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16 pages, 1732 KB  
Article
Epigenetic Regulation and Gene Expression Profiles in Cervical Swabs: Toward Non-Invasive Biomarkers of Cervical Lesion Progression
by Ivana Kašubová, Andrea Hornáková, Lucia Kotúľová, Tomáš Rokos, Zuzana Kolková, Andrea Kapinová, Terézia Pribulová, Erik Kozubík, Michal Kalman, Kamil Biringer, Erik Kúdela and Veronika Holubeková
Epigenomes 2026, 10(1), 2; https://doi.org/10.3390/epigenomes10010002 - 7 Jan 2026
Viewed by 215
Abstract
Background/Objectives: Cervical cancer is a common malignancy in women worldwide, closely associated with persistent human papillomavirus (HPV) infection. Epigenetic mechanisms, particularly promoter methylation, may contribute to tumour progression. This pilot study aimed to analyse the promoter methylation patterns and gene expression of [...] Read more.
Background/Objectives: Cervical cancer is a common malignancy in women worldwide, closely associated with persistent human papillomavirus (HPV) infection. Epigenetic mechanisms, particularly promoter methylation, may contribute to tumour progression. This pilot study aimed to analyse the promoter methylation patterns and gene expression of selected genes (DNMT, BCL2, CDH1, CD8A, MUC1, ALCAM). The goal was to identify associations between promoter hypermethylation, gene expression, and HPV infection in cervical swab specimens obtained from patients with low-grade squamous intraepithelial lesions (SILs), high-grade SILs, or squamous cell carcinomas. Methods: A total of 81 cervical swab samples from Slovak participants were included in the study. DNA methylation and gene expression profiling was performed using real-time PCR (qPCR) and pyrosequencing. Results: BCL2 expression was significantly reduced across all lesion grades. CD8A expression was slightly elevated in low- and high-grade SILs, particularly in HPV-positive samples. MUC1 showed variability with lesion grade. No statistically significant differences in DNA methylation were observed across groups stratified by HPV status, community state type, and lesion grade. Conclusions: Our findings suggest that BCL2 downregulation and gene activity variability influenced by the vaginal microbiome may play a role in cervical lesion progression. These results highlight potential non-invasive biomarkers for monitoring cervical lesions. Full article
(This article belongs to the Special Issue Epigenetic Signatures in Metabolic Health and Cancer)
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16 pages, 866 KB  
Article
Observational Management for Patients with Biochemical Recurrence Following Radical Prostatectomy, in the Absence of Detectable Disease on Restaging PSMA PET/CT Imaging
by Katelijne C. C. de Bie, Jan-Jaap J. Mellema, Dennie Meijer, Frederik R. Teunissen, Pim J. van Leeuwen, Daniela E. Oprea-Lager, Maarten L. Donswijk, Roderick C. N. van den Bergh and André N. Vis
Diagnostics 2026, 16(1), 32; https://doi.org/10.3390/diagnostics16010032 - 22 Dec 2025
Viewed by 658
Abstract
Background/Objectives: In men with biochemical recurrence (BCR) after a radical prostatectomy (RP), salvage radiotherapy (SRT) is commonly recommended when imaging shows no metastases. The optimal management for patients with negative prostate-specific membrane antigen (PSMA) PET/CT findings at BCR remains uncertain. This study evaluated [...] Read more.
Background/Objectives: In men with biochemical recurrence (BCR) after a radical prostatectomy (RP), salvage radiotherapy (SRT) is commonly recommended when imaging shows no metastases. The optimal management for patients with negative prostate-specific membrane antigen (PSMA) PET/CT findings at BCR remains uncertain. This study evaluated outcomes of patients with BCR and negative PSMA PET/CT to identify who may be safely observed and who may benefit from early SRT. Methods: This retrospective multicentre cohort study included 89 patients with BCR and negative PSMA PET/CT findings after a RP (2015–2022) who were managed with observation. The exclusion criteria were PSA levels ≥ 0.8 ng/mL at baseline, prior SRT, or prior or ongoing hormonal therapy. Minimum follow-up was 3 years. Biochemical progression (PSA rise > 0.2 ng/mL above baseline or initiation of additional treatment) and radiological progression (local or metastatic disease on follow-up PSMA PET/CT) were assessed. Patients were stratified by EAU BCR-risk classification. Multivariable Cox regression included age, biochemical persistence (BCP) after a RP, pathological tumour stage (pT), pathological ISUP grade group (pISUP), node status (pN), margin status (R), and PSA doubling time (PSAdt). Results: The median age was 66 years (IQR 60–69) and the median PSA measurement at BCR was 0.2 ng/mL (IQR 0.2–0.3). A total of 27/89 (30%) patients were EAU BCR low-risk and 62/89 (70%) were high-risk. At three years, biochemical progression occurred in 14/27 (52%) low-risk vs. 51/62 (83%) high-risk patients, with time to progression being 21 vs. 12 months (p = 0.01). A pISUP grade group ≥ 4 (HR 2.04 [95%-CI 1.11–3.74]; p = 0.022) and a PSAdt < 20 months (HR 5.72 [95%-CI 2.41–13,56]; p < 0.01) independently predicted biochemical progression. Radiological progression occurred in 43/68 (66%) rescanned patients, with 32/43 (74%) showing disease outside the prostatic fossa. Conclusions: Nearly half of patients with BCR and negative PSMA PET/CT findings who were classified as EAU BCR low-risk remained progression-free at three years. These results support a risk-adapted approach, indicating that SRT may be deferred in selected low-risk patients. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Urologic Disorders)
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17 pages, 2139 KB  
Article
Examination of Appendiceal Neoplasms—A Retrospective, Single-Centre, Cohort Study
by Berkenye Csonka, Tamás Lantos and Anita Sejben
Cancers 2025, 17(24), 4028; https://doi.org/10.3390/cancers17244028 - 18 Dec 2025
Viewed by 442
Abstract
Background: Appendiceal neoplasms are rare, but recent data indicate a rising trend, particularly in patients under the age of 50. These tumours are often diagnosed incidentally during histopathological examination. This study has aimed to examine the incidence and histological subtypes of appendiceal neoplasms [...] Read more.
