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Liao NQ, Deng ZJ, Wei W, Lu JH, Li MJ, Ma L, Chen QF, Zhong JH. Deep learning of pretreatment multiphase CT images for predicting response to lenvatinib and immune checkpoint inhibitors in unresectable hepatocellular carcinoma. Comput Struct Biotechnol J 2024; 24:247-257. [PMID: 38617891 PMCID: PMC11015163 DOI: 10.1016/j.csbj.2024.04.001] [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: 12/14/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
Objectives Combination therapy of lenvatinib and immune checkpoint inhibitors (CLICI) has emerged as a promising approach for managing unresectable hepatocellular carcinoma (HCC). However, the response to such treatment is observed in only a subset of patients, underscoring the pressing need for reliable methods to identify potential responders. Materials & methods This was a retrospective analysis involving 120 patients with unresectable HCC. They were divided into training (n = 72) and validation (n = 48) cohorts. We developed an interpretable deep learning model using multiphase computed tomography (CT) images to predict whether patients will respond or not to CLICI treatment, based on the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1). We evaluated the models' performance and analyzed the impact of each CT phase. Critical regions influencing predictions were identified and visualized through heatmaps. Results The multiphase model outperformed the best biphase and uniphase models, achieving an area under the curve (AUC) of 0.802 (95% CI = 0.780-0.824). The portal phase images were found to significantly enhance the model's predictive accuracy. Heatmaps identified six critical features influencing treatment response, offering valuable insights to clinicians. Additionally, we have made this model accessible via a web server at http://uhccnet.com/ for ease of use. Conclusions The integration of multiphase CT images with deep learning-generated heatmaps for predicting treatment response provides a robust and practical tool for guiding CLICI therapy in patients with unresectable HCC.
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Affiliation(s)
- Nan-Qing Liao
- School of Medical, Guangxi University, Nanning, China
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Zhu-Jian Deng
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Wei Wei
- Radiology Department, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Jia-Hui Lu
- School of Computer, Electronics and Information, Guangxi University, Nanning, China
| | - Min-Jun Li
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Liang Ma
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Qing-Feng Chen
- School of Computer, Electronics and Information, Guangxi University, Nanning, China
| | - Jian-Hong Zhong
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China
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Ou G, Tian Z, Su M, Yu M, Gong J, Chen Y. Identification of gemcitabine resistance-related AHNAK2 gene associated with prognosis and immune infiltration in pancreatic cancer. Heliyon 2024; 10:e33687. [PMID: 39040243 PMCID: PMC11261888 DOI: 10.1016/j.heliyon.2024.e33687] [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: 03/18/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Purpose Gemcitabine is a basic chemotherapy drug for pancreatic cancer (PC), but resistance is common and causes tumor recurrence and metastasis. Therefore, it is significant to explore gemcitabine resistance-related molecules for individualized treatment and prognosis assessment of PC. Methods In this study, transcriptome sequencing and TCGA database analysis were performed, and a differentiated gene AHNAK2 was screened. MEXPRESS database, tissue microarray analysis, and CIBERSORT and TIMER databases were used to correlate AHNAK2 expression with clinicopathological features and prognosis and immune infiltration of PC. Enrichment analysis was used to investigate the significant biological processes associated with AHNAK2. Results AHNAK2 was highly expressed in gemcitabine-resistant cells. High expression of AHNAK2 increased the risk of poor overall survival (OS) and progression-free survival (PFS) in PC. Clinicopathologic analysis revealed that AHNAK2 correlated with KRAS, TP53 mutations, histologic type, short OS, N stage, and elevated CA199 levels in PC. Knockdown of AHNAK2 inhibited the ability of cell proliferation and colony formation and enhanced the toxic effect of gemcitabine in PC. Meanwhile, the knockdown of AHNAK2 expression enhanced cell-ECM adhesion, inhibited cell-cell adhesion, and downregulated the KRAS/p53 signaling pathway in PC. Furthermore, AHNAK2 was correlated with immune infiltration, especially B cells and macrophages. Conclusions Our study unveils for the first time the pivotal role of AHNAK2 in PC, particularly its association with gemcitabine resistance, clinical prognosis, and immune infiltration. AHNAK2 not only drives the proliferation and drug resistance of PC cells by potentially activating the KRAS/p53 pathway but also significantly impacts cell-cell and cell- ECM adhesion. Additionally, AHNAK2 plays a crucial role in modulating the tumor immune microenvironment. These insights underscore AHNAK2's unique potential as a novel therapeutic target for overcoming gemcitabine resistance, offering new perspectives for PC treatment strategies.
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Affiliation(s)
- Guangsheng Ou
- Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510600, PR China
| | - Zhenfeng Tian
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
- Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
| | - Mingxin Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
- Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
| | - Miao Yu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
- Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
| | - Jin Gong
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, 510632, PR China
| | - Yinting Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
- Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, PR China
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3
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Chang JS, Kim JH. Cytokine Release Syndrome in a Patient With Metastatic Triple-Negative Breast Cancer Treated With Hypofractionated Radiation Therapy, Who Had Previously Undergone Immunotherapy: A Case Report. Adv Radiat Oncol 2024; 9:101513. [PMID: 38883994 PMCID: PMC11179535 DOI: 10.1016/j.adro.2024.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/03/2024] [Indexed: 06/18/2024] Open
Affiliation(s)
- Jee Suk Chang
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Hung Kim
- Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Franciosini G, Carlotti D, Cattani F, De Gregorio A, De Liso V, De Rosa F, Di Francesco M, Di Martino F, Felici G, Pensavalle JH, Leonardi MC, Marafini M, Muscato A, Paiar F, Patera V, Poortmans P, Sciubba A, Schiavi A, Toppi M, Traini G, Trigilio A, Sarti A. IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer. Phys Med 2024; 121:103346. [PMID: 38608421 DOI: 10.1016/j.ejmp.2024.103346] [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] [Received: 02/05/2024] [Revised: 03/13/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Partial breast irradiation for the treatment of early-stage breast cancer patients can be performed by means of Intra Operative electron Radiation Therapy (IOeRT). One of the main limitations of this technique is the absence of a treatment planning system (TPS) that could greatly help in ensuring a proper coverage of the target volume during irradiation. An IOeRT TPS has been developed using a fast Monte Carlo (MC) and an ultrasound imaging system to provide the best irradiation strategy (electron beam energy, applicator position and bevel angle) and to facilitate the optimisation of dose prescription and delivery to the target volume while maximising the organs at risk sparing. The study has been performed in silico, exploiting MC simulations of a breast cancer treatment. Ultrasound-based input has been used to compute the absorbed dose maps in different irradiation strategies and a quantitative comparison between the different options was carried out using Dose Volume Histograms. The system was capable of exploring different beam energies and applicator positions in few minutes, identifying the best strategy with an overall computation time that was found to be completely compatible with clinical implementation. The systematic uncertainty related to tissue deformation during treatment delivery with respect to imaging acquisition was taken into account. The potential and feasibility of a GPU based full MC TPS implementation of IOeRT breast cancer treatments has been demonstrated in-silico. This long awaited tool will greatly improve the treatment safety and efficacy, overcoming the limits identified within the clinical trials carried out so far.
