Search Results (81)

The objective of this research is the development of a copper-based optical sensor for the detection of ovarian cancer marker CA 125 synthesized using low-temperature plasma. Optical materials produced with metals show unique advantages due to their ability to interact with light. There are different methods currently used for the synthesis of optical materials that can be associated with longer processing times and low material yield. The novelty of this study is the development of copper-based optical material (CuPy) using low-temperature plasma and subsequent modification for the detection of CA 125. Introduction: Plasma consists of a mixture of fully and partially ionized gas. It comprises diverse, highly energized species of atoms, ions, electrons, excited molecules, and charged species. These energized species are used to create new materials, for surface modifications, and in medical applications. Plasma can create a controlled environment for the creation of novel materials. Using low-temperature plasma, it will be possible to have precise control of the chemical composition and structure due to the creation of excited molecules, ions, and free radicals. Method: The CuPy material was synthesized using radio-frequency-assisted low-temperature plasma. Prior to synthesis, the plasma chamber was cleaned using radio frequency (RF) plasma without any reagents or gases. RF plasma was used for the synthesis of CuPy for 10 min and subsequent hydrogen plasma (50 sccm) for another 10 min. Two types of products were extracted from the chamber (one in water and another in methanol). These two products were analyzed using UV–visible absorbance spectroscopy, fluorescence spectroscopy, X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR). The methanol extracted samples were further modified with CA 125 antibody. Zeta potential measurements were performed to confirm the binding of the CA 125 antibody to the sensor. The sensing efficacy of the sensor towards CA 125 antigen was monitored using fluorescence spectroscopy. Results: The absorbance spectrum of methanol extracted CuPy shows absorbances around 251 nm, 282 nm, and 339 nm. The extracted product exhibited a red edge excitation emission in the visible region. The elemental composition and oxidation state of the sample were evaluated using XPS. CA 125 antibody conjugation with CuPy was confirmed using UV–visible absorbance spectroscopy, fluorescence spectroscopy, and FTIR spectroscopy. The antibody binding resulted in the fluorescence shifts towards higher wavelengths with an increase in the emission intensity compared with CuPy. Zeta potential measurements also confirmed the binding of the CA 125 antibody to the sensor. Different concentrations of CA 125 antigen resulted in the quenching of fluorescence. This change in the fluorescence intensity was used for the detection of CA 125. Conclusions: A copper-based optical material was developed using low-temperature plasma, and it was found to be effective for the detection of CA 125 ovarian cancer marker. Full article

Ischemic heart disease (IHD) remains the leading cause of chronic heart failure (HF) worldwide, yet the biological processes underlying this transition are not fully elucidated. Growing evidence indicates that chronic, low-grade inflammation acts as a pivotal link between ischemic injury and progressive myocardial dysfunction. Our review is the most up-to-date and structured synthesis on the pathophysiological pathways, biomarkers, and therapeutic implications of subclinical inflammation in patients with IHD at risk of developing HF. Following acute or repetitive ischemic episodes, persistent immune activation—mediated through interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α)—promotes endothelial dysfunction, microvascular instability, and extracellular matrix remodeling. These mechanisms culminate in ventricular stiffness, diastolic impairment, and adverse structural remodeling, even when left ventricular ejection fraction is preserved. Biomarkers such as Galectin-3, cancer antigen 125 (CA125), and high-sensitivity C-reactive protein (hsCRP) provide valuable insight into the interplay between fibrosis, congestion, and systemic inflammatory load, supporting early detection of subclinical myocardial injury. Advanced imaging modalities, including strain echocardiography and cardiac magnetic resonance imaging (MRI) mapping, enhance the phenotypic characterization of inflammatory cardiomyopathy. Understanding and targeting these inflammatory pathways may open new avenues for precision-based prevention and treatment, ultimately improving outcomes across the IHD–HF continuum. Full article

Background/Objectives: Breast cancer (BC) is the most commonly diagnosed cancer in women, and metastasis is the leading cause of BC-related death. Circulating tumor cells (CTCs) are a prerequisite for metastasis. This study examined the diagnostic and prognostic value of CTCs for assessing metastatic risk and recurrence in BC. Methods: The Chiline CATCH^® Circulating Target Cell Enrichment System, an automated negative selection platform, was used to enrich and enumerate CTCs from the peripheral blood of patients with BC. Epithelial cell adhesion molecule (EpCAM) and cell-surface Vimentin (CSV) were used as markers for CTC identification. Results: CSV⁺ CTC counts, but not EpCAM⁺ CTC counts, were increased in patients with BC at higher metastatic risk. A cut-off of >4.5 CSV⁺-CTCs/2 mL blood yielded a sensitivity of 0.56 and specificity of 0.92 for identifying patients at high metastatic risk. CSV⁺-CTCs outperformed conventional serum tumor markers, including cancer antigen 15-3 (CA 15-3), cancer antigen 125 (CA 125), and carcinoembryonic antigen (CEA), in identifying patients with high metastatic risk, and their combined use further improved risk stratification. An elevated CSV⁺-CTC count (≥5 cells/2 mL blood) was significantly associated with worse progression-free survival in patients with BC. Conclusions: These findings suggest that CSV⁺-CTCs may serve as a biomarker for metastatic risk stratification and recurrence monitoring in BC when measured using an automated negative selection platform. Full article

