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Naveed M, Saad Mughal M, Aziz T, Jabeen K, Ali Khan A, Alhomrani M, Alsanie WF, Alamri AS. The Prominence of the Broad-Spectrum Protease inhibitor gene A2ML1 as a potential biomarker in cervical cancer diagnostics using Immunotherapeutic and Multi-Omics approaches. Int Immunopharmacol 2024; 142:113126. [PMID: 39265356 DOI: 10.1016/j.intimp.2024.113126] [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: 06/01/2024] [Revised: 08/27/2024] [Accepted: 09/06/2024] [Indexed: 09/14/2024]
Abstract
One of the venereal tumors that threaten human life is cervical cancer. A2ML1 is detected in advanced-stage cancer patients and is found to be strongly associated with cervical cancer. A2ML1 was shown to be substantially expressed in cervical cancer in this study, which used data from the TCGA database. Those with high A2ML1 expression had a lower chance of survival than patients with low A2ML1 expression. Both univariate and multivariate Cox regression analyses were utilized to investigate the relationship between clinical variables and overall survival rates. An investigation into the link between A2ML1 and immune infiltration was subsequently conducted. Utilizing the immune cell database, research was conducted to investigate the dispersion of 24 immune cells and their correlation to A2ML1 expression. In addition to this, the favorable correlation between immune cells and A2ML1 was validated using all three immune cell methodologies. The Genomics of Drug Sensitivity in Cancer database was used to confirm the idea that there is a link between A2ML1 expression and the efficacy of chemotherapy or immunotherapy. The findings demonstrated that A2ML1 is a potential biomarker for cervical cancer diagnostics. This biomarker may be used to chaperone immunotherapy, as well as to explain the elucidates of cervical cancer caused by the immunological microenvironment.
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Affiliation(s)
- Muhammad Naveed
- Department of Biotechnology, Faculty of Science and Technology, University of Central Punjab, Lahore 54590, Pakistan.
| | - Muhammad Saad Mughal
- Department of Biotechnology, Faculty of Science and Technology, University of Central Punjab, Lahore 54590, Pakistan
| | - Tariq Aziz
- Laboratory of Animal Health Food Hygiene and Quality University of Ioannina Arta Greece.
| | - Khizra Jabeen
- Department of Biotechnology, Faculty of Science and Technology, University of Central Punjab, Lahore 54590, Pakistan
| | - Ayaz Ali Khan
- Department of Biotechnology University of Malakand Chakdara Dir Lower
| | - Majid Alhomrani
- Department of Clinical Laboratory Sciences, The faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Walaa F Alsanie
- Department of Clinical Laboratory Sciences, The faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Abdulhakeem S Alamri
- Department of Clinical Laboratory Sciences, The faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
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Zhang H, Teng C, Yao Y, Bian W, Chen J, Liu H, Wang Z. MRI-based radiomics models for noninvasive evaluation of lymphovascular space invasion in cervical cancer: a systematic review and meta-analysis. Clin Radiol 2024; 79:e1372-e1382. [PMID: 39183137 DOI: 10.1016/j.crad.2024.07.018] [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: 04/24/2024] [Revised: 07/02/2024] [Accepted: 07/26/2024] [Indexed: 08/27/2024]
Abstract
AIM Aimed to evaluate the diagnostic performance of preoperative MRI-based radiomic models for noninvasive prediction of lymphovascular space invasion (LVSI) in patients with cervical cancer (CC). MATERIALS AND METHODS A systematic search of the PubMed, Embase, Web of Science, and Cochrane databases was conducted up to December 21, 2023. The quality of the studies was assessed utilizing the Radiomics Quality Score (RQS) system and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) of the summary receiver operating characteristic curve (SROC) were computed. The clinical utility was evaluated using the Fagan nomogram. Heterogeneity was investigated and subgroup analyses were conducted. RESULTS Eleven studies were included, with nine studies reporting independent validation sets. In the training sets, the pooled sensitivity, specificity, DOR, and AUC of SROC were 0.81 (95% CI: 0.75-0.85), 0.78 (95% CI: 0.73-0.83), 15 (95% CI: 11-20), and 0.86 (95% CI: 0.79-0.92), respectively. For the validation sets, the overall sensitivity, specificity, DOR, and AUC of SROC were 0.79 (95% CI: 0.73-0.84), 0.73 (95% CI: 0.67-0.78), 10 (95% CI: 7-15), and 0.83 (95% CI: 0.71-0.91), respectively. The Fagan nomogram indicated good clinical utility. Subgroup analysis revealed that multi-sequence MRI-based models exhibited superior diagnostic performance compared to single-sequence MRI-based models in validation sets. CONCLUSION This meta-analysis highlights the potential diagnostic efficacy of MRI-based radiomic models for predicting LVSI in CC. Nevertheless, large-sample, multicenter studies are still warranted, and improvements in the standardization of radiomics methodology are necessary.
