONCLUSIONS Our study identified a set of key methylation sites for colorectal cancer diagnosis from fecal samples, highlighting the importance of using tissue and fecal samples to accurately assess DNA methylation levels to screen for methylation sites, and developing an effective diagnostic model for colorectal cancer.
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Affiliation(s)
- Yue Liu
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Hongbo Ming
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Lizhi Xu
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Lizhen Li
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Qi Liu
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Jinyin Zhao
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China
| | - Cundi Zhong
- Department of Laboratory, The Second Affiliated Hospital of Dalian Medical University, 216 Zhongshan Street, Ganjingzi District, Dalian, Liaoning, 116031, China.
| | - Hongzhi Li
- Dalian Gentalker Biotech Co., Ltd., 9-2, Jinqi Road, Jinpu New District , Dalian, Liaoning, 116635, China.
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Ammirati CA, Arezzo A, Gaetani C, Strazzarino GA, Faletti R, Bergamasco L, Barisone F, Fonio P, Morino M. Can we apply the concept of sentinel lymph node in rectal cancer surgery? MINIM INVASIV THER 2024:1-7. [PMID: 39295076 DOI: 10.1080/13645706.2024.2404046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 08/08/2024] [Indexed: 09/21/2024]
Abstract
INTRODUCTION Colorectal cancer remains one of the most common causes of cancer-related mortality worldwide, and lymph node staging is crucial in the diagnostic and therapeutic process. Sentinel lymph nodes are the first involved in this process, but their validity in colorectal surgery has not yet been established. Following the emergence of new imaging instrumentation, some authors have attempted to propose different techniques for lymph node identification. However, a clear pattern of mesorectal lymph node distribution relative to the primary lesion site has yet to be defined. MATERIAL AND METHODS Our analysis retrospectively reviewed suspicious mesorectal pathological lymph nodes on pre-operative magnetic resonance imaging (MRI) of rectal cancer patients, in order to assess the distribution patterns of possible tumour-related rectal lymph nodes. Mesorectal space was subdivided into quadrants and levels, and morphological features and distances from the lymph node to the primary rectal tumour were recorded. RESULTS Two hundred and fifty-five mesorectal lymph nodes distributed among 60 patients were collected. Results show that in 92.1% of cases, nodes were distributed in the same mesorectal quadrant as the rectal primary tumour, and in 88.5% of cases, they were found at the same level as the rectal primary tumour. CONCLUSIONS Although a clear node distribution pattern was not established, these results may suggest at least a lymphatic drainage preference lane, worthy of further investigation.
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Affiliation(s)
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Clara Gaetani
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Paolo Fonio
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mario Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
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Sharma S, Chakraborty M, Yadav D, Dhullap A, Singh R, Verma RK, Bhattacharya S, Singh S. Strategic Developments in Polymer-Functionalized Liposomes for Targeted Colon Cancer Therapy: An Updated Review of Clinical Trial Data and Future Horizons. Biomacromolecules 2024; 25:5650-5669. [PMID: 39162323 DOI: 10.1021/acs.biomac.4c00847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
Liposomes, made up of phospholipid bilayers, are efficient nanocarriers for drug delivery because they can encapsulate both hydrophilic and lipophilic drugs. Conventional cancer treatments sometimes involve considerable toxicities and adverse drug reactions (ADRs), which limits their clinical value. Despite liposomes' promise in addressing these concerns, clinical trials have revealed significant limitations, including stability, targeted distribution, and scaling challenges. Recent clinical trials have focused on enhancing liposome formulations to increase therapeutic efficacy while minimizing negative effects. Notably, the approval of liposomal medications like Doxil demonstrates their potential in cancer treatment. However, the intricacy of liposome preparation and the requirement for comprehensive regulatory approval remain substantial impediments. Current clinical trial updates show continued efforts to improve liposome stability, targeting mechanisms, and payload capacity in order to address these issues. The future of liposomal drug delivery in cancer therapy depends on addressing these challenges in order to provide patients with more effective and safer treatment alternatives.
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Affiliation(s)
- Satyam Sharma
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur 844102, India
| | - Moitrai Chakraborty
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur 844102, India
| | - Dharmendra Yadav
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur 844102, India
| | - Aniket Dhullap
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur 844102, India
| | - Raghuraj Singh
- Pharmaceutical Nanotechnology lab, Institute of Nano Science and Technology (INST), Sector 81, Mohali, Punjab 140306, India
| | - Rahul Kumar Verma
- Pharmaceutical Nanotechnology lab, Institute of Nano Science and Technology (INST), Sector 81, Mohali, Punjab 140306, India
| | - Sankha Bhattacharya
- SVKM's NMIMS School of Pharmacy & Technology Management, Shirpur, Dist. Dhule, Maharashtra 425405, India
| | - Sanjiv Singh
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur 844102, India
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Ouyang Z, Chen P, Zhang M, Wu S, Qin Z, Zhou L. Arginine on immune function and post-operative obstructions in colorectal cancer patients: a meta-analysis. BMC Cancer 2024; 24:1089. [PMID: 39223466 PMCID: PMC11370068 DOI: 10.1186/s12885-024-12858-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The aim of this study is to investigate the impact of arginine on immune function and postoperative complications in colorectal cancer (CRC) patients. METHODS We conducted a comprehensive search to identify eligible RCTs in various databases, such as PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang, VIP Medicine Information System (VIP), and Chinese Biomedical Database (CBM). This study aimed to examine IgA, IgG, and IgM levels as well as CD4+ and CD8+ counts as well as the CD4+/CD8+ ratio. Anastomotic leaking, length of stay (LOS), and surgical site infection (SSI) were included as secondary outcomes. Stata (StataCorp, version 14.0) was utilized for data analysis. To ensure the results were reliable, we used meta-regression, sensitivity analysis, and publication bias analysis. RESULTS A total of 24 publications (including 1883 patients) out of 681 that were retrieved fulfilled the inclusion criteria. The arginine group showed notable improvements in humoral immunity, with gains in IgA (SMD=0.45, 95% CI: 0.30-0.60), IgG (SMD=0.80, 95% CI: 0.64-0.96), and IgM (SMD=0.66, 95% CI: 0.39-0.93). With regards to cellular immunity, the arginine group exhibited a substantial increase in the CD4+ T cell count (SMD = 1.03, 95% CI: 0.67-1.38) compared to the control group. However, the CD4+/CD8+ ratio decreased significantly (SMD=1.37, 95% CI: 0.88-1.86) in the same arginine group, indicating a change in the balance between these two cell types. Additionally, the CD8+ T cell count showed a notable decrease (SMD=-0.70, 95% CI: -1.09 to -0.32) in the arginine group when compared to the control group. Anastomotic leakage was also considerably lower in the arginine group (SMD=-0.05, 95% CI: -0.08 to -0.02), the rate of SSIs was lower (RR = -0.02, 95% CI: -0.05-0), and the length of time patients spent in the hospital was shorter (SMD=-0.15, 95% CI: -0.38 to -0.08). CONCLUSIONS After radiation treatment for CRC, arginine improves immune function and decreases the risk of infection problems. TRIAL REGISTRATION Registration with PROSPERO for this meta-analysis is number CRD42024520509.
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Affiliation(s)
- Zan Ouyang
- Colorectal and Anal Surgery, Deyang People's Hospital, No. 173, North Taishan Road, Jingyang District, Deyang, 618000, China
| | - Ping Chen
- Colorectal and Anal Surgery, Jiangbei Hospital of Traditional Chinese Medicine, Chongqing, 400020, China
| | - Min Zhang
- Colorectal and Anal Surgery, Deyang People's Hospital, No. 173, North Taishan Road, Jingyang District, Deyang, 618000, China
| | - Sijia Wu
- Clinical Laboratory, Jinjiang Maternity and Child Health Hospital, Chengdu, 610011, China
| | - Zongying Qin
- Colorectal and Anal Surgery, Zizhong People's Hospital, Zizhong, 641200, China.
| | - Li Zhou
- Colorectal and Anal Surgery, Deyang People's Hospital, No. 173, North Taishan Road, Jingyang District, Deyang, 618000, China.
