Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide prostate cancers and their relationship with the human development index

Self-screening practice of breast cancer and associated factors among female students in Ethiopian universities using the theory of planned behavior: a cross sectional study

BACKGROUND

Breast cancer is the most common cancer among females. Assessing self-screening practices for breast cancer patients is vital for developing targeted interventions. The current study aimed to assess self-screening practices for breast cancer and associated factors via the theory of planned behavior constructs among female students in Ethiopian universities.

METHODS

A cross-sectional study design was conducted using the theory of planned behavior constructs. The data were collected from January 30, 2022, to February 30, 2022, in Ethiopia. A structured, self-administered questionnaire was used. The validity and reliability tests were checked to use the questionnaire in the main study through a pilot test. The data were collected through online Google Forms by distributing them to university students via Telegram groups, Imo, emails, and Facebook. The collected data were exported to SPSS version 26 for analysis. Bivariate analysis was used to identify the candidate variables for multiple logistic regression (P value < 0.02). Those variables with a P value less than 0.05 were considered significant predictors of breast cancer screening practices.

RESULTS

A total of 418 female students participated in the study. The respondents were aged between 18 and 37 years. In the current study, 318 (76.1%; 95% CI: 72.0, 80.4) university students had good screening practices for breast cancer. Nonhealth-related departments (AOR = 1.95; 95% CI: 1.11, 3.44), having training in breast cancer self-examination (AOR = 1.87; 95% CI: 1.04, 3.35), having a good attitude (AOR = 1.96; 95% CI: 1.11, 3.47), having good behavioral control (AOR = 4.1; 95% CI: 2.18, 7.71), and having good behavioral intentions (AOR = 1.88; 95% CI: 1.09, 3.24) were associated with self-screening practices for breast cancer patients.

CONCLUSION

Designing a theory of planned behavior-based educational interventions improve self-screening practices for breast cancer among university female students. These insights could guide the development of future breast cancer awareness and prevention programs in university settings, with the goal of increasing early detection rates and lowering the risk of breast cancer. The study also serves as foundational information for designing future research using more advanced study design methods.

Pattern of burden cancer breast and relationshipin to human development index in Iran 2009 to 2019: an observational study based on the Global Burden of Diseases

OBJECTIVE

Breast cancer is one of the most common cancers in women worldwide. This study aims is to investigate the burden of breast cancer in Iran and its relationship with the Human Development Index (HDI) during 2009 to 2019.

STUDY DESIGN

The present study is an observational study in Iran during the years 2009 to 2019. Data related to the incidence, mortality, Years of Life with Disability (YLD), Years of Life Lost (YLL) and Disability-Adjusted Life-Years (DALY) of breast cancer in Iran were extracted from the Global Burden of Disease 2019 (GBD-2019) website. Correlation tests are used to check the relationship between these indicators and the human development index.

RESULTS

The highest incidence rate of breast cancer in 2019 is related to the provinces of Gilan (29 per 100,000) and Tehran (28.55 per 100,000) and the highest rate of death from breast cancer is related to the provinces of Gilan (10.71 per 100,000). and Semnan (9.97 in 100,000). The results showed that there is a positive and significant correlation between DALY (r = 0.626, P < 0.0001), YLL (r = 0.611, P < 0.0001) and, YLD (r = 0.773, P < 0.0001) breast cancer with HDI index. There is a positive and significant correlation between the incidence (r = 0.794, P < 0.0001) and mortality (r = 0.503, P = 0.003) of breast cancer with the HDI index.

CONCLUSIONS

Considering that a positive correlation was observed between the incidence and burden of breast cancer and the human development index in the country, it is suggested to implement preventive measures such as public education programs to reduce the incidence and burden of breast cancer and the necessity of screening programs in areas with low human development index. It confirms the diagnosis of disease cases.

Exploring the Disparity in Indoor/Outdoor Time and Radon Exposure as Possible Factors Contributing to the Unexpected Increase in Lung Cancer Risk among Non-Smoking Women

According to a NIH study, Lung cancer among individuals who have never smoked is more prevalent in women and occurs at an earlier age than in smokers. The rise in lung cancer rates among female non-smokers might be linked to radon inhalation and should be further investigated. Our theory is based on the differences in radon exposure between males and females, which can be attributed to the variations in time spent indoors versus outdoors. Over the past few years, the smoking rates have shown a steady decline in the United States and other developed countries. This decrease in smoking prevalence has led to a new shift in the primary risk factors associated with lung cancer. Although tobacco smoke historically served as the primary cause of lung cancer, the reduction in smoking rates has allowed other risk factors, such as radon exposure, to come to the forefront. Given that women in certain countries, on average, might spend more time indoors compared to men, they are potentially exposed to higher levels of radon. This increased exposure could explain the rising rates of lung cancer among female non-smokers. The theory is still in its nascent stages and requires further research and validation. However, if proven correct, it could significantly alter our understanding of lung cancer risk factors and lead to new prevention. It is therefore crucial to expedite the review and publication of this theory, given its potential implications for public health.

