Asian Pacific Journal Of Cancer Prevention[JOURNAL]
Sun
200 papers
Role of Cyanidin 3-glucoside Extract in the Induction of Cytotoxicity and Apoptosis in a Rat Bladder Cancer Cell Line.
Alubaidy HA, Al-Bdeery AH, Abdul-Adel E … +3 more , Juda SA, Abd Alameer TH, Jabir MS
Asian Pac J Cancer Prev · 2026 May · PMID 42169586 · Publisher ↗
OBJECTIVE: This study focused on organisms that produce natural bioactive compounds that are environmentally friendly alternatives to chemical treatments. These compounds include flavonoids derived from marine algae, inc...
OBJECTIVE: This study focused on organisms that produce natural bioactive compounds that are environmentally friendly alternatives to chemical treatments. These compounds include flavonoids derived from marine algae, including anthocyanins. Cyanidin-3-glucoside (C3G) is a natural pigment-protein complex capable of inhibiting or eradicating the proliferation of malignant cells, both in vivo and in vitro. METHODS: This includes the AY-27 rat (BC) bladder cancer cell line. Its potential effects on inhibiting the production of isolated rat bladder tumor cells and activating cellular pathways were studied, including cytotoxicity, apoptosis, the p53 pathway, mitochondrial wall loss pathway, and partial fusion. Result: The present study documented a peak mortality rate of 84.43% in the toxicity pathway on the maximum dose of 100 µg/ml of C3G. The minimum mortality rate of 9.45% was recorded at the maximum C3G concentration of 6.25 µg/ml. In the apoptotic process, dead cells were evaluated for DNA damage. C3G promotes mitochondrial failure in AY-27 cells via the mitochondrial pathway, leading to a reduction in mitochondrial membrane potential compared to untreated AY-27 cells. CONCLUSION: The study's findings showed that C3G increased p53 gene expression in AY-27 cells during the p53 pathway. The data in the tables and figures reveal that increasing the dose or concentration of C3G over time has a lethal effect on bladder cancer cells. The results indicate that C3G promotes localized apoptosis, thereby inhibiting and slowing down the progression of bladder cancer. These findings suggest that C3G could be an active natural treatment for BC in rats, with potential for further development by international pharmaceutical companies.
Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System.
Maria R, Samad FA, Khalid A … +1 more , Sidhu SM
Asian Pac J Cancer Prev · 2026 May · PMID 42169585 · Publisher ↗
OBJECTIVE: This study aimed to estimate the prevalence, severity, and multidomain impact of cancer cachexia among Pakistani breast cancer patients, using the validated Mini-CASCO scoring system. METHODS: We conducted an...
OBJECTIVE: This study aimed to estimate the prevalence, severity, and multidomain impact of cancer cachexia among Pakistani breast cancer patients, using the validated Mini-CASCO scoring system. METHODS: We conducted an observational, cross-sectional study from February to December 2024 at Fauji Foundation Hospital (FFH), Rawalpindi. Eligible participants were female patients aged 18 years or older, with stage I-III breast cancer, receiving chemotherapy. Cachexia was assessed using the Mini-CASCO, which encompasses body composition, inflammation, anorexia, physical performance, and quality of life. Demographic, anthropometric, biochemical, and validated patient-reported outcomes were collected. Group differences between cachectic and non-cachectic patients were analyzed using the chi-square (χ²) test, with statistical significance set at p < 0.05. RESULTS: Of 134 participants (mean age: 45.2 ± 8.3 years), the prevalence of cachexia was 61.9% (95% CI: 53.4-70.0). The mean Mini-CASCO score was 45.7 ± 9.3 (95% CI: 43.7-47.8), indicating moderate cachexia. The severity distribution was 16.9% mild, 49.4% moderate, and 33.7% severe; no terminal cases were detected. Body weight and composition (12.7 ± 4.3) and anorexia (9.2 ± 2.6) were the most impaired domains. Compared with non-cachectic patients, those with cachexia had significantly greater inflammation (11.2 vs. 7.4, p < 0.001), anorexia (10.9 vs. 6.8, p < 0.001), and poorer quality of life (6.2 vs. 4.7, p < 0.001). CONCLUSION: More than six in ten patients exhibited cachexia a rate substantially higher than global estimates highlighting its neglected burden in low- and middle-income country (LMIC) oncology settings. Early, structured assessment using the Mini-CASCO, along with the integration of multimodal nutritional and supportive interventions, is urgently needed to reduce preventable morbidity and mortality. Future multicenter, longitudinal studies are essential to guide evidence-based cachexia management in LMICs.
Sociodemographic and Clinical Predictors of Colonoscopy Utilization in Oman: A Call to Action within a Population-Based Cross-Sectional Study.
Al Zaabi A, Al Ghafri T, Al Habsi A … +2 more , Al Ziedi M, Al Sarmi A
Asian Pac J Cancer Prev · 2026 May · PMID 42169584 · Publisher ↗
OBJECTIVE: Colorectal cancer (CRC) is the second leading cause of cancer mortality in Oman, yet structured screening remains absent. Most cases are diagnosed at advanced stages, highlighting the need to understand predic...