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Almlöv K, Arbman G, Björnsson B, Elander NO, Hager J, Hamid S, Landerholm K, Loftås P, Sandström P. Assessment by a multidisciplinary team conference affects treatment strategy and overall survival in patients with synchronous colorectal liver metastases. HPB (Oxford) 2024; 26:1131-1140. [PMID: 38849249 DOI: 10.1016/j.hpb.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/20/2024] [Accepted: 05/20/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND The aim of this retrospective observational study was to investigate the geographical or sex differences in patients with synchronous colorectal liver metastases (sCRLM) in terms of assessment by a multidisciplinary team conference (MDT), curative treatment, and overall survival. METHOD All sCRLM patients in the South-East Health Care Region of Sweden from 2009 to 2015 were included (n = 615). Data were derived from the Swedish Colorectal Cancer Registry, Swedish Registry of Liver and Bile Surgery and medical records. RESULTS Patients who had a hepatobiliary unit (HBU) at the nearest hospital were more likely to undergo liver surgery (HBU+, 37% (n = 106), compared to HBU-, 22% (n = 60); p = 0.001) and had a better median survival (p < 0.001). No sex differences were observed. In multivariate Cox regression analyses of overall survival, assessment by an MDT that included a liver surgeon was independently linked to better survival (HR 0.574, 0.433-0.760). CONCLUSION There were no sex differences in access to liver surgery or overall survival, however, there were geographical inequalities, where residency near a hospital with HBU was associated with increased overall survival and the possibility to receive liver surgery. Assessment at MDT with liver surgeon present was associated with greater survival, indicating its important role for treatment.
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Affiliation(s)
- Karin Almlöv
- Department of Surgery in Norrköping and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden.
| | - Gunnar Arbman
- Department of Surgery in Norrköping and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Nils O Elander
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Clatterbridge Cancer Centre NHS, FT, Liverpool, United Kingdom
| | - Jakob Hager
- Department of Surgery in Norrköping and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Salik Hamid
- Department of Surgery in Norrköping and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Kalle Landerholm
- Department of Surgery in Jönköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per Loftås
- Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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30
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Cai SR, Huang YQ, Li QR, Zhu HH, Zhang SZ, Song YM, Yang JH, Zheng S. Combining FITs and HRFQ with colonoscopy improve the cost-effectiveness of a 9-year mass colorectal cancer screening program. ESMO Open 2024; 9:103676. [PMID: 39168026 PMCID: PMC11381980 DOI: 10.1016/j.esmoop.2024.103676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/12/2024] [Accepted: 07/19/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) incidence has been increasing. Colonoscopy is still a gold standard method for its early diagnosis but using colonoscopy alone as a mass screening method is unrealistic. This study is to investigate whether combining fecal immunochemical test (FIT) and high-risk-factors questionnaire (HRFQ) with colonoscopy improve the cost-effectiveness of a mass CRC screening. PATIENTS AND METHODS CRC screening protocol combining FITs and HRFQ in the first stage and colonoscopy in the second stage was used in 50 villages/towns in 2007-2015. Residents aged 40-74 years were eligible for this free screening. A total of 160 210 (76.12%) participants completed first-stage screening, and 28 679 (17.90%) participants were defined as positive, among which 21 715 (75.72%) participants completed colonoscopy and were included in the final analysis. Outcomes were followed up until 2020. RESULTS The compliance was 76.12% and 75.72% in the first and second screening stage, respectively. A total of 252 CRC, 4033 adenoma, 1234 advanced neoplasm, and 5534 total neoplasm cases were detected in the screening. The positive predictive values of CRC, adenoma, advanced neoplasm, and total neoplasm were higher in FITs+ than those in the HRFQ+ population, respectively. A total of 64.60% and 43.42% total neoplasm cases were found in FITs+ and HRFQ+ (8.02% for both), respectively. The total colorectal neoplasm and CRC cases detected by combining HRFQ and FITs increased by 55.08% and 40.00%, respectively, and their increases were higher compared to HRFQ. The detection cost per any neoplasm by combining HRFQ and FITs was <$5331, while that by FITs and HRFQ alone was <$4570 and $5380, respectively. CONCLUSIONS Combining FITs and HRFQ with colonoscopy improve the cost-effectiveness of a mass CRC screening program. This protocol can be recommended for most populations, especially those in the countries and areas with high population density and low physician/population ratio.
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Affiliation(s)
- S-R Cai
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, the China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang, The Zhejiang University School of Medicine Affiliated Second Hospital, Zhejiang; Zhejiang Provincial Clinical Research Center for Cancer and Cancer Center of Zhejiang University, Hangzhou, Zhejiang
| | - Y-Q Huang
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, the China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang, The Zhejiang University School of Medicine Affiliated Second Hospital, Zhejiang; Zhejiang Provincial Clinical Research Center for Cancer and Cancer Center of Zhejiang University, Hangzhou, Zhejiang
| | - Q-R Li
- Cancer Prevention Institute of Jiashan County, Jiashan, Zhejiang
| | - H-H Zhu
- Center for Medical Research, Zhejiang Chinese Medical University Affiliated Four-Province-Bordering Hospital of Traditional Chinese Medicine (Quzhou Hospital of Traditional Chinese Medicine), Quzhou, Zhejiang.
| | - S-Z Zhang
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, the China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang, The Zhejiang University School of Medicine Affiliated Second Hospital, Zhejiang; Zhejiang Provincial Clinical Research Center for Cancer and Cancer Center of Zhejiang University, Hangzhou, Zhejiang
| | - Y-M Song
- Department of Colorectal Surgery, The Zhejiang University School of Medicine Affiliated Second Hospital, Hangzhou, Zhejiang, P.R. China
| | - J-H Yang
- Cancer Prevention Institute of Jiashan County, Jiashan, Zhejiang
| | - S Zheng
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, the China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang, The Zhejiang University School of Medicine Affiliated Second Hospital, Zhejiang; Zhejiang Provincial Clinical Research Center for Cancer and Cancer Center of Zhejiang University, Hangzhou, Zhejiang
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31
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Milsom JW, Pua BP, Sedrakyan A, Lowenfeld L, Yeo HL. Creating the Future of (Endoluminal) GI Interventions. Clin Colon Rectal Surg 2024; 37:346-354. [PMID: 39132196 PMCID: PMC11309788 DOI: 10.1055/s-0043-1770949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Major innovation into how we pursue diagnosis and therapies for gastrointestinal (GI) diseases is urgently needed to seek better, less invasive, and less costly innovations in diagnostic and therapeutic interventions in the GI tract. Learning from prior paradigm shifts in cardiac and vascular we present here several initial steps we have undertaken to follow the endoluminal path, using advanced imaging methods, including endoscopy, and data management with avoidance of entry into a body cavity when possible. We will review the benefit and ease of incorporating routine fluoroscopy with endoscopy to improve safety and efficiency. We describe the development of "hybrid" procedure rooms for GI interventions and rationale for their use. We also emphasize the importance of collaborating with interventional radiologists, software engineers, and data specialists. We predict major improvement in outcomes in both diagnosis and treatment will follow.
