New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers

The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.

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Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193911 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3342

Author(s):

Shivangi S. Gandhi ◽

Pinal C. Shah

Keyword(s):

Cervical Cancer ◽

Developing Countries ◽

Pap Smear ◽

Early Stage ◽

Tertiary Care ◽

Developed Countries ◽

Pap Smears ◽

Papanicolaou Test ◽

Incidence And Mortality ◽

Malignant Lesions

Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer.

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Long Non-Coding RNA in the Pathogenesis of Cancers

Cells ◽

10.3390/cells8091015 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1015 ◽

Cited By ~ 72

Author(s):

Chi ◽

Wang ◽

Yu ◽

Yang

Keyword(s):

Early Stage ◽

Gene Expressions ◽

Rna Transcripts ◽

The Past ◽

Non Coding Rna ◽

Incidence And Mortality ◽

Non Coding Rnas ◽

Tumor Growth And Metastasis ◽

New Biomarkers ◽

Long Non Coding Rna

The incidence and mortality rate of cancer has been quickly increasing in the past decades. At present, cancer has become the leading cause of death worldwide. Most of the cancers cannot be effectively diagnosed at the early stage. Although there are multiple therapeutic treatments, including surgery, radiotherapy, chemotherapy, and targeted drugs, their effectiveness is still limited. The overall survival rate of malignant cancers is still low. It is necessary to further study the mechanisms for malignant cancers, and explore new biomarkers and targets that are more sensitive and effective for early diagnosis, treatment, and prognosis of cancers than traditional biomarkers and methods. Long non-coding RNAs (lncRNAs) are a class of RNA transcripts with a length greater than 200 nucleotides. Generally, lncRNAs are not capable of encoding proteins or peptides. LncRNAs exert diverse biological functions by regulating gene expressions and functions at transcriptional, translational, and post-translational levels. In the past decade, it has been demonstrated that the dysregulated lncRNA profile is widely involved in the pathogenesis of many diseases, including cancer, metabolic disorders, and cardiovascular diseases. In particular, lncRNAs have been revealed to play an important role in tumor growth and metastasis. Many lncRNAs have been shown to be potential biomarkers and targets for the diagnosis and treatment of cancers. This review aims to briefly discuss the latest findings regarding the roles and mechanisms of some important lncRNAs in the pathogenesis of certain malignant cancers, including lung, breast, liver, and colorectal cancers, as well as hematological malignancies and neuroblastoma.

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Pembrolizumab in cervical cancer: latest evidence and clinical usefulness

Therapeutic Advances in Medical Oncology ◽

10.1177/1758834017708742 ◽

2017 ◽

Vol 9 (6) ◽

pp. 431-439 ◽

Cited By ~ 35

Author(s):

Edith Borcoman ◽

Christophe Le Tourneau

Keyword(s):

Cervical Cancer ◽

Checkpoint Inhibitors ◽

Early Stage ◽

Precancerous Lesions ◽

Treatment Options ◽

Hpv Vaccination ◽

Developed Countries ◽

Clinical Usefulness ◽

Early Stage Cervical Cancer ◽

Tumor Types

Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. With the development of detection of precancerous lesions and preventive human papillomavirus (HPV) vaccination program, a survival improvement has been observed in these patients in developed countries, although disparities in accessibility to treatments exist across countries. While early-stage cervical cancer can be curable with surgery, prognosis of patients who recur remains poor, with limited treatment options. In this latter setting, recently, bevacizumab, an antiangiogenic monoclonal antibody targeting vascular endothelial growth factor (VEGF), has been shown to improve overall survival in combination with chemotherapy as compared with chemotherapy alone. No standard treatments exist beyond this treatment regimen. New effective treatments are therefore much needed in this setting. Immunotherapy has represented a breakthrough in recent years in oncology, with antitumor activity reported with immune-checkpoint inhibitors in a variety of tumor types. We discuss here the latest evidence and clinical usefulness of pembrolizumab, anti-PD-1 checkpoint inhibitor, in the treatment of advanced cervical cancer.

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Cancers of the Colon and Rectum

10.1093/oso/9780190238667.003.0036 ◽

2017 ◽

Cited By ~ 1

Author(s):

Kana Wu ◽

NaNa Keum ◽

Reiko Nishihara ◽

Edward L. Giovannucci

Keyword(s):

Physical Inactivity ◽

Early Stage ◽

Precancerous Lesions ◽

Developed Countries ◽

Incidence Rates ◽

Screening Tests ◽

Processed Meat ◽

Heavy Alcohol Use ◽

Colon And Rectum ◽

High Level

Worldwide, colorectal cancer (CRC) is the third most common cancer in men and second in women, with annual estimates of 1.4 million newly diagnosed cases and over 690,000 deaths. Incidence rates relate closely to economic development. Although incidence rates have stabilized at a high level in most economically developed countries, they continue to increase in many traditionally low-risk countries, following the uptake of Western patterns of diet and physical inactivity. In principle, CRC is among the most preventable of all common cancers. Potentially modifiable risk factors include obesity, physical inactivity, high intake of red or processed meat, tobacco smoking, and heavy alcohol use. Several screening tests effectively reduce both the incidence and death rates of CRC through the detection of precancerous lesions and the treatment of early stage cancers. Despite the preventability of CRC, incidence rates over the last twenty years have decreased in only a few countries.