Background: Appendiceal neoplasms are rare, but recent data indicate a rising trend, particularly in patients under the age of 50. These tumours are often diagnosed incidentally during histopathological examination. This study has aimed to examine the incidence and histological subtypes of appendiceal neoplasms in a Southern Hungarian population. Methods: Our study included neoplastic appendix specimens processed at the University of Szeged between 2014 and 2023. Results: Neoplasms were identified in 71 cases from 3640 appendectomies (1.9%). Benign lesions were present in 37% of cases (n = 26), with the most common subtype being the sessile serrated lesion (n = 20). Mucinous and malignant neoplasms were found in 63% of cases (n = 45), most frequently low-grade appendiceal mucinous neoplasm (n = 19), followed by neuroendocrine tumour (n = 17). Notably, colorectal neoplasm was identified in 50% of benign, and 42.2% of mucinous and malignant cases during a mean follow-up of 33.4 months. Significant associations were found between histological subtype and age (p = 0.022), complete resection (p = 0.012), presence of vascular invasion (p = 0.007), and localisation of potentially associated colorectal carcinoma (p = 0.018). Additionally, tumour dignity showed significant correlations with tumour, node, metastasis (TNM) stage (p < 0.001), vascular invasion (p = 0.017), and lastly, occurrence (p = 0.031) and localisation (p = 0.003) of associated colorectal carcinoma. Conclusions: The prevalence and characteristics observed in this Southern Hungarian population were consistent with international data, although raw case numbers suggested an upward trend. The high rate of associated colorectal neoplasms underscores the importance of thorough pathological evaluation and long-term surveillance. Full article
(This article belongs to the Special Issue Clinical Studies in Gastrointestinal Malignancies)
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16 pages, 1360 KB  
Article
Taxonomic Profiling of Systemic Inflammatory Parameters as Predictors of Tumor Progression in Primary Colorectal Cancer
by Michał Nycz, Dariusz Waniczek, Małgorzata Muc-Wierzgoń, Karolina Snopek-Miśta, Mariusz Kryj, Bartosz Bichalski, Magdalena Bichalska-Lach, Łukasz Michalecki, Wiktor Krawczyk and Zbigniew Lorenc
J. Clin. Med. 2025, 14(24), 8733; https://doi.org/10.3390/jcm14248733 - 10 Dec 2025
Viewed by 318
Abstract
Background/Objectives: Colorectal cancer (CRC) is one of the most common malignancies worldwide, with systemic inflammation increasingly recognised as a determinant of disease progression. This study aimed to establish a taxonomy-based classification of patients with newly diagnosed primary CRC using systemic inflammatory, haematological, and [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is one of the most common malignancies worldwide, with systemic inflammation increasingly recognised as a determinant of disease progression. This study aimed to establish a taxonomy-based classification of patients with newly diagnosed primary CRC using systemic inflammatory, haematological, and anthropometric markers, and to evaluate its association with tumour stage. Methods: A total of 229 patients (111 women, 118 men) undergoing surgery for primary CRC were included. Blood samples were analysed for haemoglobin, leukocytes, neutrophils, lymphocytes, platelets, C-reactive protein (CRP), and carcinoembryonic antigen (CEA). Anthropometric data were collected. Taxonomic clustering and ordinal logistic regression were used to explore associations with TNM and Astler–Coller classifications. Results: Men had higher neutrophil and leukocyte counts, elevated CEA concentrations (132.8 vs. 81.3 ng/mL), and higher NLR values (4.74 vs. 4.23) compared with women. Logistic regression confirmed that platelet count (OR 1.003; p = 0.004), PLR (OR 1.003; p = 0.003), and CEA (OR 1.03; p < 0.001) were positively associated with advanced TNM stage, while haemoglobin was inversely correlated (OR 0.88; p = 0.045). Among 84 clustering models, two taxonomies were the most clinically informative: Taxonomy I (BMI, neutrophils, platelets) and Taxonomy II (age, lymphocytes, platelets), both significantly associated with T, N, M, overall TNM stage, and