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Affiliation(s)
- H Zhang
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China
| | - C Teng
- Department of Radiology, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, China
| | - Y Yao
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China.
| | - W Bian
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China
| | - J Chen
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China
| | - H Liu
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China
| | - Z Wang
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314000, China
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Ye Y, Lian R, Li Z, Chen X, Huang Y, Yao J, Lu A, Lang J, Liu P, Chen C. Predictive value of number of metastatic lymph nodes and lymph node ratio for prognosis of patients with FIGO 2018 stage IIICp cervical cancer: a multi-center retrospective study. BMC Cancer 2024; 24:1005. [PMID: 39138415 PMCID: PMC11320992 DOI: 10.1186/s12885-024-12784-8] [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: 08/30/2023] [Accepted: 08/08/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND To identify the cut-off values for the number of metastatic lymph nodes (nMLN) and lymph node ratio (LNR) that can predict outcomes in patients with FIGO 2018 IIICp cervical cancer (CC). METHODS Patients with CC who underwent radical hysterectomy with pelvic lymphadenectomy were identified for a propensity score-matched (PSM) cohort study. A receiver operating characteristic (ROC) curve analysis was performed to determine the critical nMLN and LNR values. Five-year overall survival (OS) and disease-free survival (DFS) rates were compared using Kaplan-Meier and Cox proportional hazard regression analyses. RESULTS This study included 3,135 CC patients with stage FIGO 2018 IIICp from 47 Chinese hospitals between 2004 and 2018. Based on ROC curve analysis, the cut-off values for nMLN and LNR were 3.5 and 0.11, respectively. The final cohort consisted of nMLN ≤ 3 (n = 2,378) and nMLN > 3 (n = 757) groups and LNR ≤ 0.11 (n = 1,748) and LNR > 0.11 (n = 1,387) groups. Significant differences were found in survival between the nMLN ≤ 3 vs the nMLN > 3 (post-PSM, OS: 76.8% vs 67.9%, P = 0.003; hazard ratio [HR]: 1.411, 95% confidence interval [CI]: 1.108-1.798, P = 0.005; DFS: 65.5% vs 55.3%, P < 0.001; HR: 1.428, 95% CI: 1.175-1.735, P < 0.001), and the LNR ≤ 0.11 and LNR > 0.11 (post-PSM, OS: 82.5% vs 76.9%, P = 0.010; HR: 1.407, 95% CI: 1.103-1.794, P = 0.006; DFS: 72.8% vs 65.1%, P = 0.002; HR: 1.347, 95% CI: 1.110-1.633, P = 0.002) groups. CONCLUSIONS This study found that nMLN > 3 and LNR > 0.11 were associated with poor prognosis in CC patients.
