Search Results (9,289)

Steatotic liver disease (SLD) is characterised by profound metabolic reprogramming, yet no single biomarker reliably distinguishes disease entities, stages or sex-specific risk profiles. By integrating serum metabolomic signatures as a liquid biopsy with tumour-associated CSC marker profiles in a sex-stratified analytical framework, we aimed to identify biologically meaningful differences and improve strategies for early, presymptomatic detection of SLD progression and HCC. The present study focuses on a targeted panel of 12 strongly dysregulated serum metabolites as candidate biomarkers of disease progression, quantified by NMR-based metabolomics and ELISA and complemented by CSC marker staining. We combined these NMR-based metabolomic ‘liquid biopsy’ data with circulating tumour-associated biomarkers, MELD-based risk assessment and tissue-level CSC marker expression across MetALD, MASLD, immune-mediated and cancerogenic liver disease, HCC and healthy controls. Female MetALD patients showed the second highest mortality after HCC, with lower survival than male cancer patients, despite MELD 3.0 assigning ~50% higher scores in women. MetALD mortality clustered with GP73, CD44, metabolomics and AA/3HB ratio, indicating a distinct, high-risk female phenotype. Integrating liquid-based metabolomic profiling, AA/3HB redox assessment, CSC markers and MELD 3.0 into sex-sensitive diagnostic pathways may improve early detection and risk stratification of alcohol-associated SLD, especially in women. Full article

Triple-negative breast cancer is defined by the absence of druggable receptor targets and by a biologically dynamic phenotype that renders static, single-timepoint biomarker strategies fundamentally inadequate. Current predictive markers, including PD-L1 expression, tumor mutational burden, and genomic profiling, fail to capture the therapy-induced transcriptional reprogramming, spatial heterogeneity, and drug-tolerant persister states that drive resistance and relapse. In this review, we argue that RNA, particularly non-coding RNA (ncRNA), represents a complementary and state-aware platform for biomarker development in TNBC, capable of capturing transcriptional adaptation, regulatory threshold dynamics, and cell state transitions that static genomic markers cannot fully detect. Unlike messenger RNAs, which reflect active transcriptional programs, long non-coding RNAs and circular RNAs modulate the stability of state transitions and are specifically induced under conditions of therapeutic stress, immune exclusion, and drug tolerance, which are properties that make them suitable as potential early and sensitive indicators of adaptive reprogramming. We review the biological rationale for RNA as a state-aware readout across five dimensions: tumor plasticity, immune context, stress response, therapy adaptation, and microenvironment composition. An examination is conducted regarding how spatial transcriptomics can map RNA-defined resistant niches within TNBC, how serial liquid biopsy RNA measurements, including extracellular vesicle RNA and circulating tumor RNA, enable temporal monitoring of transcriptional state shifts before radiologic progression, and what analytical and clinical standards deployable RNA assays must meet. Finally, a state-guided adaptive management framework is proposed in which RNA signatures function as iteratively updated measurement layers informing therapy selection, on-treatment monitoring, and early resistance detection. This review outlines trial design models and defines the validation standards required before RNA-guided adaptation can enter clinical practice. Full article

The tumor suppressor protein phosphatase 2A (PP2A) plays a crucial role in regulating oncogenic signaling. Its inactivation, specifically through inhibitory phosphorylation at Tyr307 mediated by SET and CIP2A, contributes to breast cancer (BC) progression. Modulation of these interactions represents a promising pharmacological strategy to restore PP2A function. We integrated computational approaches with experimental validation to analyse SET/CIP2A mechanisms and explore how PP2A reactivation suppresses tumor progression. Molecular docking and dynamics simulations showed that the SET inhibitor/FTY-720 forms stable hydrogen bond networks with SET, disrupting its interaction with PP2A. In contrast, CIP2A suppressor/erlotinib interacts with CIP2A through weaker hydrophobic and π-interactions. Protein–protein interaction analyses indicate reduced SET/CIP2A binding to PP2A upon treatment, supporting a structural basis for PP2A reactivation. Gene expression analyses revealed upregulation of PP2A, SET, CIP2A, and cytoskeletal markers in tumor and metastatic tissues. Studies on Triple Negative Breast Cancer (TNBC) cells showed that FTY-720 and erlotinib significantly reduce PP2A-Tyr307 phosphorylation, restoring its activity. Additionally, both compounds decreased c-Myc levels and inhibited Src/FAK/paxillin/PAK1 and ERK signaling, attenuating migratory and proliferative pathways. Our findings identify the SET/CIP2A–PP2A axis as a pharmacological target for the design of next-generation PP2A activators, highlighting the potential of inhibition as a therapeutic strategy to counteract TNBC progression. Full article