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Affiliation(s)
- G Franciosini
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy
| | - D Carlotti
- Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitatio Campus-Bio Medico, Rome, Italy
| | - F Cattani
- Unit of Medical Physics, European Institute of Oncology IRCCS, Milan, Italy
| | - A De Gregorio
- National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy; Sapienza, University of Rome, Department of Physics, Rome, Italy
| | - V De Liso
- S.I.T. Sordina IORT Technologies S.p.A, Aprilia, Italy
| | - F De Rosa
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy
| | | | - F Di Martino
- Centro Pisano Multidisciplinare sulla Ricerca e Implementazione Clinica della Flash Radiotherapy (CPFR), Pisa, Italy; University of Pisa, Department of Physics, Pisa, Italy; Azienda Ospedaliero Universitaria Pisa (AOUP), Fisica Sanitaria, Pisa, Italy; National Institute of Nuclear Physics, INFN, Section of Pisa, Pisa, Italy
| | - G Felici
- S.I.T. Sordina IORT Technologies S.p.A, Aprilia, Italy
| | - J Harold Pensavalle
- S.I.T. Sordina IORT Technologies S.p.A, Aprilia, Italy; Centro Pisano Multidisciplinare sulla Ricerca e Implementazione Clinica della Flash Radiotherapy (CPFR), Pisa, Italy; National Institute of Nuclear Physics, INFN, Section of Pisa, Pisa, Italy
| | - M C Leonardi
- Division of Radiation Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - M Marafini
- National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Rome, Italy
| | - A Muscato
- National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy; Specialty School of Medical Physics, La Sapienza University of Rome, Rome, Italy
| | - F Paiar
- Centro Pisano Multidisciplinare sulla Ricerca e Implementazione Clinica della Flash Radiotherapy (CPFR), Pisa, Italy; Azienda Ospedaliero Universitaria Pisa (AOUP), Fisica Sanitaria, Pisa, Italy
| | - V Patera
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy
| | - P Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium
| | - A Sciubba
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Frascati National Laboratories (LNF), Rome, Italy
| | - A Schiavi
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy
| | - M Toppi
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy
| | - G Traini
- National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy
| | - A Trigilio
- Sapienza, University of Rome, Department of Physics, Rome, Italy; National Institute of Nuclear Physics, INFN, Frascati National Laboratories (LNF), Rome, Italy
| | - A Sarti
- Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy.
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Bai W, Ren JS, Li KR, Jiang Q. An integrated analysis revealing the angiogenic function of TP53I11 in tumor microenvironment. Heliyon 2024; 10:e29504. [PMID: 38655349 PMCID: PMC11036061 DOI: 10.1016/j.heliyon.2024.e29504] [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: 05/24/2023] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Despite growing evidence suggesting an important contribution of Tumor Protein P53 Inducible Protein 11 (TP53I11) in cancer progression, the role of TP53I11 remains unclear. Our first pan-cancer analysis of TP53I11 showed some tumor tissues displayed reduced TP53I11 expression compared to normal tissues, while others exhibited high TP53I11 expression. Meanwhile, TP53I11 expression carries a particular pan-cancer risk, as high TP53I11 expression levels are detrimental to survival for BRCA, KIRP, MESO, and UVM, but to beneficial survival for KIRC. We demonstrated that TP53I11 expression negatively correlates with DNA methylation in most cancers, and the S14 residue of TP53I11 is phosphorylated in several cancer types. Additionally, TP53I11 was found to be associated with endothelial cells in pan-cancer, and functional enrichment analysis provided strong evidence for its role in tumor angiogenesis. In vitro angiogenesis assays confirmed that TP53I11 can promote angiogenic function of human umbilical vein endothelial cells (HUVECs) in vitro. Mechanistic investigations reveal that TP53I11 is transcriptionally up-regulated by HIF2A under hypoxia.
