Asian Pacific Journal Of Cancer Prevention[JOURNAL]
Sun
200 papers
Exploring Knowledge, Attitudes, Practices, and Information-Seeking on HPV Infection and Cervical Cancer Prevention in Rural Indonesia.
Winarto H, Glenardi G, Habiburrahman M … +6 more , Kusuma F, Nuranna L, Purwoto G, Utami TW, Anggraeni TD, Nuryanto KH
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660928 · Publisher ↗
BACKGROUND: Cervical cancer remains a leading public health problem in Indonesia, with low screening and HPV vaccination coverage, particularly in rural areas where knowledge gaps and limited healthcare access persist. T...
BACKGROUND: Cervical cancer remains a leading public health problem in Indonesia, with low screening and HPV vaccination coverage, particularly in rural areas where knowledge gaps and limited healthcare access persist. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding HPV infection and cervical cancer, and the role of information-seeking behavior in identifying effective channels for raising awareness on these issues. METHODS: A cross-sectional study was conducted between 20 March 2023 and 20 January 2024, involving 220 women from two rural districts in North Moluccas, selected via convenience sampling. Data were collected using a validated questionnaire administered through face-to-face interviews. Data were analyzed using SPSS version 25.0 with descriptive statistics, normality testing (Kolmogorov-Smirnov), bivariate analyses (Chi-square, Fisher's Exact, Pearson's or Spearman's tests), and multivariate logistic regression (backward LR, p < 0.05), with model performance assessed using ROC curves and AUC values. RESULTS: Most participants demonstrated poor KAP, with 18.7% showing good knowledge, 22.7% expressing a positive attitude, and 44.5% engaging in favorable practices. KAP were found to be positively correlated (p<0.001). Key predictors of good knowledge included higher education (AOR = 7.07), family history of cancer (AOR = 15.20), private vehicle use (AOR = 4.15), and active health-information seeking behavior (HISB) (AOR = 3.41). Determinants for a positive attitude included higher education (AOR = 3.79), family history of cancer (AOR = 4.42), active HISB (AOR = 3.88), and good knowledge (OR = 10.29). Favorable practices were influenced by private vehicle use (AOR = 2.66) and positive attitude (AOR = 20.62). CONCLUSION: In conclusion, KAP are influenced by HISB, and involving healthcare workers in providing information, particularly through digital platforms, has the potential to improve KAP in rural communities.
A Multidimensional Assessment of the Aperture Shape Controller in VMAT for Ca Tongue: Implications for Plan Complexity and Quality Assurance.
M A, Show S, Jha S … +2 more , Prakash A, S C
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660927 · Publisher ↗
PURPOSE: This study aims to evaluate the impact of varying Aperture Shape Controller (ASC) settings on the optimization of VMAT plans for tongue carcinoma (Ca-Tongue), focusing on their role in modulating plan complexity...
PURPOSE: This study aims to evaluate the impact of varying Aperture Shape Controller (ASC) settings on the optimization of VMAT plans for tongue carcinoma (Ca-Tongue), focusing on their role in modulating plan complexity, maintaining dosimetric integrity, and ensuring accurate treatment delivery. MATERIALS AND METHODS: Twenty Ca-Tongue patients were retrospectively planned using four ASC settings: Off, Very Low, Moderate, and Very High, totaling 80 plans. Complexity metrics such as Modulation Complexity Score (MCSv), Small Aperture Score (SAS), and Monitor Units per cGy (MU/cGy) were computed using MATLAB from exported DICOM RT files. Each plan underwent portal dosimetry QA with gamma analysis (3%/3mm and 2%/2mm). Dosimetric quality was evaluated using Conformity Index (CI), Homogeneity Index (HI), and PTV D98%, along with doses to organs-at-risk (OARs). Statistical analysis included the Wilcoxon signed-rank test and linear regression. RESULTS: Increasing ASC level significantly reduced plan complexity: MCSv increased from 0.32±0.02 (Off) to 0.38±0.03 (Very High), SAS decreased from 0.47±0.04 to 0.37±0.07, and MU/cGy dropped from 2.25±0.09 to 2.03±0.12 (p < 0.05). However, higher ASC levels were associated with minor but consistent reductions in PTV coverage (D98%: 96.66% to 94.94%) and increases in OAR doses (e.g., spinal cord Dmax: 30.46 Gy to 34.90 Gy). CI and HI remained clinically acceptable across all settings. Gamma pass rates were uniformly high (≥98.85%), with no significant improvement across ASC levels. Weak or negligible correlations (R² < 0.323) were found between complexity metrics and gamma outcomes. CONCLUSION: The ASC effectively reduces plan complexity in VMAT for Ca-Tongue without compromising delivery accuracy. While Very High ASC yields the greatest complexity reduction, it also introduces modest trade-offs in PTV coverage and OAR sparing. The Moderate ASC setting appears optimal, offering a balance between complexity control and dosimetric quality. Clinical implementation of ASC should be tailored to tumor site and anatomy, with Moderate ASC recommended for head and neck VMAT to ensure safety, efficiency, and robust QA performance.
Analysing Breast Cancer Screening Trends in Rural Saudi Arabia: Vision 2030 Context.
Almalki S, Mcgrail M, Nasir B … +1 more , Chater B
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660926 · Publisher ↗
INTRODUCTION: Breast cancer ranks among the most prevalent cancers in Saudi Arabia. Despite this, screening rates are lower compared to other countries, especially in rural regions. AIM: To investigate the effect of the...