With colorectal cancer (CRC) accounting for over 1.9 million new cases and 930,000 deaths globally in 2020, there is a critical need for innovative indicators to forecast disease advancement and therapeutic outcomes. The gut microbiome has emerged as a fertile area for discovering such diagnostic and prognostic signals. This narrative review collected current evidence on intestinal microorganisms and their metabolic products as candidate markers for CRC control. Intestinal communities influence malignancy through diverse mechanisms, including metabolic shifts, immune modulation, inflammation, proliferation/apoptosis regulation, genotoxicity, and mucosal barrier disruption. Pathogenic species, such as Fusobacterium nucleatum and enterotoxigenic Bacteroides fragilis, facilitate tumorigenesis via FadA-mediated signaling and Th17/IL-17 responses. In contrast, beneficial taxa like Faecalibacterium prausnitzii and Akkermansia muciniphila provide protective effects through short chain fatty acid production. Macrophage phenotype physiological equilibrium is altered and inflammatory status fluctuates under the former. Metabolically, hydrogen sulfide damages mitochondrial DNA and secondary bile acids stimulate cellular proliferation. While 16S rRNA sequencing and shotgun metagenomics are established detection strategies, innovative platforms like organoids and gene arrays remain in the exploratory stage. Clinical data indicates that F. nucleatum aligns with advanced tumor stage, and its combined detection with colibactin-producing E. coli achieves high sensitivity for early-stage screening. Additionally, A. muciniphila levels can anticipate the efficacy of PD-1 blockade immunotherapy. Microbiota-derived tools represent a transformative direction in oncology. Future research must focus on standardizing protocols and validating multi-marker panels to enhance clinical translation. Full article

Mesothelin (MSLN) is a cell surface glycoprotein with limited expression in normal tissues but frequent overexpression in solid tumors, including gynecological malignancies. This review summarizes the state of the art on the biological role, diagnostic value, prognostic significance, and therapeutic potential of MSLN in ovarian, endometrial, and cervical cancers. Evidence from clinical and experimental studies indicates that MSLN contributes to tumor progression through interactions with CA125, promotion of cell adhesion and peritoneal metastasis, activation of oncogenic signaling pathways, modulation of immune responses, and development of chemoresistance. Elevated MSLN expression has been associated with advanced clinical stage of the disease, platinum resistance, and poorer survival outcomes, particularly in ovarian cancer patients, although prognostic findings remain inconsistent. Circulating soluble MSLN may serve as a minimally invasive biomarker and may improve diagnostic accuracy when combined with established markers. Therapeutic MSLN strategies—antibody-drug conjugates, CAR-T and NK cell therapies, monoclonal antibodies, immunotoxins, vaccines, and checkpoint blockade—provide promising pre-clinical and early clinical results, particularly in resistant or recurrent forms of the disease. Overall, MSLN constitutes a promising target for precision oncology in gynecological cancers, although further clinical studies are required to validate its diagnostic utility and optimize targeted therapeutic approaches. Full article