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Affiliation(s)
- Jeffrey W. Milsom
- Section of Colon and Rectal Surgery, Department of Surgery, Center for Intelligent Image-Guided Interventions (CI3), New York Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Bradley P. Pua
- Division of Interventional Radiology, Center for Intelligent Image-Guided Interventions (CI3), New York Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Art Sedrakyan
- Department of Health Policy and Research, Center for Intelligent Image-Guided Interventions (CI3), New York Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Lea Lowenfeld
- Section of Colon and Rectal Surgery, Department of Surgery, Center for Intelligent Image-Guided Interventions (CI3), New York Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Heather L. Yeo
- Section of Colon and Rectal Surgery, Department of Surgery, Center for Intelligent Image-Guided Interventions (CI3), New York Presbyterian Hospital/Weill Cornell Medicine, New York
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Almutairi MH, Alrubie TM, Alshareeda AT, Albarakati N, Almotiri A, Alamri AM, Almutairi BO, Alanazi M. Differential expression and regulation of ADAD1, DMRTC2, PRSS54, SYCE1, SYCP1, TEX101, TEX48, and TMPRSS12 gene profiles in colon cancer tissues and their in vitro response to epigenetic drugs. PLoS One 2024; 19:e0307724. [PMID: 39208330 PMCID: PMC11361649 DOI: 10.1371/journal.pone.0307724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/10/2024] [Indexed: 09/04/2024] Open
Abstract
Colon cancer (CC) is a significant cause of death worldwide, particularly in Saudi Arabia. To increase the accuracy of diagnosis and treatment, it is important to discover new specific biomarkers for CC. The main objectives of this research are to identify potential specific biomarkers for the early diagnosis of CC by analyzing the expressions of eight cancer testis (CT) genes, as well as to analyze how epigenetic mechanisms control the expression of these genes in CC cell lines. Tissue samples were collected from 15 male patients with CC tissues and matched NC tissues for gene expression analysis. The expression levels of specific CT genes, including ADAD1, DMRTC2, PRSS54, SYCE1, SYCP1, TEX101, TEX48, and TMPRSS12, were assessed using quantitative techniques. To validate the gene expression patterns, we used publicly available CC statistics. To investigate the effect of inhibition of DNA methylation and histone deacetylation on CT gene expression, in vitro experiments were performed using HCT116 and Caco-2 cell lines. There was no detected expression of the genes neither in the patient samples nor in NC tissues, except for TEX48, which exhibited upregulation in CC samples compared to NC tissues in online datasets. Notably, CT genes showed expression in testis samples. In vitro, experiments demonstrated significant enhancement in mRNA expression levels of ADAD1, DMRTC2, PRSS54, SYCE1, SYCP1, TEX101, TEX48, and TMPRSS12 following treatment with 5-aza-2'-deoxycytidine and trichostatin A in HCT116 and Caco-2 cell lines. Epigenetic treatments modify the expression of CT genes, indicating that these genes can potentially be used as biomarkers for CC. The importance of conducting further research to understand and target epigenetic mechanisms to improve CC treatment cannot be overemphasized.
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Affiliation(s)
- Mikhlid H. Almutairi
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Turki M. Alrubie
- Laboratories Directorate, General Directorate of Animal Health, Ministry Deputyship for Agriculture, Ministry of Environment, Water and Agriculture, Riyadh, Saudi Arabia
| | - Alaa T. Alshareeda
- Blood and Cancer Research Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nada Albarakati
- Blood and Cancer Research Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Alhomidi Almotiri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Ad Dawadmi, Saudi Arabia
| | - Abdullah M. Alamri
- Department of Biochemistry, Genome Research Chair, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Bader O. Almutairi
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Alanazi
- Department of Biochemistry, Genome Research Chair, College of Science, King Saud University, Riyadh, Saudi Arabia
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Lucarelli NM, Mirabile A, Maggialetti N, Morelli C, Calbi R, Bartoli S, Avella P, Saccente D, Greco S, Ianora Stabile AA. The role of superior hemorrhoidal vein ectasia in the preoperative staging of rectal cancer. Front Oncol 2024; 14:1356022. [PMID: 39161384 PMCID: PMC11330806 DOI: 10.3389/fonc.2024.1356022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 07/09/2024] [Indexed: 08/21/2024] Open
Abstract
Objective The prognosis of colorectal cancer has continuously improved in recent years thanks to continuous progress in both the therapeutic and diagnostic fields. The specific objective of this study is to contribute to the diagnostic field through the evaluation of the correlation between superior hemorrhoidal vein (SHV) ectasia detected on computed tomography (CT) and Tumor (T), Node (N), and distant metastasis (M) examination and mesorectal fascia (MRF) invasion in the preoperative staging of rectal cancer. Methods Between January 2018 and April 2022, 46 patients with histopathological diagnosis of rectal cancer were retrospectively enrolled, and the diameter of the SHV was evaluated by CT examination. The cutoff value for SHV diameter used is 3.7 mm. The diameter was measured at the level of S2 during portal venous phase after 4× image zoom to reduce the interobserver variability. The parameters evaluated were tumor location, detection of MRF infiltration (defined as the distance < 1 mm between the tumor margins and the fascia), SHV diameter, detection of mesorectal perilesional lymph nodes, and detection of metastasis. Results A total of 67.39% (31/46) of patients had SHV ectasia. All patients with MRF infiltration (4/46, 7.14%) presented SHV ectasia (average diameter of 4.4 mm), and SHV was significantly related with the development of liver metastases at the moment of primary staging and during follow-up. Conclusion SHV ectasia may be related to metastasis and MRF involvement; therefore, it could become a tool for preoperative staging of rectal cancer.
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Affiliation(s)
- Nicola Maria Lucarelli
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | | | - Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | - Chiara Morelli
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | - Roberto Calbi
- Radiology Unit, Ente Ecclesiastico Ospedale Generale Regionale “F. Miulli”, Bari, Italy
| | - Simona Bartoli
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | - Pasquale Avella
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Saccente
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | - Sara Greco
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
| | - Antonio Amato Ianora Stabile
- Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, University of Bari Medical School “Aldo Moro”, Bari, Italy
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Huang M, Wang J, Zhang Z, Zuo X. ZMIZ1 Regulates Proliferation, Autophagy and Apoptosis of Colon Cancer Cells by Mediating Ubiquitin-Proteasome Degradation of SIRT1. Biochem Genet 2024; 62:3245-3259. [PMID: 38214831 PMCID: PMC11289246 DOI: 10.1007/s10528-023-10573-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/26/2023] [Indexed: 01/13/2024]
Abstract
There are nearly 1.15 million new cases of colon cancer, as well as 586,858 deaths from colon cancer worldwide in 2020. The aim of this study is to reveal whether ZMIZ1 can control the fate of colon cancer cells and the mechanism by which it functions. Specific shRNA transfection was used to knock down the expression of ZMIZ1 in colon cancer cell lines (HCT116 and HT29), and cell proliferation was detected using EdU and CCK-8 reagents, apoptosis by flow cytometry, and autophagy by western blot. The interaction of ZMIZ1 and SIRT1 was analyzed. Knockdown of ZMIZ1 significantly inhibited autophagy and proliferation, and induced apoptosis of HCT116 and HT29 cells. The mRNA level of SIRT1 was not affected by ZMIZ1 knockdown, but the protein level of SIRT1 was significantly decreased and the protein level of the SIRT1-specific substrate, acetylated FOXO3a, was reduced. Immunoprecipitation assays identified the interaction between SIRT1 and ZMIZ1 in HCT116 and HT29 cells. ZMIZ1 increased intracellular ubiquitination of SIRT1. Knockdown or pharmacological inhibition of SIRT1 neutralized the effects of ZMIZ knockdown on proliferation, autophagy and apoptosis in HCT116 and HT29 cells. ZMIZ1 may control the fate of colon cancer cells through the SIRT1/FOXO3a axis. Targeting ZMIZ1 would be beneficial for the treatment of colon cancer.
