The Prevalence and Prognostic Impacts of Nucleophosmin Mutations in Adult Patients with De Novo Acute Myeloid Leukemia

BACKGROUND: Acute myeloid leukemia (AML) is known as cancer of the blood and bone marrow (BM) and is regarded as the commonest acute leukemia in adult patients. AIM: In this study, the aim to investigate the nucleophosmin mutations and their prognostic impacts in patients that were recently diagnosed with AML. METHODS: We have included patients who were newly diagnosed with AML and presented to the medical oncology clinics, National Cancer Institute, Cairo University, during the period from August 2016 to December 2018. To assess the laboratory and hematological outcomes of our patients, total RNA was extracted from BM and converted to cDNA then the expression of nucleophosmin 1 (NPM1) type A mutation was done by real-time quantitative polymerase chain reaction (PCR). Comparative analysis was also conducted to study outcomes between the gene mutation groups. RESULTS: We have included 89 AML patients in our study with a median age of 43 years (18–77). NPM1 gene mutation was detected in 37.1% of our patients by conventional PCR technique and agarose gel electrophoresis, of which 18% were NPM1 type A mutation. No significant differences were noticed between our patients based on their NPM1 gene mutation status (wild and mutant) in terms of sex, hepatomegaly, splenomegaly, and complete remission (CR). Lymphadenopathy was the only significant factor (p = 0.023). Surprisingly we found 9/33 patients had NPM1 mutation with recurrent cytogenetic abnormality. We found no statistical significance between mutation A and mutation non-A groups in any of the studied outcomes as sex, clinical and laboratory data, and CR. CONCLUSION: NPM1 gene mutation A was relatively low among our population but did not significantly affect the outcomes.

Diagnostic performances of leucine-rich α-2-glycoprotein 1 and stem cell factor for diagnosis and follow-up of colorectal cancer

BACKGROUND

Colorectal cancer (CRC) is one of the most frequently diagnosed tumors worldwide with high mortality and morbidity. There is an urgent need for biomarkers to improve the outcomes and early detection of CRC. The sensitivity of traditional CRC tumor markers (carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)) is not ideal. The levels of leucine-rich-alpha-2-glycoprotein 1 (LRG1) and stem cell factor (SCF) were evaluated, but the combined value of both markers is unclear. This case-control study included four groups: CRC patients before treatments (n = 22), CRC patients after treatments (n = 26), 20 patients with benign tumor, and 20 healthy subjects. Levels of routine biochemical and hematological markers, traditional tumor markers (CA19.9 and CEA), and candidate markers (LRG1 and SCF) were determined. Univariate and multivariate logistic regression analysis and area receiver-operating characteristic analysis (ROC) were used for evaluation the diagnostic performances of single and combined markers.

RESULTS

No significance difference in traditional tumor markers CEA, CA 19.9, and neutrophil-lymphocyte ratio (NLR) were found among study groups. SCF, LRG1, and platelet-lymphocyte ratio (PLR) were significantly decreased (p < 0.05) in non-treated CRC patients than after treated CRC. The combination between SCF and LRG1 showed highly significant difference in CRC patients compared with benign, healthy subjects, and among CRC groups (treated and non-treated) (p < 0.0001). The highest areas under curve (AUCs) were observed when LRG1 was used as a single predictor for discriminating CRC from healthy (0.87), benign (0.84), and non-treated CRC vs treated CRC (0.82). AUCs were jumped to 0.90, 0.84, and 0.84 when LRG1 and SCF were combined.

CONCLUSION

Our study revealed that LRG1 and SCF were potential diagnostic and follow-up markers for CRC.