A Bee Trp-Arg Dense Peptide with Antiproliferation Efficacy against the Prostate Cancer Cell Line DU145

Prostate cancer accounts for 14% of male cancer-related fatalities in the UK. Given the challenges associated with hormone-based therapies in the context of androgen-independent prostate cancer, there is an imperative need for research into anticancer drugs. N0821, a peptide belonging to the Trp-Arg dense region and derived from the homologous region of various bee species, shows substantial potential for an anticancer effect. Both MTT assays and 3D spheroid assays were conducted to substantiate its antiproliferation potential and strongly indicated the antiproliferation effect of N0820 (WWWWRWWRKI) and N0821 (YWWWWRWWRKI). Notably, the mechanism underlying this effect is related to the downregulation of CCNA2 and the upregulation of CCNE1. Cell cycle arrest results from the reduction of CCNA2 in the S/G2 phase, leading to the accumulation of CCNE1. Our peptides were predicted to make an α-helix structure. This can act as an ion channel in the cell membrane. Therefore, we analyzed genes implicated in the influx of calcium ions into the mitochondria. Trp-Arg dense-region peptides are known for their antibacterial properties in targeting cell membranes, making the development of resistance less likely. Hence, further research in this area is essential and promising.

Deciphering the functional landscape and therapeutic implications of noncoding RNAs in the TGF-β signaling pathway in colorectal cancer: A comprehensive review

Colorectal cancer (CRC) remains a major global health concern, necessitating an in-depth exploration of the intricate molecular mechanisms underlying its progression and potential therapeutic interventions. Transforming Growth Factor-β (TGF-β) signaling, a pivotal pathway implicated in CRC plays a dual role as a tumor suppressor in the early stages and a promoter of tumor progression in later stages. Recent research has shed light on the critical involvement of noncoding RNAs (ncRNAs) in modulating the TGF-β signaling pathway, introducing a new layer of complexity to our understanding of CRC pathogenesis. This comprehensive review synthesizes the current state of knowledge regarding the function and therapeutic potential of various classes of ncRNAs, including microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs), in the context of TGF-β signaling in CRC. The intricate interplay between these ncRNAs and key components of the TGF-β pathway is dissected, revealing regulatory networks that contribute to the dynamic balance between tumor suppression and promotion. Emphasis is placed on how dysregulation of specific ncRNAs can disrupt this delicate equilibrium, fostering CRC initiation, progression, and metastasis. Moreover, the review provides a critical appraisal of the emerging therapeutic strategies targeting ncRNAs associated with TGF-β signaling in CRC. The potential of these ncRNAs as diagnostic and prognostic biomarkers is discussed, highlighting their clinical relevance. Additionally, the challenges and prospects of developing RNA-based therapeutics, such as RNA interference and CRISPR/Cas-based approaches, are explored in the context of modulating TGF-β signaling for CRC treatment. In conclusion, this review offers a comprehensive overview of the intricate interplay between ncRNAs and the TGF-β signaling pathway in CRC. By unraveling the functional significance of these regulatory elements, we gain valuable insights into the molecular landscape of CRC, paving the way for the development of novel and targeted therapeutic interventions aimed at modulating the TGF-β signaling cascade through the manipulation of ncRNAs.

The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review

OBJECTIVES

The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer.

DESIGN

Scoping review.

METHODS

Arksey and O'Malley's framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Academic Search Complete and Cochrane Library) and grey literature were searched. Screening was undertaken against predetermined inclusion criteria for articles published before July 2023 and written in English. This review is reported in line with PRISMA-Sc.

RESULTS

10,899 database results were identified; 3676 papers were removed as duplicates and 7115 papers were excluded at title and abstract review. A total of 108 papers were full-text reviewed and 67 were included in the review. Grey literature searching yielded no results. Age, family history/genetics, hormones, race/ethnicity, exposure to hazards, geographical location and diet were identified as risk factors. Prostatic antigen test (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and prostate biopsy were identified as screening/diagnostic methods. The evidence reviewed highlights moderate knowledge and screening uptake of prostate cancer with less than half of men reporting for PSA screening. On the other hand, there is a year-to-year increase in PSA and DRE screening, but factors such as poverty, religion, culture, communication barriers, language and costs affect men's uptake of prostate cancer screening.

CONCLUSION

As prostate cancer rates increase globally, there is a need for greater uptake of prostate cancer screening and improved health literacy among men and health workers. There is a need to develop a comprehensive prostate cancer awareness and screening programme that targets men and addresses uptake issues so as to provide safe, quality care.

STRENGTHS AND LIMITATIONS OF THIS STUDY

(1) A broad search strategy was utilised incorporating both databases and grey literature. (2) The PRISMA reporting guidelines were utilised. (3) Only English language papers were included, and this may have resulted in relevant articles being omitted.