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Affiliation(s)
- Min Huang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan West Road, Wuhu, 241000, Anhui, China.
| | - Junfeng Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan West Road, Wuhu, 241000, Anhui, China
| | - Zhengrong Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan West Road, Wuhu, 241000, Anhui, China
| | - Xueliang Zuo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan West Road, Wuhu, 241000, Anhui, China
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35
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Rau A, Bano S, Jin Y, Azagra P, Morlana J, Kader R, Sanderson E, Matuszewski BJ, Lee JY, Lee DJ, Posner E, Frank N, Elangovan V, Raviteja S, Li Z, Liu J, Lalithkumar S, Islam M, Ren H, Lovat LB, Montiel JMM, Stoyanov D. SimCol3D - 3D reconstruction during colonoscopy challenge. Med Image Anal 2024; 96:103195. [PMID: 38815359 DOI: 10.1016/j.media.2024.103195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/08/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024]
Abstract
Colorectal cancer is one of the most common cancers in the world. While colonoscopy is an effective screening technique, navigating an endoscope through the colon to detect polyps is challenging. A 3D map of the observed surfaces could enhance the identification of unscreened colon tissue and serve as a training platform. However, reconstructing the colon from video footage remains difficult. Learning-based approaches hold promise as robust alternatives, but necessitate extensive datasets. Establishing a benchmark dataset, the 2022 EndoVis sub-challenge SimCol3D aimed to facilitate data-driven depth and pose prediction during colonoscopy. The challenge was hosted as part of MICCAI 2022 in Singapore. Six teams from around the world and representatives from academia and industry participated in the three sub-challenges: synthetic depth prediction, synthetic pose prediction, and real pose prediction. This paper describes the challenge, the submitted methods, and their results. We show that depth prediction from synthetic colonoscopy images is robustly solvable, while pose estimation remains an open research question.
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Affiliation(s)
- Anita Rau
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK; Stanford University, Stanford, CA, USA.
| | - Sophia Bano
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK.
| | - Yueming Jin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK; National University of Singapore, Singapore.
| | | | | | - Rawen Kader
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK
| | - Edward Sanderson
- Computer Vision and Machine Learning (CVML) Group, University of Central Lancashire, Preston, UK
| | - Bogdan J Matuszewski
- Computer Vision and Machine Learning (CVML) Group, University of Central Lancashire, Preston, UK
| | - Jae Young Lee
- Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Dong-Jae Lee
- Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | | | | | | | - Sista Raviteja
- Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Zhengwen Li
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, China
| | - Jiquan Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, China
| | - Seenivasan Lalithkumar
- National University of Singapore, Singapore; The Chinese University of Hong Kong, Hong Kong, China
| | | | - Hongliang Ren
- National University of Singapore, Singapore; The Chinese University of Hong Kong, Hong Kong, China
| | - Laurence B Lovat
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK
| | | | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) and Department of Computer Science, University College London, London, UK
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Shahabi F, Mehri A, Abdollahi A, Hoshyar SHH, Ghahramani A, Noei MG, Orafaie A, Ansari M. Post recurrence survival in early versus late period and its prognostic factors in rectal cancer patients. Sci Rep 2024; 14:17661. [PMID: 39085286 PMCID: PMC11291732 DOI: 10.1038/s41598-024-67852-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 07/16/2024] [Indexed: 08/02/2024] Open
Abstract
To identify factors associated with post-recurrence survival (PRS), we examined our institutional recurrence patterns following definitive resection for rectal cancer. We reviewed all patients with rectal cancer diagnosed at three hospitals in the east of Iran from 2011 to 2020. The optimal cut-off value was determined by receiver operating characteristic (ROC) analysis to determine early recurrence. The effect of recurrence time was evaluated on PRS. 326 eligible patients with a mean ± SD age of 56 ± 12.8 years were included in this study. In a median (IQR: Inter-quartile range) follow-up time of 76 (62.2) months, 106 (32.5%) patients experienced at least any recurrence (locoregional or distant metastasis) following primary resection. The median (IQR) time from initial surgery to recurrence was 29.5 (31.2) months. Based on ROC analysis, early recurrence was specified at ≤ 29 months. However, for the patients who experienced only locoregional recurrence, 33 months was the cut-off to define early recurrence. Recurrence time and recurrence management were both significant variables on PRS. Moreover, TNM staging was significantly associated with early recurrence (P = 0.003). In this research, recurrence time, recurrence management and TNM staging were found to be correlated with PRS.
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Affiliation(s)
- Fatemeh Shahabi
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Ali Mehri
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Abbas Abdollahi
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Seyed Hossein Hosseini Hoshyar
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Abolfazl Ghahramani
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Mahdie Ghiyasi Noei
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran
| | - Ala Orafaie
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran.
| | - Majid Ansari
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd, Mashhad, Iran.
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Jiao Y, Mongardini FM, Xie H, Zhou X, Kong X, Wen J, Docimo L, Li J, Gambardella C. CC vs. CC-Plus: A Comparison between Two Cranial-to-Caudal Approaches for Laparoscopic Right Hemicolectomy: A Single-Center Retrospective Study. J Pers Med 2024; 14:781. [PMID: 39201973 PMCID: PMC11355353 DOI: 10.3390/jpm14080781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/26/2024] [Accepted: 07/06/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Colorectal cancer is a leading cause of cancer-related deaths worldwide, with approximately 1.9 million new cases and over 935,000 deaths in 2020. Right-sided colon cancer, a subset of colorectal cancer, represents a significant health burden. Laparoscopic colon surgery has significantly improved postoperative recovery. The superiority of one approach or landmark over another is still argued about due to the lack of large-scale prospective studies. However, deep understanding both of the anatomical variation and characteristics of each approach is of extreme importance to minimizing adverse effects and maximizing patient benefit after laparoscopic right hemicolectomy. Among these, the cranial-to-caudal approach offers advantages such as reduced intraoperative blood loss, shorter operation time, and decreased risk of vascular injury. The purpose of this study is to compare the efficacy and safety of two cranial-to-caudal approaches for laparoscopic right hemicolectomy (LRH). Specifically, the study aims to evaluate the differences between the conventional cranial-to-caudal approach with medial ligation of the middle colic vein (MCV), and the cranial-to-caudal approach with cranial MCV ligation and surgical trunk sheath opening (CC-plus). The goal is to determine which method offers superior outcomes in terms of intraoperative blood loss, operation time, and overall patient recovery. MATERIALS AND METHODS This single-center retrospective study compared two cranial-to-caudal approaches for LRH. The study included 51 patients who underwent LRH between January 2021 and November 2023 at the Second Affiliated Hospital, Zhejiang University School of Medicine. Patients were divided into two groups: Group A (26 patients) used the cranial-to-caudal approach with medial ligation of the middle colic vein (MCV), and Group B (25 patients) used the cranial-to-caudal approach with cranial MCV ligation and surgical trunk sheath opening (CC-plus). General characteristics, intraoperative parameters, and postoperative outcomes were compared. Statistical analysis was performed using SPSS version 20.0, with significance set at p < 0.05. RESULTS There were no significant differences between the groups regarding age, gender, tumor location, or clinical staging. All patients achieved R0 resection with no perioperative deaths. The CC-plus group had significantly reduced intraoperative blood loss and shorter operation time compared to the CC group (p < 0.05). No significant differences were found in first postoperative exhausting time, first postoperative defecation time, and postoperative hospital stay between the two groups. Furthermore, no significant differences were evaluated in postoperative complications (surgical site infection (SSI), ileus or bowel obstruction, refractory diarrhea, anastomotic leakage, deep vein thrombosis (DVT), hemorrhage) between the two groups on a median follow up of 12.6 months. Pathological examination showed no significant differences in total lymph nodes dissected and tumor stage. CONCLUSIONS The cranial-to-caudal approach with MCV ligation via the cranial approach (CC-plus) is a safe and effective method for LRH, offering advantages in terms of reduced operation time and intraoperative blood loss. This study's findings suggest that the CC-plus approach may be superior to the conventional cranial-to-caudal approach.