OBJECTIVE: Colorectal cancer (CRC) is the second leading cause of cancer mortality in Oman, yet structured screening remains absent. Most cases are diagnosed at advanced stages, highlighting the need to understand predictors of colonoscopy uptake to inform national screening strategies. This study aimed to identify sociodemographic, perceptual, and healthcare-related factors associated with colonoscopy utilization-whether for screening or diagnostic purposes among Omani adults. METHODS: A nationwide, cross-sectional online survey was conducted using a structured questionnaire adapted from the Health Information National Trends Survey (HINTS) between March and August 2023. Recruitment was carried out using non-probability convenience sampling through digital platforms (Instagram, Facebook, Twitter, WhatsApp) and health networks. Data collected included sociodemographic factors, CRC risk perceptions, awareness, and healthcare interactions. Chi-square tests and multivariate regression analysis were used to identify predictors of colonoscopy uptake. RESULTS: Of the 1,060 respondents, only 137 participants (12.9%) reported ever undergoing colonoscopy; the majority (67.2%) did so due to symptoms rather than for screening. Uptake was significantly higher among men, participants aged >40 years, those who were married, and those who were employed (P < 0.05). Colonoscopy recipients were more likely to perceive themselves at higher risk for CRC and report frequent worry about the disease (P < 0.001). Multivariable analysis identified three strong predictors of colonoscopy uptake: 1. Clinical indication (presence of symptoms; OR 63.9, 95% CI: 45.6-89.1); 2. Physician recommendation (OR 9.5, 95% CI: 2.9-30.0); 3. Perception of test effectiveness [trend-level association (P = 0.054)]. CONCLUSION: Colonoscopy utilization in Oman remains low and is largely symptom-driven. Uptake was higher among men aged over 40 years, those who were married, and those who were employed, indicating that socioeconomic and life-stage factors influence engagement with colorectal health services. Physician recommendation emerged as the strongest determinant of colonoscopy uptake. These findings highlight the urgent need for a national CRC screening program that integrates the Fecal Immunochemical Test (FIT) within physician-led pathways to promote early detection and prevention.
Knowledge, Attitudes, and Practices Regarding Colorectal Cancer Screening Among Medical Residents: An Exploratory, Single-Center, Cross-Sectional Study from Egypt.
Abdeltawab K, Gebreal A, Akram Mohamed B … +13 more , Abukandil I, M Tawfik A, Ali Assy A, Gaber H, Hansen B, F Mohamed S, Ashraf Kassem R, Naga F, Ahmed L, Arafat W, Foaud M, Ebrahim E, Brand Bateman L
Asian Pac J Cancer Prev · 2026 May · PMID 42169583 · Publisher ↗
OBJECTIVE: Colorectal cancer (CRC) in Egypt has a high incidence of early-onset cases compared to Western countries. However, screening rates remain low, which may be attributed to a lack of physician awareness, as well...
OBJECTIVE: Colorectal cancer (CRC) in Egypt has a high incidence of early-onset cases compared to Western countries. However, screening rates remain low, which may be attributed to a lack of physician awareness, as well as structural and logistical limitations. This study evaluated medical residents' knowledge, attitudes, and practices regarding CRC screening, their perceptions of patient barriers, and their awareness of the "100 Million Healthy Lives" national screening initiative. METHODS: A self-administered, cross-sectional survey was conducted between September 10, 2023, and January 3, 2024, at Alexandria Main University Hospital (AMUH), Egypt. The survey was administered either face-to-face or online. We assessed the face, content, and structural validity of the questionnaire used. Descriptive statistics and bivariate analyses were performed, with associations evaluated using correlation and effect sizes. A significance level of p < 0.10 was adopted, given the exploratory nature of the study. RESULTS: The study included 70 medical residents at AMUH. The majority were female (78.6%), with a mean age of 27.97 ± 1.3 years and an average of 2.6 ± 1.2 years of clinical experience. Only 55.7% were aware of the "100 Million Healthy Lives" CRC screening program. Overall, 72.9% of participants demonstrated adequate knowledge, 66.7% showed a positive attitude, and 51.4% exhibited good practice. A total of 15.7% recommended screening for asymptomatic patients "often/always," compared to 61.4% for symptomatic patients. Financial constraints (64.3%) and low patient awareness (60%) were the most frequently cited barriers. Adequate knowledge was significantly associated with a positive attitude (80.8% vs. 19.2%; p = 0.078; Phi = 0.282). CONCLUSION: Despite generally adequate knowledge, attitudes and practices regarding CRC screening among residents remain suboptimal, hindered by limited awareness of national resources and persistent structural barriers. Strengthening provider education, improving access to screening tools, and expanding awareness of national initiatives are essential to enhance early CRC detection in Egypt.
Detection of Stages of Oral Cavity Lesions Using a Fluorescence Portable Device and Their Classification by Artificial Intelligence Tools.
Kumar P, Sah AN, Ganvir VY … +2 more , Pradhan A, Rathour R
Asian Pac J Cancer Prev · 2026 May · PMID 42169582 · Publisher ↗
OBJECTIVE: In the present study, we utilized a fluorescence-based portable device for the detection of oral lesions, as well as AI tools for the classification of the spectroscopic data. The portable device comprises opt...
OBJECTIVE: In the present study, we utilized a fluorescence-based portable device for the detection of oral lesions, as well as AI tools for the classification of the spectroscopic data. The portable device comprises optical components (lens, filters, and beam splitter), a laser, a spectrometer, and other accessories (laptop, fibers, etc.). Laser light (λexc= 405 nm), irradiated onto the lateral border of the tongue (LBT) of the oral cavity tissue, excites the fluorophores FAD (λemi ≈ 500 nm) and Porphyrin (λemi ≈ 634 nm) more significantly than the others. METHODS: Fluorescence spectra were recorded from three groups, i.e., OSCC, Dysplastic, and Normal, in the range of 450 to 750 nm. Among these groups, OSCC and Dysplastic patients exhibited a significant rise in porphyrin fluorescence. RESULT: Data analysis was accomplished using AI tools, namely Principal Component Analysis (PCA), K-Nearest Neighbors (KNN), Naïve Bayes, Linear and Quadratic Discriminant Analysis (LDA & QDA), and ROC analysis. Among these AI tools, the PCA-based QDA classifier was capable of discerning among the groups with slightly higher accuracy values (≈ 98%) than the other AI tools. CONCLUSION: Results reveal that the in-house-built fluorescence device, along with QDA, would be an elegant tool for the identification of oral lesions at the preliminary stage.