Background: Finding dependable prognostic biomarkers for metastatic colorectal cancer (mCRC) is crucial. The albumin-to-carcinoembryonic antigen (CEA) ratio (ACR), a measure of nutritional-inflammatory status and tumor load, has emerged as a promising prognostic indicator. This study assessed ACR’s prognostic value of ACR in patients with mCRC. Methods: This retrospective study included 125 patients with mCRC followed at our institution between July 2010 and March 2022. ROC curve analysis was used to determine the optimal cutoff values for ACR, prognostic nutritional index (PNI), lymphocyte-to-monocyte ratio (LMR), and CEA. Kaplan–Meier and Cox regression analyses were used to evaluate progression-free survival (PFS) and overall survival (OS). Results: PFS and OS were 13.3 and 26.0 months, respectively. Patients with an ACR ≥ 4.24 experienced significantly longer PFS (16.8 vs. 11.0 months; p = 0.001) and OS (32.0 vs. 22.3 months; p < 0.001) compared with those with ACR < 4.24. In univariable analyses, ACR was significantly associated with both PFS and OS, whereas PNI, LMR, and CEA were associated with OS only. In multivariable Cox regression models ACR showed a significant association with both PFS (HR 0.413; 95% CI: 0.265–0.643; p < 0.001) and OS (HR 0.341; 95% CI: 0.210–0.551; p < 0.001), while maintenance therapy was significantly associated with PFS only and ECOG performance status, LMR and PNI with OS only. Conclusions: ACR appears to be a cost-effective biomarker that is associated with PFS and OS in mCRC. These findings suggest that ACR may have potential value for prognostic assessment and risk stratification in patients with mCRC. Full article

Background/Objectives: The treatment options for endometriosis vary depending on individual needs and clinical circumstances. To preserve ovarian reserve, ethanol catheter-directed sclerotherapy may be considered as a treatment option. We compared the efficacy of catheter-directed sclerotherapy with that of surgical removal for the treatment of large ovarian endometriomas. Methods: This retrospective, single-center study was conducted at a tertiary care center. Patients diagnosed with ovarian endometriomas of >10 cm between 1 January 2019 and 5 December 2024 were included. Fifteen patients underwent catheter-directed sclerotherapy, and 69 underwent laparoscopic ovarian cystectomy or oophorectomy. The changes in ovarian cyst size, anti-Müllerian hormone levels, and cancer antigen 125 levels after six months of treatment were determined. Results: Before matched comparison, anti-Müllerian hormone levels decreased from 2.48 ng/mL to 1.11 ng/mL 6 months after surgical treatment. In the catheter-directed sclerotherapy group, anti-Müllerian hormone levels decreased from 1.33 ng/mL to 1.19 ng/mL. In the 1:1 matched comparison between the catheter-directed sclerotherapy and surgical groups, the anti-Müllerian hormone levels decreased by approximately −0.13 and −0.59 in the catheter-directed sclerotherapy and surgical groups, respectively. The relative reduction in the anti-Müllerian hormone levels was approximately −0.25 and −0.78 in the unilateral and bilateral ovarian surgery groups, respectively. In the surgical group, cyst size decreased to 0 cm six months after treatment, whereas CA-125 levels decreased from 62.10 U/mL to 11.20 U/mL. In the CDS group, cyst size reduced to 3.30 cm, whereas CA-125 levels decreased from 74.20 U/mL to 17.60 U/mL. Conclusions: Catheter-directed sclerotherapy preserves ovarian reserve more effectively than surgical treatment, even in cases of large endometriomas. It may be a promising treatment option for individuals with low anti-Müllerian hormone levels who are planning to conceive. Full article