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Affiliation(s)
- Yurong Jiao
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Federico Maria Mongardini
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.M.M.); (L.D.)
| | - Haiting Xie
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Xinyi Zhou
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Xiangxing Kong
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Jihang Wen
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Ludovico Docimo
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.M.M.); (L.D.)
| | - Jun Li
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.J.); (H.X.); (X.Z.); (X.K.); (J.W.); (J.L.)
| | - Claudio Gambardella
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.M.M.); (L.D.)
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Wang CX, Liu F, Wang Y. RBM5 suppresses proliferation, metastasis and glycolysis of colorectal cancer cells via stabilizing phosphatase and tensin homolog mRNA. World J Gastrointest Oncol 2024; 16:3241-3255. [PMID: 39072172 PMCID: PMC11271791 DOI: 10.4251/wjgo.v16.i7.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/07/2024] [Accepted: 05/24/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND RNA binding motif 5 (RBM5) has emerged as crucial regulators in many cancers. AIM To explore more functional and mechanistic exploration of RBM5 since the lack of research on RBM5 in colorectal cancer (CRC) dictates that is essential. METHODS Through Gene Expression Profiling Interactive Analysis, we analyzed RBM5 expression in colon adenocarcinoma and rectum adenocarcinoma tissues. For detecting the mRNA expression of RBM5, quantitative real time-polymerase chain reaction was performed. Protein expression levels of RBM5, hexokinase 2, lactate dehydrogenase A, phosphatase and tensin homolog (PTEN), phosphoinositide 3-kinase (PI3K), phosphorylated-protein kinase B (p-AKT), and AKT were determined via Western blot. Functionally, cell counting kit-8 and 5-ethynyl-2'-deoxyuridine (EDU) assay were performed to evaluate proliferation of CRC cells. Invasiveness and migration of CRC cells were evaluated through conducting transwell assays. Glucose consumption, lactate production and adenosine-triphosphate (ATP) production were measured through a glucose assay kit, a lactate assay kit and an ATP production assay kit, respectively. Besides, RNA immunoprecipitation assay, half-life RT-PCR and dual-luciferase reporter assay were applied to detect interaction between RBM5 and PTEN. To establish a xenotypic tumor mice, CRC cells were subcutaneously injected into the right flank of each mouse. Protein expression of RBM5, Ki67, and PTEN in tumor tissues was examined using immunohistochemistry staining. Haematoxylin and eosin staining was used to evaluate tumor liver metastasis in mice. RESULTS We discovered down-regulation of RBM5 expression in CRC tissues and cells. RBM5 overexpression repressed proliferation, migration and invasion of CRC cells. Meantime, RBM5 impaired glycolysis in CRC cells, presenting as decreased glucose consumption, decreased lactate production and decreased ATP production. Besides, RBM5 bound to PTEN mRNA to stabilize its expression. PTEN expression was positively regulated by RBM5 in CRC cells. The protein levels of PI3K and p-AKT were significantly decreased after RBM5 overexpression. The suppressive influences of RBM5 on glycolysis, proliferation and metastasis of CRC cells were partially counteracted by PTEN knockdown. RBM5 suppressed tumor growth and liver metastasis in vivo. CONCLUSION This investigation provided new evidence that RBM5 was involved in CRC by binding to PTEN, expanding the importance of RBM5 in the treatment of CRC.
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Affiliation(s)
- Chu-Xiang Wang
- Department of Anorectal Surgery, The Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Feng Liu
- Department of Scientific Research, Beijing Fresta Technologies Co, Ltd., Beijing 100176, China
| | - Yi Wang
- Department of VIP Medical Services, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Yang R, Yue W, Hu D, Wang G, Mao L, Huang J, Wang H, Liang G. Synthesis of compounds based on the active domain of cabotegravir and their application in inhibiting tumor cells activity. ChemistryOpen 2024; 13:e202300284. [PMID: 38315083 PMCID: PMC11230920 DOI: 10.1002/open.202300284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
Structural modification based on existing drugs, which ensures the safety of marketed drugs, is an essential approach in developing new drugs. In this study, we modified the structure of cabotegravir by introducing the front alkyne on the core structure through chemical reaction, resulting in the synthesis of 9 compounds resembling 1,2,3-triazoles. The potential of these new cabotegravir derivatives as tumor suppressors in gastrointestinal tumors was investigated. Based on the MTT experiment, most compounds showed a reduction in the viability of KYSE30 and HCT116 cells. Notably, derivatives 5b and 5h exhibited the most significant inhibitory effects. To further explore the effects of derivatives 5b and 5h on gastrointestinal tumors, KYSE30 cells were chosen as a representative cell line. Both derivatives can effectively curtail the migration and invasion capabilities of KYSE30 cells and induce apoptosis in a dose-dependent manner. We further demonstrated these derivatives induce cell apoptosis in KYSE30 cells by inhibiting the expression of Stat3 protein and Smad2/3 protein. Based on the above results, we suggest they show promise in developing drugs for esophageal squamous cell carcinoma.
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Affiliation(s)
- Ruyue Yang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Wenhui Yue
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Dong Hu
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Guidan Wang
- School of Medical Technology and Engineering, Henan University of Science & Technology, Luoyang, 471023, China
| | - Longfei Mao
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Jiahe Huang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Huili Wang
- University of North Carolina Hospitals, 101 Manning Dr, Chapel Hill, Orange County, NC 27599, USA
| | - Gaofeng Liang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
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Sameti P, Amini M, Oroojalian F, Baghay Esfandyari Y, Tohidast M, Rahmani SA, Azarbarzin S, Mokhtarzadeh A, Baradaran B. MicroRNA-425: A Pivotal Regulator Participating in Tumorigenesis of Human Cancers. Mol Biotechnol 2024; 66:1537-1551. [PMID: 37332071 DOI: 10.1007/s12033-023-00756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/17/2023] [Indexed: 06/20/2023]
Abstract
MicroRNAs (miRNAs) are small single-stranded regulatory RNAs that are shown to be dysregulated in a wide array of human cancers. MiRNAs play critical roles in cancer progression and function as either oncogenes or tumor suppressors through modulating various target genes. Therefore, they possess great potential as diagnostic and therapeutic targets for cancer detection and treatment. In particular, recent studies have illustrated that miR-425 is also dysregulated in various human malignancies and plays a fundamental role in cancer initiation and progression. miR-425 has been reported to function as a dual-role miRNA participating in the regulation of cellular processes, including metastasis, invasion, and cell proliferation by modulating multiple signaling pathways, such as TGF-β, Wnt, and P13K/AKT pathways. Therefore, regarding recent researches showing the high therapeutic potential of miR-425, in this review, we have noted the impact of its dysregulation on signaling pathways and various aspects of tumorigenesis in a variety of human cancers.
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Affiliation(s)
- Pouriya Sameti
- Department of Biology, Higher Education Institute of Rab-Rashid, Tabriz, Iran
| | - Mohammad Amini
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Oroojalian
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
- Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Maryam Tohidast
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ali Rahmani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Azarbarzin
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Ahad Mokhtarzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Khan MMM, Munir MM, Khalil M, Tsilimigras DI, Woldesenbet S, Endo Y, Katayama E, Rashid Z, Cunningham L, Kaladay M, Pawlik TM. Association of county-level provider density and social vulnerability with colorectal cancer-related mortality. Surgery 2024; 176:44-50. [PMID: 38729889 DOI: 10.1016/j.surg.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/15/2024] [Accepted: 03/21/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Health care providers play a crucial role in increasing overall awareness, screening, and treatment of cancer, leading to reduced cancer mortality. We sought to characterize the impact of provider density on colorectal cancer population-level mortality. METHODS County-level provider data, obtained from the Area Health Resource File between 2016 and 2018, were used to calculate provider density per county. These data were merged with county-level colorectal cancer mortality 2016-2020 data from the Centers for Disease Control and Prevention. Multivariable regression was performed to define the association between provider density and colorectal cancer mortality. RESULTS Among 2,863 counties included in the analytic cohort, 1,132 (39.5%) and 1,731 (60.5%) counties were categorized as urban and rural, respectively. The colorectal cancer-related crude mortality rate was higher in counties with low provider density versus counties with moderate or high provider density (low = 22.9, moderate = 21.6, high = 19.3 per 100,000 individuals; P < .001). On multivariable analysis, the odds of colorectal cancer mortality were lower in counties with moderate and high provider density versus counties with low provider density (moderate odds ratio 0.97, 95% confidence interval 0.94-0.99; high odds ratio 0.88, 95% confidence interval 0.86-0.91). High provider density remained associated with a lower likelihood of colorectal cancer mortality independent of social vulnerability index (low social vulnerability index and high provider density: odds ratio 0.85, 95% confidence interval 0.81-0.89; high social vulnerability index and high provider density: odds ratio 0.93, 95% confidence interval 0.89-0.98). CONCLUSION Regardless of social vulnerability index, high county-level provider density was associated with lower colorectal cancer-related mortality. Efforts to increase access to health care providers may improve health care equity, as well as long-term cancer outcomes.