Functions, mechanisms, and clinical applications of lncRNA LINC00857 in cancer pathogenesis

Emerging data indicated that long noncoding RNAs (lncRNAs) are crucial players in the biological processes via regulating epigenetics, transcription, and protein translation. A novel lncRNA, LINC00857, was indicated to upregulate in several types of cancer. In addition, LINC00857 was functionally related to the modulation of the cancer-linked behaviors, including invasion, migration, proliferation, epithelial-mesenchymal transition (EMT), cell cycle, and apoptosis. The importance of LINC00857 in cancer onset and development proposed that LINC00857 has major importance in the cancer progression and may be considered as a novel prognostic/diagnostic biomarker as well as a treatment target. Here, we retrospectively investigate the available progress in biomedical research investigating the functions of LINC00857 in cancer, focusing on finding the molecular mechanisms affecting various cancer-related behaviors and exploring its clinical applications.

Prostate cancer screening uptake in Kenya: An analysis of the demographic and health survey

BACKGROUND

Prostate cancer (PCa) screening is a cost-effective strategy to promote early detection and treatment. Understanding the determinants of PCa screening uptake would help policy makers to identify high-risk populations and ensure the cost-effectiveness of health promotion interventions. This study aims to estimate the prevalence of PCa screening uptake and assess its associated factors among Kenyan men.

METHODS

The study relied on data from the 2014 Kenya Demographic and Health Survey. Both descriptive and inferential analyses were performed. Firth logistic regression was employed using the "firthlogit" command in STATA. The adjusted odds ratio and 95% confidence interval were presented.

RESULTS

Overall, the prevalence of PCa screening uptake was 4.4%. The odds of PCa screening uptake were high among men aged 50-54 [aOR= 2.08; CI= 1.23, 3.52], those who had health insurance coverage [aOR= 1.69; CI= 1.28, 2.23], those who read at least once in a week [aOR= 1.52; CI= 1.10, 2.10], and among those who watched TV at least once in a week [aOR= 1.73; CI= 1.18, 2.52]. Men who resided in the Eastern [aOR= 2.23; CI= 1.39, 3.60], Nyanza [aOR= 2.13; CI= 1.29, 3.53], and Nairobi [aOR= 1.97; CI= 1.01, 3.86] had a higher likelihood of getting screened for PCa.

CONCLUSION

In conclusion, the uptake of PCa screening in Kenya is low. To ensure the cost-effectiveness of health-promoting interventions that aim to improve PCa screening uptake in Kenya, men without health insurance coverage should be targeted and prioritized. Increasing literacy rate, sensitization via television, and increasing the insurance coverage in the country would significantly contribute to a higher uptake of PCa screening.

POLICY SUMMARY

To improve the uptake of PCa screening, there would be a need to implement a national advocacy campaign that will sensitize Kenyan men about the need to undergo PCa screening. This national advocacy campaign to increase the uptake of PCa screening in Kenya must leverage mass media platforms.

Single-cell RNA sequencing uncovers heterogeneous transcriptional signatures in tumor-infiltrated dendritic cells in prostate cancer

Prostate cancer (PCa) is one of the two solid malignancies in which a higher T cell infiltration in the tumor microenvironment (TME) corresponds with a worse prognosis for the tumor. The inability of T cells to eliminate tumor cells despite an increase in their number reinforces the possibility of impaired antigen presentation. In this study, we investigated the TME at single-cell resolution to understand the molecular function and communication of dendritic cells (DCs) (as professional antigen-presenting cells). According to our data, tumor cells stimulate the migration of immature DCs to the tumor site by inducing inflammatory chemokines. Many signaling pathways such as TNF-α/NF-κB, IL2/STAT5, and E2F up-regulated after DCs enter the tumor location. In addition, some molecules such as GPR34 and SLCO2B1 decreased on the surface of DCs. The analysis of molecular and signaling alterations in DCs revealed some suppression mechanisms of tumors, such as removing mature DCs, reducing the DC's survival, inducing anergy or exhaustion in the effector T cells, and enhancing the differentiation of T cells to Th2 and T_regs. In addition, we investigated the cellular and molecular communication between DCs and macrophages in the tumor site and found three molecular pairs including CCR5/CCL5, CD52/SIGLEC10, and HLA-DPB1/TNFSF13B. These molecular pairs are involved in the migration of immature DCs to the TME and disrupt the antigen-presenting function of DCs. Furthermore, we presented new therapeutic targets by the construction of a gene co-expression network. These data increase our knowledge of the heterogeneity and the role of DCs in PCa TME.

Circ_0067934 as a novel therapeutic target in cancer: From mechanistic to clinical perspectives

Circular RNAs, as a type of non-coding RNAs, are identified in a various cell. Circular RNAs have stable structures, conserved sequence, and tissue and cell-specific level. High throughput technologies have proposed that circular RNAs act via various mechanisms like sponging microRNAs and proteins, regulating transcription factors, and scaffolding mediators. Cancer is one of the major threat for human health. Emerging data have proposed that circular RNAs are dysregulated in cancers as well as are associated with aggressive behaviors of cancer -related behaviors like cell cycle, proliferation, apoptosis, invasion, migration, and epithelial-mesenchymal transition (EMT). Among them, circ_0067934 was shown to act as an oncogene in cancers to enhance migration, invasion, proliferation, cell cycle, EMT, and inhibit cell apoptosis. In addition, these studies have proposed that it could be a promising diagnostic and prognostic biomarker in cancer. This study aimed to review the expression and molecular mechanism of circ_0067934 in modulating the malignant behaviors of cancers as well as to explore its potential as a target in cancer chemotherapy, diagnosis, prognosis and treatment.