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Affiliation(s)
- Wen Bai
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Jun-Song Ren
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Ke-ran Li
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qin Jiang
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
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Layer JP, Shiban E, Brehmer S, Diehl CD, de Castro DG, Hamed M, Dejonckheere CS, Cifarelli DT, Friker LL, Herrlinger U, Hölzel M, Vatter H, Schneider M, Combs SE, Schmeel LC, Cifarelli CP, Giordano FA, Sarria GR, Kahl KH. Multicentric Assessment of Safety and Efficacy of Combinatorial Adjuvant Brain Metastasis Treatment by Intraoperative Radiation Therapy and Immunotherapy. Int J Radiat Oncol Biol Phys 2024; 118:1552-1562. [PMID: 38199383 DOI: 10.1016/j.ijrobp.2024.01.009] [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: 08/11/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
PURPOSE After surgical resection of brain metastases (BMs), intraoperative radiation therapy (IORT) provides a promising alternative to adjuvant external beam radiation therapy by enabling superior organ-at-risk preservation, reduction of in-hospital times, and timely admission to subsequent systemic treatments, which increasingly comprise novel targeted immunotherapeutic approaches. We sought to assess the safety and efficacy of IORT in combination with immune checkpoint inhibitors (ICIs) and other targeted therapies (TTs). METHODS AND MATERIALS In a multicentric approach incorporating individual patient data from 6 international IORT centers, all patients with BMs undergoing IORT were retrospectively assessed for combinatorial treatment with ICIs/TTs and evaluated for toxicity and cumulative rates, including wound dehiscence, radiation necrosis, leptomeningeal spread, local control, distant brain progression (DBP), and estimated overall survival. RESULTS In total, 103 lesions with a median diameter of 34 mm receiving IORT combined with immunomodulatory systemic treatment or other TTs were included. The median follow-up was 13.2 (range, 1.2-102.4) months, and the median IORT dose was 25 (range, 18-30) Gy prescribed to the applicator surface. There was 1 grade 3 adverse event related to IORT recorded (2.2%). A 4.9% cumulative radiation necrosis rate was observed. The 1-year local control rate was 98.0%, and the 1-year DBP-free survival rate was 60.0%. Median time to DBP was 5.5 (range, 1.0-18.5) months in the subgroup of patients experiencing DBP, and the cumulative leptomeningeal spread rate was 4.9%. The median estimated overall survival was 26 (range, 1.2 to not reached) months with a 1-year survival rate of 74.0%. Early initiation of immunotherapy/TTs was associated with a nonsignificant trend toward improved DBP rate and overall survival. CONCLUSIONS The combination of ICIs/TTs with IORT for resected BMs does not seem to increase toxicity and yields encouraging local control outcomes in the difficult-to-treat subgroup of larger BMs. Time gaps between surgery and systemic treatment could be shortened or avoided. The definitive role of IORT in local control after BM resection will be defined in a prospective trial.
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Affiliation(s)
- Julian P Layer
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany; Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany
| | - Ehab Shiban
- Department of Neurosurgery, University Hospital Augsburg, Augsburg, Germany
| | - Stefanie Brehmer
- Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany
| | - Christian D Diehl
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Cas S Dejonckheere
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
| | - Daniel T Cifarelli
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia
| | - Lea L Friker
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany; Institute of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Michael Hölzel
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | | | | | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, Mannheim, Germany; DKFZ-Hector Cancer Institute of the University Medical Center Mannheim, Mannheim, Germany; Mannheim Institute of Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany.
| | - Klaus-Henning Kahl
- Department of Radiooncology, University Hospital Augsburg, Augsburg, Germany
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Yu H, He X, Yao J, Gu X, Zhou L, Gao L, Wang J. Potential Exploration of Biocompatible Carbon-Coated MoSe 2 Nanoparticles for Exploration of the Photothermal Potential in the Treatment of Human Choriocarcinoma. Int J Nanomedicine 2024; 19:2359-2375. [PMID: 38476276 PMCID: PMC10929259 DOI: 10.2147/ijn.s444738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/03/2024] [Indexed: 03/14/2024] Open
Abstract
Background Molybdenum diselenide (MoSe2), as a nano near-infrared absorber, has been widely studied in the field of photothermal therapy of cancer. However, there is little research on its application in the treatment of human choriocarcinoma. Methods and Results In this paper, a new type of carbon-coated MoSe2 (MEC) nanoparticles was prepared by a one-step hydrothermal method. The chemical characterization including SEM, TEM, EDS, XRD, FT-IR, TGA, Roman, and XPS showed that MEC was successfully synthesized. MEC exhibited a high photothermal conversion efficiency (50.97%) and extraordinary photothermal stability under laser irradiation. The cell experiment results showed that MEC had good biocompatibility on normal cells while significant photothermal effect on human choriocarcinoma (JEG-3) cells, achieving a good anticancer effect. The level of reactive oxygen species (ROS) in JEG-3 cells was significantly increased under the combination of MEC nanoparticles and near-infrared radiation. MEC nanoparticles could induce apoptosis of JEG-3 cells in combination with near-infrared radiation. Finally, transcriptomic analysis verified that MEC combined with laser radiation could inhibit DNA replication and induce apoptosis, thus improving its therapeutic effect on human choriocarcinoma. Conclusion MEC nanoparticles exert an excellent photothermal effect and may become an important candidate drug for the treatment of human choriocarcinoma.
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Affiliation(s)
- Hui Yu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xinyi He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Jinmeng Yao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiaoya Gu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Lin Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Li Gao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Jia Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Nguyen TX, Pham NH. Three-dimensional laparoscopic surgery for colorectal cancer: A 2-year follow-up study at Hue Central Hospital. Surg Open Sci 2024; 17:35-39. [PMID: 38282624 PMCID: PMC10818240 DOI: 10.1016/j.sopen.2023.12.007] [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: 07/16/2023] [Revised: 11/28/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Laparoscopic surgery has brought about a revolution in clinical practice since its inception. Using a new generation three-dimensional (3D) HD laparoscopic system can be seen as a beneficial "hybrid" created by fusing two different elements: increased vision quality and the viability and diffusion of laparoscopy. This study aims to determine the surgical outcomes and two-year survival of colorectal cancer patients after 3D laparoscopic surgery. Methods A prospective study was conducted on 60 patients with a definitive diagnosis of primary colorectal cancer. All patients underwent 3D laparoscopic colorectal resection from January 2020 to December 2021 by a single surgical team. Data were prospectively collected from Hue Central Hospital, including operative parameters and survival time. Results The mean age was 62.0 ± 10.6 years old. D3 lymphadenectomy accounted for most cases (96.7 %). There were no intraoperative complications or conversion to open surgery. The mean operation time was 162.3 ± 25.8 min. Postoperative complications included incisional fluid collection (5 %), wound infection (3.3 %), and drainage site bleeding (1.7 %). The average length of hospital stay was 10.4 ± 4.6 days. Overall survival rate after two years was 93 %. Conclusions 3D laparoscopic surgery for radical treatment of colorectal cancer is feasible, effective, and safe. This surgical technique offers a positive prognosis for patients.