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Affiliation(s)
- Muhammad Muntazir Mehdi Khan
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Muhammad Musaab Munir
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Mujtaba Khalil
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Diamantis I Tsilimigras
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Selamawit Woldesenbet
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Yutaka Endo
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Erryk Katayama
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Zayed Rashid
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Lisa Cunningham
- Department of Surgery, Division of Colorectal Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Matthew Kaladay
- Department of Surgery, Division of Colorectal Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Timothy M Pawlik
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
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Tovar Perez JE, Zhang S, Hodgeman W, Kapoor S, Rajendran P, Kobayashi KS, Dashwood RH. Epigenetic regulation of major histocompatibility complexes in gastrointestinal malignancies and the potential for clinical interception. Clin Epigenetics 2024; 16:83. [PMID: 38915093 PMCID: PMC11197381 DOI: 10.1186/s13148-024-01698-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Gastrointestinal malignancies encompass a diverse group of cancers that pose significant challenges to global health. The major histocompatibility complex (MHC) plays a pivotal role in immune surveillance, orchestrating the recognition and elimination of tumor cells by the immune system. However, the intricate regulation of MHC gene expression is susceptible to dynamic epigenetic modification, which can influence functionality and pathological outcomes. MAIN BODY By understanding the epigenetic alterations that drive MHC downregulation, insights are gained into the molecular mechanisms underlying immune escape, tumor progression, and immunotherapy resistance. This systematic review examines the current literature on epigenetic mechanisms that contribute to MHC deregulation in esophageal, gastric, pancreatic, hepatic and colorectal malignancies. Potential clinical implications are discussed of targeting aberrant epigenetic modifications to restore MHC expression and 0 the effectiveness of immunotherapeutic interventions. CONCLUSION The integration of epigenetic-targeted therapies with immunotherapies holds great potential for improving clinical outcomes in patients with gastrointestinal malignancies and represents a compelling avenue for future research and therapeutic development.
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Affiliation(s)
| | - Shilan Zhang
- Department of Cardiovascular Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200070, China
| | - William Hodgeman
- Wolfson Medical School, The University of Glasgow, Glasgow, G12 8QQ, UK
| | - Sabeeta Kapoor
- Center for Epigenetics and Disease Prevention, Texas A&M Health, Houston, TX, 77030, USA
| | - Praveen Rajendran
- Center for Epigenetics and Disease Prevention, Texas A&M Health, Houston, TX, 77030, USA
- Department of Translational Medical Sciences, and Antibody & Biopharmaceuticals Core, Texas A&M Medicine, Houston, TX, 77030, USA
| | - Koichi S Kobayashi
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan
- Hokkaido University Institute for Vaccine Research and Development, Sapporo, 060-8638, Japan
- Department of Microbial Pathogenesis and Immunology, Texas A&M Health, Bryan, TX, 77087, USA
| | - Roderick H Dashwood
- Center for Epigenetics and Disease Prevention, Texas A&M Health, Houston, TX, 77030, USA.
- Department of Translational Medical Sciences, and Antibody & Biopharmaceuticals Core, Texas A&M Medicine, Houston, TX, 77030, USA.
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Milton S, Macrae F, McIntosh JG, Saya S, Alphonse P, Yogaparan T, Karnchanachari N, Novy K, Nguyen P, Lau P, Emery J. Designing a decision aid for cancer prevention: a qualitative study. Fam Pract 2024; 41:349-359. [PMID: 37058423 PMCID: PMC11167968 DOI: 10.1093/fampra/cmad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
OBJECTIVES Australian guidelines recommend people aged 50-70 years old consider taking low-dose aspirin to reduce their risk of colorectal cancer. The aim was to design sex-specific decision aids (DAs) with clinician and consumer input, including expected frequency trees (EFTs) to communicate the risks and benefits of taking aspirin. METHODS Semi-structured interviews were conducted with clinicians. Focus groups were conducted with consumers. The interview schedules covered ease of comprehension, design, potential effects on decision-making, and approaches to implementation of the DAs. Thematic analysis was employed; independent coding by 2 researchers was inductive. Themes were developed through consensus between authors. RESULTS Sixty-four clinicians were interviewed over 6 months in 2019. Twelve consumers aged 50-70 years participated in two focus groups in February and March 2020. The clinicians agreed that the EFTs would be helpful to facilitate a discussion with patients but suggested including an additional estimate of the effects of aspirin on all-cause mortality. The consumers felt favourable about the DAs and suggested changes to the design and wording to ease comprehension. CONCLUSION DAs were designed to communicate the risks and benefits of low-dose aspirin for disease prevention. The DAs are currently being trialled in general practice to determine their impact on informed decision-making and aspirin uptake.
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Affiliation(s)
- Shakira Milton
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Finlay Macrae
- Department of Medicine, The University of Melbourne, Melbourne, Australia
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia
| | - Jennifer G McIntosh
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Sibel Saya
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Pavithran Alphonse
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Thivagar Yogaparan
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Napin Karnchanachari
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Kitty Novy
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Peter Nguyen
- Health and Government Sector, Quantium, Melbourne, Australia
| | - Phyllis Lau
- Department of General Practice, University of Melbourne, Melbourne, Australia
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Jon Emery
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
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Krag C, Svane MS, Madsbad S, Graversen SB, Christensen JF, Sørensen TIA, Lehrskov LL, Laurberg T. The impact of surgery and oncological treatment on risk of type 2 diabetes onset in patients with colorectal cancer: nationwide cohort study in Denmark. eLife 2024; 12:RP89354. [PMID: 38829205 PMCID: PMC11147501 DOI: 10.7554/elife.89354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Background Comorbidity with type 2 diabetes (T2D) results in worsening of cancer-specific and overall prognosis in colorectal cancer (CRC) patients. The treatment of CRC per se may be diabetogenic. We assessed the impact of different types of surgical cancer resections and oncological treatment on risk of T2D development in CRC patients. Methods We developed a population-based cohort study including all Danish CRC patients, who had undergone CRC surgery between 2001 and 2018. Using nationwide register data, we identified and followed patients from date of surgery and until new onset of T2D, death, or end of follow-up. Results In total, 46,373 CRC patients were included and divided into six groups according to type of surgical resection: 10,566 Right-No-Chemo (23%), 4645 Right-Chemo (10%), 10,151 Left-No-Chemo (22%), 5257 Left-Chemo (11%), 9618 Rectal-No-Chemo (21%), and 6136 Rectal-Chemo (13%). During 245,466 person-years of follow-up, 2556 patients developed T2D. The incidence rate (IR) of T2D was highest in the Left-Chemo group 11.3 (95% CI: 10.4-12.2) per 1000 person-years and lowest in the Rectal-No-Chemo group 9.6 (95% CI: 8.8-10.4). Between-group unadjusted hazard ratio (HR) of developing T2D was similar and non-significant. In the adjusted analysis, Rectal-No-Chemo was associated with lower T2D risk (HR 0.86 [95% CI 0.75-0.98]) compared to Right-No-Chemo.For all six groups, an increased level of body mass index (BMI) resulted in a nearly twofold increased risk of developing T2D. Conclusions This study suggests that postoperative T2D screening should be prioritised in CRC survivors with overweight/obesity regardless of type of CRC treatment applied. Funding The Novo Nordisk Foundation (NNF17SA0031406); TrygFonden (101390; 20045; 125132).