Role of microbiome and its metabolite, short chain fatty acid in prostate cancer

The microbiome which is an assembly of all microbes living inside our bodies performs a major role in maintaining human health and wellness. It has been found that the imbalance of the microbiome can cause various diseases in humans. Similarly, there is growing evidence that the microbiome largely affects a person's chance of contracting certain cancers and how the disease develops and progresses. Studies have shown that about 15% to 20% of all cancers are caused by microbial pathogens. The prevalence of prostate cancer, which is increasing rapidly in Korea, is related to lifestyle including diet. These diets can alter the gut microbial composition, and the effect of the microbiome on prostate cancer development can be estimated. However, the microbiome associated with prostate cancer has been reported differently according to race. This means that the metabolite rather than the specific microbiome will be important. Short chain fatty acids, metabolites of the microbiome, plays an important role in the action mechanism of the microbiome. Short chain fatty acids play roles such as immunomodulation and inhibition of histone deacetylase. Here, we examined the most up-to-date literature featuring the effects of the microbiome on the risk and pathogenesis of prostate cancer.

Investigating Efficacy of Three DNA-Aptamers in Targeted Plasmid Delivery to Human Prostate Cancer Cell Lines

Selection of targeted and efficient carriers to deliver drugs and genes to cells and tissues is still a major challenge and to overcome this obstacle, aptamers conjugated to nanoparticles have been broadly examined. To assess whether polycation of aptamers can improve plasmid delivery efficacy, we investigated the effect of three DNA-aptamers (AS1411, WY-5a, and Sgs-8) conjugated to branched polyethylenimine (b-PEI; MW ∼25 kDa) with different combinations of gene (plasmid) for delivery to prostate cancer cell lines (DU145 and PC3). According to transfection assessments, the dual conjugation of aptamers (AS:WY) with b-PEI produced the best results and increased the efficiency of plasmid delivery to up to three folds compared to unmodified PEI. Surprisingly, triple aptamer arrangement not only reduced transfection ability but also showed cytotoxicity. While our results demonstrated potential synergistic effects of AS1411 and WY-5a aptamers for gene delivery, it is important to note that the present evidence relies on the aptamer and cell types.

Role of Genetic Polymorphisms in Drug-Metabolizing Enzyme-Mediated Toxicity and Pharmacokinetic Resistance to Anti-Cancer Agents: A Review on the Pharmacogenomics Aspect

The inter-individual differences in cancer susceptibility are somehow correlated with the genetic differences that are caused by the polymorphisms. These genetic variations in drug-metabolizing enzymes/drug-inactivating enzymes may negatively or positively affect the pharmacokinetic profile of chemotherapeutic agents that eventually lead to pharmacokinetic resistance and toxicity against anti-cancer drugs. For instance, the CYP1B1*3 allele is associated with CYP1B1 overexpression and consequent resistance to a variety of taxanes and platins, while 496T>G is associated with lower levels of dihydropyrimidine dehydrogenase, which results in severe toxicities related to 5-fluorouracil. In this context, a pharmacogenomics approach can be applied to ascertain the role of the genetic make-up in a person's response to any drug. This approach collectively utilizes pharmacology and genomics to develop effective and safe medications that are devoid of resistance problems. In addition, recently reported genomics studies revealed the impact of many single nucleotide polymorphisms in tumors. These studies emphasized the importance of single nucleotide polymorphisms in drug-metabolizing enzymes on the effect of anti-tumor drugs. In this review, we discuss the pharmacogenomics aspect of polymorphisms in detail to provide an insight into the genetic manipulations in drug-metabolizing enzymes that are responsible for pharmacokinetic resistance or toxicity against well-known anti-cancer drugs. Special emphasis is placed on different deleterious single nucleotide polymorphisms and their effect on pharmacokinetic resistance. The information provided in this report may be beneficial to researchers, especially those who are working in the field of biotechnology and human genetics, in rationally manipulating the genetic information of patients with cancer who are undergoing chemotherapy to avoid the problem of pharmacokinetic resistance/toxicity associated with drug-metabolizing enzymes.

Identifying Gingival Pigmentation Patterns and Skin Color and Its Co-relation With Serum Ferritin Levels in Thalassemic Patients

Background: Patients with β-thalassemia major (β-TM), a genetic issue due to hemoglobin (Hb) synthesis disorder, require life-long erythrocyte transfusion. The purpose of this study is to evaluate and compare gingival pigmentation and skin color with serum ferritin levels of patients with β-TM, using the Dummett's oral pigmentation index (DOPI) and Fitzpatrick skin scale, respectively.

Methods: A total of 100 patients were monitored at a thalassemia care center. Each patient's gingival pigmentation and skin color were matched with DOPI and the skin scale under natural light. Serum ferritin levels, the interval of blood transfusions, and iron chelation medications were studied. A gingival pigmentation score and skin color type were compared with the serum ferritin.

Results: A significant correlation was found between age, serum ferritin, pigmentation score, and skin color, which means as serum ferritin level increases, gingival pigmentation score increases, and skin color darkens.