Astler–Coller grade. Taxonomy I identified three patient groups. Type 3 represented the poorest phenotype, characterised by low BMI and haemoglobin, high platelets, elevated CEA and PLR, and predominance of TNM IIIC tumours, consistent with a cachectic–inflammatory profile. Type 1 displayed higher BMI, lower inflammation, and earlier-stage disease. Type 2 was characterized by elevated neutrophils and leukocytes. Taxonomy II distinguished four groups, with Type 2 demonstrating the most favourable profile (high haemoglobin and lymphocytes, low NLR and PLR, early TNM stage). Conclusions: Systemic inflammatory markers, haemoglobin, platelets, and CEA strongly predict CRC advancement. The proposed taxonomy provides clinically meaningful stratification of CRC patients and may support personalised risk assessment. This accessible approach may facilitate early identification of high-risk individuals, although validation in prospective studies is required. Full article
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26 pages, 1269 KB  
Review
Advances in Preoperative and Intraoperative Technologies for Safe Resection of Gliomas in Cognitive Regions
by Valentina Vintimilla Rivadeneira and Jose E. Leon-Rojas
Cancers 2025, 17(24), 3890; https://doi.org/10.3390/cancers17243890 - 5 Dec 2025
Viewed by 885
Abstract
Advances in neuroimaging and intraoperative mapping have transformed brain tumour surgery from anatomy-based resection to function-guided intervention. This review synthesises current evidence on multimodal strategies for maximising tumour removal while preserving cognitive and neurological function. Integrating task-based and resting-state functional MRI (fMRI), diffusion [...] Read more.
Advances in neuroimaging and intraoperative mapping have transformed brain tumour surgery from anatomy-based resection to function-guided intervention. This review synthesises current evidence on multimodal strategies for maximising tumour removal while preserving cognitive and neurological function. Integrating task-based and resting-state functional MRI (fMRI), diffusion tensor imaging (DTI), tractography, and connectomic analysis enables personalised mapping of eloquent and cognitive networks. Intraoperatively, awake craniotomy with direct electrical stimulation (DES) remains the gold standard for real-time functional validation, while adjuncts such as intraoperative MRI (iMRI), 5-aminolevulinic acid (5-ALA) fluorescence, and ultrasound-based extended resection accuracy. However, these technologies present unique limitations, including neurovascular uncoupling in fMRI, tract distortion in DTI, and resource constraints in low-income settings. Our review differentiates their application across low-grade and high-grade gliomas, emphasising that tumour biology determines the balance between neuroplasticity-driven mapping and imaging-guided radicality. Key future priorities include validation of multimodal imaging protocols, integration of longitudinal neuropsychological outcomes, and development of interpretable connectomic models. Addressing the technological and ethical challenges of high-field MRI, data standardisation, and cost-effective implementation will be essential for equitable global adoption. Ultimately, the evolution of functional neurosurgery depends not only on new technologies but on integrating multimodal evidence and patient-centred outcome measures to achieve reproducible, safe, and personalised brain tumour surgery. Full article
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19 pages, 2413 KB  
Article
Diagnostic and Prognostic Implications of FGFR3, TP53 Mutation and Urinary Biomarkers in Urothelial Carcinoma in Pakistani Cohort
by Muhammad Asif, Faiza Abdul Rashid, Saima Shakil Malik, Dilshad Ahmed Khan, Muhammad Tanveer Sajid, Asma Gul and Muhammad Tahir Khadim
J. Clin. Med. 2025, 14(23), 8526; https://doi.org/10.3390/jcm14238526 - 1 Dec 2025
Cited by 1 | Viewed by 568
Abstract
Background: Urothelial carcinoma (UC) presents with clinically heterogeneous disease. There is an emerging need to explore the prognosis of non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Therefore, we aimed to explore the prognostic value of FGFR3 and TP53 mutations and protein [...] Read more.