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Affiliation(s)
- Yanna Ye
- Department of Midwifery, School of Health, Dongguan Polytechnic, Dongguan, 523808, China
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Rui Lian
- Emergency Department, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Zhiqiang Li
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xiaolin Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yahong Huang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jilong Yao
- Department of Obstetrics and Gynecology, Shenzhen Maternal and Child Health Hospital, Shenzhen, 518028, China
| | - Anwei Lu
- Department of Obstetrics and Gynecology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510086, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100193, China
| | - Ping Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Chunlin Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Buyukbayram ME, Hannarici Z, Turhan A, Caglar AA, Esdur PÇ, Bilici M, Tekin SB, Erdemci B. A novel prognostic biomarker in progression free survival for patients with cervical cancer, glucose to c-reactive protein ratio (GCR). BMC Cancer 2024; 24:626. [PMID: 38783223 PMCID: PMC11112963 DOI: 10.1186/s12885-024-12347-x] [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: 10/12/2023] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Cervical cancer is a tumor with high morbidity and mortality. The importance of inflammatory and metabolic parameters affecting progression-free survival (PFS) and overall survival (OS) has been investigated more intensively recently. We aimed to investigate the effect of glucose/c-reactive protein (CRP) ratio [GCR], which shows these two parameters together, on PFS in cervical cancer. METHODS We retrospectively included 90 patients with adenocarcinoma and squamous cell carcinoma of the cervix. The effects of clinical variables, inflammatory and glycemic parameters on PFS and OS were analyzed by Kaplan-Meier method. The data were compared with the healthy control group of 90 individuals using the independent t test. The effect of parameters on mortality was analyzed using ROC curves and cut off values were determined. RESULTS Glucose, CRP, CRP/lymphocyte ratio (CLR) and GCR were statistically significant in predicting mortality (p < 0.05). Disease stage, glucose, CRP, CLR and GCR were associated with overall survival. CRP, CLR and GCR were associated with progression-free survival (p < 0.05). In multivariate analysis, GCR was prognostic for PFS (p = 0.025). GCR was statistically significant while compared with the patient and healthy control group (p < 0.001). CONCLUSION In cervical cancer, GCR rate was found to be prognostic independent of stage. Higher GCR rate was associated with longer PFS duration.
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Affiliation(s)
| | - Zekeriya Hannarici
- Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Aykut Turhan
- Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | | - Pınar Çoban Esdur
- Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Mehmet Bilici
- Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Salim Basol Tekin
- Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Burak Erdemci
- Department of Radiation Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
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Zhong ML, Liu YC, Yang JT, Wang YN, Ao MH, Xiao Y, Zeng SY, Liang MR. Treatment for locally resectable stage IIIC1r cervical cancer: surgery or chemoradiotherapy? BMC Cancer 2024; 24:217. [PMID: 38360572 PMCID: PMC10870469 DOI: 10.1186/s12885-024-11944-0] [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: 09/30/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE The aim of this study was to compare the therapeutic value and treatment-related complications of radical hysterectomy with those of concurrent chemoradiotherapy (CCRT) for locally resectable (T1a2-T2a1) stage IIIC1r cervical cancer. METHODS A total of 213 patients with locally resectable stage IIIC1r cervical cancer who had been treated at Jiangxi Maternal and Child Health Care Hospital between January 2013 and December 2021 were included in the study and classified into two groups: surgery (148 patients) and CCRT (65 patients). The disease-free survival (DFS) rate, overall survival (OS) rate, side effects, and economic costs associated with the two groups were compared. RESULTS 43.9% (65/148) patients in the surgical group had no pelvic lymph node metastasis, and 21of them did not require supplementary treatment after surgery due to a low risk of postoperative pathology. The median follow-up time was 46 months (range: 7-108 months). The five-year DFS and OS rates of the surgery group were slightly higher than those of the CCRT group (80.7% vs. 75.1% and 81.6% vs. 80.6%, respectively; p > 0.05). The incidences of grade III-IV gastrointestinal reactions in the surgery and CCRT groups were 5.5% and 9.2%, respectively (p = 0.332). Grade III-IV myelosuppression was identified in 27.6% of the surgery group and 26.2% of the CCRT group (p = 0.836). The per capita treatment cost was higher for the surgery group than for the CCRT group (RMB 123, 918.6 0 vs. RMB 101, 880.90, p = 0.001). CONCLUSION The therapeutic effects and treatment-related complications of hysterectomy and CCRT are equivalent in patients with locally resectable stage IIIC1r cervical cancer, but surgery can provide accurate lymph node information and benefit patients with unnecessary radiation.