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Affiliation(s)
- Caroline Krag
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Saur Svane
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Surgical Gastroenterology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Jesper Frank Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Louise Lang Lehrskov
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Tinne Laurberg
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
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Waldmann E, Jiricka L, Zessner-Spitzenberg J, Majcher B, Rockenbauer LM, Penz D, Hinterberger A, Trauner M, Ferlitsch M. Differences between men and women with respect to colorectal cancer mortality despite screening colonoscopy. Gastrointest Endosc 2024; 99:998-1005.e2. [PMID: 38184115 DOI: 10.1016/j.gie.2024.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/26/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND AIMS Women aged 55 to 59 years have a similar prevalence rate and number needed to screen for colorectal adenomas as men at a 10-year younger age. The aim of this study was to determine sex-specific differences in colorectal cancer mortality and estimate the association with adenomas at screening colonoscopy. METHODS This retrospective study analyzed 323,139 individuals who underwent colonoscopy within a national colorectal cancer screening program in Austria between January 2007 and December 2020. RESULTS Median patient age was 60 years (interquartile range, 54-67), and the sex distribution in all age groups was nearly identical. Men had significantly higher odds of having an adenoma or serrated polyp, low-risk polyp, high-risk polyp, or colorectal cancer detected at colonoscopy than women (odds ratio [OR] 1.83; 95% confidence interval [CI], 1.80-1.86; OR, 1.46; 95% CI, 1.44-1.49; OR, 1.74; 95% CI, 1.69-1.80; and OR, 1.87; 95% CI, 1.70-2.05, respectively). Strikingly, male sex, when compared with female sex, was associated with an almost 2-fold (hazard ratio, 1.67; 95% CI, 1.05-2.67) increased risk to die from colorectal cancer when an adenoma or serrated polyp was found at the screening colonoscopy and a 4-fold (hazard ratio, 4.14; 95% CI, 2.72-6.3) increased risk when a high-risk polyp was found at the screening colonoscopy. The cumulative incidence for death of colorectal cancer for 60-year-old individuals was 8.5-fold higher in men as compared with women. Markedly, this sex gap narrowed with increasing age, whereas the difference in deaths of other causes remained similar in all age groups. CONCLUSIONS Our findings strengthen the necessity of sex-specific screening recommendations. Importantly, further prospective studies should focus on sex differences in tumor biology to propose personalized surveillance guidelines.
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Affiliation(s)
- Elisabeth Waldmann
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Lena Jiricka
- Department of Clinical Biometrics, Medical University of Vienna, Vienna, Austria
| | - Jasmin Zessner-Spitzenberg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Barbara Majcher
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Lisa-Maria Rockenbauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Daniela Penz
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Anna Hinterberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Monika Ferlitsch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Quality Certificate for Screening Colonoscopy, Austrian Society for Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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46
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García-Alfonso P, Vera R, Aranda E, Élez E, Rivera F. Delphi consensus for the third-line treatment of metastatic colorectal cancer. Clin Transl Oncol 2024; 26:1429-1437. [PMID: 38411748 PMCID: PMC11108914 DOI: 10.1007/s12094-023-03369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE The optimal drug regimen and sequence are still unknown for patients with metastatic colorectal cancer (mCRC) who are candidates for third-line (3L) or subsequent treatment. The aim of this study is to know the opinion of experts on the most appropriate treatment options for mCRC in 3L and to clarify certain clinical decisions in Spain. METHODS Using a modified Delphi method, a group of experts discussed the treatment in 3L of patients with mCRC and developed a questionnaire with 21 items divided into 5 sections. RESULTS After 2 rounds, the 67 panelists consulted agreed on 17 items (81%). They considered that the main objective of 3L is to equally increase survival and improve patients' quality of life (QoL), but preferably the QoL. It was agreed that patients with mCRC in 3L prefer to receive active versus symptomatic treatment. Panelists considered trifluridine/tipiracil (FTD/TPI) to be the best oral treatment available to them in 3L. In patients with MSI-H or dMMR and BRAF V600E, the panelists mostly prefer targeted treatments. Panelists agreed the use of a therapeutic sequence that not only increases outcomes but also allows patients to be treated later. Finally, it was agreed that FTD/TPI has a mechanism of action that allows it to be used in patients refractory to previous treatment with 5-fluorouracil. CONCLUSION The experts agreed with most of the proposed items on 3L treatment of mCRC, prioritizing therapeutic options that increase survival and preserve QoL, while facilitating the possibility that patients can continue to be treated later.
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Affiliation(s)
- Pilar García-Alfonso
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria (IiSGM), Universidad Complutense de Madrid, C/ Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | - Ruth Vera
- Department of Oncology, University Hospital of Navarra, Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Navarra, Spain
| | - Enrique Aranda
- Department of Medical Oncology, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Córdoba, Spain
| | - Elena Élez
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Rivera
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
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Wirsik NM, Appel PC, Braun A, Strowitzki MJ, Schleussner N, Nienhüser H, Schneider M, Schmidt T. Inhibition of the Renin-Angiotensin System Improves Response to Neoadjuvant Therapy in Patients With Liver Metastasis of Colorectal Cancers. J Surg Res 2024; 298:176-184. [PMID: 38621351 DOI: 10.1016/j.jss.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/01/2024] [Accepted: 03/16/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Renin-angiotensin-aldosterone system inhibitors (RAAS-I) have been shown to prolong overall survival in patients with liver metastasized colorectal cancer in combination with antiangiogenic treatment. The effects of RAAS-I combined with neoadjuvant chemotherapy on colorectal cancer liver metastasis remain unexplored. We aimed to study the response of patients undergoing liver resection to RAAS-I in combination with neoadjuvant therapy to elucidate their potential benefits. METHODS Between February 2005 and May 2012, 62 patients fulfilled the inclusion criteria for distant metastasis (cM1) and comparable computed tomography or magnetic resonance tomography scans in the Picture Archiving Communication System of our center before and after neoadjuvant chemotherapy. Follow-up data and clinicopathological characteristics were collected from a prospective database and retrospectively investigated. The chemotherapeutic response to liver metastasis was evaluated according to the Response Evaluation Criteria in Solid Tumors criteria 1.1. RESULTS Comparing the average reduction of measured lesions, a significant response to chemotherapy was detected in the patients receiving RAAS-I (n = 24) compared to those who did not (n = 38) (P = 0.031). Interestingly, the effect was more distinctive when the size reduction was compared between high responses with more than 50% size reduction of all measured lesions (P = 0.011). In the subgroup analysis of patients receiving bevacizumab treatment, high responses to chemotherapy were observed only in the RAAS-I cohort (28.6% versus 0%, P = 0.022). CONCLUSIONS For neoadjuvantly treated patients, concomitant antihypertensive treatment with RAAS-I showed a higher total size reduction of liver metastasis as a sign of treatment response, especially in combination with antiangiogenic treatment with bevacizumab.
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Affiliation(s)
- Naita M Wirsik
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany
| | - Pia C Appel
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Braun
- Department of Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Henrik Nienhüser
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Schneider
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Schmidt
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany.