Background: Urothelial carcinoma (UC) presents with clinically heterogeneous disease. There is an emerging need to explore the prognosis of non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Therefore, we aimed to explore the prognostic value of FGFR3 and TP53 mutations and protein expression and to investigate the diagnostic utility of urine cytology and Xpert bladder cancer monitor (BCM) assay in UC. Materials and Methods: A prospective cross-sectional study was conducted in a cohort of 73 Pakistani patients. Cystoscopy, biopsy, tissue diagnosis, UC grade, and stage followed by immunohistochemistry (IHC) and genotyping were recorded. Voided urine samples were also collected for urine cytology and Xpert BCM. Statistical analysis was performed using SPSS version 26.0. A p-value ≤ 0.05 was considered statistically significant. Results: In our selected patients, the majority were males who had smoking history and the common symptom was hematuria. Our findings suggest FGFR3 IHC expression is strongly linked to low-grade NMBIC (p ≤ 0.01). p53 IHC expression supports the findings of the UC grade (p ≤ 0.01). A highly significant association (p < 0.001) was observed between FGFR3 protein expression and underlying mutations. Pro72Arg polymorphism (p = 0.04) was found to be significantly correlated with p53 IHC findings. While comparing cystoscopy with cytology and Xpert BCM, the sensitivity was found to be 85.7% and 58.5%, respectively. Conclusions: The integrated approach of IHC with genotyping could improve risk stratification and guide personalized management strategies. Moreover, as cytology is less sensitive to diagnose UC, especially low-grade tumours, Xpert BCM can be used as a promising diagnostic test for both primary and recurrent BC settings. Full article
(This article belongs to the Special Issue Bladder Cancer: Clinical Diagnosis and Treatment)
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24 pages, 2759 KB  
Article
Clinical Utility of Amino Acid PET-MRI in Children with CNS Neoplasms: A Territory-Wide Study from Hong Kong
by Evelyn R. Lu, Pui Wai Cheng, Sherman S. M. Lo, Chloe W. Y. Siu, Eric C. H. Fu, Jeffrey P. W. Yau, Anselm C. W. Lee, Kwok Chun Wong, Elaine Y. L. Kan, Sarah S. N. Lau, Wilson W. S. Ho, Kevin K. F. Cheng, Emily K. Y. Chan, Ho Keung Ng, Amanda N. C. Kan, Godfrey C. F. Chan, Dennis T. L. Ku, Matthew M. K. Shing, Anthony P. Y. Liu and Deyond Y. W. Siu
Cancers 2025, 17(19), 3233; https://doi.org/10.3390/cancers17193233 - 4 Oct 2025
Viewed by 1153
Abstract
Background: Amino acid tracer positron emission tomography–magnetic resonance imaging (PET-MRI) was shown to be superior to MRI alone for evaluating central nervous system (CNS) tumours in adults. This study aimed to investigate the utility of amino acid PET-MRI in children with CNS [...] Read more.
Background: Amino acid tracer positron emission tomography–magnetic resonance imaging (PET-MRI) was shown to be superior to MRI alone for evaluating central nervous system (CNS) tumours in adults. This study aimed to investigate the utility of amino acid PET-MRI in children with CNS tumours. Methods: We reviewed the amino acid PET-MRI findings of children with suspected or confirmed CNS neoplasms managed in a territory-wide referral centre in Hong Kong from 2022 to 2025. Maximal standardized uptake values (SUVmax) were captured, and tumour-to-background SUVmax ratios (TBRmax) were measured with reference to adjacent or contralateral normal brain structures. Comparisons were made among patients with clinical high-grade and low-grade/non-neoplastic lesions. Results: Thirty-seven patients were included, with 63 PET-MRIs performed. PET-MRI was performed as part of initial diagnostics in 41% of the cases, for response assessment in 48%, and evaluation of residual/relapsed disease in 11%. High-grade lesions had a significantly higher SUVmax and TBRmax compared to low-grade/non-malignant lesions (median SUVmax 3.7 vs. 1.6, p = 0.00006; median TBRmax 2.06 vs. 0.91, p = 0.00002). Optimal SUVmax and TBRmax cut-offs by ROC analysis were 2.38 and 1.62, respectively. Similar performance was reproduced by focusing on the subset of patients with suspected CNS germ cell tumours (CNS-GCT). The impact of amino acid PET availability is considerable, as clinical management was modified in 65% of patients. Conclusions: Our study demonstrates the performance and clinical utility of amino acid PET-MRI in the management of children with CNS pathologies. Amino acid PET-MRI contributes to the diagnosis, monitoring, and treatment guidance of these patients, providing crucial information for decision-making. Full article
(This article belongs to the Special Issue Molecular Pathology of Brain Tumors)
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15 pages, 618 KB  
Article
Clinicopathological Characteristics and Oncologic Outcomes of Endometrioid Ovarian Carcinoma: A Retrospective Study from a Tertiary Cancer Centre
by Christina Pappa, Aakriti Aggarwal, Sally El Tawab, Sabina Nistor, Jennifer Thorne, Negin Sadeghi, Sanjiv Manek, Kezia Gaitskell, Sunanda Dhar, Jacopo Conforti, Federico Ferrari and Hooman Soleymani majd
Biomedicines 2025, 13(10), 2381; https://doi.org/10.3390/biomedicines13102381 - 28 Sep 2025
Viewed by 1428
Abstract
Background/Objectives: To evaluate the clinicopathological features, treatment, and survival outcomes and to identify independent prognosticators for recurrence and mortality in patients with endometrioid ovarian cancer. Methods: The medical records of patients diagnosed with endometrioid ovarian carcinoma between January 2010 and December [...] Read more.