Conclusion: This study evaluated the correlation between gingival pigmentation and skin color with serum ferritin levels and established gingival pigmentation as a sign of iron deposition in β-TM patients. This is the simplest and least invasive method for evaluating serum ferritin level parameters in β-TM patients.

CRL2KLHDC3 mediates p14ARF N-terminal ubiquitylation degradation to promote non-small cell lung carcinoma progression

Kelch superfamily involves a variety of proteins containing multiple kelch motif and is well characterized as substrate adaptors for CUL3 E3 ligases, which play critical roles in carcinogenesis. However, the role of kelch proteins in lung cancer remains largely unknown. In this study, the non-small cell lung cancer (NSCLC) patients with higher expression of a kelch protein, kelch domain containing 3 (KLHDC3), showed worse overall survival. KLHDC3 deficiency affected NSCLC cell lines proliferation in vitro and in vivo. Further study indicated that KLHDC3 mediated CUL2 E3 ligase and tumor suppressor p14ARF interaction, facilitating the N-terminal ubiquitylation and subsequent degradation of p14ARF. Interestingly, Gefitinib-resistant NSCLC cell lines displayed higher KLHDC3 protein levels. Gefitinib and Osimertinib medications were capable of upregulating KLHDC3 expression to promote p14ARF degradation in the NSCLC cell lines. KLHDC3 shortage significantly increased the sensitivity of lung cancer cells to epidermal growth factor receptor (EGFR)-targeted drugs, providing an alternative explanation for the development of Gefitinib and Osimertinib resistance in NSCLC therapy. Our works suggest that CRL2^KLHDC3 could be a valuable target to regulate the abundance of p14ARF and postpone the occurrence of EGFR-targeted drugs resistance.

Analysis of BRCA Germline Mutations in Chinese Prostate Cancer Patients

Recent studies have indicated that prostate cancer (PCa) with BRCA2 mutations is more aggressive. However, these reports mostly focused on Caucasus populations, and large-scale studies on BRCA mutations in Chinese PCa populations remain limited. Herein, we screened, from multiple centers in China, a total of 172 patients with PCa carrying BRCA1/2 germline mutations. The variant distribution and type, associated somatic variant, and frequency of the BRCA germline variants in these patients were analyzed retrospectively. We found that Chinese patients with PCa carrying BRCA1/2 germline mutations were diagnosed at an earlier age, i.e., 67 years (range, 34–89 years), and most had metastatic castration-resistant PCa (mCRPC) (54.65%, 94/172). The top three BRCA variants were frameshift, missense, and splicing variants. The overall pathogenic rates of the BRCA1 and BRCA2 variants were 17.46% (11/63) and 56.55% (82/145), respectively. Among the somatic mutations associated with BRCA2 germline mutations, the highest frequency was for FOXA1 (circulating tumor DNA [ctDNA] sequencing, 7.4%; tissue samples, 52%) and NCOR2 mutations (ctDNA sequencing, 7.4%; tissue samples, 24%); TP53 was the dominant somatic mutation associated with BRCA1 germline mutations (ctDNA sequencing, 25%; tissue samples, 17%). Ultimately, in Chinese patients, PCa with BRCA1/2 germline mutations tends to be more aggressive. Compared with BRCA1, BRCA2 has a higher frequency of germline pathogenic mutations. FOXA1, NCOR2, and TP53 somatic mutations associated with higher BRCA1/2 germline pathogenic mutations. Our description of BRCA germline mutations in the Chinese PCa patients provides more reference data for the precise diagnosis and treatment of Chinese PCa patients.

Patient Preferences for Lung Cancer Treatments: A Study Protocol for a Preference Survey Using Discrete Choice Experiment and Swing Weighting

Background: Advanced treatment options for non-small cell lung cancer (NSCLC) consist of immunotherapy, chemotherapy, or a combination of both. Decisions surrounding NSCLC can be considered as preference-sensitive because multiple treatments exist that vary in terms of mode of administration, treatment schedules, and benefit–risk profiles. As part of the IMI PREFER project, we developed a protocol for an online preference survey for NSCLC patients exploring differences in preferences according to patient characteristics (preference heterogeneity). Moreover, this study will evaluate and compare the use of two different preference elicitation methods, the discrete choice experiment (DCE) and the swing weighting (SW) task. Finally, the study explores how demographic (i.e., age, gender, and educational level) and clinical (i.e., cancer stage and line of treatment) information, health literacy, health locus of control, and quality of life may influence or explain patient preferences and the usefulness of a digital interactive tool in providing information on preference elicitation tasks according to patients.

Methods: An online survey will be implemented with the aim to recruit 510 NSCLC patients in Belgium and Italy. Participants will be randomized 50:50 to first receive either the DCE or the SW. The survey will also collect information on participants' disease-related status, health locus of control, health literacy, quality of life, and perception of the educational tool.