Hepatocellular carcinoma (HCC) is a highly heterogeneous malignancy characterized by poor prognosis and limited therapeutic response. Cancer stem cells (CSCs) contribute to tumor progression, therapeutic resistance, and tumor recurrence. Among transcriptional regulators potentially involved in these processes, Specificity Protein 1 (SP1) has emerged as a candidate integrator of oncogenic and epigenetic signaling networks. However, its contribution to CSC-associated phenotypes and drug resistance in HCC remains incompletely defined. In this study, we combined transcriptomic analyses of TCGA datasets with functional experiments in HCC cell lines (Huh7 and HepG2). SP1-associated transcriptional programs were targeted pharmacologically using mithramycin A (MIT-A) and genetically using siRNA-mediated knockdown. The effects were assessed by RNA sequencing, RT-qPCR, Western blotting, flow cytometry, and functional assays evaluating proliferation, migration, CSC-associated properties, and response to sorafenib. MIT-A treatment markedly reduced the expression of stemness-associated transcription factors (NANOG, OCT4, SOX2) and CSC markers (CD133, CD24), impaired CSC-related functions including ALDH activity and the Side Population phenotype, and inhibited cell proliferation and migration. MIT-A also sensitized both parental and sorafenib-resistant HCC cells to sorafenib, associated with modulation of apoptotic regulators and reduced transporter-mediated efflux activity. SP1 knockdown partially reproduced several of these effects, supporting a contribution of SP1-dependent transcriptional programs to these phenotypes. Overall, these findings identify SP1-associated transcriptional networks as potential regulators of CSC features and therapeutic resistance in HCC and support targeting SP1-associated transcriptional programs as a strategy to enhance sorafenib efficacy. Full article

Background/Objectives: Trastuzumab emtansine (T-DM1) is widely used in Human Epidermal Growth Factor Receptor2 (HER2)-positive metastatic breast cancer; however, outcomes vary, and reliable prognostic markers remain limited. We developed the CALA index as a composite biomarker integrating CA15-3, lactate dehydrogenase (LDH), and albumin. This study aimed to evaluate the prognostic value of the CALA index in metastatic breast cancer treated with T-DM1. Methods: This multicenter retrospective study included 168 patients treated with T-DM1 across four tertiary centers. The CALA index was calculated using pretreatment levels of CA15-3, LDH, and albumin. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value, and patients were stratified into groups accordingly. Survival outcomes and independent risk factors were assessed using Kaplan–Meier and Cox regression analyses. Results: The median overall survival (OS) was 26 months (95% CI: 21.3–30.7). ROC analysis identified an optimal CALA cutoff value of 118.3. Patients with CALA ≤ 118.3 demonstrated significantly longer OS compared with those with CALA > 118.3 (log-rank p = 0.006), with 1- and 3-year OS rates of 81.2% and 43.2% versus 69.8% and 22.7%, respectively. In univariate analysis, CALA > 118.3 was associated with worse OS (HR: 1.699; 95% CI: 1.151–2.506; p = 0.008), and this association remained significant in multivariate analysis (HR: 1.671; 95% CI: 1.088–2.565; p = 0.019). Conclusions: The CALA index was associated with overall survival in metastatic breast cancer treated with trastuzumab emtansine and may serve as a practical tool for risk stratification. Full article

Background: Persistent lymph node metastases after neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer indicate poor response to treatment. This study evaluated the long-term prognosis of patients with residual nodal disease following neoadjuvant RCT and total mesorectal excision (TME) in comparison with patients who underwent upfront TME without adjuvant radiotherapy. Methods: Consecutive patients with rectal adenocarcinoma and histopathologically confirmed lymph node metastases after TME were identified from the prospectively maintained database of the colorectal unit at Dresden-Friedrichstadt General Hospital. Patients with distant metastases, in-hospital mortality, or postoperative radiotherapy were excluded. The two groups were comprehensively compared regarding patient-, tumor-, and treatment-related characteristics. Cumulative local recurrence, time to recurrence, cancer-specific survival, and overall survival were analyzed using the Kaplan–Meier method. Results: Between 1996 and 2021, 155 eligible patients were identified, including 101 patients in the RCT group and 54 in the upfront surgery group. Baseline characteristics were largely comparable, except for a higher median age (70.5 vs. 64 years, p < 0.001) and a higher proportion of lymphovascular invasion (36.0% vs. 15.2%, p = 0.004) in the upfront surgery group. Ten-year local recurrence rates were similar between groups (21.0% [95% CI: 10.4–31.6] vs. 20.8% [95% CI: 8.5–33.1], p = 0.609). No significant differences were observed in time to recurrence or cancer-specific survival. Overall survival was lower in the upfront surgery group, most likely reflecting the substantially higher age of these patients. Conclusions: Despite more intensive treatment, patients with a persistent ypN-positive category have outcomes no better than untreated patients with node-positive disease after TME, indicating a biologically high-risk subgroup. Non-response is therefore a sign of a negative selection. These patients may lose the opportunity for optimal local tumor control during prolonged neoadjuvant treatment, underscoring the urgent need for reliable predictive markers to identify non-responders and guide individualized treatment strategies. Full article