Background/Objectives: To evaluate the clinicopathological features, treatment, and survival outcomes and to identify independent prognosticators for recurrence and mortality in patients with endometrioid ovarian cancer. Methods: The medical records of patients diagnosed with endometrioid ovarian carcinoma between January 2010 and December 2022 were reviewed retrospectively. Demographic and disease-related data were evaluated. Kaplan–Meier survival analysis using log rank test and Cox regression was performed. Results: Seventy-six patients were included in the study. The median age at diagnosis was 54 years (range 31–86). A total of 85.5% of the patients were diagnosed with early-stage disease and 88.1% of the tumours represented low-grade carcinomas. Synchronous endometrioid endometrial cancer was confirmed in 19.7% of the cases. All patients underwent surgical management and 65.8% received adjuvant chemotherapy. Median follow-up time was 67.5 months. The 5-year disease-free survival and overall survival were 92.1% and 93.4%, respectively. The risk of cancer-related death was higher in advanced stages (HR = 13.86; 95% CI 2.16–57.17; p < 0.001) and in the presence of residual disease (HR = 15.18; 95% CI 2.36–87.17; p < 0.002). Residual disease and advanced stages were also identified as independent risk factors for disease relapse with HR = 16.04 (95% CI 2.61–93.7; p < 0.002) and HR = 11.73 (95% CI 1.92–41.6; p < 0.001), respectively. Conclusions: Endometrioid ovarian carcinoma usually affects younger patients with the majority of the cases representing low-grade carcinomas diagnosed at early stages. Residual disease and advanced stages are independently associated with inferior survival outcomes. There was no significance of lymph node dissection and adjuvant chemotherapy in the overall and recurrence-free survival rates. Further research focusing on molecular profiling should aim to define the prevalence and the prognostic value of major molecular alterations and develop precise stratification models to plan personalised treatment for optimal care. Full article
(This article belongs to the Special Issue New Advances in Ovarian Cancer)
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52 pages, 10321 KB  
Article
Prognostic Significance of WWOX/HIF1A Ratio in Cancer Subtypes: Insights into Metabolism, ECM, and EMT
by Izabela Baryła, Raneem Y. Hammouz, Kinga Maciejek and Andrzej K. Bednarek
Biology 2025, 14(9), 1151; https://doi.org/10.3390/biology14091151 - 1 Sep 2025
Viewed by 1249
Abstract
WWOX and HIF1α proteins are involved in cancer progression; their functions are closely related. WWOX binds HIF1α through its WW domains, sequestering it in the cytoplasm and inhibiting its transcriptional activity. This study evaluates the prognostic significance of the WWOX/HIF1A interaction [...] Read more.
WWOX and HIF1α proteins are involved in cancer progression; their functions are closely related. WWOX binds HIF1α through its WW domains, sequestering it in the cytoplasm and inhibiting its transcriptional activity. This study evaluates the prognostic significance of the WWOX/HIF1A interaction across cancers, breast cancer subtypes, glioblastoma (GBM), low-grade glioma (LGG), and hepatocellular carcinoma (HCC) through gene expression and pathway analysis focused on metabolism, ECM, and epithelial–mesenchymal transition. In breast cancer, metabolic pathways correlated with good prognosis in basal subtypes. HER2 subtypes showed enrichment in DNA replication pathways. Luminal A subtypes showed favourable prognosis via TNF and PI3K/AKT signalling, while luminal B subtypes had poor prognosis tied to metabolic activity; genes associated with good prognosis mirrored those tied to poor prognosis in luminal A. In HCC, enhanced metabolic activity was associated with good prognosis. In contrast, poor prognosis involved TNF signalling and cytoskeleton-related pathways, indicating more aggressive tumour behaviour. In LGG, good prognosis was linked to metabolic and cAMP pathways, while poor outcomes involved TNF, cell cycle, apoptosis, and focal adhesion pathways. GBM showed similar patterns: metabolic and cAMP pathways indicated better outcomes, while NFKB, TNF, JAK-STAT, and PI3K/AKT pathways marked poor prognosis. These findings suggest the WWOX/HIF1A ratio is a robust prognostic marker and a possible guide for developing targeted treatments. Full article
(This article belongs to the Section Cancer Biology)
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18 pages, 2150 KB  
Systematic Review
Role of Radical Prostatectomy in Oligo-Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Meta-Analysis
by Karthik Rajan, Kalpesh Parmar, Shri-Ishvarya Rajamoorthy, Robert Geraghty, Eleanor Whyte and Bhavan Prasad Rai
Cancers 2025, 17(17), 2757; https://doi.org/10.3390/cancers17172757 - 24 Aug 2025
Viewed by 1928
Abstract
Introduction and Aims: Androgen deprivation therapy (ADT) with systemic anti-cancer treatment (SACT) ± palliative radiotherapy (pRT) is the current standard of care for Oligo-metastatic hormone-sensitive prostate cancer (o-mHSPC). Cytoreductive radical prostatectomy (cRP) has gained interest in this group of patients, with potential benefits [...] Read more.