INTRODUCTION: Breast cancer ranks among the most prevalent cancers in Saudi Arabia. Despite this, screening rates are lower compared to other countries, especially in rural regions. AIM: To investigate the effect of the NHSTP on breast cancer screening and diagnosis among women attending healthcare clinics in Bisha, a rural area of Saudi Arabia. METHODS: This study was a retrospective analysis of 2023 data retrieved from the Bisha Health Directorate and the breast cancer screening dashboard at the Ministry of Health (MOH) for both the Bisha region and national-level data. A frequency analysis for breast cancer screening and diagnosis in women attending healthcare clinics in Bisha was performed. Historical data from 2017-2023 were analyzed to compare pre- and post-NHSTP implementation periods. Secondary data on screening facilities, infrastructure improvements, and national screening benchmarks in the Bisha region were also analyzed. RESULTS: In 2023, the Bisha health cluster had a monthly breast cancer screening goal of 668 women and a total of 8016 women for the calendar year. Aggregated services were provided to 7101 women, resulting in a coverage rate of 88.6% in 2023 compared to the annual goal. This is a significant increase from 2022, during which 3212 women were screened in the Bisha region. The number of diagnosed breast cancer cases increased from 45 in 2022 to 88 in 2023, though the prevalence of diagnosed cases decreased from 1.4% to 1.2% as screening expanded to include more lower-risk women. Infrastructure improvements included an increase from 3 to 6 mammography devices between 2021 and 2023. CONCLUSION: Substantial growth in breast cancer screening and early diagnosis has been observed in Bisha, Saudi Arabia. A rising trend in the proportion of women utilizing breast cancer screening services, following the establishment of new facilities, was observed in the Bisha region after the implementation of the NHSTP.
Exploring the Role Of CD155 in Urothelial Carcinoma of the Urinary Bladder: An Immunohistochemical Study & Its Correlation With PD-L1.
Shibel PE, Elyamany AM, El Shorbagy G … +1 more , Abd Elmaogod EA
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660925 · Publisher ↗
BACKGROUND: Urinary bladder carcinoma is one of the most immunogenic cancers. Several immune checkpoint inhibitors targeting programmed death-ligand 1 (PD-L1) have been approved by the FDA for bladder carcinoma treatment...
BACKGROUND: Urinary bladder carcinoma is one of the most immunogenic cancers. Several immune checkpoint inhibitors targeting programmed death-ligand 1 (PD-L1) have been approved by the FDA for bladder carcinoma treatment. However, additional immunotherapeutic targets are still needed. CD155 is another immune checkpoint molecule that has been shown to be overexpressed in several cancers and is associated with poor prognosis. AIM: This study aimed to evaluate CD155 expression in cases of urinary bladder urothelial carcinoma using immunohistochemistry and to correlate this expression with the clinicopathological parameters of the cases as well as with PD-L1 expression. METHODS: Immunohistochemical staining for CD155 and PD-L1 was performed on 67 cases of urothelial carcinoma of the urinary bladder. RESULTS: CD155 was positive in 41.8% of cases and was significantly associated with invasive tumors and advanced T stage. PD-L1 was positive in 35.8% of cases and was significantly associated with advanced T stage, distant metastasis, muscle invasion and lymphovascular emboli. A statistically significant positive correlation was observed between the expression of both CD155 and PD-L1. CONCLUSION: Our study demonstrated increased expression of CD155 in urothelial carcinoma of the urinary bladder with advancing stage, suggesting its potential as a therapeutic target. Additionally, CD155 expression correlated positively with PD-L1 expression, indicating that some patients might benefit from a combined blockade of both targets.
Prevalence of Transcriptionally Active HPV16 and HPV18 infection in Anogenital Warts: A Study in Sikkim, India.
Lal S, Sharma RL, Pradhan A … +1 more , Sherpa ML
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660924 · Publisher ↗
BACKGROUND: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection globally and is causally related to anogenital and oral cancers, with 311,000 associated deaths recorded in men and women every...
BACKGROUND: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection globally and is causally related to anogenital and oral cancers, with 311,000 associated deaths recorded in men and women every year. The presence of oncogenic HPV genotypes in anogenital warts is reported by few studies, while many groups have reported an associated higher risk of anogenital and other cancers in patients with anogenital warts. This study aimed to detect HPV16 and HPV18 DNA and mRNA markers in anogenital warts to assess infection and viral persistence. METHOD: A cross-sectional study design was adopted to enroll 50 consenting men and women presenting with anogenital warts at the dermatology clinics of two existing referral hospitals in Sikkim. Samples were processed for DNA and RNA extraction, cDNA conversion, followed by qPCR-based amplification for HPV16 and HPV18 E6/E7 DNA and mRNA. RESULT: High presence of E6/E7 genes of HPV16 and HPV18 with DNA and mRNA was observed in the exfoliated anogenital warts tissue samples, evaluated using quantitative PCR (qPCR). HPV16E6 and HPV18E6 DNA was present in 75.5% (37/49) and 26.6% (13/49) of the samples, while HPV16E6 and HPV18E6 mRNA was present in 62.0% (31/50) and 52.0% (26/50) of the samples, respectively, 18.0% (9/50) of the samples tested positive for HPV16E7 mRNA, while none were positive for HPV18E7 mRNA. CONCLUSION: High prevalence of HPV16 and HPV18 seen in males and females with Anogenital warts in the present study re-emphasizes the significance of including men in HPV screening and vaccination programs, and importance of testing oncogenic HPV genotypes in anogenital warts to improve the overall reduction of clinical manifestations associated with HPV.
Whole Exome Sequencing Revealed Rare Variants in BRCA2, RAD51D, FANGC, CYP24A1 Genes in Breast/Ovarian Cancer Patients from a Small Buryat Ethnic Group.
Gervas P, Molokov A, Babyshkina N … +7 more , Ivanova A, Kollantay O, Buldakov M, Molonova L, Zarubin A, Choynzonov E, Cherdyntseva N
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660923 · Publisher ↗
OBJECTIVE: Breast cancer is a public health problem with increasing incidence, prevalence, and mortality worldwide. Germline variants in the DNA repair genes BRCA1/2 are involved in the pathogenesis of hereditary breast/...
