Circulating immune- and inflammation-related biomarkers and early-stage noncardia gastric cancer risk

Targeted plasma proteomic analysis uncovers a high-performance biomarker panel for early diagnosis of gastric cancer

BACKGROUND

Gastric cancer (GC) is characterized by high morbidity, high mortality and low early diagnosis rate. Early diagnosis plays a crucial role in radically treating GC. The aim of this study was to identify plasma biomarkers for GC and early GC diagnosis.

METHODS

We quantified 369 protein levels with plasma samples from discovery cohort (n = 88) and validation cohort (n = 50) via high-throughput proximity extension assay (PEA) utilizing the Olink-Explore-384-Cardiometabolic panel. The multi-protein signatures were derived from LASSO and Ridge regression models.

RESULTS

In the discovery cohort, 13 proteins (GDF15, ITIH3, BOC, DPP7, EGFR, AMY2A, CCDC80, CD163, GPNMB, LTBP2, CTSZ, CCL18 and NECTIN2) were identified to distinguish GC (Stage I-IV) and early GC (HGIN-I) groups from control group with AUC of 0.994 and AUC of 0.998, severally. The validation cohort yielded AUC of 0.930 and AUC of 0.818 for GC and early GC, respectively.

CONCLUSIONS

This study identified a multi-protein signature with the potential to benefit clinical GC diagnosis, especially for Asian and early GC patients, which may contribute to the development of a less-invasive, convenient, and efficient early screening tool, promoting early diagnosis and treatment of GC and ultimately improving patient survival.

Exploring the association between inflammatory biomarkers and gastric cancer development: A two-sample mendelian randomization analysis

This study aimed to elucidate the potential causative links between inflammatory biomarkers and gastric cancer risk via a two-sample Mendelian randomization approach. Leveraging genome-wide association study (GWAS) data, we conducted a two-sample Mendelian randomization analysis. Instrumental variable selection for inflammatory markers - namely, tissue factor, monocyte chemotactic protein-1, E-selectin, interleukin 6 receptor, and fatty acid-binding protein 4 - was informed by SNP data from the IEU database. Strongly associated SNPs served as instrumental variables. We applied a suite of statistical methods, including Inverse Variance Weighted (IVW), Weighted Median Estimator (WME), MR-Egger, and mode-based estimates, to compute the odds ratios (ORs) that articulate the impact of these markers on gastric cancer susceptibility. The IVW method revealed that the interleukin 6 receptor was inversely correlated with gastric cancer progression (OR = 0.86, 95% CI = 0.74-0.99, P = .03), whereas fatty acid-binding protein 4 was found to elevate the risk (OR = 1.21, 95% CI = 1.05-1.39, P = .03). Instrumental variables comprised 5, 4, 7, 2, and 3 SNPs respectively. Convergent findings from WME, MR-Egger, and mode-based analyses corroborated these associations. Sensitivity checks, including heterogeneity, horizontal pleiotropy assessments, and leave-one-out diagnostics, affirmed the robustness and reliability of our instruments across diverse gastric malignancy tissues without substantial bias. Our research suggests that the interleukin 6 receptor potentially mitigates, while fatty acid-binding protein 4 may contribute to the pathogenesis of gastric cancer (GC). Unraveling the intricate biological interplay between inflammation and oncogenesis offers valuable insights for preemptive strategies and therapeutic interventions in gastric malignancy management.

Adverse outcomes and health-ecological influencing factors of preoperative frailty among elderly patients with gastric cancer

PURPOSE

Frailty is defined as a state of decreased physiologic reserves arising from cumulative deficits in multiple homeostatic systems, which is important in the field of clinical oncology. We aimed to explore the relationship between preoperative frailty and adverse outcomes, and systematically analyze the factors influencing frailty based on the health ecology model among elderly gastric cancer patients.

METHODS

A observational study was conducted to select 406 elderly patients who would undergo gastric cancer surgery at a tertiary hospital. The logistic regression model was used to examine the relationship between preoperative frailty and adverse outcomes, including total complications, prolonged length of stay (PLOS), and 90-day hospital readmission. Based on the health ecology model, the factors which may influence frailty were collected from four levels. Univariate and multivariate analysis were utilized to determine the factors influencing preoperative frailty.