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Hans R, Sharma N, Tiwari M, Dwivedi S, Dwivedi S. Quality of Life in Locally Advanced Carcinoma Rectum Patients During Various Phases of NACRT: An Indian Perspective. Indian J Surg Oncol 2024; 15:276-287. [PMID: 38741630 PMCID: PMC11088610 DOI: 10.1007/s13193-024-01878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/08/2024] [Indexed: 05/16/2024] Open
Abstract
In low- and middle-income countries (LMICs) including India, cancer patients have a poor prognosis because of late diagnosis and cases already grown to advanced stages, low cancer awareness and skewed cancer care facilities. In India, the incidence of colorectal cancer (CRC) is ranked the 4th most common (6.4%) in males and the 5th most common (3.4%) in females. The improvement in the cure rate of rectal cancer has increased life expectancy, and assessment of the quality of life (QoL) in these patients has become a fundamental requirement. Little is known about how the patients perceive these adverse effects during curatively intended radiotherapy. Although studies have investigated the various adverse effects that can occur with radiotherapy and chemotherapy in carcinoma rectum patients, these have not yet been critically appraised and synopsized to form a comprehensive review of their prevalence and effects on QoL. The study was designed to explore the QoL issues in locally advanced carcinoma rectum patients during various phases of neoadjuvant concurrent chemo-radiotherapy (NACCRT). The study was performed over a period of 2 years at a single super speciality cancer hospital in North India. Patients were selected as per the inclusion criteria and followed up with a standard questionnaire incorporating various aspects depicting QoL. The interview technique was used for collecting QoL data at four points, at baseline, midway during treatment, at the end of treatment and 4 weeks after completion of NACCRT, using EORTC QLQ C30, for QLQ CR29. Special care was taken to avoid observer bias in cases of language issues, and interpreters' services were utilised, and compared with the baseline pre-treatment scores, patients reported a statistically significant and large clinically meaningful change in the global health status, social functioning, fatigue (FACIT-F), appetite loss, anxiety, sore skin and male and female sexual function at the post-treatment time point. Statistically significant changes with moderate clinically meaningful changes were reported for the functional scales-physical, role and emotional functioning of the QLQ C30 questionnaire and body image and weight of the CR29 questionnaire. Similar moderate clinical changes were found in the symptom scales-fatigue, nausea and vomiting, insomnia, constipation and diarrhoea of QLQ C30 and stool frequency, embarrassment with bowel function, impotence and dyspareunia. These parameters returned to almost the pre-treatment values after 4 weeks of completion of NACRT. Since QoL is a relatively subjective variable, differences in human race, culture, education and social environment will have impacts on the results. International cooperation is needed to study the QoL in patients with multiple cultural backgrounds. The existing QoL questionnaire tools have been designed with Western countries in mind, and we did face multiple social issues. We suggest that many similar multicentre studies shall be required to essentially tap the accurate QoL-related issues keeping in mind the diverse social, economic, racial and educational backgrounds. As we deal with the ever-increasing cancer menace and better life expectancy, QoL issues shall be a major determinant of treatment success besides primary treatment. These factors should form an integral part of treatment modality, and adequate counselling must be performed prior to initiation of care.
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Affiliation(s)
- Raj Hans
- Radiation Oncologist ,department of MDTC, Command Hospital SC Pune, Pune, India
| | - Neelam Sharma
- Present Address: Radiation Oncologist, Department of MDTC, CH EC, Kolkata, Kolkata, India
| | - Manu Tiwari
- Radiation Oncologist Department of MDTC, CH EC KOLKATA, kolkata, India
| | - Surjeet Dwivedi
- Department of Surgery, Command Hospital Air Force, Bangalore, 560007 India
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Mahmood AS, Ahmed Abbas M, Gany Yassin A, Ahmed HA, Sabri S, Shakir AA, Abbas H, Ismail M. Evaluating Postoperative Prognosis: A Single Surgeon's Experience With Total Mesorectal Excision in Middle and Lower Rectal Cancer Cases in Iraq. Cureus 2024; 16:e62174. [PMID: 38993431 PMCID: PMC11238923 DOI: 10.7759/cureus.62174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Surgical intervention for rectal cancer is widely recognized for its potential to significantly impact quality of life, chiefly due to the high probability of permanent colostomy and the associated postoperative complications. OBJECTIVE This study aimed to evaluate the short-term outcomes and morbidity associated with total mesorectal excision for middle and lower rectal cancer within an Iraqi cohort, in a prospective setting. METHODS This study prospectively collected and analyzed data from 89 patients who underwent a standardized radical rectal resection, with a follow-up period extending to one month post-surgery. RESULTS The mean age of patients was 54.4 ± 12.9 years, with a gender distribution of 46 males and 43 females. A total of 33 patients presented with preoperative comorbidities, which heightened the risk of adverse short-term outcomes by a factor of 7.51. The most prevalent comorbidities were hypertension and diabetes mellitus, affecting 22 and 20 patients, respectively. Patients aged 60 years and above were at a 3.97 times greater risk of developing complications. The overall complication rate was 21.35%, with wound infections (9.0%) and cardiovascular events (3.4%) being the most common. Mortality during the follow-up was 1.1%. CONCLUSION The findings indicate that increased age and the presence of comorbidities are significant risk factors for morbidity and mortality post-surgery. Neoadjuvant chemoradiotherapy or radiotherapy was shown to reduce morbidity and mortality rates while improving survival. The morbidity and mortality rates observed in this study concur with existing literature.
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Affiliation(s)
- Aqeel S Mahmood
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, IRQ
| | | | - Ammar Gany Yassin
- Department of Biochemistry, College of Medicine, University of Karbala, Karbala, IRQ
| | - Haider A Ahmed
- Department of Surgery, Iraqi Board of Medical Specializations, Baghdad, IRQ
| | - Samer Sabri
- Department of Surgery, Baghdad Teaching Hospital, Baghdad, IRQ
| | - Ahmed A Shakir
- Department of Surgery, Baghdad Teaching Hospital, Baghdad, IRQ
| | - Hussein Abbas
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, IRQ
| | - Mustafa Ismail
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, IRQ
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Devalle S, Aran V, Bastos Júnior CDS, Pannain VL, Brackmann P, Gregório ML, Ferreira Manso JE, Moura Neto V. A panorama of colon cancer in the era of liquid biopsy. THE JOURNAL OF LIQUID BIOPSY 2024; 4:100148. [PMID: 40027146 PMCID: PMC11863817 DOI: 10.1016/j.jlb.2024.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/05/2025]
Abstract
Colon cancer (CC) is one of the most frequent cancers worldwide being responsible for over 500 thousand deaths in 2022. Its financial and human burden is expected to increase in the next decades accompanying the growing and aging of the global population. Much of this burden could be alleviated considering that the lethality of CC is mostly due to its late diagnosis and failure in the individualized management of patients. Coordinated government actions and implementation of better diagnostic tools capable of detecting CC earlier and of tracking tumoral evolution are mandatory to achieve a reduction in CC's social impact. CtDNA-based liquid biopsy (LB) has great potential to contribute to patients' screening adhesion, CC earlier detection, and to longitudinal tumor follow-up. In this review, we will discuss the latest epidemiological data on CC disease, diagnostic, subtypes, genetics, and treatment management focusing on the advantages and limitations of ctDNA-based LB, including important bottlenecks and solutions necessary for its clinical translation. The latest ctDNA-directed CC clinical trials will also be examined.
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Affiliation(s)
- Sylvie Devalle
- Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria de Estado de Saúde, Rio de Janeiro, Brazil
| | - Veronica Aran
- Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria de Estado de Saúde, Rio de Janeiro, Brazil
| | | | - Vera Lucia Pannain
- Departamento de Patologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo Brackmann
- Clínica de Coloproctologia do Hospital Naval Marcílio Dias - IPB/HNMD, Rio de Janeiro, Brazil
| | - Marcelo Leal Gregório
- Instituto de Pesquisas Biomédicas do Hospital Naval Marcílio Dias - IPB/HNMD, Rio de Janeiro, Brazil
| | - José Eduardo Ferreira Manso
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vivaldo Moura Neto
- Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria de Estado de Saúde, Rio de Janeiro, Brazil
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