OBJECTIVE: Breast cancer is a public health problem with increasing incidence, prevalence, and mortality worldwide. Germline variants in the DNA repair genes BRCA1/2 are involved in the pathogenesis of hereditary breast/ovarian cancer. However, for many ethnic groups that are isolated geographically worldwide, founder variants of breast cancer still have not been found. In this study, we provide whole exome sequencing data performed in a group of breast/ovarian cancer patients who belong to the Buryats. METHODS: Our study included 56 Buryat patients with histologically confirmed primary breast/ovarian cancer who completed an anonymous questionnaire about basic information and nationality. Genomic DNA was isolated from peripheral blood leukocytes. Libraries were prepared using a BGI Optimal DNA Library Prep kit (MGI, China). An Agilent SureSelect Human All Exon V6 kit (Agilent, USA) was used for hybridization. High-throughput sequencing was performed on a DNA nanoball sequencing platform DNBSeq-G400 (MGI, China). Result: In the overall group of patients with signs of hereditary breast/ovarian cancer, likely pathogenic/pathogenic variants were detected in 16% (9/56). We have discovered likely pathogenic/pathogenic variants that can either directly (BRCA2, RAD51D, FANCG) or indirectly (POLR2C, FOXL2, GDF9, CYP21A4) initiate breast/ovarian cancer. For the first time, three rare germinal variants in the BRCA2 gene were detected in a small Buryat ethnic group. Further studies are required to confirm their role in the pathogenesis of breast /ovarian cancer in this ethnic group. We found that the RAD51D gene variant c.757C>T is recurrent and was observed in 4% of Buryat patients with breast/ovarian cancer. CONCLUSION: For the first time, rare germinal variants in the BRCA2, RAD51D, FANGC, CYP24A1 genes were detected in a small Buryat ethnic group. Our data are consistent with existing data showing that variants in the RAD51D gene may be involved in the pathogenesis of breast/ovarian cancer. We also showed that the Mongolic-speaking Buryat populations exhibited strong genetic resemblance to those of Chinese.
An Altered Ratio of CD4+ and CD8+ T Lymphocytes in Cervical Cancer Tissue and Peripheral Blood as a Predictor of Prognostic Outcome: A Clinicopathological Study.
Das D, Sepai HM, Pal SK … +3 more , Chakraborty BC, Adhikary A, Thoudam M
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660922 · Publisher ↗
OBJECTIVE: The aim of our study is to compare CD4+ & CD8+ T lymphocytes in the cervical tumor tissue with those in peripheral blood in patients with carcinoma cervix and to access thier association with known prognostic...
OBJECTIVE: The aim of our study is to compare CD4+ & CD8+ T lymphocytes in the cervical tumor tissue with those in peripheral blood in patients with carcinoma cervix and to access thier association with known prognostic factors. The study also aims to investigate the association between tumor infiltrating lymphocytes (TILs) and the HPV status of the patients. METHODS: In this prospective study, 42 patients with locally advanced squamous cell carcinoma of cervix were included. Percentages of CD4+ and CD8+ T lymphocytes were obtained using flow cytometry-based method from single-cell suspension prepared from simultaneously collected tumor tissue and peripheral blood samples. DNA extracted from tumor tissue was analysed to detect HPV16 (Human Papillomavirus 16) and HPV18 infection. T lymphocyte subsets in blood and tumor tissue were compared. The association of T lymphocytes with known prognostic factors and HPV status of the tumor was examined. RESULT: Both CD4+ and CD8+ T cells were significantly higher in peripheral blood compared to tumor tissue (p < 0.001). The CD4/CD8 ratio was reversed in tumor tissue compared to peripheral blood due to relatively lower reduction of CD8+ cells compared to CD4+ cells in tumor tissue. No significant association of T lymphocyte subpopulation was found with known prognostic parameters of cervical cancer. CD4+ and CD8+ T lymphocyte infiltration was significantly higher in tumor with HPV16 infection (p < 0.05). A significant alteration of CD4/CD8 ratio was observed for HPV18 positive tumors (p < 0.05). CONCLUSION: Our study demonstrates that both CD4+ and CD8+ T lymphocyte, which are major component of TILs, are significantly lower in tumor tissue compared to peripheral blood in locally advanced cervical cancer. No association was observed between T lymphocyte subpopulations and major prognostic factors of cervical cancer. The enhanced TILs observed in HPV-associated cervical cancer represents a significant alteration with promising therapeutic applications.
The Relationship between SALL4 and Fascin Expression and the Progression of Colorectal Carcinoma.
El-Iraqi AM, Abdel-Rhaman NM, Kamal Taha A
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660921 · Publisher ↗
OBJECTIVE: SALL4 (Spalt-like transcription factor 4) is a stem cell transcription factor that is reactivated in various tumor tissues and has a proven pro-metastatic role in colorectal cancer (CRC). However, the mechanis...
OBJECTIVE: SALL4 (Spalt-like transcription factor 4) is a stem cell transcription factor that is reactivated in various tumor tissues and has a proven pro-metastatic role in colorectal cancer (CRC). However, the mechanism of its reactivation in CRC remains elusive. fascin is an actin-bundling protein linked to CRC progression. Independent of this activity, fascin regulates stemness and embryonic stem cell-related genes in some cancers. Data on the role of fascin in regulating stem cell transcription factors in CRC are scarce, and the relationship between fascin and SALL4 expression in CRC has not been investigated. This study aims to evaluate the immunohistochemical expression of SALL4 and fascin in fifty-four CRC cases and their relationship with clinicopathological parameters. METHODS: The expression of SALL4 and Fascin determined using immunohistochemistry in 54 paraffin-embedded colectomy specimens from patients with primary colorectal adenocarcinoma. RESULT: SALL4-positive expression was detected in 9 cases (16.7%), while moderate-to-high fascin expression was found in 21 cases (38.9%). A significant positive relationship was identified between SALL4 expression and lymphovascular invasion (LVI) (P = 0.033). Moderate-to-high fascin expression was significantly associated with advanced pathological tumor (pT) stage (P = 0.023), lymph node (LN) spread (P = 0.031), and LVI (P = 0.010). Furthermore, a significant association was observed between SALL4 positivity and moderate-to-high fascin expression (P = 0.009). CONCLUSION: This is the first study to demonstrate a significant association between SALL4 and fascin expression in CRC patients, suggesting a potential interplay between them. Both proteins may represent potential markers of CRC progression. Molecular studies are required to further investigate the interaction between SALL4 and fascin in CRC.