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Affiliation(s)
- Thanh Xuan Nguyen
- Department of Pediatric surgery and Abdominal emergency, Hue Central hospital, Hue city, Viet Nam
| | - Nhu Hiep Pham
- Department of Pediatric surgery and Abdominal emergency, Hue Central hospital, Hue city, Viet Nam
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Krauss P, Kahl KH, Bonk MN, Wolfert C, Sommer B, Stueben G, Shiban E. Intraoperative radiotherapy after resection of brain metastases located in the posterior fossa. Analysis of postoperative morbidity and mortality in a single center cohort. J Clin Neurosci 2023; 118:1-6. [PMID: 37832264 DOI: 10.1016/j.jocn.2023.09.014] [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: 08/08/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION In order to improve surgical outcome and accelerate the adjuvant oncologic therapy, intraoperative Radiotherapy (IORT) has become a treatment option in oncologic surgery for various diseases including glioma and brain metastasis (BM). BMs are often located in the cranial posterior fossa (PF) requiring specific surgical considerations due to its complex anatomy. Up until now, data on IORT for BMs is limited and detailed description in the use of IORT for lesions in the PF is lacking. Our aim is to provide more insight into this emerging treatment strategy. METHODS We performed a retrospective analysis of patients receiving surgery for BMs and undergoing IORT at our institution. Each patient was discussed at the interdisciplinary tumor board decision before the intervention. Patient characteristics, functional status (Karnofsky Performance Score, KPS) before and after surgery, disease (recursive partitioning analysis, lesion size) and operative parameters were analyzed. Adverse events (AE) were recorded up until 30 days after the intervention and rated according to the Clavien Dindo Rating scale. RESULTS Nine patients (5 female) were included. None underwent prior radiotherapy (RT). Mean age was 66 ± 11 years. Preoperative median KPS was 80%. Mean BM diameter was 3.2 ± 0.9 cm. There was no statistically significant deterioration of the functional status after the intervention. Two patients experienced AEs with both of them needing revision surgery. CONCLUSION Surgery for BMs with IORT in the PF seems safe and feasible. Further studies are needed to evaluate the influence of IORT on long-term outcome after BM surgery.
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Affiliation(s)
- Philipp Krauss
- Department of Neurosurgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany.
| | - Klaus Henning Kahl
- Department of Radiooncology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Maximilian Niklas Bonk
- Department of Neurosurgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Christina Wolfert
- Department of Neurosurgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Bjoern Sommer
- Department of Neurosurgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Georg Stueben
- Department of Radiooncology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Ehab Shiban
- Department of Neurosurgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
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Tashkandi J, Brkljača R, Alt K. Progress in magnetic particle imaging signal and iron quantification methods in vivo - application to long circulating SPIONs. NANOSCALE ADVANCES 2023; 5:4873-4880. [PMID: 37705773 PMCID: PMC10496917 DOI: 10.1039/d3na00260h] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023]
Abstract
The strengths of Magnetic Particle Imaging (MPI) lay in its sensitivity, quantitative nature, and lack of signal attenuation for Superparamagnetic Iron Oxide Nanoparticles (SPION). These advantages make MPI a powerful tool for the non-invasive monitoring of tracer behaviour over time. With more MPI studies emerging, a standardized method for determining the boundaries of a region of interest (ROI) and iron quantification is crucial. The current approaches are inconsistent, making it challenging to compare studies, hindering MPI progression. Here we showcase three different ROI selection methods for the quantification of iron in vivo and ex vivo. Healthy mice were intravenously administered a long circulating tracer, never before applied in MPI, and the ROI methods were tested for their ability to accurately quantify the total signal present, in addition to the accumulation of the tracer in individual organs. We discuss how the quantified iron amount can be vastly altered based on the choice of ROI, the importance of the standard curve and the challenges associated with each method. Lastly, the user variability and accuracy of each method was compared by 3 independent users to ensure their consistency and lack of bias.
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Affiliation(s)
- Jurie Tashkandi
- Australian Centre for Blood Diseases, Central Clinical School, Monash University Australia
| | | | - Karen Alt
- Australian Centre for Blood Diseases, Central Clinical School, Monash University Australia
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11
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Dejonckheere CS, Layer JP, Hamed M, Layer K, Glasmacher A, Friker LL, Potthoff AL, Zeyen T, Scafa D, Koch D, Garbe S, Holz JA, Kugel F, Grimmer M, Schmeel FC, Gielen GH, Forstbauer H, Vatter H, Herrlinger U, Giordano FA, Schneider M, Schmeel LC, Sarria GR. Intraoperative or postoperative stereotactic radiotherapy for brain metastases: time to systemic treatment onset and other patient-relevant outcomes. J Neurooncol 2023; 164:683-691. [PMID: 37812290 PMCID: PMC10589145 DOI: 10.1007/s11060-023-04464-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Intraoperative radiotherapy (IORT) has become a viable treatment option for resectable brain metastases (BMs). As data on local control and radiation necrosis rates are maturing, we focus on meaningful secondary endpoints such as time to next treatment (TTNT), duration of postoperative corticosteroid treatment, and in-hospital time. METHODS Patients prospectively recruited within an IORT study registry between November 2020 and June 2023 were compared with consecutive patients receiving adjuvant stereotactic radiotherapy (SRT) of the resection cavity within the same time frame. TTNT was defined as the number of days between BM resection and start of the next extracranial oncological therapy (systemic treatment, surgery, or radiotherapy) for each of the groups. RESULTS Of 95 BM patients screened, IORT was feasible in 84 cases (88%) and ultimately performed in 64 (67%). The control collective consisted of 53 SRT patients. There were no relevant differences in clinical baseline features. Mean TTNT (range) was 36 (9 - 94) days for IORT patients versus 52 (11 - 126) days for SRT patients (p = 0.01). Mean duration of postoperative corticosteroid treatment was similar (8 days; p = 0.83), as was mean postoperative in-hospital time (11 versus 12 days; p = 0.97). Mean total in-hospital time for BM treatment (in- and out-patient days) was 11 days for IORT versus 19 days for SRT patients (p < 0.001). CONCLUSION IORT for BMs results in faster completion of interdisciplinary treatment when compared to adjuvant SRT, without increasing corticosteroid intake or prolonging in-hospital times. A randomised phase III trial will determine the clinical effects of shorter TTNT.
