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Djordjevic V, Knezevic D, Trotovsek B, Tomazic A, Petric M, Hadzialjevic B, Grubor N, Djokic M. Navigating Intraductal Papillary Mucinous Neoplasm Management through Fukuoka Consensus vs. European Evidence-Based Guidelines on Pancreatic Cystic Neoplasms-A Study on Two European Centers. Cancers (Basel) 2024; 16:2156. [PMID: 38893274 PMCID: PMC11171892 DOI: 10.3390/cancers16112156] [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: 04/08/2024] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024] Open
Abstract
This study addresses the critical need for the accurate diagnosis and management of intraductal papillary mucinous neoplasms (IPMNs), which are pancreatic cystic neoplasm types holding a substantial potential for malignancy. It evaluates the diagnostic effectiveness of the Fukuoka consensus guidelines and the European evidence-based guidelines in detecting high-grade dysplasia/invasive carcinoma in IPMNs, utilizing a retrospective analysis of 113 patients from two European medical centers. The methods include a comparative analysis of clinical, radiological, and endoscopic ultrasonography data, alongside an assessment of guideline-driven diagnostic performance. The results demonstrate that both guidelines offer similar accuracy in identifying severe disease stages in IPMNs, with certain clinical markers-such as jaundice, solid mass presence, and an increase in CA 19-9 levels-being pivotal in predicting the need for surgical intervention. This study concludes that while both guidelines provide valuable frameworks for IPMN management, there is an inherent need for further research to refine these protocols and improve patient-specific treatment strategies. This research contributes to the ongoing discourse on optimizing diagnostic and treatment paradigms for pancreatic cystic neoplasms, aiming to enhance clinical outcomes and patient care in this challenging medical field.
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Affiliation(s)
- Vladimir Djordjevic
- First Surgical Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (D.K.); (N.G.)
| | - Djordje Knezevic
- First Surgical Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (D.K.); (N.G.)
| | - Blaz Trotovsek
- University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.T.); (A.T.); (M.P.); (B.H.); (M.D.)
| | - Ales Tomazic
- University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.T.); (A.T.); (M.P.); (B.H.); (M.D.)
| | - Miha Petric
- University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.T.); (A.T.); (M.P.); (B.H.); (M.D.)
| | - Benjamin Hadzialjevic
- University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.T.); (A.T.); (M.P.); (B.H.); (M.D.)
| | - Nikica Grubor
- First Surgical Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (D.K.); (N.G.)
| | - Mihajlo Djokic
- University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.T.); (A.T.); (M.P.); (B.H.); (M.D.)
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Forte G, Pisano A, Bocca B, Fenu G, Farace C, Etzi F, Perra T, Sabalic A, Porcu A, Madeddu R. Toxic Metal and Essential Element Concentrations in the Blood and Tissues of Pancreatic Ductal Adenocarcinoma Patients. TOXICS 2024; 12:32. [PMID: 38250988 PMCID: PMC10818929 DOI: 10.3390/toxics12010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive lethal neoplasm, and it has an average 5-year survival rate of less than 10%. Although the factors that influence PDAC development remain unclear, exposure to toxic metals or the imbalance in essential elements may have a role in PDAC-associated metabolic pathways. METHODS This study determined the concentrations of Cd, Cr, Cu, Fe, Mn, Ni, Pb, Se and Zn in whole blood, cancer and non-cancer tissues of patients affected by PDAC, and compared them with levels in healthy controls using inductively coupled plasma mass spectrometry. RESULTS Results of the whole blood showed significantly higher levels of Cr, Cu and Cu/Zn ratio in PDAC patients compared to the controls. In addition, the concentrations of Cu, Se, Fe and Zn significantly increased in cancer tissue compared to the healthy counterparts. CONCLUSIONS This study revealed evidence of altered metal levels in the blood and pancreatic tissues of PDAC patients with respect to healthy controls. These changes may contribute to multiple mechanisms involved in metal-induced carcinogenesis, including oxidative stress, DNA damage, genetic alteration, decreased antioxidant barriers and inflammatory responses. Thus, the analysis of metals can be used in the diagnosis and monitoring of PDAC neoplasms.