MALAT1 Gene Variants rs619586, rs664589, and rs3200401 and Their Association with Non-Hodgkin Lymphoma Risk: Evidence from a Case- Control Study in Southeast Iran.
Mozaffari H, Hashemi SM, Sadraei M … +3 more , Taheri M, Behdani M, Bahari G
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660920 · Publisher ↗
INTRODUCTION: Non-Hodgkin lymphoma (NHL) represents a diverse spectrum of lymphoid malignancies, which are defined by abnormal proliferation of lymphocytes and the absence of Reed-Sternberg cells. Both genetic and epigen...
INTRODUCTION: Non-Hodgkin lymphoma (NHL) represents a diverse spectrum of lymphoid malignancies, which are defined by abnormal proliferation of lymphocytes and the absence of Reed-Sternberg cells. Both genetic and epigenetic mechanisms play critical roles in the etiology of this group of cancers. In this context, the present study aimed to assess the potential relationship between three specific single nucleotide polymorphisms (SNPs) in the MALAT1 gene namely rs619586 A>G, rs664589 C>G, and rs3200401 C>T and their association with susceptibility to NHL in a population sample from Zahedan, Iran. MATERIALS AND METHODS: A case-control study design was utilized, comprising 185 individuals diagnosed with NHL (118 men and 67 women; mean age: 45.46 ± 15.44 years) and an equal number of age- and sex-matched healthy controls (106 men and 79 women; mean age: 43.26 ± 12.27 years). Genomic DNA was isolated from peripheral blood leukocytes using the conventional salting-out method. Genotyping for the selected MALAT1 polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system PCR (ARMS-PCR) methodologies. Statistical evaluations were performed using chi-square tests, independent sample t-tests, and logistic regression models to analyze the data. RESULTS: The rs3200401 C>T polymorphism of the MALAT1 gene was significantly associated with a reduced risk of NHL, suggesting a protective effect (P<0.05). Similarly, the rs619586 A>G variant showed a significant protective association with NHL. In contrast, the rs664589 C>G polymorphism did not show any significant differences in genotype or allele frequencies between NHL patients and healthy subjects (P>0.05). CONCLUSION: The findings suggest that MALAT1 gene polymorphisms, particularly rs3200401 and rs619586, as well as the TCG haplotype, may influence susceptibility to non-Hodgkin lymphoma and serve as potential genetic biomarkers. However, further studies involving larger and ethnically diverse cohorts are required to validate these associations.
Tumor-Intrinsic PD-1 Regulatory Network Drives Lapatinib Resistance in HER2⁺ Breast Cancer: An Integrative Bioinformatics Analysis.
Alhallaq AS, Sultan NS
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660919 · Publisher ↗
BACKGROUND: Lapatinib resistance evolution in HER2+ breast cancer is still a crucial therapeutic hurdle, with immune microenvironmental reprogramming playing a minimally explored role. Beyond its canonical expression on...
BACKGROUND: Lapatinib resistance evolution in HER2+ breast cancer is still a crucial therapeutic hurdle, with immune microenvironmental reprogramming playing a minimally explored role. Beyond its canonical expression on T cells, programmed cell death protein 1 (PD-1/PDCD1) is intrinsically induced in resistant breast tumors. Through the binding of tumor-intrinsic PD-1 to PD-L1 on adjacent tumor or stromal cells, inhibitory signals are generated, establishing an immunosuppressive microenvironment. METHODS: This exploratory study investigated the tumor-intrinsic (PD-1)-lapatinib resistance (PLR) regulatory network driving lapatinib resistance in HER2⁺/ER-/PR- breast cancer using an integrative bioinformatics analysis. The GSE38376 dataset and PDCD1 co-expressed genes were utilized to construct the protein-protein interaction (PPI) of the PLR regulatory network. Gene expression patters were visualized using a complex heatmap. Gene ontology, KEGG functional enrichment, gene-metabolite interaction network, immune cell infiltration, comparative gene expression profiling, correlation analysis of PDCD1-hub genes, survival analysis, and genetic alterations analysis were performed on the PLR regulatory network to elucidate the mechanisms of lapatinib resistance. RESULTS: Pathways and gene-metabolite analyses showed that the PLR regulatory network genes were enriched in immune regulation pathways and lipid metabolic reprogramming. The top 10 PLR-hub genes were identified. Expression profiling in lapatinib-resistant cells revealed the upregulation of PDCD1, B2M, and ITGB2, while other genes, particularly those involved in interferon response and antigen presentation, were downregulated. Immune infiltration analysis indicated exhausted T cells and an immunosuppressive microenvironment. Comparative gene expression and survival analyses of PLR-hub genes implicated the PLR regulatory network in lapatinib resistance. Genetic alterations were infrequent, suggesting that regulation may occur epigenetically or transcriptionally. CONCLUSION: The findings revealed that the PLR regulatory network is associated with HER2⁺/ER-/PR- lapatinib resistance through multiple mechanisms, including interferon signaling silencing, T cell exhaustion, and the fostering of an immunosuppressive niche. These insights pave the way for interventions aimed at overcoming lapatinib resistance in HER2⁺ breast cancer.