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Affiliation(s)
- Mei-Ling Zhong
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Yin-Chuan Liu
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Jian-Tong Yang
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Ya-Nan Wang
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Mei-Hong Ao
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Yun Xiao
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang Medical College, 330029, Nanchang, Jiangxi, China
| | - Si-Yuan Zeng
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China
| | - Mei-Rong Liang
- Department of Gynecological Oncology, Jiangxi Maternal and Child Health Care Hospital, 330008, Nanchang, Jiangxi, China.
- Graduate School, Medical College of Nanchang University, No. 318, Bayi Avenue, 330006, Nanchang, Jiangxi, China.
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Zhang W, Yu H, Xiu Y, Meng F, Wang Z, Zhao K, Wang Y, Chen Z, Liu J, Chen J, Sun B. Clinical Outcomes and Prognostic Factors in Stage III C Cervical Cancer Patients Treated with Radical Radiotherapy or Radiochemotherapy. Technol Cancer Res Treat 2024; 23:15330338241254075. [PMID: 38720626 PMCID: PMC11085003 DOI: 10.1177/15330338241254075] [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: 10/23/2022] [Revised: 05/02/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
Objective: Since the update of the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria, there have been few reports on the prognosis of stage III C cervical cancer. Moreover, some studies have drawn controversial conclusions, necessitating further verification. This study aims to evaluate the clinical outcomes and determine the prognostic factors for stage III C cervical cancer patients treated with radical radiotherapy or radiochemotherapy. Methods: The data of 117 stage III C cervical cancer patients (98 III C1 and 19 III C2) who underwent radical radiotherapy or radiochemotherapy were retrospectively analyzed. We evaluated 3-year overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. Prognostic factors were analyzed using the Log-rank test and Cox proportional hazard regression model. The risk of para-aortic lymph node metastasis (LNM) in all patients was assessed through Chi-squared test and logistic regression analysis. Results: For stage III C1 and III C2 patients, the 3-year OS rates were 77.6% and 63.2% (P = .042), and the 3-year DFS rates were 70.4% and 47.4% (P = .003), respectively. The pretreatment location of pelvic LNM, histological type, and FIGO stage was associated with OS (P = .033, .003, .042, respectively); the number of pelvic LNM and FIGO stage were associated with DFS (P = .015, .003, respectively). The histological type was an independent prognostic indicator for OS, and the numbers of pelvic LNM and FIGO stage were independent prognostic indicators for DFS. Furthermore, a pelvic LNM largest short-axis diameter ≥ 1.5 cm and the presence of common iliac LNM were identified as high-risk factors influencing para-aortic LNM in stage III C patients (P = .046, .006, respectively). Conclusions: The results of this study validated the 2018 FIGO staging criteria for stage III C cervical cancer patients undergoing concurrent chemoradiotherapy. These findings may enhance our understanding of the updated staging criteria and contribute to better management of patients in stage III C.
