Asian Pacific Journal of Cancer Biology

ALDH1A1 as a Stem Cell Marker and its Correlation with the Clinico-pathological Parameters in Invasive Mammary Carcinoma

Noha ED Hassab El-Naby — 2025-01-12

Background: Breast cancer is a major public health concern due to its high incidence worldwide. Globally, it is considered the most common cancer to be diagnosed and one of the main causes for cancer deaths in women. Breast cancer stem cells (BCSCs) are the leading cause of adverse clinical outcomes and resistance to therapeutic agents because of their great capacity for self-renewal and differentiation. Aldehyde dehydrogenase1A1 (ALDH1A1) belongs to the aldehyde dehydrogenase (ALDH) superfamily of enzymes. It is one of the most important markers for cancer stem cells (CSCs). Its expression level in tumor cells is higher than in normal tissues. Recently, it has been widely investigated as a potential prognostic factor and therapeutic target.

Objectives: The purpose of this study was to assess the prognostic value of ALDH1A1 expression in invasive mammary carcinoma by correlating its expression to various clinicopathological characteristics and molecular subtypes and highlight the relationship between ALDH1A1 expression and tumor-infiltrating lymphocytes (TILs).

Methods: Seventy-two samples of invasive mammary carcinoma were retrieved from the archive of the Pathology Laboratory, Sohag University Hospital; of which 70 were of ductal origin and only 2 were of lobular origin, which were excluded from statistical analysis and discussed separately. Immunohistochemical (IHC) expression of ALDH1A1 was evaluated using an anti-human ALDH1A1 antibody. To elucidate the prognostic value of ALDH1A1 in breast cancer, its expression was statistically correlated with the available clinicopathological data.

Results: This study revealed positive ALDH1A1 expression in 54.3% of mammary invasive ductal carcinoma (IDC) specimens. ALDH1A1 up-regulation was significantly positively correlated with poor prognostic indicators, including larger tumor size (p= 0.007), high grade (p= 0.001), advanced stage (p< 0.001), poor Nottingham Prognostic Index (NPI) (p= 0.01), lymphovascular invasion (LVI) (p= 0.03), lymph node metastasis (LNM) (p=0.04), and a triple negative phenotype (p< 0.001). Moreover, we observed that tumors with positive ALDH1A1 expression exhibited higher levels of TILs with a statistically significant correlation (p= 0.001).

Conclusion: The current study revealed that ALDH1A1 up-regulation in invasive breast carcinoma is linked to aggressive behavior and different unfavorable prognostic indicators. It could be useful as a promising potential prognostic biomarker, serving as a prospective target for anti-cancer therapy.

Relationship of Tumor-Associated Neutrophil Expression and Neutrophil-to-Lymphocyte Ratio with Clinical Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

Abd. Rahman — 2025-01-12

Introduction: Breast cancer (BC) is a serious health concern. Neoadjuvant chemotherapy (NAC) is a crucial therapy for managing BC, but further research is needed to identify biomarkers that can help to predict the efficacy of this therapy. The presence and functional activity of tumor-associated neutrophils (TANs) are capable of serving as predictive biomarkers for therapeutic outcomes. Elevated neutrophil-to-lymphocyte ratio (NLR) is linked to high tumor stage and low histological grade, indicating a more aggressive disease profile. This study analyzed the relationship between TAN expression and NLR with clinical response to NAC in locally advanced BC (LABC).

Methods: This was a cohort study of 41 patients with BC. TAN expression was examined using immunohistochemistry, NLR was obtained from routine blood tests, and chemotherapy response was assessed using the RECIST method. The relationship between TAN expression and NLR with chemotherapy response in LABC was tested using chi-square tests.

Results: High and low TAN expression was observed in 80.5% and 19.5% of patients, respectively. For NLR before chemotherapy, 48.8% and 51.2% of patients exhibited a high and low NLR, respectively; after chemotherapy, 51.2% and 48.8% of patients exhibited a high and low NLR, respectively. Moreover, 90.2% patients responded to NAC. A significant relationship was observed between TAN expression and chemotherapy response in BC, with a moderately strong negative correlation.

Conclusion: TAN expression is an important potential predictor of chemotherapy response in LABC. By identifying biomarkers like TAN, clinicians may be better able to customize treatment plans and enhance outcomes for patients with LABC.

Low PD-1 mRNA Expression in Peripheral Blood of Childhood Leukemia

Mururul Aisyi — 2025-01-12

Background: The expression of PD-1 has been linked to prognosis and response to immune checkpoint inhibitors in solid tumors, but less is known about their role in pediatric blood cancers. Therefore, we aimed to study the levels of PD-1 mRNA in children with leukemia and explore how they relate to clinical factors.