Pancreatic cancer remains one of the most aggressive digestive neoplasms, especially due to late diagnosis. The aim of our study was to investigate cytokeratin-19 fragments (CYFRA 21-1), osteopontin (OPN), and human epididymis protein 4 (HE4) clinical significance in pancreatic adenocarcinoma. Our research is a single-center cross-sectional prospective study that included sixty hospitalized patients diagnosed with pancreatic adenocarcinoma and fourteen controls. CYFRA 21-1, OPN, and HE4 were tested in all participants using Luminex x MAP technology. Serum CYFRA 21-1 levels were weakly correlated with those of OPN (r = 0.302; p = 0.009), HE4 (r = 0.485; p < 0.001), and carbohydrate antigen (CA) 125 (r = 0.376; p = 0.037). Similarly to CA 19-9 and CA 125, the serum OPN levels were higher in patients with pancreatic cancer when compared to controls, 3.37 (1.84; 9.12) ng/mL versus 1.59 (1.09; 2.51) ng/mL; p = 0.003. However, in multivariate analysis, the OPN was not an independent predictor for pancreatic cancer. Further, the receiver operating characteristic (ROC) curve analysis identified CA 19-9 as the biomarker with the highest diagnostic accuracy, while CYFRA 21-1, OPN, and HE4 did not reach clinically meaningful results. Further, the CYFRA 21-1 levels were significantly higher in cases subjected to significant weight loss before admission. Full article

Biomarkers such as CEACAM-5, CA125 and HE4 have been implicated in tumor progression, invasion, and microenvironment modulation in several cancers, but their protein expression in GEP-NET remains poorly characterized. This study aimed to evaluate CEACAM-5, CA125 and HE4 levels in tumors and matched surgical margin samples from 59 GEP-NET patients and assess correlations with clinical and demographic variables. Total protein concentration was measured spectrophotometrically, and selected cytokines by multiplex immunoassay. No significant differences in CEACAM-5, CA125 and HE4 protein concentrations were found between tumor and margin samples. However, in tumor tissue, CA125 protein levels showed a statistically significant association with T and M status. A significantly higher level of all proteins was observed in ileum or colon tumors compared to pancreas. Analysis of HE4 revealed differences in protein levels between male and female tumor samples. CEACAM-5, CA125 and HE4 proteins showed distinct expression patterns in GEP-NET according to tumor stage, metastasis, primary tumor location, and sex, highlighting their potential as tissue biomarkers of tumor aggressiveness and microenvironmental activity. These findings provide a basis for future studies on their prognostic and therapeutic relevance. Full article

Background: Patients with colorectal cancer (CRC) have varying responses to 5-fluorouracil (5-FU) treatment, particularly reduced-dose regimens. Inflammatory and tumor-associated serum biomarkers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125, may refine prognostic assessment. However, their combined performance in patients with CRC receiving reduced-dose 5-FU remains understudied. This retrospective study evaluated the prognostic value of multiple biomarkers in these patients, aiming to identify optimal combinations for personalized therapeutic strategies and improved clinical outcomes. Methods: Data (2017–2023) on patients’ clinicopathological characteristics and pretreatment serum biomarker levels were collected from a medical center in central Taiwan. Dose classification followed institutional standards. Reduced-dose chemotherapy was confirmed from patients’ medical records. Intergroup comparisons, receiver operating characteristic curve analysis, logistic regression, Cox proportional hazards modeling, and survival analysis were performed. Furthermore, a multivariate prognostic nomogram was constructed. Results: The study cohort comprised 95 patients receiving reduced-dose 5-FU. Univariate analyses highlighted cigarette smoking, advanced stage, poor tumor differentiation, and elevated pretreatment CEA level as significant predictors of mortality. Multivariate analysis indicated tumor differentiation grade and pretreatment CEA level as significant independent predictors. Cancer antigen 125, CEA, and CA19-9 exhibited robust discriminatory performance. The multivariate nomogram exhibited acceptable discrimination. Conclusions: Tumor differentiation, disease stage, and pretreatment CEA level emerged as independent predictors of overall survival in patients with CRC receiving reduced-dose 5-FU. Serum biomarkers, particularly CEA and CA19-9, may be included in comprehensive prognostic models alongside clinicopathological characteristics. The validated prognostic nomogram may support personalized risk stratification and individualized dose-adjusted chemotherapy. Full article

Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH in a rural town in Gabon, in Central Africa. Methods. Adult WLWH attending the local HIV outpatient center were prospectively enrolled and underwent cervical visual inspection and cervicovaginal and blood sampling. HIV RNA load and CA-125 levels were measured from plasma using the Cepheid^® Xpert^® HIV-1 Viral Load kit and BioMérieux VIDAS^® CA-125 II assay, respectively. HPV detection and genotyping were performed via a nested polymerase chain reaction (MY09/11 and GP5+/6+), followed by sequencing. Results. Fifty-eight WLWH (median age: 52 years) were enrolled. Median CD4 count was 547 cells/µL (IQR: 412.5–737.5) and HIV RNA load 4.88 Log₁₀ copies/mL (IQR: 3.79–5.49). HPV prevalence was 68.96%, with HR-HPV detected in 41.37% of women. Among HR-HPV-positive samples, 87.5% (21/24) were genotypes targeted by the Gardasil vaccine, while 12.5% (3/24) were non-vaccine types. Predominant HR-HPV types included HPV-16 (13.8%), HPV-33 (10.34%), HPV-35 (5.17%), HPV-31, and HPV-58 (3.45%). Most participants had normal cervical cytology (62.07%), and a minority (14.29%) had elevated CA-125 levels, with no correlation to cytological abnormalities. Conclusions. In the hinterland of Gabon, WLWH are facing an unsuspected yet substantial burden of cervical HR-HPV infection and a neglected risk for cervical cancer. Strengthening cervical cancer prevention through targeted HPV vaccination, sexual education, and accessible screening strategies will help in mitigating associated risk. Full article

Background: A single measurement or a summary of a limited number of measurements of CA125 was considered in the prediction of clinical outcomes for patients with ovarian cancer. We aimed to identify the classes of patients with advanced ovarian cancer based on their CA125 trajectory and to investigate the heterogeneity of clinical outcomes among the patients in the different classes. Methods: CA125 trajectory classes were identified by latent-class mixed models based on values collected within 3 and 6 months post-treatment for 819 women with advanced ovarian cancer enrolled in a randomized trial. Results: Based on their CA125 values during the first 6 months of treatment, the patients with low CA125 levels at baseline that remained low during treatment had the best clinical outcome (a median survival of 83 months and a progression-free survival of 34 months). In contrast, the patients with high CA125 values at baseline with a modest decrease during treatment had the highest risk of death and progression (hazard ratio [95% confidence interval]: 4.83 [3.56, 6.54] for overall survival and 5.15 [3.87, 6.87] for progression-free survival). Conclusions: Longitudinal trajectories of CA125 may provide more direct information for the prognoses of patients with advanced ovarian cancer undergoing chemotherapy treatment. Full article

Background/Objectives: Carbohydrate antigen 125 (CA125) is a glycoprotein commonly overexpressed in epithelial ovarian cancer and widely recognized as a tumor marker. However, elevated CA125 levels are also observed in various non-malignant conditions, including diseases affecting mucosal surfaces, pleural or peritoneal effusions, cirrhosis (with or without ascites), endometriosis, uterine fibroids, adenomyosis, pelvic inflammatory disease, and pregnancy. This review aims to explore the role of CA125 in non-malignant serous effusions, highlighting its diagnostic and prognostic potential beyond the realm of oncology. Methods: A comprehensive literature search was conducted across multiple databases and clinical trial registries. Eligible studies included full-text original research articles, reviews, and case reports published in English over the past 10 years. Inclusion criteria were limited to studies involving human subjects and focused on the role of CA125 in non-malignant serous effusions. Results: CA125 is produced by coelomic epithelial cells lining the ovary, pleura, pericardium, and peritoneum. Its serum concentration is not significantly influenced by age, body weight, or renal function, even in the advanced stages of the disease. In peritoneal conditions, CA125 is synthesized by mesothelial cells and serves as a potential marker of peritoneal involvement. The prevailing pathophysiological mechanism suggests that mechanical stretching of mesothelial cells due to ascitic pressure stimulates CA125 release. Similarly, in heart failure, mesothelial cells of the pericardium produce CA125, which correlates with congestion severity, supports risk stratification, and may inform diuretic therapy. Conclusions: While a threshold of 35 U/mL is established for malignancy, no standardized cutoff exists for CA125 in non-malignant conditions. The utility of CA125 measurement in peritoneal, pleural, or pericardial effusions—and cardiovascular diseases such as acute heart failure—for purposes of differential diagnosis, treatment guidance, or prognostication warrants further investigation through prospective clinical trials. Full article

Ovarian cancer (OC) is one of the leading causes of gynecological cancer-related death worldwide. Late diagnosis at advanced stages of OC is the reason for a higher mortality rate. Earlier diagnosis and proper treatment are important for improving the prognosis of OC patients. Biosensors offer accurate, low-cost, rapid, and user-friendly devices that can be employed for the detection of OC-specific biomarkers in the early stage. Therefore, it is important to consider the potential biomarkers in the biological fluids to confirm the OC prognosis. Out of many biomarkers, the most commonly tested clinically is cancer antigen 125 (CA-125). However, CA-125 is considered to be a poor biomarker for OC diagnosis. Several biosensing methods were developed for the sensitive and quantitative detection of each biomarker. In abnormal expression in OC patients, nucleic acids, enzymes, cells, and exosomes are used as target biomarkers for the construction of biosensors. This review focuses on the development for the detection of various biomarkers using multiple biosensing methods. Here, we describe the origin and the significance of OC-associated biomarkers, the working principle of biosensors, and the classification of biosensors based on their recognition elements and signal transducers. The modes of detection and sensitivity of the sensors are discussed. Finally, the challenges in the fabrication, obstacles in the clinical application, and future prospects are discussed. Full article