Discussion: This protocol outlines methodological and practical steps to quantitatively elicit and study patient preferences for NSCLC treatment alternatives. Results from this study will increase the understanding of which treatment aspects are most valued by NSCLC patients to inform decision-making in drug development, regulatory approval, and reimbursement. Methodologically, the comparison between the DCE and the SW task will be valuable to gain information on how these preference methods perform against each other in eliciting patient preferences. Overall, this protocol may assist researchers, drug developers, and decision-makers in designing quantitative patient preferences into decision-making along the medical product life cycle.

Body weight variability and cancer incidence in men aged 40 years and older-Korean National Insurance Service Cohort

Repeated weight fluctuation has been proposed as a potential risk factor for increasing morbidity and mortality including cancer. We aimed to investigate the association between body weight variability (BWV) and all cancer and site-specific cancer incidence and the impact of smoking on these associations. A total of 1,759,848 cancer-free male subjects who had their weight measured at least 5 times from the National Health Insurance Service-Health Screening Cohort from 2002 to 2011 were included and followed up until 2015. BWV was defined as the average absolute difference between successive values (ASV). The risk of cancer and site-specific cancer from BWV was identified using Cox proportional hazards regression analysis using hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for potential confounders including weight, and stratified analysis was also conducted according to smoking status. During the 7,015,413 person-years of follow-up, 11,494 patients (0.65%) developed new-onset cancers. BWV was associated with a higher risk of all cancers after adjustment for confounders. The highest BWV quintile group compared to the lowest had greater risks of all cancers and site-specific cancers including lung, liver, and prostate cancer (HR 1.22, 95% CI 1.15–1.30; HR 1.22, 95% CI 1.07–1.39; HR 1.46, 95% CI 1.19–1.81; HR 1.36, 95% CI 1.15–1.62, in all cancers, lung, liver and prostate cancer, respectively). Due to small number of cancer occurrence, the risk of kidney cancer was increased, but statistically insignificant (HR 1.38, 95% CI 0.91–2.10). Similar results were observed in noncurrent smokers. However, in current smokers, the risks of all cancers and only prostate cancer were significantly increased in the highest BWV quintile group (HR 1.19, 95% CI 1.09–1.31; HR 1.51, 95% CI 1.08–2.11). The risk of kidney cancer also increased in this group, although the finding was not statistically significant (HR 1.77, 95% CI 0.87–3.63) This study suggested BWV is an independent risk factor for cancer in men, especially in lung, liver, and prostate cancer, but evidence was weaker in kidney cancer. This association remained significant only in prostate cancer in current smokers.

Analysis of Intestinal Flora and Levels of Epidermal Growth Factor Receptor, Interleukin-32, and Gastrin 17 in Patients with Gastric Cancer via Carbon Nanoparticle Laparoscopy

In order to explore the changes of intestinal flora and serum levels of relevant substances in patients with gastric cancer before and after surgery with carbon nanoparticle laparoscopy, a total of 180 patients with early distal gastric cancer who adopted laparoscopic radical gastrectomy for distal gastric cancer in the general surgery department of TCM Hospital of Shi Jia Zhuang City from January 2018 to January 2020 were selected and randomly divided into two groups: traditional laparoscopic operation (control group) and carbon nanoparticle laparoscopic operation (experimental group) were adopted for treatment for the two groups, respectively. Postoperative evaluation included the difference between the two groups in the operative time, the efficiency of intraoperative lymph node dissection, and the number of lymph node detection. The adverse reactions, changes of intestinal flora before and after surgery in the two groups, and the serum levels of epidermal growth factor receptor (EGFR), interleukin-32 (IL-32), and gastrin 17 were evaluated. In the experimental group, the success rate of carbon nanoparticle tracer black staining reached 100%, and the operation time of the experimental group was significantly shorter than that of the control group (P < 0.05). The lymph node detection rate of the experimental group was higher than that of the control group (P < 0.05), but there was no significant difference in the lymph node metastasis rate between the two groups (P > 0.05). The sentinel lymph node sensitivity of the experimental group reached 92.3%, and the specificity, accuracy, and positive and negative prediction rates reached 100%; the experimental group patients were with an obviously higher incidence of level I-II gastrointestinal reaction (P < 0.05). Postoperative increases in Bifidobacteria and Lactobacillus were observed in both groups, while decreases in Enterococcus and Escherichia coli were observed in both groups (P < 0.05). Moreover, the degree of increase and decrease in the experimental group was greater than that in the control group (P < 0.05). The serum levels of EGFR, IL-32, and gastrin 17 in the two groups were significantly lower than those in the control group on 3 d, 7 d, and 15 d after surgery (P < 0.05). In the radical gastrectomy for distal gastric cancer, carbon nanoparticle laparoscopy was not only helpful for the localization of small tumors but also for the thorough dissection of lymph nodes after the surgery, and the postoperative adverse reactions of carbon nanoparticle laparoscopy were also less, which was of great significance for the improvement of intestinal flora and the reduction of serum levels of EGFR, IL-32, and gastrin 17 in gastric cancer patients.

Real-world Israeli single institution experience with PET-PSMA for staging of patients with clinically staged localized prostate carcinoma

Background

A recent prospective trial, the proPSMA study, showed superior specificity and sensitivity of Positron emission tomography (PET) ‐ Prostate‐specific membrane antigen (PSMA) imaging compared standard Computerized tomography (CT) and bone scan for staging of recently diagnosed high‐risk local prostate carcinoma for curative intent treatment.