Methods: Blood samples were collected from 15 children with leukemia and 11 healthy individuals. PD-1 mRNA expression was analyzed using real time PCR.

Results: PD-1 mRNA expression was significantly lower in childhood leukemia patients (average DCT: 12.3±2.5) compared to healthy individuals (average DCT: 10.3±0.5) (p=0.011). PD-1 mRNA expression did not correlate with gender, age, diagnosis, remission status, down syndrome, hyperleukocytosis, infection, and outcome.

Conclusion: Our findings indicated that mRNA expression of PD-1 was reduced in children with leukemia compared to healthy individuals and was not associated with all analyzed clinical factors. These results provide early insights into PD-1 expression in Indonesian pediatric leukemia patients.

Identification and Functional Characterization of Upregulated Hub Genes in Adenocarcinoma across Multiple Organ Sites

Ricardo Romero — 2025-01-12

Objective: This study aimed to identify and characterize key hub genes involved in adenocarcinoma progression across multiple organ types via integrative bioinformatics analysis.

Methods: Gene expression datasets from GEO and GEPIA2 were analyzed to identify genes whose expression was upregulated across various adenocarcinoma types. Protein‒protein interaction networks were constructed, and hub genes were identified. Transcription factors and microRNA regulatory networks were mapped, and functional enrichment analysis was performed.

Results: Ten hub genes (CHEK1, CDC20, ANLN, RRM2, CCNB1, CCNA2, KIF23, TOP2A, BUB1, and KIF11) were consistently overexpressed in six adenocarcinoma types and linked to cell cycle regulation and mitotic progression. In prostate adenocarcinoma, five of these genes were not significantly overexpressed. Survival analysis revealed that most hub genes were associated with poorer survival. Regulatory network analysis identified key transcription factors (e.g., TP53 and MYC) and miRNAs (e.g., hsa-miR-103a-3p and hsa-let-7e-5p) as modulators of these genes.

Conclusions: This integrative approach identified critical hub genes and regulatory networks involved in adenocarcinoma progression, offering potential avenues for targeted therapies and emphasizing the importance of personalized strategies for different adenocarcinoma subtypes.

Minimizing the Risk of Sample Mix-ups in the Molecular Pathology Section in Oncology Center Using Risk Assessment Matrix (RAM)

Ibrahim Hassan Al Haddabi — 2025-01-12

Background: Sample mix-ups in molecular pathology can result in diagnostic errors, inappropriate treatment, and compromised patient safety. These risks are exacerbated in oncology settings, where accurate diagnoses directly impact patient outcomes.

Purpose: This study aims to evaluate the effectiveness of the Risk Assessment Matrix (RAM) in minimizing the risk of sample mix-ups in the molecular pathology section of an oncology center.

Methods: A prospective quality improvement design was adopted, comparing pre- and post-intervention data to assess the impact of RAM. Risks were identified through quality rounds and categorized using the RAM, where Likelihood (L) and Severity (S) scores were assigned to each risk (L × S = Risk Score). Interventions included automation, barcode labeling, revised workflows, and staff training. The effectiveness of interventions was measured through re-evaluation of risk scores and percentage risk reduction.

Results: The interventions resulted in significant improvements across multiple areas. The risk score for Excel-based registration dropped from 16 to 2, representing an 88% reduction. Handwritten labeling errors decreased by 83%, and inaccurate documentation in LIS/HIS systems was reduced by 83%. Additionally, the risk associated with unattended PTS sample transport was lowered by 63%, and eliminating manual entry processes reduced errors by 67%. Most risks showed reductions above 60%, demonstrating the effectiveness of RAM in improving sample management and patient safety.

Conclusion: The application of RAM in the molecular pathology section of an oncology center significantly reduced the likelihood of sample handling errors, enhancing both diagnostic accuracy and patient safety. The study highlights the importance of automation, real-time monitoring, and multidisciplinary collaboration in sustaining these improvements. RAM provides a structured framework for prioritizing and mitigating risks in complex healthcare workflows.

Potential Effect of Spirulina Extracts on Serum Iron Reduction: Possible Application in Cancer Treatment

Azhaar Asker Hamadi — 2025-01-12

Background: Iron overload is a significant health concern that has been linked to various pathological conditions, including cancer and thalassemia. The relationship between iron overload and cancer has been extensively studied, particularly in the context of hepatocellular carcinoma (HCC) and other malignancies. Spirulina platensis is a blue-green algae that contains bioactive compounds such as carbohydrates, proteins, lipids, vitamins, omega-3, and omega-6. These compounds make spirulina a source of antioxidants. The compound, which acts as an antioxidant, is said to decrease or stop oxidative stress resulting from free radicals, which can lead to cancer and thalassemia. Spirulina has properties as an antioxidant, anticancer, anti-apoptotic, anti-inflammatory, immunomodulatory, and antiviral agent. In the present study, an attempt is made to evaluate the effect of spirulina extract as an antioxidant and anti-inflammatory agent on iron status in thalassemia patients and its possible application in cancer treatment.