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Affiliation(s)
- Cas S Dejonckheere
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Julian P Layer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Institute of Experimental Oncology, University Hospital Bonn, 53127, Bonn, Germany
| | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany
| | - Katharina Layer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Andrea Glasmacher
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Lea L Friker
- Institute of Experimental Oncology, University Hospital Bonn, 53127, Bonn, Germany
- Institute of Neuropathology, University Hospital Bonn, 53127, Bonn, Germany
| | | | - Thomas Zeyen
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, 53127, Bonn, Germany
| | - Davide Scafa
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - David Koch
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Stephan Garbe
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jasmin A Holz
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Fabian Kugel
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Molina Grimmer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | | | - Gerrit H Gielen
- Institute of Neuropathology, University Hospital Bonn, 53127, Bonn, Germany
| | | | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, 53127, Bonn, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, 68167, Mannheim, Germany
| | - Matthias Schneider
- Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany
| | | | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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12
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Miura S, Dolker T, Sanderford M, Kumar S. Improving cellular phylogenies through the integrated use of mutation order and optimality principles. Comput Struct Biotechnol J 2023; 21:3894-3903. [PMID: 37602230 PMCID: PMC10432911 DOI: 10.1016/j.csbj.2023.07.018] [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: 05/20/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
The study of tumor evolution is being revolutionalized by single-cell sequencing technologies that survey the somatic variation of cancer cells. In these endeavors, reliable inference of the evolutionary relationship of single cells is a key step. However, single-cell sequences contain many errors and missing bases, which necessitate advancing standard molecular phylogenetics approaches for applications in analyzing these datasets. We have developed a computational approach that integratively applies standard phylogenetic optimality principles and patterns of co-occurrence of sequence variations to produce more expansive and accurate cellular phylogenies from single-cell sequence datasets. We found the new approach to also perform well for CRISPR/Cas9 genome editing datasets, suggesting that it can be useful for various applications. We apply the new approach to some empirical datasets to showcase its use for reconstructing recurrent mutations and mutational reversals as well as for phylodynamics analysis to infer metastatic cell migrations between tumors.
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Affiliation(s)
- Sayaka Miura
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, PA 19122, USA
- Department of Biology, Temple University, Philadelphia, PA 19122, USA
| | - Tenzin Dolker
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, PA 19122, USA
- Department of Biology, Temple University, Philadelphia, PA 19122, USA
| | - Maxwell Sanderford
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, PA 19122, USA
- Department of Biology, Temple University, Philadelphia, PA 19122, USA
| | - Sudhir Kumar
- Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia, PA 19122, USA
- Department of Biology, Temple University, Philadelphia, PA 19122, USA
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13
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Layer JP, Hamed M, Potthoff AL, Dejonckheere CS, Layer K, Sarria GR, Scafa D, Koch D, Köksal M, Kugel F, Grimmer M, Holz JA, Zeyen T, Friker LL, Borger V, Schmeel FC, Weller J, Hölzel M, Schäfer N, Garbe S, Forstbauer H, Giordano FA, Herrlinger U, Vatter H, Schneider M, Schmeel LC. Outcome assessment of intraoperative radiotherapy for brain metastases: results of a prospective observational study with comparative matched-pair analysis. J Neurooncol 2023; 164:107-116. [PMID: 37477822 PMCID: PMC10462513 DOI: 10.1007/s11060-023-04380-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Intraoperative radiation therapy (IORT) is an emerging alternative to adjuvant stereotactic external beam radiation therapy (EBRT) following resection of brain metastases (BM). Advantages of IORT include an instant prevention of tumor regrowth, optimized dose-sparing of adjacent healthy brain tissue and immediate completion of BM treatment, allowing an earlier admission to subsequent systemic treatments. However, prospective outcome data are limited. We sought to assess long-term outcome of IORT in comparison to EBRT. METHODS A total of 35 consecutive patients, prospectively recruited within a study registry, who received IORT following BM resection at a single neuro-oncological center were evaluated for radiation necrosis (RN) incidence rates, local control rates (LCR), distant brain progression (DBP) and overall survival (OS) as long-term outcome parameters. The 1 year-estimated OS and survival rates were compared in a balanced comparative matched-pair analysis to those of our institutional database, encompassing 388 consecutive patients who underwent adjuvant EBRT after BM resection. RESULTS The median IORT dose was 30 Gy prescribed to the applicator surface. A 2.9% RN rate was observed. The estimated 1 year-LCR was 97.1% and the 1 year-DBP-free survival 73.5%. Median time to DBP was 6.4 (range 1.7-24) months in the subgroup of patients experiencing intracerebral progression. The median OS was 17.5 (0.5-not reached) months with a 1 year-survival rate of 61.3%, which did not not significantly differ from the comparative cohort (p = 0.55 and p = 0.82, respectively). CONCLUSION IORT is a safe and effective fast-track approach following BM resection, with comparable long-term outcomes as adjuvant EBRT.