Aim

To share our experience with false‐positive PET PSMA scans in newly diagnosed intermediate‐risk prostate cancer.

Methods and results

Here, we report a series of eight patients who underwent systemic staging using PET‐PSMA with false‐positive results who were ultimately treated with definitive radiation or surgery. Of the eight patients, two patients were diagnosed with favorable intermediate disease, four with unfavorable intermediate risk, and two with high‐risk disease. Seven of eight were shown to have false‐positive bone uptake, one patient had uptake in lung nodules. Three patients underwent bone biopsy and proven benign. The rest of the patients were proven as non‐metastatic radiologically by repeat PSMA, CT, or Magnetic resonance imaging (MRI). All subsequently preceded to definitive localized treatment and remain disease free as of this study.

Conclusion

This study emphasizes the importance of prudent clinical judgment when utilizing this highly sensitive imaging technique.

Epidemiology and genomics of prostate cancer in Asian men

Prostate cancer is a global health problem, but incidence varies considerably across different continents. Asia is traditionally considered a low-incidence area, but the incidence and mortality of prostate cancer have rapidly increased across the continent. Substantial differences in epidemiological features have been observed among different Asian regions, and incidence, as well as mortality-to-incidence ratio, is associated with the human development index. Prostate cancer mortality decreased in Japan and Israel from 2007 to 2016, but mortality has increased in Thailand, Kyrgyzstan and Uzbekistan over the same period. Genomic analyses have shown a low prevalence of ERG oncoprotein in the East Asian population, alongside a low rate of PTEN loss, high CHD1 enrichments and high FOXA1 alterations. Contributions from single-nucleotide polymorphisms to prostate cancer risk vary with ethnicity, but germline mutation rates of DNA damage repair genes in metastatic prostate cancer are comparable in Chinese and white patients from the USA and UK. Pharmacogenomic features of testosterone metabolism might contribute to disparities seen in the response to androgen deprivation between East Asian men and white American and European men. Overall, considerable diversity in epidemiology and genomics of prostate cancer across Asia defines disease characteristics in these populations, but studies in this area are under-represented in the literature. Taking into account this intracontinental and intercontinental heterogeneity, translational studies are required in order to develop ethnicity-specific treatment strategies.

Quercetin and Its Nano-Scale Delivery Systems in Prostate Cancer Therapy: Paving the Way for Cancer Elimination and Reversing Chemoresistance

Prostate cancer is the second most leading and prevalent malignancy around the world, following lung cancer. Prostate cancer is characterized by the uncontrolled growth of cells in the prostate gland. Prostate cancer morbidity and mortality have grown drastically, and intensive prostate cancer care is unlikely to produce adequate outcomes. The synthetic drugs for the treatment of prostate cancer in clinical practice face several challenges. Quercetin is a natural flavonoid found in fruits and vegetables. Apart from its beneficial effects, its plays a key role as an anti-cancer agent. Quercetin has shown anticancer potential, both alone and in combination. Therefore, the current study was designed to collect information from the literature regarding its therapeutic significance in the treatment of prostate cancer. Studies performed both in vitro and in vivo have confirmed that quercetin effectively prevents prostate cancer through different underlying mechanisms. Promising findings have also been achieved in clinical trials regarding the pharmacokinetics and human applications of quercetin. In the meantime, epidemiological studies have shown a negative correlation between the consumption of quercetin and the incidence of prostate cancer, and have indicated a chemopreventive effect of quercetin on prostate cancer in animal models. The major issues associated with quercetin are its low bioavailability and rapid metabolism, and these require priority attention. Chemoresistance is another main negative feature concerning prostate cancer treatment. This review highlights the chemotherapeutic effect, chemo preventive effect, and chemoresistance elimination potential of quercetin in prostate cancer. The underlying mechanisms for elimination of prostate cancer and eradication of resistance, either alone or in combination with other agents, are also discussed. In addition, the nanoscale delivery of quercetin is underpinned along with possible directions for future study.

A Staging Auxiliary Diagnosis Model for Nonsmall Cell Lung Cancer Based on the Intelligent Medical System

At present, human health is threatened by many diseases, and lung cancer is one of the most dangerous tumors that threaten human life. In most developing countries, due to the large population and lack of medical resources, it is difficult for doctors to meet patients' needs for medical treatment only by relying on the manual diagnosis. Based on massive medical information, the intelligent decision-making system has played a great role in assisting doctors in analyzing patients' conditions, improving the accuracy of clinical diagnosis, and reducing the workload of medical staff. This article is based on the data of 8,920 nonsmall cell lung cancer patients collected by different medical systems in three hospitals in China. Based on the intelligent medical system, on the basis of the intelligent medical system, this paper constructs a nonsmall cell lung cancer staging auxiliary diagnosis model based on convolutional neural network (CNNSAD). CNNSAD converts patient medical records into word sequences, uses convolutional neural networks to extract semantic features from patient medical records, and combines dynamic sampling and transfer learning technology to construct a balanced data set. The experimental results show that the model is superior to other methods in terms of accuracy, recall, and precision. When the number of samples reaches 3000, the accuracy of the system will reach over 80%, which can effectively realize the auxiliary diagnosis of nonsmall cell lung cancer and combine dynamic sampling and migration learning techniques to train nonsmall cell lung cancer staging auxiliary diagnosis models, which can effectively achieve the auxiliary diagnosis of nonsmall cell lung cancer. The simulation results show that the model is better than the other methods in the experiment in terms of accuracy, recall, and precision.