Oral Vitamin B12 versus Placebo for the Prevention of Chemotherapy-Induced Peripheral Neuropathy in Gynecological Cancer Patients: A Randomized, Double-Blind, Placebo-Controlled Trial.
Insin P, Chaiwongsa T, Prueksaritanond N
Asian Pac J Cancer Prev · 2026 May · PMID 42169581 · Publisher ↗
OBJECTIVE: To evaluate the efficacy of vitamin B12 (cyanocobalamin) in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with gynecological cancer who are receiving neurotoxic chemotherapy. MATERIA...
OBJECTIVE: To evaluate the efficacy of vitamin B12 (cyanocobalamin) in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with gynecological cancer who are receiving neurotoxic chemotherapy. MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled study enrolled gynecological cancer patients undergoing chemotherapy at Rajavithi Hospital between January and September 2021. Patients were assigned in a 1:1 ratio to receive either vitamin B12 (500 micrograms) or a placebo, administered as two oral tablets twice daily from the start of chemotherapy until four weeks after completing six cycles. Primary endpoints included the incidence of CIPN, measured by the Patient Neurotoxicity Questionnaire (PNQ) score, and quality of life, assessed by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) at four time points: (i) before the first chemotherapy cycle, (ii) before the third cycle, (iii) before the sixth cycle, and (iv) four weeks after completion. Safety was evaluated by monitoring vitamin B12-related adverse events. RESULTS: Forty patients were randomized into either the vitamin B12 group (n = 20) or the placebo group (n = 20). Chemotherapy regimens included taxane-based combinations with either carboplatin (87.5%) or cisplatin (12.5%). The incidence of CIPN (PNQ score ≥ 4) was significantly lower in the vitamin B12 group than in the placebo group (5% vs. 20%, p = 0.008; OR 0.21, 95% CI: 0.07-0.66). No significant differences in FACT/GOG-Ntx scores or adverse effects were observed (p > 0.05). CONCLUSION: This study highlights the significant effect of vitamin B12 in reducing the incidence of CIPN among gynecological cancer patients undergoing neurotoxic chemotherapy, with a favorable safety profile. Therefore, vitamin B12 may be recommended as a preventive measure for CIPN in this context.
A Novel Circulating microRNA Signature Panel as a Prognostic Biomarker for in Patients with Colorectal Cancer.
Bader El Din NG, Farouk S, El-Shenawy RM … +4 more , Moustafa RI, Elbrashy MM, Khairy AM, Ibrahim MK
Asian Pac J Cancer Prev · 2026 May · PMID 42169580 · Publisher ↗
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, necessitating the development of reliable prognostic biomarkers. Circulating microRNAs (miRs) have emerged as promising, non-i...
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, necessitating the development of reliable prognostic biomarkers. Circulating microRNAs (miRs) have emerged as promising, non-invasive biomarkers. This study was designed as a comprehensive evaluation, conducted in two independent stages, to identify circulating miRs capable of providing an accurate prognosis of CRC. SUBJECTS: The study included 225 subjects (150 Egyptian CRC patients and 75 healthy controls). We selected 25 miRs based on recent studies and our previous work and evaluated their expression in the Evaluation Group (65 subjects). The miRs showing significant differential expression were further confirmed in the Validation Group (160 subjects: 110 CRC patients and 50 controls). For all samples, miRNAs were extracted, and their concentration, integrity, and purity were measured using a NanoDrop, followed by cDNA synthesis and qRT-PCR analysis. RESULTS: The serum levels of eight miRNAs (Let-7c, miR-21, miR-26a, miR-26b, miR-126, miR-146a, miR-223, and miR-374) were significantly higher in CRC patients and were able to discriminate between CRC patients and healthy controls. The combined analysis of all eight miRNAs showed higher specificity, with an AUC of 0.92 and a specificity of 99.73% for CRC patients. The combination of five miRNAs, which exhibited a greater fold change in CRC patients, achieved an AUC of 0.97 and a specificity of 99.6%. In contrast, the combination of miR-21, miR-26a, and miR-26b demonstrated the highest AUC value of 0.974, with a specificity of 99.27%. Computational analysis revealed that CCND1 and TP53 function dually as efficacy and prognostic biomarkers for CRC, and that these roles are regulated by let-7a-5p. Collectively, the data indicate that this novel miRNA signature panel improves prognostic accuracy compared to individual miRNA analysis and may support enhanced patient screening and personalized treatment strategies in CRC. CONCLUSION: We established a circulating miRs signature panel for the first time to accurately predict the prognosis of Egyptian CRC patients.
Effectiveness of a Nurse-Led, WhatsApp-Based, Interactive Educational Intervention on Skin Cancer Knowledge and Sun Protection Behaviors: A Randomized, Controlled, Solomon Four-Group Study.
Bebiş H, Gül Z
Asian Pac J Cancer Prev · 2026 May · PMID 42169579 · Publisher ↗
OBJECTIVE: This study aimed to examine the effectiveness of an interactive educational intervention delivered via WhatsApp on improving community-dwelling women 's knowledge of skin cancer and sun protection behaviors. T...