Introduction and Aims: Androgen deprivation therapy (ADT) with systemic anti-cancer treatment (SACT) ± palliative radiotherapy (pRT) is the current standard of care for Oligo-metastatic hormone-sensitive prostate cancer (o-mHSPC). Cytoreductive radical prostatectomy (cRP) has gained interest in this group of patients, with potential benefits including reduced tumour burden and a lower risk of local events from disease progression. In this review, we compare both survival outcomes and local event rates between cRP and upfront ADT ± SACT. Methods: All randomised trials and observational studies comparing cRP with standard treatment (ST), which we defined as ADT ± SACT for o-mHSPC, were included in the review. The study protocol was registered in PROSPERO (CRD42024516586), and the review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases searched included Embase, Medline, Cochrane Library, PubMed, and Web of Science. A risk of bias assessment was performed for the included studies as recommended by the Cochrane Handbook of Systematic Reviews and Interventions. The primary outcome measures were Overall Survival (OS), Cancer-Specific Survival (CSS), Progression-free Survival (PFS), Castrate-resistant Prostate Cancer-free Survival (CRPC-FS), and local complication rates. The secondary outcome measures were complication rates and functional outcomes post-cRP. Results: A total of 5130 studies were identified for this review (5119 by database searching and 11 through manual searching). Eight studies were included in the review, comprising 611 patients. cRP was identified to have superior OS (HR: 0.56 (95% CI: 0.34–0.92), I2 = 0%, p = 0.02 (very low certainty)) and CSS (HR: 0.27 (95% CI: 0.15–0.47), I2 = 0%, p < 0.0001 (very low certainty)). The PFS (HR: 0.67 (95% CI: 0.34–1.33), I2 = 58%, p = 0.25 (very low certainty)) and CRPC-FS (HR: 0.67 (95% CI: 0.32–1.43), I2 = 57%, p = 0.30 (very low certainty)) were similar between the two groups. The rates of local events were significantly lower in patients undergoing cRP (RR 0.27 (95% CI: 0.13–0.59), I2 = 17%, p = 0.001 (low certainty)). The rates of Clavien–Dindo (CD) grade 3 or higher complications ranged from 0% to 13.1%. Additionally, the reported continence rates ranged from 81.5% to 91.3%. The review is limited by the lack of a uniform definition for o-mHSPC and the predominance of low-quality, heterogeneous studies. Despite mitigation strategies, the overall certainty of evidence remains very low per GRADE assessment. Conclusion: cRP significantly reduces local event rates compared with ST and offers comparable PFS and CFPC-FS, with superior OS and CSS in the cRP arm compared to the ST arm in patients with o-mHSPC. However, there is a paucity of high-quality literature on this subject. Ongoing randomised controlled trials may soon clarify the role of cRP in the context of o-mHSPC concerning survival benefits. Full article
(This article belongs to the Special Issue Novel Advances in Surgery for Prostate Cancer)
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9 pages, 1785 KB  
Article
Immunohistochemical Demonstration of Tuft Cells in Human Acinar-to-Ductal Metaplasia and Pancreatic Intraepithelial Neoplasia
by Kensuke Nakanishi, Mitsuaki Ishida, Kohei Taniguchi, Kenta Hosomi, Jun Arima, Atsushi Tomioka, Mitsuhiro Asakuma, Yoshiharu Miyamoto, Ko Fujimori, Yoshinobu Hirose and Sang-Woong Lee
Biomedicines 2025, 13(8), 1944; https://doi.org/10.3390/biomedicines13081944 - 8 Aug 2025
Viewed by 871
Abstract
Background/Objectives: Acinar-to-ductal metaplasia (ADM) refers to the dedifferentiation or transdifferentiation of pancreatic acinar cells. Recently, ADM has received considerable attention as a potential precursor of pancreatic tumours. Previous studies in mouse models identified tuft cells, chemosensory epithelial cells, in ADM and pancreatic [...] Read more.
Background/Objectives: Acinar-to-ductal metaplasia (ADM) refers to the dedifferentiation or transdifferentiation of pancreatic acinar cells. Recently, ADM has received considerable attention as a potential precursor of pancreatic tumours. Previous studies in mouse models identified tuft cells, chemosensory epithelial cells, in ADM and pancreatic intraepithelial neoplasia (PanIN), both considered precursor lesions of pancreatic ductal adenocarcinoma (PDAC), but not in PDAC. We examined the presence of tuft cells in human ADM and PanIN. Methods: We analysed tissue samples from 29 patients (16 women, 13 men; median age 74 years) who underwent surgical resection for pancreatic tumours. Immunohistochemical staining for the tuft cell marker, POU2F3, was used to detect tuft cells in ADM and PanIN lesions. Results: ADM was present in all patients. POU2F3-positive tuft cells were observed in 46.4% of ADM lesions (327/705) but not in normal pancreatic acini. The number of POU2F3-positive tuft cells per PanIN area were significantly higher in low-grade PanIN (median, 2 cells; range, 0–20 positive cells) than in high-grade PanIN (median, 0 cell; range 0–4 positive cells) (p = 0.0050). The percentage of POU2F3-positive tuft cells per total cells in low-grade PanIN lesions (median, 1.1%; range 0–2.5%) was also significantly higher than that in high-grade PanIN lesions (median, 0%; range 0–1.1%) (p = 0.0044). Conclusions: Our results suggest that tuft cells emerge in human pancreatic acini during ADM, possibly as part of tissue repair following injury. Full article
(This article belongs to the Section Cell Biology and Pathology)
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33 pages, 5180 KB  
Review
Fluorescence Guidance in Glioma Surgery: A Narrative Review of Current Evidence and the Drive Towards Objective Margin Differentiation
by Matthew Elliot, Silvère Ségaud, Jose Pedro Lavrador, Francesco Vergani, Ranjeev Bhangoo, Keyoumars Ashkan, Yijing Xie, Graeme J. Stasiuk, Tom Vercauteren and Jonathan Shapey
Cancers 2025, 17(12), 2019; https://doi.org/10.3390/cancers17122019 - 17 Jun 2025
Cited by 4 | Viewed by 3875
Abstract
Fluorescence-guided surgery (FGS) was pioneered for glioma and is now established as the standard of care. Gliomas are infiltrative tumours with diffuse margins. FGS provides improved intra-operative identification of tumour margins based on tumour-specific emission visible to the operating surgeon, resulting in increased [...] Read more.
