Cancer diagnosis & prognosis最新文献

{"title":"Cancer of Unknown Primary Most Suggestive of Colorectal Origin With Microsatellite Instability-high Status and High Tumor Mutation Burden Including NTRK Fusion.","authors":"Hirofumi Sato, Masatsugu Hiraki, Tomonori Shimonishi, Yukari Takase, Natsuko Komiya, Chiho Nakashima, Hiroyuki Irie, Yoshito Akagi, Naoko Aragane","doi":"10.21873/cdp.10580","DOIUrl":"10.21873/cdp.10580","url":null,"abstract":"<p><strong>Background/aim: </strong>Cancer of unknown primary (CUP) is associated with a poor prognosis. Recent advances in comprehensive genomic profiling (CGP) have made it possible to detect actionable mutations in CUP cases, which allows the inference of the primary tumor site. This report demonstrates CUP most suggestive of colorectal origin and highlights how CGP can significantly impact treatment decisions and outcomes.</p><p><strong>Case report: </strong>A 73-year-old woman presented with altered consciousness secondary to diabetic ketoacidosis. Imaging revealed a huge mass with abscess formation near the hepatic flexure, but colonoscopy and biopsy failed to identify a definitive primary site. The histopathology of echo-guided percutaneous tumor biopsy showed poorly differentiated adenocarcinoma. Immunohistochemistry revealed that it was positive for cytokeratin (CK) 7, negative for CK20, and slightly positive for caudal type homeobox (CDX) 2. Although colorectal cancer was the most suspected diagnosis based on imaging examination, the patient was still diagnosed with CUP and treated with carboplatin and nab-paclitaxel, resulting in a partial response; however, treatment was discontinued due to adverse effects. CGP revealed microsatellite instability (MSI)-high, high tumor mutation burden (TMB) of 100/Mb, and neurotrophic tropomyosin receptor tyrosine kinase (<i>NTRK</i>) fusion. The patient was subsequently treated with larotrectinib, to achieve further tumor shrinkage. Considering MSI-high and <i>TPM3-NTRK1</i> fusion in addition to radiological examinations, colorectal cancer was the most suspected diagnosis.</p><p><strong>Conclusion: </strong>CUP is generally associated with poor prognosis. Comprehensive genomic profiling (CGP) offers a promising avenue for discovering personalized and potentially effective therapeutic strategies.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"795-802"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Distal Femoral Surface Tumor With Extraosseous Lesion Mimicking Parosteal Osteosarcoma: A Diagnostic Challenge.","authors":"Rio Wikanjaya, Sei Morinaga, Katsuhiro Hayashi, Shinji Miwa, Takashi Higuchi, Yuta Taniguchi, Hirotaka Yonezawa, Yohei Asano, Satoru Demura","doi":"10.21873/cdp.10582","DOIUrl":"10.21873/cdp.10582","url":null,"abstract":"<p><strong>Background/aim: </strong>Parosteal osteosarcoma is a low-grade surface osteosarcoma that most commonly arises from the posterior aspect of the distal femur. In pediatric patients, a surface-based sclerotic lesion accompanied by an extraosseous component may closely resemble parosteal osteosarcoma, creating a diagnostic dilemma.</p><p><strong>Case report: </strong>A six-year-old boy was referred with right knee discomfort and progressive difficulty in deep flexion. Imaging revealed a broad-based sclerotic surface lesion on the posterior distal femur with an extraosseous component, closely resembling previously reported pediatric parosteal osteosarcoma, although an open biopsy revealed no malignant features. A hemicortical excision without internal fixation was performed, resulting in a cortical defect involving <25% of the femoral circumference. Histopathological examination confirmed a sessile-type osteochondroma. Postoperatively, the patient achieved full weight-bearing and unrestricted knee motion. Radiological remodeling was observed at six months without fracture or recurrence.</p><p><strong>Conclusion: </strong>Sessile-type osteochondroma of the pediatric distal femur can radiologically and clinically simulate low-grade parosteal osteosarcoma by presenting as a heavily ossified exophytic surface mass with an extraosseous component. Histopathological validation coupled with the absence of MDM2 amplification provides definitive differentiation between these entities, guiding appropriate bone-conserving hemicortical excision without the need for internal fixation.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"810-819"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis Using Modified Albumin-Bilirubin Grade in Resected Biliary Tract Cancer: A Multicenter Propensity Score-matched Analysis.","authors":"Toru Takahashi, Hiroaki Yanagimoto, Masayuki Akita, Daisuke Tsugawa, Michihiko Yoshida, Yasuhiro Ueda, Taro Okazaki, Kimihiko Ueno, Hayato Miyazaki, Izuru Otsubo, Shohei Komatsu, Takumi Fukumoto","doi":"10.21873/cdp.10570","DOIUrl":"10.21873/cdp.10570","url":null,"abstract":"<p><strong>Background/aim: </strong>Currently, the modified albumin-bilirubin (mALBI) grade, a novel liver function assessment, is used as a prognostic factor in many areas of gastrointestinal cancer. We evaluated whether mALBI grade predicted survival in a large multicenter cohort of patients who underwent curative-intent resection for biliary tract cancer (BTC).