Background/Objectives: This paper describes the synthesis of silica nanoparticles (SiNPs) and their surface modification with amino and phosphate groups (SiNPs-NH₂-PO₃). The functionalized nanoparticles were subsequently loaded with the anticancer drug 5-fluorouracil (SiNPs-NH₂-PO₃-5-FLU) and further modified with PEG2000 (SiNPs-NH₂-PO₃-5-FLU-PEG2000). Methods: In this study, a one-step, two-phase, sol–gel method carried out at room temperature was used to synthesize the nanoparticles. The size and surface zeta potential of the created SiNPs were determined by DLS measurements. HPLC was used to determine the amount of drug loaded into silica nanoparticles and the drug release profile in two different pH environments (slightly acidic and physiological). Based on physicochemical characteristics, the SiNPs-NH₂-PO₃-5-FLU and SiNPs-NH₂-PO₃-5-FLU-PEG2000 formulations were chosen for comprehensive characterization. The cytotoxicity of the studied complexes was assessed in MCF7 breast cancer cells, while their ability to induce apoptosis in those cells was examined using specific immunofluorescence markers: active caspase-7, active poly(ADP-ribose) polymerase (PARP), and p53 protein. Results: Our findings demonstrate that SiNPs-NH₂-PO₃-5-FLU can induce a stronger apoptotic response than free 5-FLU at equivalent concentrations. We observed that drug release occurs not only under physiological conditions but is further enhanced in a mildly acidic environment (pH 5.0), characteristic of the tumor microenvironment. Conclusions: Most 5-fluorouracil formulations are administered as injectable solutions, resulting in systemic exposure and significant adverse effects. However, their encapsulation within nanoparticles could favor preferential drug release in the acidic tumor microenvironment, thus supporting targeted therapy and reducing toxicity to healthy tissues. Moreover, PEGylation of the nanoformulation allows prolonged and controlled release. Full article

Background/Objectives: The triglyceride–glucose (TyG) index, a reliable marker for insulin resistance, is strongly associated with T2DM, hypertension, and cardiovascular disease. Less well known is its relationship with cancer risk. The aim of this study was to quantify the association between the TyG index and risk of different types of cancer. Methods: Publications were searched in the PubMed, Web of Science, and Scopus databases using appropriate keywords. The PICOS framework was used to select the studies, and their quality was evaluated according to the “Newcastle–Ottawa Scale” (NOS). Meta-analysis was performed through a random-effects model using cancer risk parameters (RR: relative risk, OR: odds ratio and HR: hazard ratio) extracted from 26 selected studies associated with TyG index values. The weighted mean difference (WMD) was used to compare the mean of the TyG index in cancer patients to that of the control group. Heterogeneity was assessed by Cochran’s Q and I² statistics, while publication bias was evidenced using the Egger test and the Begg test, and funnel plot asymmetry. Results: A higher TyG index value was observed in cancer subjects (9483) compared to healthy controls (978,675) (WMD: 0.23, 95% CI: 0.16–0.31, p < 0.0001, n = 15). A statistically significant increase in cancer risk was associated with the TyG index level, expressed as both a categorical (OR 1.33, 95% CI 1.22–1.45, p < 0.0001, n = 29) and continuous (OR 1.14, 95% CI 1.10–1.19, p < 0.0001, n = 27) variable. The effect was more evident in case–control/cross-sectional studies compared to cohort studies (OR 1.78, 95% CI 1.51–2.09 vs. OR 1.19, 95% CI 1.10–1.29 TyG categorical; OR 1.46, 95% CI 1.21–1.76 vs. OR 1.09, 95% CI 1.05–1.12 TyG continuous). Stratified analysis showed an increased risk of cancer occurrence for gastrointestinal, gynecological, colorectal, breast, and gastric sites, while no association was observed for endometrial, ovarian, prostate, lung or esophageal cancers. Conclusions: Our results evidence an increase in cancer risk associated with higher TyG index values. However, due to the low number of studies, the effect on specific tumor sites was not statistically significant. Additional epidemiological studies with a cohort design are necessary to confirm these associations. Full article