Fluorescence-guided surgery (FGS) was pioneered for glioma and is now established as the standard of care. Gliomas are infiltrative tumours with diffuse margins. FGS provides improved intra-operative identification of tumour margins based on tumour-specific emission visible to the operating surgeon, resulting in increased rates of gross total resection. Multiple fluorescence agents may be used including 5-ALA, fluorescein sodium, and indocyanine green (ICG). This review details the indication, required equipment, mechanism of action, evidence base, limitations, and regulatory issues for each fluorophore as utilised in current clinical practice. FGS for glioma is limited by a reliance on subjective interpretation of visible fluorescence, which is often not present in low-grade glioma (LGG) or at the infiltrative tumour margin. Consequently, there has been a drive to develop enhanced, objective FGS techniques utilising both quantitative fluorescence (QF) imaging systems and novel fluorophores. This review provides an overview of emerging QF imaging systems for FGS. The pipeline for novel fluorophore development is also summarised. Full article
(This article belongs to the Special Issue Applications of Imaging Techniques in Neurosurgery)
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16 pages, 1668 KB  
Systematic Review
Use of COX Inhibitors in Plastic Surgery Fibroproliferative Disorders: A Systematic Review
by Yu Ting Tay, Elisha Purcell, Ishith Seth, Gianluca Marcaccini and Warren M. Rozen
J. Pers. Med. 2025, 15(6), 257; https://doi.org/10.3390/jpm15060257 - 17 Jun 2025
Viewed by 1225
Abstract
Background/Objectives: Fibroproliferative disorders (FPDs), such as Dupuytren’s contracture, scleroderma, capsular contracture, rhinophyma, and keloid scars, are characterised by excessive fibroblast activity and collagen deposition. These conditions are frequently encountered in plastic and reconstructive surgery and remain therapeutically challenging. Cyclooxygenase (COX) inhibitors have emerged [...] Read more.
Background/Objectives: Fibroproliferative disorders (FPDs), such as Dupuytren’s contracture, scleroderma, capsular contracture, rhinophyma, and keloid scars, are characterised by excessive fibroblast activity and collagen deposition. These conditions are frequently encountered in plastic and reconstructive surgery and remain therapeutically challenging. Cyclooxygenase (COX) inhibitors have emerged as a potential adjunct therapy to modulate fibrotic pathways and improve clinical outcomes. This systematic review aims to evaluate the efficacy and safety profile of COX inhibitors in the management of plastic-surgery-related FPDs. In doing so, it explores how phenotype-guided and route-specific COX-inhibitor use may contribute to precision, patient-centred care. Methods: To identify eligible studies, a comprehensive search was conducted in MEDLINE, Embase, and the Cochrane Library. Data were synthesised using both tabular summaries and narrative analysis. The certainty of evidence was appraised according to the GRADE guidelines. Results: Thirteen studies from 1984 to 2024 met inclusion criteria, addressing FPDs such as hypertrophic scarring, Dupuytren’s contracture, and desmoid tumours, representing 491 patients. Of those, five studies were related to Dupuytren contracture, three studies were related to hypertrophic scar, and one study each was on topics related to scleroderma, keloid scar, osteogenesis imperfecta, actinic keloidalis nuchae/dissecting cellulitis of the scalp, and desmoid tumours. Nine studies reported clinical improvements (four demonstrating statistically significant outcomes), three showed no difference, and one did not assess outcomes. The thirteen studies show minor side effects from oral and topical COX inhibitors. The overall certainty of evidence was graded as “low.” Conclusions: COX inhibitors demonstrate promising efficacy with minimal adverse effects in the management of plastic-surgery-related FPDs. Their accessibility, safety, and potential to reduce fibrosis underscore the need for future high-quality, large-scale studies to establish definitive clinical recommendations. Full article
(This article belongs to the Special Issue Plastic Surgery: New Perspectives and Innovative Techniques)
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15 pages, 2552 KB  
Article
Detection of CADM1, MAL, and PAX1 Methylation by ddPCR for Triage of HPV-Positive Cervical Lesions
by Maria Anisimova, Mark Jain, Liya Shcherbakova, Liana Aminova, Andrey Bugerenko, Natalia Novitskaya, Larisa Samokhodskaya, Vladislav Kokarev, Victoria Inokenteva and Olga Panina
Biomedicines 2025, 13(6), 1450; https://doi.org/10.3390/biomedicines13061450 - 12 Jun 2025
Cited by 4 | Viewed by 1794
Abstract
The aberrant DNA methylation of tumour suppressor genes, including CADM1, MAL, and PAX1, is implicated in cervical carcinogenesis. Objectives: This pilot study aimed to evaluate the methylation levels of these genes in HPV-positive women and assess their diagnostic performance for [...] Read more.