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Affiliation(s)
- Giovanni Forte
- Department of Environment and Health, Italian National Institute of Health, 00161 Rome, Italy;
| | - Andrea Pisano
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
| | - Beatrice Bocca
- Department of Environment and Health, Italian National Institute of Health, 00161 Rome, Italy;
| | - Grazia Fenu
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
| | - Cristiano Farace
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
- National Institute of Biostructures and Biosystems, Interuniversity Consortium INBB, 00136 Rome, Italy
| | - Federica Etzi
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
| | - Teresa Perra
- Department of Medicine, Surgery and Pharmacy, Unit of General Surgery, University of Sassari, 07100 Sassari, Italy; (T.P.); (A.P.)
| | - Angela Sabalic
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
| | - Alberto Porcu
- Department of Medicine, Surgery and Pharmacy, Unit of General Surgery, University of Sassari, 07100 Sassari, Italy; (T.P.); (A.P.)
| | - Roberto Madeddu
- Department of Biomedical Science—Histology, University of Sassari, 07100 Sassari, Italy; (A.P.); (G.F.); (C.F.); (F.E.); (A.S.); (R.M.)
- National Institute of Biostructures and Biosystems, Interuniversity Consortium INBB, 00136 Rome, Italy
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Khoshakhlagh AH, Mohammadzadeh M, Bamel U, Gruszecka-Kosowska A. Human exposure to heavy metals and related cancer development: a bibliometric analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:109867-109888. [PMID: 37792180 DOI: 10.1007/s11356-023-29939-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/13/2023] [Indexed: 10/05/2023]
Abstract
As notifications on carcinogenicity of heavy metals increase, more and more attention is paid recently to heavy metals exposure. In our study, the human exposure to heavy metals and cancer knowledge epistemology was investigated using bibliometric analysis. The bibliometric data of the research articles were retrieved using following keywords: "heavy metal," "trace element", "cancer", "carcinogen", and "tumor" in the Scopus database. Specifically, 2118 articles published between 1972 and 2023 were found, covering a total of 1473 authors, 252 sources, and 2797 keywords. Retrospective data obtained from 251 documents and 145 journals were further analyzed by performance analysis and techniques of science mapping. The number of studies conducted in this field increased from one article published in 1972 to 18 articles published in 2022 in the study of Michael P Waalkes. The most impactful author regarding the number of published papers was Masoudreza Sohrabi with 7 publications. In the majority of the published papers, the most popular keywords were "cadmium" and "carcinogenicity". However, in recent 4 years, the emphasis has been placed more on epidemiology studies. Our study provides general knowledge about the trend of publication on the role of heavy metals in causing cancer. The leading researchers in the field of the effects of heavy metals on the development of cancer were identified in our studies. Our results might also create a better understanding of new and emerging issues and can be used as a comprehensive road map for future researchers.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahdiyeh Mohammadzadeh
- Department of Environmental Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
| | - Umesh Bamel
- OB & HRM Group, International Management Institute New Delhi, New Delhi, India
| | - Agnieszka Gruszecka-Kosowska
- Faculty of Geology, Geophysics, and Environmental Protection, Department of Environmental Protection, AGH University of Science and Technology in Krakow, Al. Mickiewicza 30, 30-059, Krakow, Poland
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Maric D, Baralic K, Javorac D, Mandic-Rajcevic S, Zarkovic M, Antonijevic B, Djukic-Cosic D, Bulat Z, Djordjevic AB. Nickel as a potential disruptor of thyroid function: benchmark modelling of human data. Front Endocrinol (Lausanne) 2023; 14:1145153. [PMID: 37800147 PMCID: PMC10549921 DOI: 10.3389/fendo.2023.1145153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/16/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Nickel (Ni) is one of the well-known toxic metals found in the environment. However, its influence on thyroid function is not explored enough. Hence, the aim of this study was to analyse the potential of Ni to disrupt thyroid function by exploring the relationship between blood Ni concentration and serum hormone levels (TSH, T4, T3, fT4 and fT3), as well as the parameters of thyroid homeostasis (SPINA-GT and SPINA-GD) by using correlation analysis and Benchmark (BMD) concept. Methods Ni concentration was measured by ICP-MS method, while CLIA was used for serum hormone determination. SPINA Thyr software was used to calculate SPINA-GT and SPINA-GD parameters. BMD analysis was performed by PROAST software (70.1). The limitations of this study are the small sample size and the uneven distribution of healthy and unhealthy subjects, limited confounding factors, as well as the age of the subjects that could have influenced the obtained results. Results and discussion The highest median value for blood Ni concentration was observed for the male population and amounted 8,278 µg/L. Accordingly, the statistically significant correlation was observed only in the male population, for Ni-fT4 and Ni-SPINA-GT pairs. The existence of a dose-response relationship was established between Ni and all the measured parameters of thyroid functions in entire population and in both sexes. However, the narrowest BMD intervals were obtained only in men, for Ni - SPINA-GT pair (1.36-60.9 µg/L) and Ni - fT3 pair (0.397-66.8 µg/L), indicating that even 78.68 and 83.25% of men in our study might be in 10% higher risk of Ni-induced SPINA-GT and fT3 alterations, respectively. Due to the relationship established between Ni and the SPINA-GT parameter, it can be concluded that Ni has an influence on the secretory function of the thyroid gland in men. Although the further research is required, these findings suggest possible role of Ni in thyroid function disturbances.