Evaluation of the Diagnostic Accuracy of Cervical Cell Morphologies from Android Device-Captured Cytopathological Microscopic Images through Artificial Intelligence in Mainly Rural or Resource-Constraint Areas of India.
Ray A, Karmakar A, Maiti M … +6 more , Banerjee S, Dasgupta S, Dey S, Faruk U, Das P, Saha P
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660918 · Publisher ↗
OBJECTIVE: This study aims at develop and evaluate an artificial intelligence programming software, an integrated system that automatically detects and classifies cells from microscopic Pap smear slide images taken on An...
OBJECTIVE: This study aims at develop and evaluate an artificial intelligence programming software, an integrated system that automatically detects and classifies cells from microscopic Pap smear slide images taken on Android phones or tabs to diagnose the cervical cell morphology in a time-efficient and cost-effective manner. METHODS: This study presents an integrated system designed to automatically detect and classify cells in Pap smear slide images, differentiating cellular morphologies. The system leverages three deep learning (DL) and one machine learning (ML) models, each tailored to specific tasks in the image analysis pipeline. The analysis of 292 hospital in-house microscopic Pap smear images was conducted from July 2023 to December 2024 at CliniMed LifeSciences, Kolkata, India. The following article describes the datasets used, the training procedures and the performance metrics for each model. Results: Pap smear images have been validated and standardized by using SipakMed, Herlev (public datasets) and hospital in-house data. A total of 292 in-house Pap smear images have been analysed through the newly developed AI software. Standardization and validation include an Intersection-over-Union score of cell-nuclei boundary extraction model of 71.14%, the accuracy of cell classification model and morphological feature based ML model are 99.213% and 91.23% respectively. The custom AI model could successfully classify 98.09% and 80.49% of normal and abnormal cells in hospital in-house samples respectively. Also a significant meaningful correlation is observed between biopsy (gold standard) and AI reports. CONCLUSION: AI offers a lot of promise for diagnosing cervical cancer, and its uses in cervical cytology screening are particularly well-established. Manual screening of cervical cytology smears is a time-tested method, but AI is set to revolutionize the process by improving outreach, availability, accuracy and economy. A total of 292 hospital in-house Pap smear images have been validated and examined in this study with significant accuracy percentages between AI and expert eyes.
Arsenic-Based Homeopathic Preparations Induce Metabolic Disruption and Reactive Oxygen Species-Mediated Cell Death in Glioblastoma Multiforme.
Pateriya A, Kulkarni C, Tomar MS … +4 more , Porwal K, Gupta AK, Chattopadhyay N, Shrivastava A
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660917 · Publisher ↗
BACKGROUND: Glioblastoma multiforme (GBM) is a highly aggressive brain cancer with a poor median survival rate. There is an urgent need for effective and affordable anti-cancer agents for GBM treatment. In this context,...
BACKGROUND: Glioblastoma multiforme (GBM) is a highly aggressive brain cancer with a poor median survival rate. There is an urgent need for effective and affordable anti-cancer agents for GBM treatment. In this context, arsenic-based homeopathic preparations may serve as promising therapeutic candidates. OBJECTIVES: This study aimed to evaluate the efficacy of Arsenicum iodatum and Arsenicum album-induced cytotoxicity in GBM cells and to investigate the underlying mechanisms of action in the U-87-MG and LN-229 cell lines. RESULTS: Treatment with varying concentrations of Arsenicum iodatum and Arsenicum album resulted in dose- and time-dependent inhibition of GBM cells growth in U87-MG and LN-229. These preparations induced distinct morphological changes and cell death in both GBM cell lines. Gas chromatography-mass spectrometry (GC-MS)-based metabolomics revealed significant alterations in the key metabolic pathways. A total of 107 metabolites were quantified. Univariate analysis identified 73 and 30 significantly altered metabolites in Arsenicum album-treated U-87-MG and LN-229 cells, respectively. Meanwhile, U-87 showed 69 and LN-229 showed 50 significantly affected metabolites in the Arsenicum iodatum-treated groups. In GBM cells treated with Arsenicum album and Arsenicum iodatum, glycine and serine, which are involved in redox balance, were altered, while branched-chain amino acids (valine, leucine, isoleucine)- essential for protein synthesis and mTOR signaling- were downregulated. Changes were also observed in nucleotide sugar, purine, and nicotinate/nicotinamide metabolism. The findings suggest that both agents cause strong metabolic disruptions, potentially contributing to their anti-cancer effects. Biochemical assays confirmed increased reactive oxygen species (ROS) levels and decreased mitochondrial membrane potential following treatment with these arsenic based homeopathic preparation. CONCLUSION: Arsenicum iodatum and Arsenicum album exhibit growth-inhibitory effects on GBM cells, likely through metabolic disruption and ROS-mediated cell death. Further studies are warranted to elucidate the precise mechanisms of cell death and to evaluate their efficacy and safety in vivo.
Deciphering the Predictive Utility of N-telopeptide (NTx) and C-telopeptide (CTx) for Early Bony Invasion in Oral Squamous Cell Carcinoma (OSCC).
Singh P, Singh N, Shekhar R … +2 more , Kumari R, Singh S
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660916 · Publisher ↗
BACKGROUND: Early bony invasion in oral squamous cell carcinoma (OSCC) often remains undetected by conventional CT imaging. Bone turnover markers like N-telopeptide (NTx) and C-telopeptide (CTx) may serve as sensitive bi...