Background: Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) generally has a more favorable prognosis compared to HPV-negative cases. Overexpression of p16^INK4a is widely used as a surrogate marker for HPV-induced carcinogenesis, and it also represents an important tumor suppressor gene, the second most frequently altered after TP53. In turn, mutations in TP53 are characteristic of tumors linked to smoking and alcohol consumption and p53 expression is consistently associated with worse clinical outcomes. Aims: Investigate the impact of p53 immunohistochemical expression on prognosis of OPSCC. Methods: This retrospective study included 155 OPSCC patients with longitudinal follow-up exceeding 10 years. Immunohistochemistry was used to evaluate p53 protein expression. Clinicopathological associations were performed to evaluate the prognostic impact of p53 protein expression in OPSCC HPV-positive and HPV-negative tumors. Results: Among the 155 OPSCC cases, 90 (58.1%) were classified as HPV-positive and 65 (41.9%) as HPV-negative. HPV status was inversely associated with p53 positivity, with HPV-negative tumors showing a higher frequency of p53 expression (p < 0.0001). Patients with HPV-positive tumors experienced better clinical outcomes than those with HPV-negative disease, including cancer-specific survival (CSS; HR: 3.47, 95% CI 1.16–10.4, p = 0.02) and disease-free survival (DFS; HR: 3.73, 95% CI 1.29–10.7, p = 0.01), whereas p53 positivity alone was not independently associated with survival. Notably, individuals with HPV-negative and p53-positive tumors exhibited the poorest outcomes, in contrast to patients with HPV-positive OPSCC, regardless of p53 expression. Conclusions: Patients with HPV-negative and p53-positive OPSCC showed inferior clinical outcomes compared with their HPV-positive counterparts, independent of p53 status. These findings underscore the prognostic relevance of jointly evaluating HPV status and p53 expression in OPSCC and support more refined risk stratification and personalized therapeutic strategies. Full article

Purpose: Lymph node (LN) excision is critical in oncologic surgery to provide important therapeutic and diagnostic information. LN evaluation helps in staging cancers, predicting prognosis and improving survival. The ultimate wish of a surgical oncologist would be to localize and dissect all pathologically positive LNs while avoiding the morbidity of removing true negative LNs. The goal of our study was to identify a reliable marker for clinical prediction of LNs with cancer cells from non-small cell lung cancer (NSCLC) versus LNs without. We identified epithelial cell adhesion molecule (EpCAM), a membrane protein normally expressed in epithelial tissues, including in lung. Patients and Methods: We used human specimens immunostained with anti-EpCAM monoclonal antibody. Results: EpCAM was expressed in NSCLC metastasis to LNs, as shown in 74 positive LNs from patients with resected primary NSCLC. Among pathologically negative LNs, regardless of PET avidity, EpCAM was absent; whereas among pathologically positive LNs, all PET uptake groups exhibited high EpCAM positivity. Together, these biomarkers had a 100% accuracy. There was no difference in expression between hilar and mediastinal LNs, nor between primary tumor histology. Conclusions: EpCAM may be useful for the surgical oncologist for preoperative or intraoperative detection of positive LNs from NSCLC. Full article