RESULTS

Preoperative frailty was associated with total complications (odds ratio [OR] 2.776, 95% confidence interval [CI] 1.588-4.852), PLOS (OR 2.338, 95%CI 1.342-4.073), and 90-day hospital readmission (OR 2.640, 95% CI 1.275-5.469). Besides, nutritional risk (OR 4.759, 95% CI 2.409-9.403), anemia (OR 3.160, 95% CI 1.751-5.701), number of comorbidity ≥ 2 (OR 2.318, 95% CI 1.253-4.291), low physical activity level (OR 3.069, 95% CI 1.164-8.092), apathetic attachment (OR 2.656, 95% CI 1.457-4.839), personal monthly income ≤ 1000 yuan (OR 2.033, 95% CI 1.137-3.635) and anxiety (OR 2.574, 95% CI 1.311-5.053) were independent risk factors for frailty. High physical activity level (OR 0.413, 95% CI 0.208-0.820) and improved objective support (OR 0.818, 95% CI 0.683-0.978) were independent protective factors for frailty.

CONCLUSIONS

Preoperative frailty was associated with multiple adverse outcomes and could be affected by factors of different dimensions from the health ecology perspective, including nutrition, anemia, comorbidity, physical activity, attachment style, objective support, anxiety, and income, which can guide the formation of a comprehensive prehabilitation for frailty among elderly gastric cancer patients.

The Human Gastric Juice: A Promising Source for Gastric Cancer Biomarkers

Gastric cancer (GC) is a major public health problem worldwide, with high mortality rates due to late diagnosis and limited treatment options. Biomarker research is essential to improve the early detection of GC. Technological advances and research methodologies have improved diagnostic tools, identifying several potential biomarkers for GC, including microRNA, DNA methylation markers, and protein-based biomarkers. Although most studies have focused on identifying biomarkers in biofluids, the low specificity of these markers has limited their use in clinical practice. This is because many cancers share similar alterations and biomarkers, so obtaining them from the site of disease origin could yield more specific results. As a result, recent research efforts have shifted towards exploring gastric juice (GJ) as an alternative source for biomarker identification. Since GJ is a waste product during a gastroscopic examination, it could provide a "liquid biopsy" enriched with disease-specific biomarkers generated directly at the damaged site. Furthermore, as it contains secretions from the stomach lining, it could reflect changes associated with the developmental stage of GC. This narrative review describes some potential biomarkers for gastric cancer screening identified in gastric juice.

Serum Proteomics in Patients with Head and Neck Cancer: Peripheral Blood Immune Response to Treatment

In this real-world study, the aims were to prospectively evaluate the expression of inflammatory proteins in serum collected from head and neck cancer patients before and after treatment, and to assess whether there were differences in expression associated with treatment modalities. The mixed study cohort consisted of 180 patients with head and neck cancer. The most common tumor sites were the oropharynx (n = 81), the oral cavity (n = 53), and the larynx (n = 22). Blood tests for proteomics analysis were carried out before treatment, 7 weeks after the start of treatment, and 3 and 12 months after the termination of treatment. Sera were analyzed for 83 proteins using an immuno-oncology biomarker panel (Olink, Uppsala, Sweden). Patients were divided into four treatment groups: surgery alone (Surg group, n = 24), radiotherapy with or without surgery (RT group, n = 94), radiotherapy with concomitant cisplatin (CRT group, n = 47), and radiotherapy with concomitant targeted therapy (RT Cetux group, n = 15). For the overall cohort, the expression levels of 15 of the 83 proteins changed significantly between the pretreatment sample and the sample taken 7 weeks after the start of treatment. At 7 weeks after the start of treatment, 13 proteins showed lower expression in the CRT group compared to the RT group. The majority of the inflammatory proteins had returned to their pretreatment levels after 12 months. It was clearly demonstrated that cisplatin-based chemoradiation has immunological effects in patients with head and neck cancer. This analysis draws attention to several inflammatory proteins that are of interest for further studies.