OBJECTIVE: This study aimed to examine the effectiveness of an interactive educational intervention delivered via WhatsApp on improving community-dwelling women 's knowledge of skin cancer and sun protection behaviors. The study was conducted using a randomized, controlled experimental design based on the Solomon four-group model. METHODS: A randomized, controlled trial was conducted with 152 female participants assigned to four groups based on the Solomon design (two experimental, two control). One experimental and one control group were pre-tested, while the others were not. The experimental groups received structured, interactive education via WhatsApp for twelve weeks. Outcomes were measured using validated tools to assess skin cancer knowledge and sun protection behaviors. Data were analyzed with SPSS using descriptive and non-parametric tests. The Kolmogorov-Smirnov test indicated a non-normal distribution; therefore, Wilcoxon and Mann-Whitney U tests were applied. Statistical significance was set at p < 0.05. RESULTS: Post-test scores showed significant improvements in knowledge and sun protection behaviors in the intervention groups compared to controls (p<0.05). No significant pre-test effect was detected, supporting the intervention's internal validity. The findings indicate that WhatsApp-based interactive education effectively enhances health literacy and sun protection behaviors. CONCLUSION: The results demonstrate the efficacy of a randomized, controlled educational intervention using mobile technology to enhance knowledge and health-related behavior. This approach provides a low-cost, scalable method for community-based health promotion.
Breast Cancer Screening Patterns Following National Crises: Experience from a Lebanese Tertiary Center.
Abou Ltaif D, Hamideh R, Zeineddine F … +2 more , Khalil F, Mourad CJ
Asian Pac J Cancer Prev · 2026 May · PMID 42169578 · Publisher ↗
BACKGROUND: Lebanon's recent compounded crises-including economic collapse, the COVID-19 pandemic, and the Beirut Port explosion-have disrupted healthcare access, including breast cancer (BC) screening. This study assess...
BACKGROUND: Lebanon's recent compounded crises-including economic collapse, the COVID-19 pandemic, and the Beirut Port explosion-have disrupted healthcare access, including breast cancer (BC) screening. This study assesses adherence to BC screening after the onset of these crises and evaluates associated imaging outcomes. METHODS: This retrospective, single-center study included women aged ≥40 who underwent screening mammography (± ultrasound) at Lebanese Hospital Geitaoui (LHG) between October 2018 and October 2019, during the year that preceded the crisis. Exclusions included known BC, symptomatic imaging, and age <40. Data were extracted from the Picture Archiving and Communication System (PACS) and pathology records, including demographic, clinical, and imaging variables. Participants were stratified into two groups: Group Loyal (prior LHG screening) and Group New (no prior LHG screening). Imaging, histopathologic, and follow-up data (2019-2022) were analyzed. Non-adherent Group Loyal subjects were contacted via survey to explore screening barriers. RESULTS: Among 642 women screened, 461 met inclusion criteria (Group Loyal: 247; Group New: 214). Group Loyal had a higher family history of BC (31.6% vs. 21.5%, p = 0.005) and lower baseline BI-RADS scores. Overall, 191/461 (41.4%) underwent follow-up screening, with significantly higher adherence in Group Loyal (54.6%) than Group New (26.2%, p < 0.001). Among 44 Group Loyal non-adherent respondents, 47% cited crisis-related barriers. Nine women had increased BI-RADS over time; one was diagnosed with infiltrative ductal carcinoma. Baseline biopsies confirmed four malignancies, yielding a cancer detection rate of 8.6 per 1,000. CONCLUSION: Post-crisis BC screening adherence declined significantly, particularly among women without prior institutional screening. Continued follow-up was associated with more stable BI-RADS outcomes and earlier-stage cancer detection. Sustained public health strategies are needed to mitigate the impact of national emergencies on cancer prevention.
Optimizing Radiotherapy for Left Breast Cancer: A Dosimetric Evaluation of Hypofractionated vs. Conventional VMAT with DIBH.
Moussawi N, Balaa HE, Kanawati WE
Asian Pac J Cancer Prev · 2026 May · PMID 42169577 · Publisher ↗
PURPOSE: This study aimed to determine whether the hypofractionated regimen offers dosimetric and radiobiological benefits compared to a conventional regimen delivered with deep inspiration breath-hold (DIBH) for left br...
PURPOSE: This study aimed to determine whether the hypofractionated regimen offers dosimetric and radiobiological benefits compared to a conventional regimen delivered with deep inspiration breath-hold (DIBH) for left breast cancer patients following breast-conserving surgery using the VMAT technique. The primary objective was to assess whether the hypofractionated regimen provides equivalent target coverage and improved sparing of organs at risk (OARs). METHODS: Twenty-four patients with histologically confirmed left-sided breast cancer, aged between 42 and 68 years, were included and divided into two fractionation protocols: 12 received a conventional regimen (50 Gy in 25 fractions), and 12 received a hypofractionated regimen (40 Gy in 15 fractions). Dosimetric parameters including clinical target volume (CTV) coverage, homogeneity index (HI), conformity index (CI), number of monitor units (MUs), and dose to critical structures were compared between the two regimens. The biological impact of the different fractionation schemes was assessed by calculating the biological effective dose (BED) and the equivalent dose in 2 Gy fractions (EQD2). For statistical analysis, an independent-sample t-test was used (P < 0.05). RESULTS: Both treatment approaches provided excellent target coverage, with no significant differences observed in CI. The conventional VMAT plan demonstrated better dose homogeneity (HI = 0.165 ± 0.038) compared to the hypofractionated plan (HI = 0.304 ± 0.090; p < 0.001). The hypofractionated approach showed a tendency for increased sparing of organs at risk, notably a 28.7% reduction in mean heart dose (6.24 Gy vs. 8.91 Gy), a lower EQD₂ (4.27 Gy vs. 5.99 Gy), and a significantly reduced dose to the contralateral lung (5.62 Gy vs. 7.32 Gy; p = 0.029). For the contralateral breast, no statistically significant difference was observed (p > 0.05). CONCLUSION: Research indicates that hypofractionated VMAT with DIBH offers potential dosimetric advantages over the conventional regimen, most notably by reducing radiation exposure to the heart and contralateral lung.