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Affiliation(s)
- Wenting Zhang
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Hong Yu
- Jilin Province Institute of Cancer Prevention and Treatment, Jilin Province Cancer Hospital, Changchun, China
| | - Yuting Xiu
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Fanxu Meng
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Zhuo Wang
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Kangkang Zhao
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Yunlong Wang
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Zhishen Chen
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
| | - Juntian Liu
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Jie Chen
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Baosheng Sun
- Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
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Hu G, Xiao Y, Ma C, Wang J, Qian X, Wu X, Zhu F, Sun S, Qian J. Lumican is a potential predictor on the efficacy of concurrent chemoradiotherapy in cervical squamous cell carcinoma. Heliyon 2023; 9:e18011. [PMID: 37483824 PMCID: PMC10362307 DOI: 10.1016/j.heliyon.2023.e18011] [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: 02/16/2023] [Revised: 06/25/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose To identify new novel biomarkers for predicting the efficacy of concurrent chemoradiotherapy(CCRT) in cervical squamous cell carcinoma(CESC). Methods Gene expression datasets GSE56363, GSE5787, and GSE168009 were analyzed to identify candidate genes to predict the efficacy of CCRT in CESC. Single-cell RNA sequencing (scRNA-seq) data from GSE168652 and CESC patients in The Cancer Genome Atlas(TCGA) were systematically analyzed to explore possible molecular mechanisms. Kaplan-Meier evaluated the correlation between LUM (Lumican) and prognostic significance. The expression of LUM protein in biopsy tissues before CCRT was detected by immunohistochemistry in 15 CESC patients. Results LUM mRNA levels were significantly upregulated in nonresponders of CESC.patients receiving CCRT and positively correlated with poor therapeutic effect. Furthermore, high expression of LUM influenced the immune microenvironment in CESC patient-derived organoids treated with CCRT. LUM overexpression in CESC cells induced resistance to CCRT, potentially via immune landscape modulation. Gene Set Enrichment Analysis (GSEA) revealed that possible mechanisms underlying resistance to CCRT might involve the PARs and IL1 signaling pathway affecting the immune landscape. Conclusions High LUM expression is correlated with poor efficacy in CESC patients receiving CCRT, possibly through the PARs and IL1 signaling pathway affecting the immune landscape.
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Affiliation(s)
- Ge Hu
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
| | - Ying Xiao
- The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, PR China
| | - Chanchan Ma
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Anhui Medical University, Hefei, 230031, PR China
| | - Jinyun Wang
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
| | - Xiaotao Qian
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
| | - Xiaowei Wu
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
| | - Fengqin Zhu
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
| | - Shiying Sun
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Anhui Medical University, Hefei, 230031, PR China
| | - Junchao Qian
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei,230031, PR China
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Ou X, You J, Liang B, Li X, Zhou J, Wen F, Wang J, Dong Z, Zhang Y. Prognostic Factors Analysis of Metastatic Recurrence in Cervical Carcinoma Patients Treated with Definitive Radiotherapy: A Retrospective Study Using Mixture Cure Model. Cancers (Basel) 2023; 15:2913. [PMID: 37296875 PMCID: PMC10252127 DOI: 10.3390/cancers15112913] [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: 04/07/2023] [Revised: 05/16/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES This study aims to identify prognostic factors associated with metastatic recurrence-free survival of cervical carcinoma (CC) patients treated with radical radiotherapy and assess the cure probability of radical radiotherapy from metastatic recurrence. METHODS Data were from 446 cervical carcinoma patients with radical radiotherapy for an average follow up of 3.96 years. We applied a mixture cure model to investigate the association between metastatic recurrence and prognostic factors and the association between noncure probability and factors, respectively. A nonparametric test of cure probability under the framework of a mixture cure model was used to examine the significance of cure probability of the definitive radiotherapy treatment. Propensity-score-matched (PSM) pairs were generated to reduce bias in subgroup analysis. RESULTS Patients in advanced stages (p = 0.005) and those with worse treatment responses in the 3rd month (p = 0.004) had higher metastatic recurrence rates. Nonparametric tests of the cure probability showed that 3-year cure probability from metastatic recurrence was significantly larger than 0, and 5-year cure probability was significantly larger than 0.7 but no larger than 0.8. The empirical cure probability by mixture cure model was 79.2% (95% CI: 78.6-79.9%) for the entire study population, and the overall median metastatic recurrence time for uncured patients (patients susceptible to metastatic recurrence) was 1.60 (95% CI: 1.51-1.69) years. Locally advanced/advanced stage was a risk factor but non-significant against the cure probability (OR = 1.078, p = 0.088). The interaction of age and activity of radioactive source were statistically significant in the incidence model (OR = 0.839, p = 0.025). In subgroup analysis, compared with high activity of radioactive source (HARS), low activity of radioactive source (LARS) significantly contributed to a 16.1% higher cure probability for patients greater than 53 years old, while cure probability was 12.2% lower for the younger patients. CONCLUSIONS There was statistically significant evidence in the data showing the existence of a large amount of patients cured by the definitive radiotherapy treatment. HARS is a protective factor against metastatic recurrence for uncured patients, and young patients tend to benefit more than the elderly from the HARS treatment.