BACKGROUND: Early bony invasion in oral squamous cell carcinoma (OSCC) often remains undetected by conventional CT imaging. Bone turnover markers like N-telopeptide (NTx) and C-telopeptide (CTx) may serve as sensitive biomarkers for subclinical bone involvement. OBJECTIVE: To evaluate the potential of serum NTx and CTx levels as diagnostic markers for early bony invasion in OSCC patients whose CT scans showed no radiological evidence of bone involvement. METHODS: A prospective observational study was conducted on 50 OSCC patients with negative CT reports for bone invasion. Serum NTx and CTx levels were measured using ELISA. Based on biomarker levels, patients were categorized into two groups: Group A (elevated NTx and/or CTx) and Group B (normal levels). Statistical comparisons, ROC curve analysis, and logistic regression were employed to assess the diagnostic potential of these biomarkers. RESULTS: Group A (n = 25) showed significantly elevated levels of serum NTx (mean ± SD: 20.4 ± 4.1 nM BCE) and CTx (860 ± 130 ng/L) compared to Group B (NTx: 11.5 ± 2.9 nM BCE; CTx: 540 ± 110 ng/L), with p < 0.001. ROC analysis (receiver operating characteristic) revealed AUCs ( area under the curve) of 0.902 for NTx and 0.928 for CTx, suggesting excellent diagnostic accuracy. Logistic regression confirmed serum NTx and CTx as independent predictors of probable microinvasion. A subgroup analysis based on tumor histopathology revealed NTx to be more sensitive in moderately differentiated tumors, while CTx was more sensitive in poorly differentiated tumors. CONCLUSION: Elevated serum levels of NTx and CTx in OSCC patients with negative CT scans may indicate early bony microinvasion. Incorporating biomarker screening into diagnostic protocols could enhance treatment planning and reduce recurrence.
Identification of BRCA1 and BRCA2 Germline Mutations in Female Breast Cancer Patients Using Next Generation Sequencing.
Swellam M, Khalifa MK, Nageeb AM … +7 more , Sayed Mahmoud M, Hashim M, Alisslam I A Alshazly A, Mahfouz ME, Ez ElArab LR, Mahmoud MH, Emam Sobeih M
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660915 · Publisher ↗
BACKGROUND: Breast cancer is the most common cancer affecting females according to WHO 2020 report, with BRCA1 and BRCA2 identified as the major tumor suppressor genes linked to disease susceptibility. Hence, the purpose...
BACKGROUND: Breast cancer is the most common cancer affecting females according to WHO 2020 report, with BRCA1 and BRCA2 identified as the major tumor suppressor genes linked to disease susceptibility. Hence, the purpose of the current study was to investigate germline mutations among these genes in a group of Egyptian female breast cancer patients. METHODS: Blood samples from primary breast cancer patients (n=22), benign breast lesions (n=5) and healthy controls (n=7) were sequenced for BRCA genes by next generation sequencer. RESULTS: A total of 135 genetic variations were detected, 59 in BRCA1 and 76 BRCA2, 2 indels (insertion-deletion) and 133 SNV (single nucleotide variation), nearly 55% of those variants were missense variants, 38% were synonymous and 7% were nonsense. A total of 59 variations were detected in BRCA1 and they were categorized as exonic (n=10) and intronic (n=49) regions, BRCA1 exonic variants were categorized into: missense (n=12), non-coding transcript (n=11) synonymous (n=6), splice region synonymous (n=2), stop gain (n=2) and 3-prime UTR (n=1) variants. Regarding variations detected in BRCA2, 55 intronic and 21 exonic variants were identified. Among these 21 variants; 13 novel mutations and 8 formally reported as follows: 7 as benign and one previously reported with contradictory pathogenicity according to the Clinvar database which is a freely available, public archive of reports of the relationships between human variations and phenotypes hosted by the National Center for Biotechnology Information (NCBI) and funded by intramural National Institutes of Health (NIH) funding. CONCLUSION: BRCA1 and BRCA2 germline profiling based on next-generation sequencing technology among Egyptian breast cancer female patients revealed 135 germline variations -104 intronic and 31 exonic, respectively. Among the exonic variants; 13 were newly reported mutations. Hence further study is required to enhance mutational analysis which may benefit clinical system.
Expression of Survivin and HER-2 as Independent Predictive Factors for Treatment Response in Locally Advanced Breast Cancer: A Prospective Cohort Study.
Badiri SW, Indra I, Sampepajung E … +5 more , Pieter J, Nelwan BJ, Ferianto D, Syamsu SA, Faruk M
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660914 · Publisher ↗
BACKGROUND: Locally advanced breast cancer (LABC) requires a multimodal approach, often starting with neoadjuvant chemotherapy (NACT) to reduce tumor size. However, response to NACT in LABC is highly variable. Predictive...
BACKGROUND: Locally advanced breast cancer (LABC) requires a multimodal approach, often starting with neoadjuvant chemotherapy (NACT) to reduce tumor size. However, response to NACT in LABC is highly variable. Predictive biomarkers such as HER-2 and Survivin may have the potential to predict treatment response and prognosis. This study aims to analyze the relationship between Survivin and HER-2 expression and the clinical response to NACT in LABC patients. METHODS: In this prospective cohort study, we enrolled 56 female LABC patients scheduled for a Taxane, Adriamycin, and Cyclophosphamide NACT regimen. Pre-treatment biopsy tissues were examined for Survivin and HER-2 expression via immunohistochemistry. Clinical response was evaluated after three cycles using the RECIST criteria. Data were analyzed using the Chi-Square test and multivariate logistic regression. RESULTS: High Survivin expression was found in 32/56 (57.1%) participants and positive HER-2 expression in 28/56 (50%). A significant correlation was found between high Survivin expression and HER-2 positivity (p=0.007). High Survivin expression (p<0.001; PR=4.688; 95% CI: 1.881-11.682) and HER-2 positivity (p<0.001; PR=5.585; 95% CI: 2.227-14.012) were significantly associated with poor chemotherapy response (non-response). Multivariate analysis showed that Survivin (OR=0.032; p=0.002) and HER-2 (OR=0.022; p=0.001) were significant independent predictors of chemotherapy response. CONCLUSION: Survivin and HER-2 expression are significantly associated and serve as independent predictors of poor response to NACT in LABC patients. Evaluation of these biomarkers could be crucial in risk stratification and the personalization of therapy.