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Affiliation(s)
- Julian P Layer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany.
| | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Cas S Dejonckheere
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Katharina Layer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Davide Scafa
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - David Koch
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Mümtaz Köksal
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Fabian Kugel
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Molina Grimmer
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jasmin A Holz
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Thomas Zeyen
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Lea L Friker
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany
- Institute of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - F Carsten Schmeel
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Johannes Weller
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Michael Hölzel
- Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany
| | - Niklas Schäfer
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Stephan Garbe
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | | | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, Mannheim, Germany
- DKFZ-Hector Cancer Institute of the University Medical Center Mannheim, Mannheim, Germany
- Mannheim Institute of Intelligent Systems in Medicine (MIISM), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - L Christopher Schmeel
- Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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14
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Blanco-García L, Ruano Y, Blanco Martínez-Illescas R, Cubo R, Jiménez Sánchez P, Sánchez-Arévalo Lobo VJ, Riveiro Falkenbach E, Ortiz Romero P, Garrido MC, Rodríguez Peralto JL. pTERT C250T mutation: A potential biomarker of poor prognosis in metastatic melanoma. Heliyon 2023; 9:e18953. [PMID: 37609429 PMCID: PMC10440525 DOI: 10.1016/j.heliyon.2023.e18953] [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: 12/29/2022] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
Melanoma is the most aggressive form of skin cancer and the leading cause of death from cutaneous tumors. Several studies have associated alterations in the TERT promoter region (pTERT) with gene overexpression, aggressiveness and poor prognosis of the disease. The aim of this study was to clarify the role of pTERT molecular status in paired samples of primary melanoma and metastasis using tissue and plasma to establish a correlation with disease progression and survival. A total of 88 FFPE tissue samples from 53 patients with advanced melanoma were analyzed. Of these, 35 had paired samples. We also examined cfDNA samples from plasma of 25 patients. We detected a good correlation between primary tumors and metastases in pTERT mutation and methylation status. We were also able to identify pTERT mutations in plasma samples that correlated with mutational status in tissue samples. Interestingly, the C250T mutation was associated with worse survival and higher TERT mRNA expression, compared to the other most common mutation: C228T. In addition, hyper-methylation of the promoter region seems to be related to the progression of pTERT wild type (WT) patients. These results suggest that TERT gene alterations plays an important role during tumor progression, with the detection of the C250T mutation in tissue and plasma as a potential biomarker of poor prognosis in patients with advanced melanoma.
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Affiliation(s)
| | - Yolanda Ruano
- Research Institute 12 de Octubre Hospital, Madrid, Spain
| | - Raquel Blanco Martínez-Illescas
- Research Institute 12 de Octubre Hospital, Madrid, Spain
- Biosanitary Research Institute, Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Madrid, Spain
| | - Rocío Cubo
- Research Institute 12 de Octubre Hospital, Madrid, Spain
| | - Paula Jiménez Sánchez
- Research Institute 12 de Octubre Hospital, Madrid, Spain
- Biosanitary Research Institute, Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Madrid, Spain
| | - Víctor J. Sánchez-Arévalo Lobo
- Research Institute 12 de Octubre Hospital, Madrid, Spain
- Biosanitary Research Institute, Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Madrid, Spain
| | | | - Pablo Ortiz Romero
- Department of Dermatology, 12 de Octubre University Hospital, Madrid, Spain
| | - María C. Garrido
- Department of Pathology, 12 de Octubre University Hospital, Madrid, Spain
- Complutense University of Madrid; Madrid, Spain
| | - José L. Rodríguez Peralto
- Department of Pathology, 12 de Octubre University Hospital, Madrid, Spain
- Complutense University of Madrid; Madrid, Spain
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15
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Diehl CD, Giordano FA, Grosu AL, Ille S, Kahl KH, Onken J, Rieken S, Sarria GR, Shiban E, Wagner A, Beck J, Brehmer S, Ganslandt O, Hamed M, Meyer B, Münter M, Raabe A, Rohde V, Schaller K, Schilling D, Schneider M, Sperk E, Thomé C, Vajkoczy P, Vatter H, Combs SE. Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases. Cancers (Basel) 2023; 15:3670. [PMID: 37509330 PMCID: PMC10377800 DOI: 10.3390/cancers15143670] [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: 04/18/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Postsurgical radiotherapy (RT) has been early proven to prevent local tumor recurrence, initially performed with whole brain RT (WBRT). Subsequent to disadvantageous cognitive sequalae for the patient and the broad distribution of modern linear accelerators, focal irradiation of the tumor has omitted WBRT in most cases. In many studies, the effectiveness of local RT of the resection cavity, either as single-fraction stereotactic radiosurgery (SRS) or hypo-fractionated stereotactic RT (hFSRT), has been demonstrated to be effective and safe. However, whereas prospective high-level incidence is still lacking on which dose and fractionation scheme is the best choice for the patient, further ablative techniques have come into play. Neoadjuvant SRS (N-SRS) prior to resection combines straightforward target delineation with an accelerated post-surgical phase, allowing an earlier start of systemic treatment or rehabilitation as indicated. In addition, low-energy intraoperative RT (IORT) on the surgical bed has been introduced as another alternative to external beam RT, offering sterilization of the cavity surface with steep dose gradients towards the healthy brain. This consensus paper summarizes current local treatment strategies for resectable brain metastases regarding available data and patient-centered decision-making.
