Asian Pacific Journal of Cancer Prevention最新文献

{"title":"Cost Barriers and Health Literacy on Cholangiocarcinoma Rescreening Intention in Khon Kaen, Thailand: A Causal Mediation Analysis.","authors":"Surachai Phimha, Jitlada Roobsung, Nopparat Senahad, Natnapa Heebkaew Padchasuwan, Prachak Bouphan, Prapassara Sirikarn","doi":"10.31557/APJCP.2026.27.8.3055","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.3055","url":null,"abstract":"<p><strong>Background: </strong>Cholangiocarcinoma (CCA) is a major public health issue in Southeast Asia and has the highest global incidence in Northeast Thailand. Thailand has implemented cholangiocarcinoma screening; nonetheless, public access to screening remains limited. This study aims to examine the impact of cost barriers on cholangiocarcinoma rescreening intention with a mediating effect of health literacy.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with participants who received cholangiocarcinoma screening in four community hospitals between November and December 2024. The association between costs, health literacy, and rescreening intention was investigated through causal mediation analysis.</p><p><strong>Results: </strong>This study examined 171 participants; most participants were female (57.9%). Participants' rescreening intention was 71.9% (95%CI: 65.2% to 78.7%). Males intend to rescreen 75% more than females (69.7%). When quantifying the effect of costs channeled through health literacy to rescreening intention, 1) direct non-medical costs in the natural indirect effect showed statistically significant results at the lower to moderate cost levels. The results showed a statistically significant negative indirect effect at 300 THB (probability difference = -0.118, 95% CI: -0.182 to -0.055) and 500 THB (probability difference -0.135, 95% CI: -0.244 to -0.027). 2) Indirect costs in the natural indirect effect showed statistically significant results at the lowest levels. A statistically significant negative indirect effect was observed at 300 THB (probability difference -0.059, 95% CI: -0.095 to -0.023).</p><p><strong>Conclusion: </strong>Using health literacy as a mediator, direct non-medical costs and indirect cost expenses affect cholangiocarcinoma screening decisions. Expanding screening to communities, minimizing costs, and increasing health literacy on cholangiocarcinoma may increase screening.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"3055-3062"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education to Implementation: A Mixed-Methods Study of Tobacco Cessation Counselling Practices Among Recently Graduated Dentists in India.","authors":"Sreeja Gummalla, Gaurav Mishra, Sumit Kumar, Vinay Kumar Gupta, Nishita Kankane, Deepak S, Sifpsa Diwakar, Aayushi Aggarwal, Aditya Agarwal","doi":"10.31557/APJCP.2026.27.8.2989","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.2989","url":null,"abstract":"<p><strong>Background: </strong>India bears a high burden of tobacco-related oral disease. The Dental Council of India (DCI) has recently mandated the establishment of Tobacco Cessation Centres (TCCs) in dental colleges and released operating guidelines to standardise their functioning. Evidence on how recently graduated dental practitioners engage with TCC-related competencies in actual practice remains limited.</p><p><strong>Methods: </strong>A sequential explanatory mixed-methods study was conducted among BDS graduates (2018 onwards) currently in clinical practice in Uttar Pradesh, India. A cross-sectional online survey (n = 264) assessed TCC practices, attitudes, perceived barriers, and support needs. A composite Attitude-and-Practice Score was generated, and univariate linear regression examined associations with participant characteristics. In the qualitative phase, eight semi-structured in-depth interviews were analyzed using reflexive thematic analysis and interpreted through the COM-B (Capability-Opportunity-Motivation-Behaviour) model.</p><p><strong>Results: </strong>Although 83.7% of respondents reported undergraduate posting in a TCC centre, only 37.1% had received additional cessation-related training and 14.8% reported personal tobacco use. Routine enquiry and brief advice were common, but pharmacotherapy use, structured follow-up and formal referral were inconsistent. The mean Attitude-and-Practice Score was approximately 74%, with personal tobacco use emerging as the only significant negative predictor. Qualitative analysis identified four interacting themes: procedure-driven clinical identity, system-level constraints, patient-related, challenges and training-related capability gaps. These collectively reflected limited capability, constrained opportunity, and fragile motivation within COM-B.