Investigation of the Anticancer Effects and Senescence Induction of Hesperetin Combined with Cisplatin in Hepatocellular Carcinoma and Embryonic Fibroblast Cell Lines.
Artanti AN, Jenie RI, Rumiyati R … +3 more , Hermawan A, Jun-Ya K, Hanifa M
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660913 · Publisher ↗
OBJECTIVE: Hepatocellular carcinoma (HCC), the most common form of liver cancer, often develops in individuals with chronic liver diseases, especially cirrhosis. Cisplatin (Cisp), a chemotherapy agent commonly used in HC...
OBJECTIVE: Hepatocellular carcinoma (HCC), the most common form of liver cancer, often develops in individuals with chronic liver diseases, especially cirrhosis. Cisplatin (Cisp), a chemotherapy agent commonly used in HCC treatment, is effective but is known to damage normal cells, including fibroblasts. Hesperetin (HST), a citrus flavanone found abundantly in citrus fruits, has demonstrated antioxidant, anti-inflammatory, and anticancer properties. This study aimed to investigate the synergistic cytotoxic effects and selective induction of senescence by HST in combination with Cisp in HepG2 cancer cells and NIH-3T3 fibroblast cells. METHODS: The cytotoxic effects of HST were assessed using the MTT assay to determine cell viability. The antiproliferative properties were evaluated using colony formation assays. Senescence was assessed using SA-β-gal staining, while flow cytometry was used to analyze cell cycle distribution and apoptosis. Protein expression related to proliferation and apoptosis was determined via Western blot analysis. RESULTS: MTT assay results indicated that both HST and Cisp reduced HepG2 cell viability in a dose-dependent manner, with IC values of 258 ± 2.47 µM and 5 ± 1.83 µM, respectively. Their combination (HST: 33-130 µM; Cisp: 0.6-2.5 µM) showed synergistic effects (combination index, CI < 1) co-treatment with HST (65 and 130 µM) significantly enhanced senescence in HepG2 cells. Clonogenic assays showed inhibition of colony formation, supported by reduced expression of p-ERK1/2 and Cyclin D1. Flow cytometry revealed increased apoptosis and G2/M phase arrest, with upregulation of Bax and caspase-3, and downregulation of Bcl-xL. In NIH-3T3 cells, HST showed minimal cytotoxicity (IC50 > 500 µM), and co-treatment with Cisp reduced senescence markers. CONCLUSION: These results suggest that HST and Cisp co-treatment synergistically reduces cancer cell viability while protecting normal fibroblasts from senescence, supporting its potential as a co-chemotherapeutic agent in HCC treatment, while also serving as a protective agent against senescence in healthy tissues.
TMEPAI Confers Paclitaxel Resistance in Triple-Negative Breast Cancer Cells by Promoting AKT Phosphorylation and Its Downstream Cascade.
Louisa M, Wardhani BWK, Watanabe Y … +1 more , Kato M
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660912 · Publisher ↗
OBJECTIVE: TMEPAI (transmembrane prostate androgen-induced protein) is one of the proteins associated with the resistance of triple-negative breast cancer (TNBC) to various cytotoxic medicines. However, it has remained u...
OBJECTIVE: TMEPAI (transmembrane prostate androgen-induced protein) is one of the proteins associated with the resistance of triple-negative breast cancer (TNBC) to various cytotoxic medicines. However, it has remained uncertain how TMEPAI mechanistically contributes to TNBC resistance to paclitaxel. Thus, this study aimed to investigate the effect and possible mechanism of TMEPAI gene editing via CRISPR-Cas9 on the response of triple-negative breast cancer cells to paclitaxel. METHODS: The present study was conducted on wild-type triple-negative breast cancer cells (BT-549) and BT-549 cells with TMEPAI knocked out using CRISPR-Cas9. Both cell types underwent treatment with TGF-β, followed by paclitaxel, and were evaluated for cell viability and the expression of cell proliferation, apoptosis, drug efflux transporters, and epithelial-mesenchymal transition markers. RESULT: TMEPAI knock-out cells exhibited a markedly increased susceptibility to paclitaxel, as characterized by decreased viability and elevated expression of pro-apoptotic genes (Bax, caspase-3, caspase-9), as well as a reduction in anti-apoptotic markers (Bcl-2). The presence of TMEPAI perpetuated the phosphorylation of AKT (pAKT/AKT), elevated the expression of drug efflux transporters (particularly P-glycoprotein and MRP-1), and facilitated epithelial-mesenchymal transition (EMT), as evidenced by increased levels of Snail, Zeb1, and Twist. All these effects were diminished in TMEPAI-knock-out triple-negative breast cancer cells. CONCLUSION: TMEPAI appears to facilitate paclitaxel resistance in triple-negative breast cancer cells by promoting cell survival signaling, inhibiting apoptosis, enhancing drug efflux, and initiating epithelial-mesenchymal transition (EMT). Targeting TMEPAI may be a viable approach to overcoming resistance and improving treatment outcomes in triple-negative breast cancer cells.
Knowledge, Attitudes, and Screening Practices for Lung Cancer in Uzbekistan: A Nationwide Cross-Sectional Study.
Dadaboev A, Shukurova M, Aziziy A … +2 more , Ruziyeva N, Shakib Kotamjani S
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660911 · Publisher ↗
OBJECTIVE: Lung cancer is among the most lethal cancers worldwide and ranks as the third leading cause of cancer-related deaths in Uzbekistan. Despite its growing burden, public knowledge and participation in early scree...