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed data for 634 patients who underwent curative resection for BTC at four centers during 2001-2023. The mALBI grade was calculated from preoperative albumin and total bilirubin levels. Cox proportional hazards regression was used to assess the association of mALBI grade with overall survival (OS) and recurrence-free survival (RFS) in a propensity score-matched cohort. The mALBI grade was defined by subdividing ALBI grade 2 at a cutoff of -2.27; patients with mALBI grades 1-2a were classified as the low mALBI group, and those with grades 2b-3 as the high mALBI group.</p><p><strong>Results: </strong>After propensity score-matching, the high mALBI group remained associated with poorer OS (44 <i>vs</i>. 70 months; <i>p</i>=0.015) than the low mALBI group. Multivariate analysis revealed that high mALBI grade was independently associated with poor OS (hazard ratio=1.584, 95% confidence interval=1.077-2.331; <i>p</i>=0.020) and RFS (hazard ratio =1.447, 95% confidence interval=1.023-2.046, <i>p</i>=0.037).</p><p><strong>Conclusion: </strong>A high mALBI grade was associated with shorter OS and RFS in patients with resected BTC. Preoperative mALBI grade is an important prognostic indicator for risk stratification and prognostic evaluation.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"703-714"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimized Prostate Cancer Stage Classification Using XGBoost Based on Racial miRNA Expression.","authors":"Jheno Syechlo, David Agustriawan, Vincent Kurniawan, Adithama Mulia, Ezra Bernardus Wijaya, Rizky Nurdiansyah, Dinar Ajeng Kristiyanti, Ajie Kusuma Wardhana","doi":"10.21873/cdp.10566","DOIUrl":"10.21873/cdp.10566","url":null,"abstract":"<p><strong>Background/aim: </strong>Prostate cancer has a high mortality rate and shows diagnostic disparities between racial groups, particularly between White and Black populations. This study aimed to develop a prostate cancer stage classification model using the XGBoost algorithm on miRNA expression data with a focus on race-based analysis.</p><p><strong>Materials and methods: </strong>The data used in this study were obtained from the Genomic Data Commons. The Cancer Genome Atlas through the UCSC Xena Browser, consisting of miRNA expression and patient clinical data. Several feature selection methods were applied, including Student's <i>t</i>-test, mutual information, chi-square, and limma. Data balancing techniques such as RandomOversampler, SMOTE, SMOTEENN, and BorderlineSMOTE were also implemented to address class imbalance.</p><p><strong>Results: </strong>The results showed that the XGBoost model achieved an accuracy of up to 89% on data from White patients. Additionally, the F1-score shows the results of 92%, these results suggest this model is particularly strong in identifying minority class in this unbalance data. However, when tested on data from Black patients, the accuracy decreased to 72-74%, indicating limitations in cross-race performance. Additionally, Local Interpretable Model-agnostic Explanations (LIME) was implemented to identify the gene features that contributed most significantly to the model's predictions.</p><p><strong>Conclusion: </strong>The study demonstrates that XGBoost, combined with race-specific feature selection and hyperparameter tuning, can accurately detect prostate cancer with high performance. These findings highlight the potential of XGBoost for improving prostate cancer detection while also emphasizing the importance of considering race-specific differences in machine learning models.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"660-673"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Comprehensive Panel NGS Testing and Cascade Family Screening on Early Diagnosis of Prostate Cancer and MINAS (<i>ATM+MITF</i>) Management.","authors":"Irem Bilgetekin, Taha Bahsi, Yusuf Bahap, Mehmet Ali Ergün, Ibrahim Güllü","doi":"10.21873/cdp.10574","DOIUrl":"10.21873/cdp.10574","url":null,"abstract":"<p><strong>Background/aim: </strong>With the expansion of next-generation sequencing (NGS)-based hereditary cancer panels, this study aimed to: (i) identify non-<i>BRCA</i> predisposition genes in an index case with three different primary cancers; (ii) demonstrate the clinical utility of cascade testing <i>via</i> comprehensive panel NGS testing for early cancer detection in asymptomatic relatives; (iii) discuss the potential association between a co-segregating <i>MITF</i> variant and a family history of recurrent meningioma; and (iv) provide a practical management framework for Multilocus Inherited Neoplasia Allele Syndrome (MINAS) in the context of dual <i>ATM+MITF</i> carriership.</p><p><strong>Materials and methods: </strong>Index patient and family members who have a history of cancer with a familial cancer pedigree were evaluated using a multigene NGS approach. Targeted sequencing was performed on the MGI DNBSEQ-G400 platform using the Twist Bioscience Hereditary Cancer Panel.