</p><p><strong>Conclusion: </strong>Undergraduate training alone has not ensured routine tobacco cessation counselling among recently graduated dentists. Bridging the gap between training and practice requires competency-based education, supportive systems, and a shift in dentist's perceptions to value preventive counselling as an integral part of clinical care. Strengthening these elements is essential for enhancing the role of dental professionals in oral cancer prevention.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"2989-2997"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Lymphovascular Space Invasion and Its Quantification in Endometrial Carcinoma in Northern Thailand.","authors":"Tip Pongsuvareeyakul, Panruethai Wongkampan, Phitchayut Phinyo, Noraworn Jirattikanwong, Chalong Cheewakriangkrai, Kornkanok Sukpan, Jongkolnee Settakorn, Sumalee Siriaunkgul, Surapan Khunamornpong","doi":"10.31557/APJCP.2026.27.8.3021","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.3021","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic performance of lymphovascular space invasion (LVSI) quantification in patients with endometrial carcinoma (EC).</p><p><strong>Methods: </strong>Clinical and pathological data from EC patients who underwent primary surgical treatment between January 2008 and December 2020 were analyzed. Five-year progression-free survival (PFS) and overall survival (OS) were compared across LVSI categories (absent, focal, substantial) using previously proposed thresholds for substantial LVSI (≥3, ≥4, or ≥5 involved spaces).</p><p><strong>Results: </strong>A total of 843 patients were included (mean follow-up, 9.5 years). All three thresholds (3, 4, or 5 spaces) yielded significant differences in PFS and OS across LVSI categories (absent, focal, and substantial; p < 0.001). After adjustment for established clinicopathologic prognostic factors, substantial LVSI remained independently associated with worse PFS and OS compared with absent LVSI (PFS: p = 0.005-0.007; OS: p = 0.002-0.006). Focal LVSI, defined as <4 or <5 spaces, showed a trend toward lower adjusted PFS compared with absent LVSI, although the difference did not reach statistical significance (p = 0.052-0.059). For OS, focal LVSI showed worse adjusted outcomes than absent LVSI when using the <5-space definition (p = 0.024). No significant adjusted differences in PFS or OS were observed between focal and substantial LVSI.</p><p><strong>Conclusion: </strong>Substantial LVSI (at least 3 involved spaces) is strongly associated with poorer prognosis in EC. Additionally, focal LVSI may be linked to decreased survival. These findings underscore the prognostic value of LVSI quantification and support further investigation into the clinical relevance of focal LVSI.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"3021-3027"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, and Clinical Practice of HPV Vaccination and Cervical Cancer Screening: A National Survey of OB-GYN Practitioners in Thailand.","authors":"Supakorn Pitakkarnkul, Uraiwan Khomphaiboonkij, Siriwan Tangjitgamol, Jatupol Srisomboon, Kittipat Charoenkwan, Chuenkamol Charakorn, Marut Yanaranop, Saranya Chanpanitkitchot, Natacha Phoolcharoen, - Thai Gynecologic Cancer Society Research Group","doi":"10.31557/APJCP.2026.27.8.3097","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.3097","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate knowledge, attitudes, and practices regarding human papillomavirus (HPV) vaccination and cervical cancer screening among obstetricians and gynecologists (OB-GYNs), residents, and gynecologic oncology fellows in Thailand.</p><p><strong>Methods: </strong>A nationwide cross-sectional survey (September 2024-June 2025) was conducted using a content-validated questionnaire. Domains (numbers of items) included knowledge about HPV (7), HPV vaccination (13), and screening (10), attitudes (14), and practices (6). Composite 'good' knowledge thresholds were pre-specified (HPV 5-7/7; screening 7-10/10; vaccination 10-13/13; total 22-30/30). Associations with good total knowledge were examined.