SAP-cGAN: Adversarial learning for breast mass segmentation in digital mammogram based on superpixel average pooling

PURPOSE

Breast mass segmentation is a prerequisite step in the use of computer-aided tools designed for breast cancer diagnosis and treatment planning. However, mass segmentation remains challenging due to the low contrast, irregular shapes, and fuzzy boundaries of masses. In this work, we propose a mammography mass segmentation model for improving segmentation performance.

METHODS

We propose a mammography mass segmentation model called SAP-cGAN, which is based on an improved conditional generative adversarial network (cGAN). We introduce a superpixel average pooling layer into the cGAN decoder, which utilizes superpixels as a pooling layout to improve boundary segmentation. In addition, we adopt a multiscale input strategy to enable the network to learn scale-invariant features with increased robustness. The performance of the model is evaluated with two public datasets: CBIS-DDSM and INbreast. Moreover, ablation analysis is conducted to evaluate further the individual contribution of each block to the performance of the network.

RESULTS

Dice and Jaccard scores of 93.37% and 87.57%, respectively, are obtained for the CBIS-DDSM dataset. The Dice and Jaccard scores for the INbreast dataset are 91.54% and 84.40%, respectively. These results indicate that our proposed model outperforms current state-of-the-art breast mass segmentation methods. The superpixel average pooling layer and multiscale input strategy has improved the Dice and Jaccard scores of the original cGAN by 7.8% and 12.79%, respectively.

CONCLUSIONS

Adversarial learning with the addition of a superpixel average pooling layer and multiscale input strategy can encourage the Generator network to generate masks with increased realism and improve breast mass segmentation performance through the minimax game between the Generator network and Discriminator network.

Co-delivery of Sorafenib and CRISPR/Cas9 Based on Targeted Core-Shell Hollow Mesoporous Organosilica Nanoparticles for Synergistic HCC Therapy

The rapid development of CRISPR/Cas9 systems has opened up tantalizing prospects to sensitize cancers to chemotherapy using efficient targeted genome editing, but safety concerns and possible off-target effects of viral vectors remain a major obstacle for clinical application. Thus, the construction of novel nonviral tumor-targeting nanodelivery systems has great potential for the safe application of CRISPR/Cas9 systems for gene-chemo-combination therapy. Here, we report a polyamidoamine-aptamer-coated hollow mesoporous silica nanoparticle for the co-delivery of sorafenib and CRISPR/Cas9. The core-shell nanoparticles had good stability, enabled ultrahigh drug loading, targeted delivery, and controlled-release of the gene-drug combination. The nanocomplex showed >60% EGFR-editing efficiency without off-target effects in all nine similar sites, regulating the EGFR-PI3K-Akt pathway to inhibit angiogenesis, and exhibited a synergistic effect on cell proliferation. Importantly, the co-delivery nanosystem achieved efficient EGFR gene therapy and caused 85% tumor inhibition in a mouse model. Furthermore, the nanocomplex showed high accumulation at the tumor site in vivo and exhibited good safety with no damage to major organs. Due to these properties, the nanocomplex provides a versatile delivery approach for efficient co-loading of gene-drug combinations, allowing for precise gene editing and synergistic inhibition of tumor growth without apparent side effects on normal tissues.

Combination of Curcumin and Metformin Inhibits Cell Growth and Induces Apoptosis without Affecting the Cell Cycle in LNCaP Prostate Cancer Cell Line

Side effects and chemotherapy resistance, demand new therapeutics with minimal side effects. Here, we investigated the combined effect of curcumin and metformin on the LNCaP prostate cancer cell line. LNCaP cells were treated with curcumin, metformin, and their combination at different concentrations. Cell viability was assessed by MTT assay and expression of Bax, Bcl-2, mTOR, hTERT, PUMA, p53 and p21 genes was analyzed by real-time PCR. Apoptosis and cell cycle were assessed by flow cytometry. Our results revealed that the viability of cells treated with curcumin, metformin, and their combination was significantly (P < 0.05) reduced with increasing the concentration and prolonging the treatment time. Meanwhile, the combination showed a synergistic effect within 48 h. In the curcumin treated group, the expression of Bcl-2 and hTERT genes diminished. In the metformin treated group, the expression of Bax and PUMA genes was enhanced while the expression of Bcl-2, hTERT, mTOR, and p53 genes declined. Although all treatments induced apoptosis, the combination of curcumin and metformin showed the maximum level of apoptosis, cytotoxicity, and expression of Bax gene. The combination of curcumin and metformin showed synergistic effects within 48 h. This combination could be a potential therapeutic candidate for prostate cancer to be further investigated.