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Affiliation(s)
- Xiaxian Ou
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (X.O.); (J.Z.); (J.W.)
| | - Jing You
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; (J.Y.); (X.L.); (Z.D.); (Y.Z.)
| | - Baosheng Liang
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (X.O.); (J.Z.); (J.W.)
| | - Xiaofan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; (J.Y.); (X.L.); (Z.D.); (Y.Z.)
| | - Jiangjie Zhou
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (X.O.); (J.Z.); (J.W.)
| | - Fengyu Wen
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China;
| | - Jingyuan Wang
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (X.O.); (J.Z.); (J.W.)
| | - Zhengkun Dong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; (J.Y.); (X.L.); (Z.D.); (Y.Z.)
| | - Yibao Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; (J.Y.); (X.L.); (Z.D.); (Y.Z.)
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China;
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Padavu S, Kumar BK, Kumar A, Rai P. In-silico Analysis of Human Papillomavirus – 45 E6, E7 & L1 Proteins as Potential Immunogens. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2023; 17:554-566. [DOI: 10.22207/jpam.17.1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Globally, cervical cancer is the fourth most common cancer among women. After being cloned from a recurring cervical lesion in 1987, Human papillomavirus (HPV) type-45 was identified as a high-risk HPV type. It is the third most common cancer-causing HPV subtype, after HPV-16 and HPV-18. Immunogenic epitopes and structural features provide the most useful information for vaccine development. Computational algorithms provide quick, simple, trustworthy, and cost-efficient methods for predicting immunogenic epitopes. In this study, both B and T cell epitopes have been identified as potential immunogens that can elicit a response from the host system. Three potential B-cell epitopes, i.e., SIAGQYRGQCNTCCDQ, LQEIVLHLEPQNELDP, and DSTVYLPPPSVARVVS, were identified in this study. A potential epitope for E6 (ATLERTEVY) was predicted to 8 MHC-I alleles (HLA-A*30:02, HLA-B*15:01, HLA-A*01:01, HLA-A*26:01, HLA-A*32:01, HLA-B*35:01, HLA-B*58:01, HLA-A*11:01) and for L1 epitope (NVFPIFLQM) was predicted for 4 MHC-I alleles (HLA-A*30:02, HLA-A*32:01, HLA-B*53:01, HLA-B*51:01). To conclude, the epitopes identified here might potentially be useful for developing a cervical cancer vaccine against HPV-45 strains, but in vitro and in vivo trials are needed to validate their safety and efficacy.
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Kashima Y, Murakami K, Miyagawa C, Takaya H, Kotani Y, Nakai H, Matsumura N. Treatment for Locally Resectable Stage IIIC1 Cervical Cancer: A Retrospective, Single-Institution Study. Healthcare (Basel) 2023; 11:632. [PMID: 36900641 PMCID: PMC10000378 DOI: 10.3390/healthcare11050632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
According to the revision of the FIGO 2018 staging system, cervical cancer with pelvic lymph node metastases was changed to stage IIIC1. We retrospectively analyzed the prognosis and complications of locally resectable (classified as T1/T2 by TNM classification of the Union for International Cancer Control) stage IIIC1 cervical cancer. A total of 43 patients were divided into three groups: surgery with chemotherapy (CT) (ope+CT group) (T1; n = 7, T2; n = 16), surgery followed by concurrent chemoradiotherapy (CCRT), or radiotherapy (RT) (ope+RT group) (T1; n = 5, T2; n = 9), and CCRT or RT alone (RT group) (T1; n = 0, T2; n = 6). In T1 patients, recurrence was observed in three patients, but there was no difference among the treatment groups, and no patients died. In contrast, in T2 patients, recurrence and death were observed in nine patients (8 in ope+CT; 1 in ope+RT), and recurrence-free survival and overall survival were lower in the ope+CT group (p = 0.02 and 0.04, respectively). Lymphedema and dysuria were more common in the ope+RT group. A randomized controlled trial comparing CT and CCRT as an adjuvant therapy after surgery in T1/T2 patients, including those with pelvic lymph node metastases, is currently underway. However, our data suggest that performing CT alone after surgery in T2N1 patients is likely to worsen the prognosis.