</p><p><strong>Results: </strong>Of 227 respondents, 74.5% were female, and 83.7% worked in government hospitals. Overall, good knowledge was observed in 55.5%. A wide range of good knowledge was found in each domain: HPV (71.0%), vaccination (41.8%), and screening (87.7%). Frequent misconceptions (incorrect answers) were about the benefits of HPV vaccination in HPV infection clearance (52.8%) and the necessity for HPV testing in men with infected partners (35.7%). The majority agreed or strongly agreed that self-collected and healthcare-collected HPV tests were equally effective (66.5%). In multivariable analysis, years of practice was the only independent factor associated with overall good knowledge (adjusted odds ratio 1.08, 95% CI 1.02-1.14; p = 0.010).</p><p><strong>Conclusion: </strong>Thai OB-GYN practitioners showed good overall knowledge, especially those with more experience, and positive attitudes toward cervical screening. However, a knowledge gap in HPV vaccination was observed, highlighting the need for continuing education on vaccination.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"3097-3103"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Analysis of the STING1-IRF1 Signaling Pathway and Genomic Alterations in Breast Cancer: Implications for Immune Evasion and Patient Prognosis.","authors":"Isra Alhamadani, Mohammad Alzeyadi","doi":"10.31557/APJCP.2026.27.8.3063","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.3063","url":null,"abstract":"<p><strong>Background: </strong>The STING1-IRF1 axis plays a crucial role in sensing innate immunity within the tumor microenvironment. However, the genomic landscape of this axis and its clinical implications in breast cancer still require a deeper understanding, more comprehensive explanation, and greater detail.</p><p><strong>Methods: </strong>This study adopted a multi-cohort integrated analytical approach. Gene expression and clinical survival data were retrieved from the GEO database under the serial number GSE42568, while somatic mutation data were obtained from the TCGA-BRCA database. A comprehensive bioinformatics analysis was performed, including survival analysis (Kaplan-Meier), differential gene expression analysis (volcano plots), and genomic mutation characterization (Oncoprint), using the R programming language and suitable packages.</p><p><strong>Results: </strong>The results in cohort GSE42568 showed high expression of the STING1-IRF1 axis it is associated with a positive trend towards improved survival rates. Transcriptional analysis also revealed a decrease in the expression of HLA-B and HLA-C genes, immunotropic chemokines (CXCL9, CXCL 10) in tumors with low STING1 expression this suggests a \"cold\" immune pattern. Conversely parallel genomic analysis of the TCGA cohort has identified high frequency of mutations in the MAP3K1 (56%) and PIK3CA (53%), TP53 (46%) genes in addition to mutations in STING1which was directly linked to a disruption in tumor signaling pathways particularly in cell cycle pathways and TP53 and PIK3CA this contributes to strengthening immune escape mechanisms.</p><p><strong>Conclusion: </strong>Our results indicate that the STING1-IRF1 axis is a prognostic biomarker for predicting the course of the disease, targeting this pathway may help overcome immune evasion resulting from specific genomic changes in breast cancer patients.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"3063-3071"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Low-Dose Bevacizumab Regimens in High-Grade Gliomas: A Policy Brief for Resource-Limited Settings.","authors":"Yegane Parivar, Danial Fazilat-Panah, James S Welsh, Babak Peyro Shabany, Seyed Alireza Javadinia, Elham Khakshour","doi":"10.31557/APJCP.2026.27.8.2753","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.2753","url":null,"abstract":"","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"2753-2754"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNA-21 (miR-21), Mutant Tumor Protein p53, and Matrix Metalloproteinase-9 (MMP-9) as Risk Markers for High-Grade Tumor Budding (HGTB) in Cervical Carcinoma: A Case-Control Study in a Balinese Population.","authors":"Ni Wayan Armerinayanti, Desak Putu Oki Lestari, I Gede Wikania Wira Wiguna","doi":"10.31557/APJCP.2026.27.8.2931","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.2931","url":null,"abstract":"<p><strong>Objective: </strong>High-grade tumor budding (HGTB) is still a controversial parameter in determining the aggressiveness of cervical carcinoma, yet the molecular mechanism of TB is still not comprehensively understood. This study aimed to evaluate whether miR-21, mutant p53, and MMP-9 expression are associated with HGTB in cervical carcinoma.