Diagnostic Accuracy and Reproducibility of ChatGPT-4o for HER2 Immunohistochemistry Scoring in Equivocal Breast Cancer Cases.
Charoenlap C, Arunsawat P, Chienwichai K … +2 more , Prateepchaiboon T, Chang A
Asian Pac J Cancer Prev · 2026 May · PMID 42169576 · Publisher ↗
BACKGROUND: HER2 immunohistochemistry (IHC) plays a central role in therapeutic decision-making for breast cancer. However, interpretation of equivocal (2+) IHC results remains challenging and is subject to interobserver...
BACKGROUND: HER2 immunohistochemistry (IHC) plays a central role in therapeutic decision-making for breast cancer. However, interpretation of equivocal (2+) IHC results remains challenging and is subject to interobserver variability, necessitating reflex in situ hybridization testing. This study evaluated the diagnostic performance and reproducibility of ChatGPT-4o, a general-purpose large language model, in scoring HER2 IHC in breast cancer cases initially classified as IHC 2+. METHODS: We retrospectively analyzed 81 formalin-fixed, paraffin-embedded invasive carcinoma of no special type (NST) cases with prior HER2 IHC 2+ scores and corresponding dual in situ hybridization (DISH) results. Five high-power field images per case were independently analyzed by ChatGPT-4o across three sessions, using a standardized prompt aligned with the ASCO/CAP 2023 guidelines. Cases remaining equivocal after AI-assisted interpretation were excluded from diagnostic performance calculations. HER2 DISH served as the reference standard. RESULTS: Fourteen cases (17.3%) remained equivocal following AI interpretation. Among the 67 reclassified cases, ChatGPT-4o demonstrated an overall diagnostic accuracy of 79% (95% CI: 67-88%), a sensitivity of 30%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 77%. Intra-model reproducibility was good (intraclass correlation coefficient = 0.78), whereas agreement with HER2 DISH was fair (Cohen's κ = 0.375). Misclassification predominantly involved false-negative interpretations among HER2-positive cases. CONCLUSION: ChatGPT-4o demonstrated high specificity and reproducibility for identifying HER2 IHC 3+ cases but showed limited sensitivity and only fair concordance with HER2 DISH. These findings indicate that, in its current general-purpose form, ChatGPT-4o is not suitable for independent HER2 assessment and may serve, at best, as an exploratory adjunct to pathologist interpretation.
Inhibitory Effect of Melatonin on the Proliferation of Breast Cancer Cells MDA-MB-468 by Antioxidants Superoxide Dismutase and Glutathione Peroxidase.
Bevita B, Rahmah NA, Tunru IS … +2 more , Harliansyah H, Eliana F
Asian Pac J Cancer Prev · 2026 May · PMID 42169575 · Publisher ↗
OBJECTIVE: The purpose of this study was to determine the inhibitory effect of melatonin on breast cancer cells MDA-MB-468 by the antioxidant superoxide dismutase and glutathione peroxidase. METHODS: This research was an...
OBJECTIVE: The purpose of this study was to determine the inhibitory effect of melatonin on breast cancer cells MDA-MB-468 by the antioxidant superoxide dismutase and glutathione peroxidase. METHODS: This research was an in-vitro experimental study using MDA-MB-468 breast cancer cells from ATCC, treated with melatonin at concentrations of 1.5 mM, 2 mM, and 2.5 mM, with a 24-hour incubation. Cytotoxicity was examined using WST-8. SOD and GPx levels were measured using ELISA. Data analysis was performed using SPSS 27.0 with a one-way ANOVA parametric test, followed by post-hoc LSD analysis. RESULT: The IC₅₀ of melatonin in MDA-MB-468 breast cancer cells was 1.9 mM. There was a significant increase in SOD antioxidant levels (p = 0.000) in the melatonin concentration groups of 1.5 mM, 2 mM, and 2.5 mM. An increase in GPx antioxidant levels was also observed at the same concentrations (1.5 mM, 2 mM, and 2.5 mM), but it was not statistically significant (p > 0.05). CONCLUSION: Melatonin at concentrations of 1.5 mM, 2 mM, and 2.5 mM acts as an antiproliferative agent in MDA-MB-468 cells by significantly increasing the antioxidant activity of SOD and increasing GPx activity, although not significantly.
Characteristics of Lymph Node Metastasis in Esophageal Squamous-Cell Carcinoma Undergoing Upfront Minimally Invasive Esophagectomy: A Prospective Surgical Cohort Study.
Pham BV, Nguyen DD, Thai AD
Asian Pac J Cancer Prev · 2026 May · PMID 42169574 · Publisher ↗
INTRODUCTION: This study aims to evaluate the characteristics of lymph node metastasis (LNM) in patients with early esophageal squamous cell carcinoma (ESCC) undergoing upfront minimally invasive esophagectomy and extend...