OBJECTIVE: Lung cancer is among the most lethal cancers worldwide and ranks as the third leading cause of cancer-related deaths in Uzbekistan. Despite its growing burden, public knowledge and participation in early screening remain poorly understood in the region. This study aimed to assess general awareness, attitudes, and practices related to lung cancer and its screening among the adult population of Uzbekistan. METHODS: A cross-sectional survey was conducted between January 25 and February 3, 2025, involving 561 participants from all 14 regions of Uzbekistan. A structured, validated questionnaire was used to assess socio-demographic data, lung cancer knowledge, risk perception, and willingness to participate in screening. Descriptive statistics, chi-square tests, t-tests, ANOVA, and multivariable analysis, such as linear regression and logistic regression were employed to examine associations between knowledge scores and demographic variables. Knowledge was categorized as poor, moderate, or good. RESULTS: Only 4% of participants demonstrated good knowledge, while 79% had poor knowledge about lung cancer and its early detection. Although 73.2% recognized smoking as a major risk factor, only 37.4% were aware of early screening methods such as low-dose computed tomography (LDCT). Higher knowledge scores were significantly associated with older age, higher education, income, and urban residence (p < 0.05). Gender and smoking status were not significantly correlated with knowledge levels. CONCLUSIONS: This nationally representative study reveals substantial gaps in public awareness of lung cancer and its screening in Uzbekistan. Targeted public health interventions focusing on youth, rural populations, and individuals with lower educational backgrounds are urgently needed. Expanding educational outreach and increasing access to early detection services may significantly improve outcomes and reduce mortality in high-risk populations.
Hybrid Treatment Planning in Breast and Esophageal Cancer: A Feasible Approach for High-Volume Radiotherapy Centers.
Srivastava S, S SP, Mishra A … +1 more , Singh NM
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660910 · Publisher ↗
OBJECTIVE: To evaluate the feasibility of hybrid intensity-modulated radiotherapy (IMRT) technique in patients with esophageal and breast cancer within a high-patient volume setup. MATERIALS AND METHODS: A total of 36 pa...
OBJECTIVE: To evaluate the feasibility of hybrid intensity-modulated radiotherapy (IMRT) technique in patients with esophageal and breast cancer within a high-patient volume setup. MATERIALS AND METHODS: A total of 36 patients with carcinoma of the left breast and esophagus were retrospectively studied with 3D-CRT, IMRT and Hybrid techniques. 3D-CRT plans for esophageal cancer consisted of one anterior-postertior (AP) and two oblique beams, while IMRT consisted of seven beams. The hybrid plan consisted of AP and PA static beams combined with five conformal beams, with a weighting ratio of 5:5 and 4:6. In breast cases, hybrid planning involved two tangential static beams and three conformal beams with a weighting ratio of 7:3. Dosimetric parameters of the hybrid-IMRT plans were then compared with those of the 3D-CRT and IMRT plans. RESULTS: In esophageal cancer patients, there was a significant difference found in the PTV coverage and conformity. The V20 and Dmean of left lung showed significant differences between IMRT and Hybrid IMRT. V25 and Dmean for heart showed reduced values in IMRT plan. The maximum dose to the spinal cord was higher in Hybrid IMRT compared to IMRT and 3D-CRT. In breast cancer patients, V20 and Dmean for the left lung were 23.77±4.28% and 11.09±1.70 Gy in hybrid plans; 26.50±5.06 % and 12.44±1.62 Gy in IMRT; and 25.47±5.07% and 11.52±1.54 Gy in 3D-CRT. The dose to the contralateral breast was higher in the IMRT plans. CONCLUSION: Considering its comparable planning time to IMRT and the added benefit of reduced OAR doses, hybrid planning could be a valuable option in high-patient-volume settings.
Prevalence of Oral Precancerous Lesions and Conditions among Rural Population of Karnataka: A Community-based Cross-Sectional Study.
Narasannavar AB, Angolkar M, Wantamutte A
Asian Pac J Cancer Prev · 2026 Feb · PMID 41660909 · Publisher ↗
BACKGROUND: Globally, Oral Cancer alone is responsible for more than 6 million deaths each year, with nearly 10 million new cases diagnosed annually. India alone accounts for one-third of the world's oral cancer cases. I...
BACKGROUND: Globally, Oral Cancer alone is responsible for more than 6 million deaths each year, with nearly 10 million new cases diagnosed annually. India alone accounts for one-third of the world's oral cancer cases. India is considered as the oral cancer capital of the world, with an estimated 1% of the population having oral premalignant lesions. Early detection of oral precancerous lesions is practically possible and associated with a high expectation of the prevention of deformity, relapse, and mortality. The present study aims to estimate the magnitude of oral precancerous lesions and conditions among the rural population of Karnataka, India. METHODS: A community-based analytical cross-sectional study was conducted among the 6010 rural population of Belgaum. Participants were recruited through stratified cluster random sampling and were screened for oral precancerous lesions and conditions through visual examination and toluidine blue application. The data on socio-demographic variables, tobacco consumption, medical & dental history was collected and analyzed using IBM SPSS version 22. Logistic regression and Chi-square test were used to analyze inferential data at 95% confidence interval. Descriptive data were analyzed using percentage and proportion. RESULTS: The majority of participants were females (53.9%), and the mean age was 40 years. The prevalence of precancerous lesions and conditions was 16.38%. Among them, 4.5% had tobacco pouch keratosis, and 4.4% Oral Sub Mucous Fibrosis (OSMF). Age was associated with all types of lesions and conditions and similarly, cigarette and bidi smoking are associated with smoker's palate. 4.2% leukoplakia and smoker's palate were found in 1.6%. A high prevalence of Smokeless tobacco consumption was found, and among them, gutkha was most commonly used. These lesions were associated with age, education, tobacco, type of diet and sharp cusps. CONCLUSION: The overall prevalence of precancerous lesions and conditions was high. It was high among the elderly, except for OSMF which was more prevalent among the younger age group.
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