</p><p><strong>Methods: </strong>This nested case-control study was conducted at the Anatomical Pathology Laboratory of Balimed Denpasar Hospital, Mangusada Badung Hospital, and the Biomolecular Laboratory, Faculty of Medicine and Health Sciences, Warmadewa University, from November 2022 to April 2023. The samples were paraffin blocks from a radical hysterectomy of patients with cervical carcinoma. The expression of miR-21 was examined by real-time quantitative PCR (RT-qPCR), while p53 and MMP-9 were analyzed by immunohistochemistry (IHC). A total of 40 samples were selected using simple random sampling, consisting of 20 low-grade tumor budding (LGTB) samples (controls) and 20 HGTB samples (cases). Data analysis was performed using SPSS version 24.</p><p><strong>Results: </strong>This study found that the risk of HGTB significantly increased in miR-21 overexpression (OR=13.222; 95%CI: 2.790-62.670; p-value<0.001) with sensitivity (SN) 70% and specificity (SP) 85%, high mutant p53 expression (OR=44.333; 95%CI: 4.783-410.943; p-value<0.001) with SN=95% and SP=70%, and high MMP-9 expression (OR=10.524; 95%CI: 2.271-48.757; p-value=0.001) with SN=65% and SP=85%. Multivariate analysis showed a significant independent association between mutant p53 expression (aOR=53.676; 95%CI: 3.844-749.474; p-value = 0.003) and high MMP-9 (aOR=13.355; 95%CI: 1.359-131.237; p-value = 0.026), yet miR-21 did not show a significant result.</p><p><strong>Conclusion: </strong>These findings showed a significant relationship between p53 and MMP-9 expression as pro-oncogenic and pro-invasive molecular factors in HGTB cervical carcinoma.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"2931-2940"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Internal Validation of the SPR-HCC Score System: A Prognostic Tool for Survival Prediction in Hepatocellular Carcinoma in a Resource-Limited Setting.","authors":"Sunee Neesanun, Jayanton Patumanond","doi":"10.31557/APJCP.2026.27.8.2803","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.2803","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a heterogeneous disease, in which survival is influenced by various factors beyond tumor characteristics. Although many prognostic models have been developed, they often have limitations, and the models do not include data from Thai patients. This study aimed to develop and internally validate a prognostic scoring system (SPR-HCC) using routinely available clinical and laboratory parameters.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 484 HCC patients diagnosed between October 2018 and April 2023 at a Thai tertiary center. Clinical, laboratory, and treatment data were extracted from electronic records. Independent mortality predictors were identified via multivariable Cox regression. Model performance was evaluated using Harrell's C-statistic, calibration plots, bootstrap resampling, and decision curve analysis.</p><p><strong>Results: </strong>Among 484 patients, 399 (82.4%) had died. The median overall survival (mOS) was 4.73 months (95% CI: 3.68-6.51). Eight independent predictors were identified: ECOG performance status, Child-Pugh class, tumor size >5 cm, bone metastasis, ALP >120 IU/L, AFP ≥400 ng/mL, PLR ≥150, and treatment aim. The final SPR-HCC model demonstrated strong discrimination (C-statistic = 0.797) and good calibration. Patients were stratified into low- (0-5 points), intermediate- (5.5-9.5 points), and high-risk (≥10 points) groups, with corresponding mOS of 29.12, 6.24, and 1.51 months (log-rank p < 0.001). Bootstrap validation showed minimal optimism (0.0000442) and a shrinkage factor of 0.9995. DCA indicated net clinical benefit across a threshold probability range of 0.15-0.60, with optimal benefit between 0.25-0.45.</p><p><strong>Conclusions: </strong>The model demonstrated good performance in stratifying patients into three risk groups with significantly different survival. This scoring system may be applied to clinical decision-making by providing risk group stratification for HCC patients.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"2803-2810"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Immuno-inflammatory Markers as Predictors of Deep Myometrial Invasion in Endometrial Cancer: A Retrospective Study from Southern Thailand.","authors":"Ascharavadee Pulsawat, Sitchuphong Noothong, Nathapol Sirimusika","doi":"10.31557/APJCP.2026.27.8.2839","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.2839","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the predictive value of preoperative systemic inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) for deep myometrial invasion (MI) in patients with endometrial cancer (EC), emphasizing their utility in resource-limited settings.