INTRODUCTION: This study aims to evaluate the characteristics of lymph node metastasis (LNM) in patients with early esophageal squamous cell carcinoma (ESCC) undergoing upfront minimally invasive esophagectomy and extended two-field lymph node dissection. PATIENTS AND METHODS: This prospective study was conducted from October 2022 to May 2024. All patients with early esophageal squamous cell carcinoma (ESCC) who underwent minimally invasive esophagectomy and extended two-field lymph node dissection were selected for this study. Postoperative lymph nodes were divided into the upper thoracic, middle thoracic, lower thoracic, and abdominal lymph node groups. Univariate and multivariable logistic regression analyses were performed to identify risk factors associated with lymph node metastasis (LNM). Disease-free survival (DFS) was assessed using the Kaplan-Meier method. RESULTS: The overall rate of LNM was 30%, with increasing incidence by pathological T stage: 14.3% in pT1a, 32.1% in pT1b, and 50% in pT2. LNM was most frequently observed in upper thoracic and abdominal lymph node groups. Univariate analysis identified poor differentiation, lymphovascular/perineural invasion (LVI/PNI), tumor size >2 cm, and increased esophageal wall thickness on endoscopic ultrasound as significant risk factors. However, in multivariable analysis, only tumor size >2 cm remained independently associated with LNM (OR 5.47; 95% CI: 1.05-32.65; p = 0.04). Patients without LNM had significantly longer DFS compared to those with LNM (22.4 vs. 14.5 months; p = 0.003). CONCLUSION: Lymph node metastasis can occur even in early-stage esophageal squamous cell carcinoma. Poor differentiation, lymphovascular/perineural invasion, tumor size >2 cm, and esophageal wall thickness on endoscopic ultrasound were identified as independent prognostic factors for lymph node metastasis.
Evaluating Cancer Patients' Knowledge of Chemotherapy: Identifying Communication Gaps and Medication Errors in General Hospital of Thamar City.
Khalil AH, Al-Akhali K, Sakran F … +1 more , Al-Jamei S
Asian Pac J Cancer Prev · 2026 May · PMID 42169573 · Publisher ↗
OBJECTIVE: In Yemen, there is a notable lack of data regarding cancer patients' knowledge of chemotherapy and the communication gaps that may contribute to medication errors. To our knowledge, this is the first study to...
OBJECTIVE: In Yemen, there is a notable lack of data regarding cancer patients' knowledge of chemotherapy and the communication gaps that may contribute to medication errors. To our knowledge, this is the first study to assess cancer patients' understanding of chemotherapy in Thamar City, aiming to evaluate their knowledge, communication practices, and the impact of these factors on treatment-related errors. METHODS: A cross-sectional study was conducted between December 2024 and March 2025 at the General Hospital in Thamar City. Adult cancer patients who were either undergoing chemotherapy or receiving follow-up care were included. Data were collected through structured, face-to-face interviews conducted by trained clinical pharmacists using a validated, culturally adapted questionnaire. The survey covered socio-demographic characteristics, chemotherapy knowledge, adherence practices, communication behaviors, preferred information sources, and experiences with medication errors. Data were analyzed using SPSS version 28. RESULTS: Of the 209 cancer patients surveyed, the majority were female (65.1%), aged over 50 (58.4%), and unemployed (90.0%). While 87.1% demonstrated good knowledge about chemotherapy, only 9.1% could name their medications, and misunderstandings about managing side effects remained. Despite high treatment adherence, communication challenges were prevalent-71.8% found medical terminology difficult to understand, and 24.4% experienced medication errors. Knowledge levels were significantly associated with gender, education, and employment status (p < 0.05). CONCLUSION: While most cancer patients demonstrated good overall knowledge about chemotherapy, significant challenges persist particularly in medication-specific awareness and side effect management. Communication gaps, including unclear explanations and limited patient engagement, were associated with medication errors. Enhancing communication practices and delivering patient-centered education can play a crucial role in reducing errors and supporting optimal treatment outcomes.
Indonesian Midwives' Readiness to Upscale the Secondary Prevention of Cervical Cancer within Primary Health Clinics: A Qualitative Study of Midwives Across Three Provinces.
Wilopo SA, Harisaputra RK, Hadati RS … +5 more , Mustikaningtyas M, Setyawan A, Eka Putri IGAP, Frans SO, Bennett LR
Asian Pac J Cancer Prev · 2026 May · PMID 42169572 · Publisher ↗
OBJECTIVE: This article analyzes the readiness of Indonesian midwives for the rapid scale-up of secondary prevention of cervical cancer, in line with Indonesia's National Plan for Cervical Cancer Elimination (2023-2030)....
OBJECTIVE: This article analyzes the readiness of Indonesian midwives for the rapid scale-up of secondary prevention of cervical cancer, in line with Indonesia's National Plan for Cervical Cancer Elimination (2023-2030). METHODS: Data were collected via a mixed-methods study conducted in 2024. We analyzed a subset of qualitative data from semi-structured interviews with 24 midwives, sampled from 13 primary health clinics (PHCs) in Kupang City, Purworejo Regency, and Palu City. Thematic analysis revealed four key themes relevant to determining midwives' readiness: knowledge; technical training and confidence in performing visual inspection with acetic acid (VIA); communication skills; and motivation. RESULT: Midwives' knowledge of causation and risk factors was high, underpinning their high perception of cervical cancer risk and subsequent strong motivation to provide screening. However, inconsistent knowledge existed regarding screening targets, intervals, and clinical indications for screening. Training coverage was low, with only half of the midwives having received training. Multiple midwives viewed their training as inadequate for establishing competency in the interpretation of VIA results, negatively impacting their motivation. Midwives reported high confidence in communication skills but noted a lack of health communication materials for patient education and raised concerns over the suitability of PHC information systems for enabling follow-up. CONCLUSION: The proportion of Indonesian midwives receiving training in cervical screening and provider-administered HPV DNA testing needs to increase significantly. Training in cervical cancer prevention should receive greater attention in the core curriculum for midwifery accreditation. The content should be more comprehensive, addressing knowledge gaps, low confidence in interpreting VIA results, and the transition to HPV DNA testing. A train-the-trainer program for senior midwives to enable high-quality peer education would be a strategic investment. Critical system-level changes such as adequate budgets, provision of health communication materials, and improvements to the design and use of health information systems are also required.