Materials and Methods: Fifty male patients with thalassemia, aged 5–16 years, were enrolled in this research study. The serum of these patients was treated with spirulina. Afterward, the serum levels of iron, ferritin, transferrin, TIBC, and UIBC before and after treatment were evaluated.

Results: The results indicated a decrease in iron, ferritin, and transferrin saturation levels, while total iron binding capacity, unsaturated iron binding capacity, and transferrin levels were increased.

Conclusion: In conclusion, the correlation between iron overload, cancer, and thalassemia presents a complex interplay of genetic, biochemical, and environmental factors. Reducing the total body iron stored is a crucial treatment goal for thalassemia and cancer.

Plant Secondary Metabolites Inhibit Cancer by Targeting Epidermal Growth Factor Receptor (EGFR): An Updated Review on their Regulation and Mechanisms of Action

Adil Jamal — 2025-01-12

Cancer is an exceedingly pervasive disease currently, with approximately 14 million individuals diagnosed every year. The lifestyle and environmental changes are the most widespread causes of cancer. There are numerous cancer treatments available, including chemotherapy, radiotherapy, and hormone therapies. However, these procedures have adverse effects. In such circumstances, plant-based therapies have shown increased efficacy. Plant secondary metabolites such as alkaloids, polyphenols, cannabinoids, and flavonoids have anti-inflammatory, anti-tumor, and anti-proliferative properties, making them ideal candidates for cancer treatment. They inhibit major signaling pathways like MAPK, EGFR, VEGF, Ras/Raf, NF-kβ, induce necrosis, apoptosis, ferroptosis, and cause cell cycle arrest. Phytochemicals together with nanomedicines have a better possibility of eliminating malignant cells. They impede mitophagy while regulating Caspase-dependent cascades. Molecular investigation has revealed that they influence DNA repair, liposomal activities, and the phagocytosis process. The highlights of this review encompass how chemotherapeutic agents induce multidrug resistance, and phytochemical-based cancer treatments and their mechanisms of action, including how they rejuvenate cell damage and eliminate tumor cells from the body.

Association Between Autoimmune Thyroiditis and Thyroid Cancer: A Systematic Review of Studies in the Indian Population

Monalisha Saikia Borah — 2025-01-12

Background and Purpose: Thyroid cancer is a significant global health concern, and autoimmune thyroiditis, including Hashimoto's thyroiditis and chronic lymphocytic thyroiditis, has been suggested as a potential risk factor. This meta-analysis aimed to investigate the association between autoimmune thyroiditis and thyroid carcinoma in the Indian population.

Methods: A systematic search yielded 53 studies, of which six were included. Statistical analysis assessed the correlation between autoimmune thyroiditis and thyroid carcinoma.

Results: The analysis reveals a significant association between autoimmune thyroiditis and thyroid carcinoma in the Indian population, primarily driven by Hashimoto's thyroiditis.

Conclusion: This study underscores the relevance of autoimmune thyroiditis as a potential risk factor for thyroid carcinoma in India. Further research is needed to confirm these findings and elucidate the underlying mechanisms.

Unleashing Translational Opportunities of Loco-Regional Drug Delivery to Treat Malignancy

Pranjal Sachan — 2025-01-12

Background: Loco-regional drug delivery for cancer treatment has emerged as a promising approach to enhance therapeutic efficacy while minimizing systemic toxicity. Various strategies have been developed, including localized drug delivery systems and targeted delivery methods, to improve drug distribution and retention at tumor sites. Despite significant progress, several challenges persist, necessitating further exploration and innovation.

Objective: This review aims to provide insights into the recent advances and challenges in loco-regional drug delivery for cancer therapy and identify future translational opportunities in this field.

Materials and Methods: A literature search was conducted on loco-regional drug delivery systems for cancer treatment, identifying advancements in nanoparticle-based formulations, hydrogels, implants, and image-guided delivery techniques. Challenges include drug resistance, limited tumor tissue penetration, and tumor microenvironment complexity.

Conclusion: Loco-regional drug delivery has the potential to transform cancer therapy by allowing for precision targeting, combining therapeutic modalities, using nanotechnology, and utilising modern imaging tools.

Discussion: Collaboration among academics, physicians, and industry stakeholders is critical for expediting the clinical translation of innovative drug delivery platforms, which have the potential to drastically improve malignancy patient outcomes as well as enable personalised treatment methods.