Background/Objectives: The Mediterranean diet is widely recognized for its cardiovascular and metabolic benefits, including weight reduction; however, the metabolic mechanisms underlying these effects remain incompletely understood. This study investigated whether changes in circulating polyamines are associated with metabolic improvements following a Mediterranean diet intervention, particularly in breast cancer survivors. Methods: This exploratory secondary analysis used stored paired serum samples from a previously reported 8-week controlled intervention conducted in three groups: Group A (breast cancer survivors following a Mediterranean diet alone, n = 21), Group B (breast cancer survivors following a Mediterranean diet combined with naltrexone/bupropion, n = 23), and Group C (non-cancer participants receiving the combined intervention, n = 28). Paired polyamine data were available for 16, 9, and 16 participants, respectively. Breast cancer survivors were randomized to Groups A and B, whereas Group C was enrolled as a non-randomized active comparison group. Serum metabolic profiles were analyzed using liquid chromatography–mass spectrometry-based untargeted metabolomics, and nine polyamines were quantified using targeted analysis. An exploratory indirect-effect analysis examined associations between changes in serum polyamines and clinical outcomes, including body composition and lipid parameters. Results: Body weight, fat mass, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) decreased significantly within all three groups after the 8-week intervention (median changes: −1.9 to −2.8 kg, −1.9 to −2.8 kg, and −0.3 to −0.7, respectively). LDL cholesterol decreased significantly only within the two groups receiving naltrexone/bupropion (median changes: −20.6 and −10.1 mg/dL). However, between-group differences in these changes were not statistically significant. N-acetylspermine increased nominally in all groups (p < 0.01), whereas spermine increased only in the Mediterranean diet alone group (p = 0.015). Conclusions: Mediterranean diet-related metabolic improvements were accompanied by changes in circulating polyamines. Spermine and N-acetylspermine may represent candidate metabolic response markers associated with nutritional and pharmacological interventions in breast cancer survivorship. Full article

Alpha-fetoprotein (AFP) is a glycoprotein primarily produced by the fetal liver and yolk sac during development. It is a multifaceted biomarker with significant applications in the prenatal screening of congenital abnormalities, cancer, and other disorders. The level of AFP in maternal blood may indicate several obstetric concerns and complications during pregnancy. Atypical AFP levels are commonly utilized as a biomarker for detecting fetal anomalies, placental complications, and other pregnancy-related issues. These findings raise concerns regarding the effectiveness of screening maternal serum alpha-fetoprotein (MS-AFP) as a primary indicator of pregnancy problems and underscore the need for further investigation into the functional role of AFP throughout pregnancy. The measurement of MS-AFP has been utilized for the past four decades. It is anticipated that MS-AFP measurement will continue to be utilized as a component of integrated or sequential tests for chromosomal abnormalities and may serve as a prognostic indicator for adverse obstetric outcomes. Critically, whether AFP functions solely as a passive marker or plays active biological roles in pregnancy physiology and pathology remains unresolved, necessitating additional mechanistic investigation and discourse. This review consolidates critical data from numerous studies on AFP, focusing specifically on its diagnostic and prognostic applications for congenital abnormalities and problems during pregnancy. This review also identifies key research gaps regarding the functional biology of AFP, particularly whether AFP functions as a passive biomarker or an active participant in the pathophysiology of adverse pregnancy outcomes. Full article

Blood disorders encompass a wide range of diseases including anemia, hemophilia, thrombotic disorders, platelet dysfunction, and hematological cancers, making blood disorders a major global health concern. These conditions can impair processes vital to human physiology including oxygenation, coagulation, and immune defense. Hematologic malignancies, both chronic and acute, require timely diagnosis and ongoing disease monitoring for effective clinical management. Microfluidic technologies have emerged as promising alternatives to benchtop techniques for diagnosing and monitoring hematological disorders. For example, microfluidic assays can be used for the isolation and characterization of liquid biopsy markers such as rare cells, extracellular vesicles, and cell-free molecules to support disease management in a minimally invasive manner while the process automation afforded by microfluidics decentralizes healthcare, making it more accessible. Advances in lab-on-a-chip technologies, including large-scale fabrication methods and novel design strategies, will provide tools for the clinical validation of biomarkers and the translation of these technologies from the laboratory bench to the patient bedside. In this review, we will show that microfluidic devices enable disease monitoring via high-throughput analysis of liquid biopsy samples for the detection of rare disease-specific biomarkers found in blood, plasma, urine, etc., providing an alternative to standard benchtop testing using specimens secured via invasive bone marrow procedures, typically used for managing blood-based diseases. A key advantage of microfluidics is their ability to manipulate blood components at scales that closely mimic the body’s microvascular environment. Not surprisingly, microfluidic vascular models have been developed to replicate physiological rheology enabling quantitative assessment of blood cell deformability, aggregation, or clot formation. We provide a critical perspective on the use of the microfluidic “organ-on-chip” designed for blood disorders’ modeling and employed to recapitulate the blood cancer microenvironment. A summary of advances in microfluidic strategies for detection, diagnosis, drug screening, and mechanistic investigations of blood disorders, and future directions for precision testing, will be presented. Full article