Time to Treatment Initiation Analysis in Patients with Localized Extremity Non-Small Round Cell Sarcoma.
Takahashi S, Matsuoka M, Onodera T … +6 more , Iwasaki K, Sato D, Ebata T, Hosokawa Y, Kondo E, Iwasaki N
Asian Pac J Cancer Prev · 2026 May · PMID 42169571 · Publisher ↗
INTRODUCTION: Time-to-treatment initiation (TTI) is an increasingly recognized factor influencing survival in cancer care. Although prolonged TTI has been associated with worse survival in various malignancies, its impac...
INTRODUCTION: Time-to-treatment initiation (TTI) is an increasingly recognized factor influencing survival in cancer care. Although prolonged TTI has been associated with worse survival in various malignancies, its impact on patients with localized extremity non-small-round-cell sarcoma (NSRCS) remains unclear. METHODS: Data were extracted from the SEER database, encompassing 11,380 patients diagnosed with localized extremity NSRCS from 2000 to 2019. Patients were categorized into three cohorts based on TTI: less than 1 month, less than 2 months, and less than 4 months. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association between TTI and overall survival (OS), adjusting for variables including age, sex, ethnicity, socioeconomic status, tumor location, AJCC stage, and treatment modalities. RESULTS: Multivariate analysis revealed that overall survival (OS) in the TTI delay group was nearly equivalent to that of patients with a TTI of less than 1 month (HR = 1.01; 95% confidence interval [CI], 0.97-1.10). In contrast, in cohorts 2 and 3, the TTI delay group demonstrated worse OS (cohort 2: HR = 1.10; 95% CI, 1.02-1.20; cohort 3: HR = 1.30; 95% CI, 1.10-1.70). Subgroup analysis indicated that adjuvant therapy, including chemotherapy and radiation therapy, may potentially mitigate the decreased survival associated with TTI delay. DISCUSSION: This study highlights the detrimental impact of delayed TTI on survival in patients with localized extremity NSRCS. Furthermore, it suggests that adjuvant therapy may help mitigate the adverse effects associated with TTI delay.
Investigating the Impact of Curcumin on the Methylation of DNMT1, CDH1, SMG1, and WT1 Genes in the MIAPaCa2 Cell Line Using High-Resolution Melting Analysis Compared to Methylation-Specific PCR.
Mousavi S, Azad M, Karami Chermahini N … +1 more , Momeni A
Asian Pac J Cancer Prev · 2026 May · PMID 42169570 · Publisher ↗
BACKGROUND: Curcumin, a natural compound extracted from turmeric, has shown potential in modulating epigenetic mechanisms, including DNA methylation, which is critical in gene regulation and cancer progression. This stud...
BACKGROUND: Curcumin, a natural compound extracted from turmeric, has shown potential in modulating epigenetic mechanisms, including DNA methylation, which is critical in gene regulation and cancer progression. This study investigates the impact of curcumin on the methylation of DNMT1, CDH1, SMG1, and WT1 genes in the MIAPaCa2 pancreatic cancer cell line. METHODS: MIAPaCa-2 pancreatic cancer cells were cultured and treated with varying concentrations of curcumin (2.5, 10, 20, 40, and 80 μM) for 24, 48, and 72 hours. DNA was extracted and subjected to bisulfite conversion to analyze methylation. The methylation status of DNMT1, CDH1, SMG1, and WT1 promoters was assessed using methylation-specific PCR (MSP) and methylation-sensitive high-resolution melting (MS-HRM) analysis. MSP involved amplifying methylated and unmethylated alleles, while MS-HRM provided quantitative methylation analysis. Standard curves and controls were used to ensure accuracy and validate the results. RESULTS: MSP analysis revealed that DNMT1, initially hemi-methylated in control cells, exhibited decreased methylation levels across all concentrations of curcumin (2.5 to 80 μM), whereas CDH1 remained consistently unmethylated before and after treatment. MS-HRM employed a standard curve method to quantify methylation, showing that DNMT1 methylation decreased from approximately 50% in control cells to about 20% after exposure to 80 μM curcumin. Meanwhile, CDH1 maintained its unmethylated state throughout. The methylation status of SMG1 was inconclusive in this study, while WT1 initially showed 70% unmethylation, reducing after curcumin treatment. CONCLUSION: These findings underscore the differential effects of curcumin on DNA methylation patterns in pancreatic cancer-related genes, highlighting its potential as a modulator of epigenetic mechanisms in cancer therapy.
Hybrid Modelling of Pulmonary Cancer Risk Prediction Using Classical Algorithms to Modern Machine Learning Techniques.
Devi S, Yadav R, Mathivanan JR … +2 more , Joshi S, Jogdeo B
Asian Pac J Cancer Prev · 2026 May · PMID 42169569 · Publisher ↗
BACKGROUND: Despite significant advancements in oncology, early diagnosis of pulmonary cancer poses a clinical challenge, thus making it a leading cause of cancer-related mortality and a focal point for the development o...