Background and clinical significance: Large-cell neuroendocrine carcinoma (LCNEC) of the cervix is considered a rare type of cancer: it represents <1% of invasive cervical cancers. The optimal treatment protocol is not fully established because of its rarity and diagnostic challenges. Case Presentation: A 72-year-old Asian female presented to our outpatient clinic with postmenopausal vaginal spotting for 1 month. Vaginal sonography revealed a cervical tumor of 2.7 cm in diameter with hypervascularity. Tumor markers such as CA 125, CA 19-9, carcinoembryonic antigen, and squamous cell carcinoma antigen all showed no abnormality. Due to high suspicion of cervical cancer, a pap smear and endocervical curettage were performed and confirmed the diagnosis of LCNEC. A positron emission tomography–computed tomography scan demonstrated a glucose hypermetabolic lesion in the mid-pelvic region, localized to the uterus, consistent with LCNEC. Surgery with radical hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymph node dissection was performed. The patient was finally diagnosed with pT1b2N1mi, FIGO IIIC1. Immunohistochemical stain shows that the neoplastic cells were CK (+), p63 (−), p16 (−), CEA (−), vimentin (−), ER (−), WT-1 (−), p53 (−), and CD56 (+), with a high Ki67 index (75%). Concurrent chemotherapy with cisplatin and radiotherapy was performed. Four cycles of etoposide and cisplatin were planned. A 3-month follow-up of this patient revealed stable tumor marker levels. Conclusions: This case highlights the diagnostic challenges and aggressive nature of LCNEC of the cervix, emphasizing the need for a standardized treatment approach to improve patient outcomes. Full article

Borderline Ovarian Tumours (BOTs) are a heterogenous group of ovarian neoplasms which have increased mitotic activity but lack stromal invasion. We performed a narrative review of the literature, aiming to identify prognostic molecular biomarkers that can potentially be used for treatment personalisation. We identified and discussed BRAF/KRAS, Cancer Antigen 125 (Ca 125), Calprotectin, p16ink4a, and Microsatellite instability (MSI) as the most studied biomarkers related to BOTs. Overall, BRAF and KRAS mutations are associated with earlier-stage and favourable prognosis; KRASmt may indicate extraovarian disease in serous BOT (sBOT). Ca125, the only currently clinically used biomarker, can be assessed pre-operatively and has an established role in post-operative surveillance, especially when it is raised pre-operatively or a high potential for malignant transformation is suspected post-operatively. p16ink4a expression trends could also indicate the malignant transformation of the tumour. Calprotectin has an inferior specificity to Ca125 and is not yet established as a biomarker, whilst there is very limited evidence available for MSI. As new evidence is coming along with artificial intelligence platforms, these biomarkers can be integrated and used towards the development of a precision model for treatment stratification and counselling in women diagnosed with BOTs. Full article

The discovery of tumor-derived neoantigens which elicit an immune response through major histocompatibility complex (MHC-I/II) binding has led to significant advancements in immunotherapy. While many neoantigens have been discovered through the identification of non-synonymous mutations, the rate of these is low in some cancers, including head and neck squamous cell carcinoma. Therefore, the identification of neoantigens through additional means, such as aberrant splicing, is necessary. To achieve this, we developed the splice isoform neoantigen evaluator (SINE) pipeline. Our tool documents peptides present on spliced or inserted genomic regions of interest using Patient Harmonic-mean Best Rank scores, calculating the MHC-I/II binding affinity across the complete human leukocyte antigen landscape. Here, we found 125 potentially immunogenic events and 9 principal binders in a cohort of head and neck cancer patients where the corresponding wild-type peptides display no MHC-I/II affinity. Further, in a melanoma cohort of patients treated with anti-PD1 therapy, the expression of immunogenic splicing events identified by SINE predicted response, potentially indicating the existence of immune editing in these tumors. Overall, we demonstrate SINE’s ability to identify clinically relevant immunogenic neojunctions, thus acting as a useful tool for researchers seeking to understand the neoantigen landscape from aberrant splicing in cancer. Full article