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Affiliation(s)
- Christian D Diehl
- Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, 81675 München, Germany
- Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, 80336 München, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Anca-L Grosu
- Department of Radiation Oncology, University Medical Center, Medical Faculty, 79106 Freiburg, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Faculty of Medicine, Technical University of Munich, 81675 München, Germany
| | - Klaus-Henning Kahl
- Department of Radiation Oncology, University Medical Center Augsburg, 86156 Augsburg, Germany
| | - Julia Onken
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, 37075 Göttingen, Germany
- Comprehensive Cancer Center Niedersachsen (CCC-N), 37075 Göttingen, Germany
| | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, 53127 Bonn, Germany
| | - Ehab Shiban
- Department of Neurosurgery, University Medical Center Augsburg, 86156 Augsburg, Germany
| | - Arthur Wagner
- Department of Neurosurgery, Faculty of Medicine, Technical University of Munich, 81675 München, Germany
| | - Jürgen Beck
- Department of Neurosurgery, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Stefanie Brehmer
- Department of Neurosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Oliver Ganslandt
- Neurosurgical Clinic, Klinikum Stuttgart, 70174 Stuttgart, Germany
| | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Faculty of Medicine, Technical University of Munich, 81675 München, Germany
| | - Marc Münter
- Department of Radiation Oncology, Klinikum Stuttgart Katharinenhospital, 70174 Stuttgart, Germany
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Veit Rohde
- Department of Neurosurgery, Universitätsmedizin Göttingen, 37075 Göttingen, Germany
| | - Karl Schaller
- Department of Neurosurgery, University of Geneva Medical Center & Faculty of Medicine, 1211 Geneva, Switzerland
| | - Daniela Schilling
- Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, 81675 München, Germany
- Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Matthias Schneider
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Elena Sperk
- Mannheim Cancer Center, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, 81675 München, Germany
- Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, 80336 München, Germany
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16
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Malalasekera AP, Neththikumara N, Somasundaram P, Pathirana S, Ediriweera C, Ediriweera D, Goonewardena SAS, Perera ND, Abeygunasekara A, Jayasekara RW, Wettasinghe K, Lokuhetty MDS, Dissanayake VHW. Clinical Exome Gene Panel Analysis of a Cohort of Urothelial Bladder Cancer Patients from Sri Lanka. Asian Pac J Cancer Prev 2023; 24:1533-1542. [PMID: 37247272 PMCID: PMC10495915 DOI: 10.31557/apjcp.2023.24.5.1533] [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: 10/13/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Bladder cancer has a high rate of recurrence and high mortality rates in those who progress to muscle invasive disease. Biomarkers and molecular sub classification of tumours beyond standard histopathology has been proposed to address therapeutic dilemmas. The Cancer Genome Atlas project and other studies have contributed to the enhanced knowledge base of the mutational landscape of urothelial bladder cancer. Once again, these are mostly from Caucasian and Chinese patients, with data from the rest of Asia and Sri Lanka being sparse. The objective of this study was to assess the genomic variations of a cohort of urothelial bladder cancer patients in Sri Lanka. METHODS The molecular genetic study was conducted on formalin fixed paraffin embedded tumour samples of 24 patients, prospectively enrolled from 2013 to 2017. The samples were sequenced and variant distribution performed based on a 70-gene panel. RESULTS Total number of filtered mutations in the 24 patients was 10453. Median mutations per patient were 450 (range 22-987). The predominant mutational change was C>T and G>A. The top 5 mutated genes in our cohort were SYNE1, SYNE2, KMT2C, LRP2, and ANK2. The genes were clustered into 3 groups dependent on the number of mutations per patient per gene. The genes of cluster 1 and 2 mapped to Chromatin modifying enzymes and Generic Transcription Pathway. The chromatin remodelling pathway accounted for the largest proportion (22%) of mutations. CONCLUSIONS Clinical exome sequencing utilising a gene panel yielded a high mutation rate in our patients. The predominant mutational change was C>T and G>A. Three clusters of genes were identified. SYNE1 was the gene with the most mutations. The mutations comprised predominantly of genes of the chromatin remodelling pathway.
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Affiliation(s)
- Ajith P Malalasekera
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Nilaksha Neththikumara
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Praveenan Somasundaram
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Sajeewani Pathirana
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | | | - Dileepa Ediriweera
- Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | | | - Neville D Perera
- Department of Urology, National Hospital of Sri Lanka, Colombo, Sri Lanka.
| | | | - Rohan W Jayasekara
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Kalum Wettasinghe
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - M Dilani S Lokuhetty
- Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Vajira H W Dissanayake
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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17
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Carconi C, Cerreti M, Roberto M, Arrivi G, D'Ambrosio G, De Felice F, Di Civita MA, Iafrate F, Lucatelli P, Magliocca FM, Picchetto A, Picone V, Catalano C, Cortesi E, Tombolini V, Mazzuca F, Tomao S. The Management of Oligometastatic Disease in Colorectal Cancer: Present Strategies and Future Perspectives. Crit Rev Oncol Hematol 2023; 186:103990. [PMID: 37061075 DOI: 10.1016/j.critrevonc.2023.103990] [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: 10/13/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/17/2023] Open
Abstract
Oligometastatic disease has been described as an intermediate clinical state between localized cancer and systemically metastasized disease. Recent clinical studies have shown prolonged survival when aggressive locoregional approaches are added to systemic therapies in patients with oligometastases. The aim of this review is to outline the newest options to treat oligometastatic colorectal cancer (CRC), also considering its molecular patterns. We present an overview of the available local treatment strategies, including surgical procedures, stereotactic body radiation therapy (SBRT), thermal ablation, as well as trans-arterial chemoembolization (TACE) and selective internal radiotherapy (SIRT). Moreover, since imaging methods provide crucial information for the early diagnosis and management of oligometastatic CRC, we discuss the role of modern radiologic techniques in selecting patients that are amenable to potentially curative locoregional treatments.