BACKGROUND: Despite significant advancements in oncology, early diagnosis of pulmonary cancer poses a clinical challenge, thus making it a leading cause of cancer-related mortality and a focal point for the development of data-driven prediction models. The objective of the study was to predict pulmonary cancer using hybrid machine learning models. METHODS: This study presents a comprehensive review of machine learning (ML) algorithms to facilitate early prediction of pulmonary carcinoma using electronic medical records (EMRs) data. The dataset comprising 1000 patient records and 25 predictor variables, was subjected to rigorous pre-processing, including label correction, multicollinearity assessment, and dimensionality reduction. Eighteen statistically significant features, encompassing symptoms, lifestyle factors, and environmental exposures were identified through variance inflation factor (VIF) analysis and chi-square testing. Multiple ML models, including Support Vector Machine (SVM), Random Forest (RF), Logistic Regression (LR), and Deep Learning (DL) classifiers, were trained and evaluated using precision, recall, F1 score, specificity, and AUC metrics. RESULTS: The chi-square test revealed that age (χ²=44.187, p<0.001), passive smoking (χ²=752.960, p<0.001), obesity (χ²=712.088, p<0.001), smoking (χ²=671.006, p<0.001), and symptoms like coughing blood (χ²=818.669, p<0.001) were significantly associated with pulmonary Carcinoma. The performance metrics indicate that most basic and ensemble models, including DT, SVM, LR, KNN, AdaBoost, and RF, achieved perfect scores (accuracy, precision, recall, F1, AUC = 1.000), demonstrating optimal classification. DL and SVM Bagging showed 97% accuracy, while NN and MLP performed well with accuracy above 96%, though slightly less than the ensemble models. CONCLUSION: These findings accentuate the potential of ML, especially SVM, for early prediction of pulmonary carcinoma using structured EMR data. These findings support the integration of ML-based tools into clinical workflows, supporting data-driven, personalized cancer screening and decision-making in health care.
The Dual Role of ABCG2 Copy Number Variation: A Protective Factor in Cancer Risk, and a Prognostic Marker for Survival in Thai Breast Cancer.
Sophonnithiprasert T, Pongtheerat T, Saelee P
Asian Pac J Cancer Prev · 2026 May · PMID 42169568 · Publisher ↗
OBJECTIVE: This study aimed to investigate CNVs of MDR1 and ABCG2 and their associations with clinicopathological characteristics and survival outcomes in Thai breast cancer patients. METHODS: Genomic DNA from 126 breast...
OBJECTIVE: This study aimed to investigate CNVs of MDR1 and ABCG2 and their associations with clinicopathological characteristics and survival outcomes in Thai breast cancer patients. METHODS: Genomic DNA from 126 breast cancer patients and 162 healthy controls was analyzed. CNVs were determined using real-time PCR and the ∆Ct method. Associations with clinicopathological parameters were assessed using the Chi-square test. Kaplan-Meier survival analysis and the log-rank test, were used to evaluate overall survival. RESULT: The ABCG2 >1/1 genotype was significantly more common in controls than in patients (OR = 0.32, 95% CI: 0.19-0.525, P < 0.001), suggesting a protective role. MDR1 CNVs showed no significant difference between groups. Among breast cancer patients, the MDR1 >1/1 genotype was associated with larger tumor size (>3 cm) and distant metastasis (P = 0.037, 0.008), while the ABCG2 >1/1 genotype was correlated with progesterone receptor positivity and distant metastasis (P = 0.005, 0.046). Survival analysis revealed that ABCG2 >1/1 was associated with shorter overall survival (P = 0.013), whereas MDR1 CNVs showed no significant association with survival (P = 0.127). CONCLUSION: These findings suggest that copy number variations (CNVs) in ABCG2 may serve as both protective and prognostic markers in breast cancer, while MDR1 CNVs may be associated with tumor aggressiveness. Both genes hold potential as biomarkers for breast cancer pathogenesis, clinicopathological characteristics, and survival outcomes in Thai breast cancer patients.
Oral Cancer Diagnosis Using an Optimized InceptionV3 Model Powered by the Aquila Metaheuristic Algorithm.
Urundai Meeran SB, S K, B C
Asian Pac J Cancer Prev · 2026 May · PMID 42169567 · Publisher ↗
OBJECTIVE: Early and accurate detection of oral cancer plays a pivotal role in improving patient prognosis and survival rates. Deep learning (DL) models have shown promise in automating medical image classification; howe...
OBJECTIVE: Early and accurate detection of oral cancer plays a pivotal role in improving patient prognosis and survival rates. Deep learning (DL) models have shown promise in automating medical image classification; however, performance optimization remains a challenge due to complex network configurations and hyperparameter dependencies. This study introduces an enhanced diagnostic framework combining the InceptionV3 convolutional neural network with the Aquila Optimizer (AO), a nature-inspired metaheuristic algorithm, to achieve superior classification accuracy in identifying oral cancer lesions. METHODS: A standardized dataset of labeled oral lesion images, including both benign and malignant cases captured via mobile and intraoral cameras, was used for training. The InceptionV3 model, initially pre-trained, was fine-tuned for binary classification tasks. AO was employed to optimize the hyperparameters by defining a search space and iteratively improving model performance through accuracy maximization and loss minimization strategies. The optimized model was compared against leading architectures such as AlexNet, MobileNet, Xception, ResNet-50, and the original InceptionV3, using comprehensive performance indicators like accuracy, precision, recall, F1-score, AUC-ROC, specificity, log loss, and Matthews Correlation Coefficient (MCC). RESULT: The proposed AO-InceptionV3 model consistently outperformed the other DL architectures across all metrics. It achieved a classification accuracy of 97.80%, precision of 97.81%, recall of 97.79%, and an MCC of 0.956, while maintaining a low log loss of 0.0735 and an AUC-ROC of 99.81%. Visual analyses, including ROC curves and 3D plots, reinforced the robustness and reliability of the model in distinguishing between benign and malignant lesions with minimal inference time. CONCLUSION: The integration of the Aquila Optimizer into the InceptionV3 architecture significantly improves the diagnostic performance of DL models for oral cancer detection. The proposed framework demonstrates excellent potential for real-time clinical deployment, offering high accuracy, efficiency, and reliability, and sets a benchmark for future AI-driven cancer diagnostic systems.
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