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Affiliation(s)
- Djurdjica Maric
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Katarina Baralic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Dragana Javorac
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Stefan Mandic-Rajcevic
- School of Public Health and Health Management and Institute of Social Medicine, University of Belgrade – Faculty of Medicine, Belgrade, Serbia
| | - Milos Zarkovic
- Department of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia
| | - Biljana Antonijevic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Danijela Djukic-Cosic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Zorica Bulat
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
| | - Aleksandra Buha Djordjevic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade — Faculty of Pharmacy, Belgrade, Serbia
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Environmental Exposure to Metals, Parameters of Oxidative Stress in Blood and Prostate Cancer: Results from Two Cohorts. Antioxidants (Basel) 2022; 11:antiox11102044. [PMID: 36290767 PMCID: PMC9598453 DOI: 10.3390/antiox11102044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
We studied the potential role of exposure to various metal(oid)s (As, Cd, Cr, Hg, Ni, and Pb) in prostate cancer. Two cohorts were established: the Croatian cohort, consisting of 62 cases and 30 controls, and the Serbian cohort, consisting of 41 cases and 61 controls. Blood/serum samples were collected. Levels of investigated metal(oid)s, various parameters of oxidative stress, and prostate-specific antigen (PSA) were determined in collected samples. A comparison of the measured parameters between 103 prostate cancer patients and 91 control men from both Croatian and Serbian cohorts showed significantly higher blood Hg, SOD, and GPx levels and significantly lower serum SH levels in prostate cancer patients than in controls. Correlation analyses revealed the significant relationship between certain parameters of oxidative stress and the concentrations of the measured metal(loid)s, pointing to the possible role of metal(oid)-induced oxidative stress imbalance. Furthermore, a significant inverse relationship was found between the blood Pb and the serum PSA in prostate cancer patients, but when the model was adjusted for the impacts of remaining parameters, no significant association between the serum PSA and the measured parameters was found. The results of the overall study indicate a substantial contribution of the measured metal(loid)s to the imbalance of the oxidant/antioxidant system. Although somewhat conflicting, the results of the present study point to the possible role of investigated metal(oid)s in prostate cancer, especially for Hg, since the obtained relationship was observed for both cohorts, followed by the disturbances in oxidative stress status, which were found to be correlated with Hg levels. Nevertheless, further studies in larger cohorts are warranted to explain and confirm the obtained results.
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Buha A, Manic L, Maric D, Tinkov A, Skolny A, Antonijevic B, Hayes AW. The effects of endocrine-disrupting chemicals (EDCs) on the epigenome-A short overview. TOXICOLOGY RESEARCH AND APPLICATION 2022. [DOI: 10.1177/23978473221115817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To understand the effects of endocrine-disrupting chemicals (EDCs), the mechanism(s) by which EDCs exert their harmful effects on humans and their offspring needs careful examination and clarification. Epigenetic modification, including DNA methylation, expression of aberrant microRNA (miRNA), and histone modification, is one mechanism assumed to be a primary pathway leading to the untoward effects of endocrine disruptors. However, it remains unclear whether such epigenetic changes caused by EDCs are truly predicting adverse outcomes. Therefore, it is important to understand the relationship between epigenetic changes and various endocrine endpoints or markers. This paper highlights the possibility that certain chemicals (Cd, As, Pb, bisphenol A, phthalate, polychlorinated biphenyls) reported having ED properties may adversely affect the epigenome. Electronic database sources PubMed, SCOPUS, JSTOR, and the Google Scholar web browser were used to search the literature. The search was based on keywords from existing theories and basic knowledge of endocrine disorders and epigenetic effects, well-known EDCs, and previous search results. Unclear and often conflicting results regarding the effects of EDCs indicate the need for further research to support better risk assessments and management of these chemicals.
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Affiliation(s)
- Aleksandra Buha
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade – Faculty of Pharmacy, Belgrade, Serbia
| | - Luka Manic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade – Faculty of Pharmacy, Belgrade, Serbia
| | - Djurdjica Maric
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade – Faculty of Pharmacy, Belgrade, Serbia
| | - Alexey Tinkov
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl, Russia
- Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anatoly Skolny
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl, Russia
- Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Biljana Antonijevic
- Department of Toxicology “Akademik Danilo Soldatović”, University of Belgrade – Faculty of Pharmacy, Belgrade, Serbia
| | - A. Wallace Hayes
- Center for Environmental Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, FL, USA
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, USA
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