</p><p><strong>Methods: </strong>This retrospective cohort study included 377 patients with histologically confirmed EC who underwent primary surgery at Hatyai Hospital, Southern Thailand, from October 2016 to September 2024. Preoperative hematologic markers were obtained within two weeks before surgery. Patients with active infection, other inflammatory conditions, or prior neoadjuvant treatment were excluded. Deep MI was defined as ≥50% myometrial invasion on final pathology. Logistic regression was used to identify independent predictors, and diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Deep MI was present in 162 patients (42.97%) and was associated with older age, postmenopausal status, advanced FIGO stage, high-grade tumors, larger size, nodal and cervical involvement, and LVSI (all p<0.001). NLR, PLR, MLR, and SII were significantly elevated in this group. Multivariate analysis identified FIGO stage III (OR 7.25; 95% CI, 3.55-14.82), tumor size ≥2 cm (OR 3.85; 95% CI, 1.26-11.77), LVSI (OR 5.01; 95% CI, 2.77-9.08), NLR (OR 1.20; 95% CI, 1.04-1.39), and MLR (OR 57.68; 95% CI, 3.46-960.81) as independent predictors. MLR demonstrated the highest predictive value among biomarkers (AUC 0.612; 95% CI, 0.554-0.670).</p><p><strong>Conclusion: </strong>Preoperative immunoinflammatory markers, particularly MLR and NLR, are independently associated with deep MI in EC. MLR, despite variability, may serve as a cost-effective adjunct for risk stratification, especially in resource-limited settings.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"2839-2845"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Yield and Cost of Morphology-Guided Immunohistochemistry in Liver Tumors.","authors":"Cheep Charoenlap, Pakorn Arunsawat, Tanaporn Prateepchaiboon, Kittiphan Chienwichai, Arunchai Chang","doi":"10.31557/APJCP.2026.27.8.3081","DOIUrl":"https://doi.org/10.31557/APJCP.2026.27.8.3081","url":null,"abstract":"<p><strong>Background: </strong>In many routine pathology settings, particularly where resources are constrained, liver tumors are evaluated with an individualized, morphology-guided immunohistochemistry (IHC) strategy rather than fixed panels or molecular assays. Despite widespread use, the real-world diagnostic yield, stain utilization, and laboratory cost of this approach are not well defined.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive malignant liver tumor diagnoses at a university-affiliated hospital from January 2020 to December 2023. Cases were classified as primary liver cancers or metastatic tumors. IHC was performed using a morphology-guided, case-based sequence. Primary outcomes were histologic subtype assignment among primary liver cancers and determination of the primary site among liver metastases. Secondary outcomes were IHC stain utilization and laboratory cost per case.</p><p><strong>Results: </strong>Among 279 malignant liver tumors, 144 (51.6%) were primary and 135 (48.4%) were metastatic. Hepatocellular carcinoma accounted for 80.6% of primary liver cancers. Among metastases, a likely primary site was identified in most cases; colorectal (31.1%), lung (9.6%), and pancreatic (8.1%) primaries were most common, while cancers of unknown primary comprised 14.8%. IHC utilization was lower in primary tumors than in metastases (median 2 stains/case [IQR 2-4] vs 4 stains/case [IQR 2-7]; p<0.001). Correspondingly, median laboratory IHC cost per case was lower for primary tumors than for metastases (USD 29.90 [IQR 21.73-51.00] vs USD 46.92 [IQR 21.73-92.57]; p<0.001).</p><p><strong>Conclusions: </strong>An individualized, morphology-guided IHC strategy enabled reliable subtyping of primary liver cancers and identification of likely primary sites for most liver metastases while maintaining compact stain utilization and moderate laboratory costs. These data provide practical, real-world benchmarks for diagnostic performance and resource use and support targeted, hypothesis-driven IHC where broad fixed panels or molecular diagnostics are not routinely available.</p>","PeriodicalId":55451,"journal":{"name":"Asian Pacific Journal of Cancer Prevention","volume":"27 8","pages":"3081-3088"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}