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Potential Role of Traditional Chinese Medicines by Wnt/β-Catenin Pathway Compared With Targeted Small Molecules in Colorectal Cancer Therapy

Frontiers in Pharmacology ◽

10.3389/fphar.2021.690501 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jinrong Chang ◽

Hoileong Wong Xavier ◽

Dongfeng Chen ◽

Yamei Liu ◽

Hui Li ◽

...

Keyword(s):

Colorectal Cancer ◽

Potential Role ◽

Early Stage ◽

Precancerous Lesions ◽

Public Health Problem ◽

New Drugs ◽

Traditional Chinese Medicines ◽

Chinese Medicines ◽

Incidence And Mortality

Colorectal cancer (CRC) has become a global public health problem because of its high incidence and mortality rate worldwide. The previous clinical treatment for CRC mainly involves conventional surgery, chemotherapy, and radiotherapy. With the development of tumor molecular targeted therapy, small molecule inhibitors present a great advantage in improving the survival of patients with advanced CRC. However, various side effects and drug resistance induced by chemotherapy are still the major obstacles to improve the clinical benefit. Thus, it is crucial to find new and alternative drugs for CRC treatment. Traditional Chinese medicines (TCMs) have been proved to have low toxicity and multi-target characteristics. In the last few decades, an increasing number of studies have demonstrated that TCMs exhibit strong anticancer effects in both experimental and clinical models and may serve as alternative chemotherapy agents for CRC treatment. Notably, Wnt/β-catenin signaling pathway plays a vital role in the initiation and progression of CRC by modulating the stability of β-catenin in the cytoplasm. Targeting Wnt/β-catenin pathway is a novel direction for developing therapies for CRC. In this review, we outlined the anti-tumor effects of small molecular inhibitors on CRC through Wnt/β-catenin pathway. More importantly, we focused on the potential role of TCMs against tumors by targeting Wnt/β-catenin signaling at different stages of CRC, including precancerous lesions, early stage of CRC and advanced CRC. Furthermore, we also discussed perspectives to develop potential new drugs from TCMs via Wnt/β-catenin pathway for the treatment of CRC.

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Extracellular vesicles as mediators and markers of acute organ injury: current concepts

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01607-1 ◽

2021 ◽

Author(s):

Birte Weber ◽

Niklas Franz ◽

Ingo Marzi ◽

Dirk Henrich ◽

Liudmila Leppik

Keyword(s):

Extracellular Vesicles ◽

Inflammatory Diseases ◽

Organ Injury ◽

Isolation And Characterization ◽

Communication Processes ◽

Incidence And Mortality ◽

New Biomarkers ◽

And Function

AbstractDue to the continued high incidence and mortality rate worldwide, there is a need to develop new strategies for the quick, precise, and valuable recognition of presenting injury pattern in traumatized and poly-traumatized patients. Extracellular vesicles (EVs) have been shown to facilitate intercellular communication processes between cells in close proximity as well as distant cells in healthy and disease organisms. miRNAs and proteins transferred by EVs play biological roles in maintaining normal organ structure and function under physiological conditions. In pathological conditions, EVs change the miRNAs and protein cargo composition, mediating or suppressing the injury consequences. Therefore, incorporating EVs with their unique protein and miRNAs signature into the list of promising new biomarkers is a logical next step. In this review, we discuss the general characteristics and technical aspects of EVs isolation and characterization. We discuss results of recent in vitro, in vivo, and patients study describing the role of EVs in different inflammatory diseases and traumatic organ injuries. miRNAs and protein signature of EVs found in patients with acute organ injury are also debated.

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The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants

BMC Cancer ◽

10.1186/s12885-021-08640-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ane Sørlie Kværner ◽

Einar Birkeland ◽

Cecilie Bucher-Johannessen ◽

Elina Vinberg ◽

Jan Inge Nordby ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Gut Microbiome ◽

Precancerous Lesions ◽

Colorectal Carcinogenesis ◽

Screening Tools ◽

Screening Methods ◽

Crc Screening ◽

Link Type ◽

Incidence And Mortality

Abstract Background Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions. Methods The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50–74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period. Discussion The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. Trial registration ClinicalTrials.gov Identifier: NCT01538550.