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Affiliation(s)
- Catia Carconi
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Micaela Cerreti
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Michela Roberto
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy.
| | - Giulia Arrivi
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giancarlo D'Ambrosio
- Department of General Surgery, Surgical Specialties and Organ Transplantation, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Mattia Alberto Di Civita
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Franco Iafrate
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabio Massimo Magliocca
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Picchetto
- Emergency Department, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Picone
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Enrico Cortesi
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Federica Mazzuca
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Silverio Tomao
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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18
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de Castro DG, Sanematsu PI, Pellizzon ACA, Suzuki SH, Fogaroli RC, Dias JES, Gondim GRM, Estrada DA, Silva MLG, Rassi MS, Chen MJ, Giacomelli R, Ramos H, Neto ES, Abrahão CH, Coelho TM, Yu LS, de Queiroz Tannous C, Calsavara VF, Giordano FA, de Oliveira JG. Intraoperative radiotherapy for brain metastases: first-stage results of a single-arm, open-label, phase 2 trial. J Neurooncol 2023; 162:211-215. [PMID: 36826700 DOI: 10.1007/s11060-023-04266-x] [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: 01/09/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Focal stereotactic radiosurgery to the surgical cavity lowers local recurrence after resection of brain metastases (BM). To evaluate local control (LC) and brain disease control (BDC) after intraoperative radiotherapy (IORT) for resected BM. METHODS Adult patients with completely resected single supratentorial BM were recruited and underwent IORT to the cavity with a prescribed dose of 18 Gy to 1 mm-depth. Primary endpoints were actuarial LC and BDC. Local failure (LF) and distant brain failure (DBF), with death as a competing risk, were estimated. Secondary endpoints were overall survival (OS) and incidence of radiation necrosis (RN). Simon's two-stage design was used and estimated an accrual of 10 patients for the first-stage analysis and a LC higher than 63% to proceed to second stage. We report the final analysis of the first stage. RESULTS Between June 2019 to November 2020, 10 patients were accrued. Median clinical and imaging FU was 11.2 and 9.7 months, respectively. Median LC was not reached and median BDC was 5 months. The 6-month and 12-month LC was 87.5%. The 6-month and 12-month BDC was 39% and 13%, respectively. Incidence of LF at 6 and 12 months was 10% and of DBF at 6 and 12 months was 50% and 70%, respectively. Median OS was not reached. The 6-month and 12-month OS was 80%. One patient had asymptomatic RN. CONCLUSION IORT for completely resected BM is associated with a potential high local control and low risk of RN, reaching the pre-specified criteria to proceed to second stage and warranting further studies.
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Affiliation(s)
| | | | | | | | - Ricardo Cesar Fogaroli
- Department of Radiation Oncology, A.C. Camargo Cancer Center, 01509-001, São Paulo, Brazil
| | | | | | | | | | - Marcio Saquy Rassi
- Department of Neurosurgery, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Michael Jenwei Chen
- Department of Radiation Oncology, A.C. Camargo Cancer Center, 01509-001, São Paulo, Brazil
| | - Richard Giacomelli
- Department of Neurosurgery, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Henderson Ramos
- Department of Radiation Oncology, A.C. Camargo Cancer Center, 01509-001, São Paulo, Brazil
| | - Elson Santos Neto
- Department of Radiation Oncology, A.C. Camargo Cancer Center, 01509-001, São Paulo, Brazil
| | | | | | - Liao Shin Yu
- Department of Imaging, A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | | | - Frank Anton Giordano
- Department of Radiation Oncology, DKFZ-Hector Cancer Institute, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jean Gonçalves de Oliveira
- Division of Neurosurgery, Department of Surgery, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
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19
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Ebrahimian Shiadeh A, Hamidi Sofiani V, Saber Amoli S, Taheri M, Tabarraei A, Razavi nikoo H, Sadeghi F, Khafri S, Kamrani G, Yahyapour Y, Moradi A. EBV and HPV Infections in Colorectal Cancer and Their Effect on P53 and P16 Protein Expression. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2023; 12:288-299. [PMID: 38751659 PMCID: PMC11092901 DOI: 10.22088/ijmcm.bums.12.3.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/20/2024] [Accepted: 02/06/2024] [Indexed: 05/18/2024]
Abstract
Viral infections contribute to 15-20% of newly diagnosed cancers worldwide. There is evidence of a possible etiological role of Epstein-Barr virus (EBV) and high-risk human papillomaviruses (HR-HPVs) in colorectal carcinoma (CRC). Loss of p53 and p16 function has been found in many cancers and this may occur in many different ways, including gene mutation or interaction with viral oncoproteins. This study aimed to evaluate the presence of EBV and HPV in CRC patients in northern Iran and to assess p53 and p16 protein expression related to these viral infections. Real-time PCR was used to amplify the DNA sequences of these viruses in 55 colorectal tumoral tissues, along with their corresponding non-tumoral adjacent tissues. Additionally, immunohistochemistry (IHC) was utilized to determine p53 and p16 protein expression. EBV DNA was detected in 49.1% of CRC tissues. Furthermore, HPV DNA was present in 7.3% of CRC tissues. Notably, the prevalence of EBV infection in tumoral tissues was significantly higher than in non-tumoral tissues (P=0.001). The EBV DNA polymerase catalytic subunit (BALF5) copy number in tumoral tissues was higher than in non-tumoral tissues and this difference was statistically significant (P=0.008). P53 was positive in 21/26 (80.8%) EBV-positive and in 11/25 (44%) EBV-negative samples and this difference was significant (P=0.007). P16 was positive in 13/26 (50%) EBV-positive and in 14/25 (58.3%) EBV-negative samples (P= 0.668). Our findings suggest that EBV infection can increase the risk of CRC. In addition, EBV seems to stabilize p53 in EBV-positive CRC which needs further research. No significant correlation was detected between EBV infection and p16 expression. Also, we could not find a causal relationship between HPV infection and CRC in the study population.
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Affiliation(s)
- Arefeh Ebrahimian Shiadeh
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
| | - Vahideh Hamidi Sofiani
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
| | - Saghar Saber Amoli
- Department of Medical Microbiology and Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
| | - Mahdie Taheri
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
| | - Alijan Tabarraei
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
| | - Hadi Razavi nikoo
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
| | - Farzin Sadeghi
- Department of Medical Microbiology and Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Sorayya Khafri
- Social Determinants of Health Research Center, Health Research institute, Babol University of Medical Sciences, Babol, Iran.
| | - Ghodsieh Kamrani
- Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran.
- Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
| | - Yousef Yahyapour
- Department of Medical Microbiology and Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Abdolvahab Moradi
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Science, Gorgan, Iran.
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