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Affiliation(s)
| | - Kosuke Murakami
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Sayama 589-8511, Japan
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Ma Y, Li J, Tan X, Cai M, Zhang X, Ma J. Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer. Int J Womens Health 2022; 14:1807-1819. [PMID: 36579180 PMCID: PMC9792117 DOI: 10.2147/ijwh.s386689] [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: 08/18/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Individual survival prediction is of vital importance to optimize the individualized treatment of metastatic cervical cancer (mCC) patients. The goal of this study was to identify the potential risk factors for the survival of mCC patients and construct a nomogram for their prognosis. Methods Medical records of patients with newly diagnosed mCC at the First Affiliated Hospital of Xi'an Jiaotong University were reviewed retrospectively. Risk factors were identified using Cox proportional hazards analysis and Kaplan-Meier curves. Random forest was used to identify factors associated with therapy strategy. Nomogram and dynamic nomogram were established using 'rms' and "DynNom" R package. Results A total of 98 patients with mCC were finally identified. In Cox analyses, multiple metastases and concurrent chemoradiotherapy (CCRT) were identified as independent predictors for overall survival (OS). We further explored the prognostic value of metastatic number and sites and therapy strategies for mCC patients by Kaplan-Meier curves. A dynamic nomogram including metastases number and sites (multiple metastases, liver and lymph node (LN) above diaphragm metastases) and chemoradiotherapy strategies (CCRT, postradiotherapy chemotherapy, and radiotherapy to metastatic sites) was constructed for predicting the prognosis of mCC patients. For newly diagnosed patients, we strongly recommended the combination of chemotherapy and definitive pelvic radiotherapy and, if possible, radiation to metastatic site, but CCRT should be implemented with caution. We constructed a dynamic nomogram indicating that patients with younger age, shorter symptom duration, and better laboratory test results are suitable for CCRT. Conclusion Survival analyses showed that the metastatic number and sites and therapy strategies are associated with the prognosis of mCC patients. The CCRT and prognostic nomograms may help clinicians to make better clinical decisions and effectively predict the prognosis for newly diagnosed mCC patients.
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Affiliation(s)
- Yuan Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Jing Li
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xinyue Tan
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Mengjiao Cai
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xiaozhi Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Jinlu Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China,Correspondence: Jinlu Ma; Xiaozhi Zhang, Email ;
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Muhaidat N, Alshrouf MA, Alshajrawi RN, Miqdadi ZR, Amro R, Rabab’ah AO, Qatawneh SA, Albandi AM, Fram K. Cervical Cancer Screening among Female Refugees in Jordan: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10071343. [PMID: 35885869 PMCID: PMC9322376 DOI: 10.3390/healthcare10071343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cervical cancer (CC) is mainly linked to infection with a high-risk oncogenic human papillomavirus (HPV), with 85% of deaths occurring in developing countries. Refugees are less likely to be aware of screening methods and to have routine gynecological examinations. Methods: This is a cross-sectional study involving a total of 359 women aged 19–64 living in the Jerash camp in Jordan. Data were collected using a carefully developed and validated questionnaire. Results: A total of 359 participants were included in the study, with a mean age of 38.99 ± 10.53. Participants demonstrated fair knowledge of CC risk factors (4.77 ± 2.85 out of 11). Among the participants, 73.5% had heard of the cervical smear test; however, only 12.8% had actually undergone the test, with a mean total number of smear tests performed of 1.48 ± 0.79 and the mean age at the time of the first test was 32.5 ± 7.89. Conclusions: Refugee women have a fair level of knowledge of CC risk factors but are unmotivated to have a Pap smear test to screen for CC. Efforts should be made to raise awareness about the issue and promote testing for underrepresented women in refugee camps.