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Clinical and Demographic Predictors of Mortality due to COVID-19 Pandemic: A Retrospective Study

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210511 ◽

2021 ◽

Vol 11 (5) ◽

pp. 74-81

Author(s):

Ayushi Rajkumar Jain ◽

Doss Prakash ◽

Sheetal Swamy

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Early Stage ◽

Major Complication ◽

Respiratory Arrest ◽

Chi Square ◽

High Risk Factors ◽

Demographic Predictors ◽

Chi Square Test ◽

The Common

The alarming statistics of COVID-19 surges up in 2021 throwing an enormous burden on the healthcare system across the world. According to WHO reports on 14th April 2021, globally 136,996,364 confirmed COVID-19 cases are reported across the continents, including 2,951,832 deaths. The state of Maharashtra reported the maximum number of cases of India including high mortality rate. This study was conducted to identify and describe the relation of different predictors (Age, gender, duration of hospital stay, presence of co morbidities) of mortality among the COVID-19 deceased patients by retrospectively analyzing the medical case records of 121 patients from a dedicated COVID hospital at Aurangabad from July 2020 to December 2020. Chi-square test was performed to assess the association between causes of death with different cluster of variables and their significance. This study helps us to identify risk factors that show association between various predictors and mortality rate in COVID-19 patients. Out of 121 deaths, 96 (79%) were male, 61 (49.6%) were in age group between 60-79 years, ARDS was one of the major complication in the deceased patients accounting 29.8% and cardio respiratory arrest was the common cause of death among the deceased patients with 85%. It was also observed that mortality rate was very higher in the initial five days of hospitalization with critical care support. Our result findings provide clinical inferences for physicians to identify high-risk factors with COVID-19 at a very early stage. Key words: COVID-19, Mortality rate, Demographic predictors, Co-morbidities, Cardio respiratory arrest.

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Emerging Role of Inhibin as a Biomarker for Ovarian Cancer

Women s Health ◽

10.1517/17455057.1.1.051 ◽

2005 ◽

Vol 1 (1) ◽

pp. 51-57 ◽

Cited By ~ 1

Author(s):

David M Robertson ◽

Martin K Oehler

Keyword(s):

Ovarian Cancer ◽

Granulosa Cell ◽

Early Stage ◽

Clinical Stage ◽

Survival Rates ◽

Ovarian Carcinomas ◽

Gynecological Malignancy ◽

Granulosa Cell Tumors ◽

Ovarian Cancers ◽

Specificity And Sensitivity

Ovarian cancer is the most lethal gynecological malignancy as it is diagnosed at a late clinical stage in more than 80% of patients. The development of diagnostic tests that can detect all types of ovarian cancers with high specificity and sensitivity, and at an early stage would improve survival rates. Serum inhibin is an ovarian hormone involved in the regulation of fertility, decreasing to undetectable levels after menopause. Certain ovarian malignancies, such as mucinous carcinomas and granulosa cell tumors, continue to produce inhibin, which is detectable in serum. A test for serum inhibin has been developed which is able to diagnose granulosa cell tumors and mucinous carcinomas with high accuracy. When the inhibin assay is used in conjunction with the CA125 test, which detects epithelial ovarian carcinomas, the two tests detect the majority of ovarian cancers with high sensitivity (95%) and specificity (95%). This article discusses the application of the inhibin test in ovarian cancer.

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Diagnostic value of macrophage inhibitory cytokine 1 as a novel prognostic biomarkers for early gastric cancer screening

10.21203/rs.3.rs-17962/v1 ◽

2020 ◽

Author(s):

Xin Ge ◽

Xiaolei Zhang ◽

Yanling Ma ◽

Shaohua Chen ◽

Zhaowu Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Cancer Diagnosis ◽

Early Stage ◽

Precancerous Lesions ◽

Diagnostic Value ◽

Low Grade ◽

Serum Samples ◽

Early Screening ◽

Roc Curve Analysis

Abstract BACKGROUND Early diagnosis is very important to improve the survival rate of patients with gastric cancer, especially in asymptomatic participants. However, low sensitivity of common biomarkers has caused difficulties in early screening of gastric cancer. In this study, we explored whether MIC-1 can improve the detection rate of early gastric cancer.METHODS We screened 8,257 participants based on risk factors such as age, gender, and family history for physical examination including gastroscopy. Participant blood samples were taken for measure MIC-1, CA-199, CA72-4 and PG1/PG2 levels. The diagnostic performance of MIC-1 was assessed and compared with CA-199, CA72-4 and PG1/PG2, and its role in early gastric cancer diagnosis and the assessment of the risk of precancerous lesions have also been studied.RESULTS Based on endoscopic and histopathological findings, 55 participants had gastric cancer, 566 participants had low-grade neoplasia, 2605 participants had chronic gastritis. MIC-1 levels were significantly elevated in gastric cancer serum samples as compared to controls (p<0.001). The sensitivity of serum MIC-1 for gastric cancer diagnosis was much higher than that of CA-199 (49.1% vs. 20.0%) with similar specificities. Moreover, receiver operating characteristic (ROC) curve analysis also showed that serum MIC-1 had a better performance compared with CA-199, CA72-4 and PG1/PG2 in distinguishing early-stage gastric cancer (AUC: 72.9% vs. 69.5%, 67.5%, 44.0% respectively).CONCLUSIONS Serum MIC-1 is significantly elevated in most patients with early gastric cancer. MIC-1 can serve as a novel diagnostic marker of early gastric cancer and value the risk of gastric cancer.

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