The aberrant DNA methylation of tumour suppressor genes, including CADM1, MAL, and PAX1, is implicated in cervical carcinogenesis. Objectives: This pilot study aimed to evaluate the methylation levels of these genes in HPV-positive women and assess their diagnostic performance for detecting histologic high-grade squamous intraepithelial lesions (HSILs) and carcinoma. Methods: Cervical samples from 73 HPV-positive women were analyzed using droplet digital PCR (ddPCR) to quantify methylation levels of CADM1, MAL, and PAX1. The methylation levels were further compared across cytological and histological classifications. A control group of 26 HPV-negative women with negative cytology was also included. The diagnostic performance was assessed through receiver operating characteristic (ROC) analysis, as well as sensitivity and specificity calculations for individual genes and gene panels. Results: MAL methylation was absent in NILM, LSIL, and HSIL samples but was significantly elevated in carcinoma. PAX1 methylation was observed in both high-grade and some low-grade lesions. CADM1 methylation remained low or undetectable in the NILM, LSIL, and HSIL groups, with a significant increase observed in carcinoma cases. The CADM1/MAL panel demonstrated the highest diagnostic accuracy, with an area under the curve (AUC) of 0.912, 70% sensitivity, and 100% specificity. ddPCR exhibited superior analytical sensitivity compared to real-time PCR. Conclusions: The CADM1/MAL methylation panel, assessed by ddPCR, may serve as a specific biomarker for the triage of HPV-positive women at risk of HSIL and carcinoma. However, this study’s limited sample size and single-centre design necessitate cautious interpretation. Further validation in larger, population-based cohorts is necessary to confirm its clinical utility. Full article
(This article belongs to the Section Molecular Genetics and Genetic Diseases)
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20 pages, 7995 KB  
Article
Reduced HLA-I Transcript Levels and Increased Abundance of a CD56dim NK Cell Signature Are Associated with Improved Survival in Lower-Grade Gliomas
by Md Abdullah Al Kamran Khan, Lorenza Peel, Alexander J. Sedgwick, Yuhan Sun, Julian P. Vivian, Alexandra J. Corbett, Riccardo Dolcetti, Theo Mantamadiotis and Alexander D. Barrow
Cancers 2025, 17(9), 1570; https://doi.org/10.3390/cancers17091570 - 5 May 2025
Viewed by 1743
Abstract
Background: Human leukocyte antigen class I (HLA-I) plays a pivotal role in shaping anti-tumour immunity by influencing the functionality of T cells and natural killer (NK) cells within the tumour microenvironment. Methods: Here, we explored the transcriptional landscape of HLA-I molecules across various [...] Read more.
Background: Human leukocyte antigen class I (HLA-I) plays a pivotal role in shaping anti-tumour immunity by influencing the functionality of T cells and natural killer (NK) cells within the tumour microenvironment. Methods: Here, we explored the transcriptional landscape of HLA-I molecules across various solid cancer transcriptomes from The Cancer Genome Atlas (TCGA) database and assessed the impact of HLA-I expression on the clinical significance of tumour-infiltrating CD56dim and CD56bright NK cells. Results: Our analysis revealed that high HLA-I expression correlated with reduced patient survival in the TCGA lower-grade glioma (LGG) cohort, with this association varying by histopathological subtype. We then estimated the relative abundance of 23 immune and stromal cell signatures in LGG transcriptomes using a cellular deconvolution approach, which revealed that LGG patients with low HLA-I expression and high CD56dim NK cell abundance had better survival outcomes compared to those with high HLA-I expression and low CD56dim NK cell abundance. Furthermore, HLA-I expression was positively correlated with various inhibitory NK cell receptors and negatively correlated with activating NK cell receptors, particularly those within the killer cell lectin-like receptor (KLR) gene family. High co-expression of HLA-E and NKG2A predicted poor survival outcomes in LGG patients, whereas low HLA-E and high NKG2C/E abundance predicted more favourable outcomes, suggesting a potential modulatory role of HLA-I on the tumour-infiltrating cytotoxic CD56dim NK cell subset. Conclusions: Overall, our study unveils a potential role for deregulated HLA-I expression in modulating the clinical impact of glioma-infiltrating CD56dim NK cells. These findings lay the foundation for future in-depth experimental studies to investigate the underlying mechanisms. Full article
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