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Affiliation(s)
- Nadia Muhaidat
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
- Correspondence: (N.M.); (M.A.A.); Tel.: +962-79-838-5775 (N.M.); +962-78-686-0770 (M.A.A.)
| | - Mohammad A. Alshrouf
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
- Correspondence: (N.M.); (M.A.A.); Tel.: +962-79-838-5775 (N.M.); +962-78-686-0770 (M.A.A.)
| | - Roaa N. Alshajrawi
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
| | - Zeina R. Miqdadi
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
| | - Raghad Amro
- Department of Surgery, Faculty of Medicine, Mutah University, Kerak 61710, Jordan; (R.A.); (S.A.Q.)
| | | | - Serena A. Qatawneh
- Department of Surgery, Faculty of Medicine, Mutah University, Kerak 61710, Jordan; (R.A.); (S.A.Q.)
| | - Alaa M. Albandi
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
| | - Kamil Fram
- Department of Obstetrics & Gynaecology, School of Medicine, The University of Jordan, Amman 11942, Jordan; (R.N.A.); (Z.R.M.); (A.M.A.); (K.F.)
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Li S, Zhang H, Jiao Y, Song X, Wei L, Liu X. Oxymatrine induces anti-tumor response in cervical cancer by modulating circ_0008460/miR-197-3p/ribonucleotide reductase subunit M2 (RRM2). Bioengineered 2022; 13:12912-12926. [PMID: 35609310 PMCID: PMC9275878 DOI: 10.1080/21655979.2022.2078943] [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] [Indexed: 11/29/2022] Open
Abstract
Oxymatrine (OMT) has exhibited an anti-cancer role in human cancers, including cervical cancer (CC). The dysregulated circular RNAs (circRNAs) are key regulators in cancer biology, and circ_0008460 was upregulated in CC. This study was performed to investigate the circRNA-based molecular mechanism for OMT in CC. RNA detection for circ_0008460, microRNA-197-3p (miR-197-3p), or ribonucleotide reductase subunit M2 (RRM2) was completed using reverse transcription-quantitative polymerase chain reaction assay. Cell behaviors were assessed by Cell Counting Kit-8 assay for cell viability, colony formation assay or Edu assay for cell proliferation, flow cytometry for cell apoptosis, and wound healing assay/transwell assay for migration/invasion. Protein expression examination was conducted using western blot. Dual-luciferase reporter assay and RNA pull-down assay were applied to confirm target binding. Tumor xenograft assay was performed for OMT research in vivo. OMT induced circ_0008460 downregulation in CC cells. OMT-induced inhibitory effects on cell growth, migration, and invasion but promoting effect on cell apoptosis were attenuated by circ_0008460. Circ_0008460 directly interacted with miR-197-3p, and OMT inhibited malignant behaviors of CC cells via mediating circ_0008460/miR-197-3p axis. RRM2 acted as a target for miR-197-3p and circ_0008460 affected the RRM2 level through absorbing miR-197-3p. OMT upregulated miR-197-3p to inhibit RRM2 expression to impede CC cell development. CC tumorigenesis was suppressed by OMT via targeting circ_0008460/miR-197-3p/RRM2 axis in vivo. These results suggested that OMT restrained CC cell progression in vitro and tumor growth in vivo by downregulating circ_0008460 to mediate miR-197-3p/RRM2 axis.
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Affiliation(s)
- Siwei Li
- Pharmacy Department, Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Heng Zhang
- Pharmacy Department, Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Yunping Jiao
- Clinical Pharmacy Department, the Second People's Hospital of Shaanxi Province, Xi'an, Shaanxi, China
| | - Xiao Song
- Pharmacy Department, Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Lei Wei
- Pharmacy Department, Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Xing Liu
- Obstetrics Department, Northwest Women and Children Hospital, Xi'an, Shaanxi, China
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