</p><p><strong>Results: </strong>A germline <i>ATM</i> variant was identified in the index case, and <i>ATM</i> carrier status was confirmed in his two sons. During cascade screening, early-stage colon cancer was detected on colonoscopy in one son, while prostate cancer was diagnosed in the other. <i>MITF</i> carrier status was identified in three family members; among them, the index patient's sister and one nephew had a history of meningioma, and the nephew was also shown to be an <i>ATM</i> carrier. A history of meningioma was also present in another family member with an <i>MITF</i> variant.</p><p><strong>Conclusion: </strong>Large-panel NGS testing in cancer patients is transforming family-based risk management by enabling the identification of homologous recombination repair (HRR) genes (including <i>ATM</i>) beyond <i>BRCA1/2</i>. Cascade testing <i>via</i> comprehensive NGS provides tangible clinical benefits by detecting malignancies early in clinically silent carriers.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"737-744"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Skeletal Muscle Radiodensity in Advanced Urothelial Carcinoma Undergoing Avelumab Maintenance Therapy.","authors":"Nobuhiko Shimizu, Taku Naiki, Yosuke Sugiyama, Aya Naiki-Ito, Takashi Nagai, Toshiki Etani, Hiroko Suzuki, Yohei Tsubouchi, Toshiharu Morikawa, Masakazu Gonda, Maria Aoki, Daiki Ishikawa, Ryosuke Ando, Takahiro Yasui","doi":"10.21873/cdp.10569","DOIUrl":"10.21873/cdp.10569","url":null,"abstract":"<p><strong>Background/aim: </strong>A significant survival benefit was found for avelumab maintenance therapy <i>versus</i> best supportive care in patients with advanced urothelial carcinoma who attained disease control after platinum-based chemotherapy in the JAVELIN Bladder 100 trial. Although patients generally tolerate avelumab maintenance therapy, some patients experience rapid progression and prognostic factors are not well established.</p><p><strong>Patients and methods: </strong>In this retrospective study, we investigated the prognostic significance of computed tomography-derived body composition indicators in 57 patients with advanced urothelial carcinoma who received avelumab maintenance therapy after first-line platinum-based chemotherapy. These patients were from within a cohort of 85 patients who underwent first-line platinum-based chemotherapy. Patients were divided into two groups based on a low or high skeletal muscle radiodensity (SMD). Prognostic factors were determined using univariate and multivariate analyses.</p><p><strong>Results: </strong>Among patients treated with avelumab, median progression-free survival (PFS) was 6.4 months in the high SMD group <i>versus</i> 4.8 months in the low skeletal muscle radiodensity group, while median overall survival (OS) was not reached <i>versus</i> 16.7 months, respectively. In a Cox proportional hazards model, only low SMD indicated a worse prognosis for PFS [hazard ratio (HR)=2.07, 95% confidence interval (CI)=1.06-4.04], while low SMD plus a high neutrophil-lymphocyte ratio were independent predictors for worse OS (HR=2.29, 95%CI=1.04-5.05 and HR=2.44, 95%CI=1.11-5.37, respectively).</p><p><strong>Conclusion: </strong>SMD is a potential prognostic factor for advanced urothelial carcinoma cases undergoing avelumab maintenance therapy.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"692-702"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stressful Events in Life Due to Losses and Deficit Could Predict 25-year Outcome in Patients With Breast Cancer Symptoms.","authors":"Matti Eskelinen, Riika Koskela, Tuomas Selander, Kai Kaarniranta, Paula Ollonen, Maaret Eskelinen","doi":"10.21873/cdp.10543","DOIUrl":"10.21873/cdp.10543","url":null,"abstract":"<p><strong>Background/aim: </strong>Psychosocial stressful (PS) factors like losses and deficit could associate indirectly to breast carcinoma (BC) risk, but the long-term impact of losses, deficit and stressful (LDS) events on outcome of patients with BC symptoms is rarely reported.</p><p><strong>Patients and methods: </strong>A study cohortof 115 patients with BC symptoms completed the LDS inventory (LDSI). Associations between LDSI and long-term outcomes were examined.</p><p><strong>Results: </strong>In the Cox model, the LDSI predicted the 25-year relapse-free survival (RFS) in patients with BC [hazard ratio (HR)=5.02, <i>p</i>=0.01] and the LDSI scale predicted 25-year overall survival (OS) in women with BC symptoms (HR=2.37, <i>p</i>=0.05). In the Kaplan-Meier survival analysis by the log-rank test, the 25-year relapse rate differed between low LDSI (<83) <i>versus</i> the high LDSI (≥83) in patients with BC symptoms (27.9% <i>versus</i> 54.5%, log-rank <i>p-</i>value=0. 098). Also, the low LDSI (<83) was a favourable predictor of the RFS [HR=5.02, 95% confidence interval (CI)=1.42-17.8, <i>p</i>=0.01] in patients with BC. The 25-year OS rate differed between low LDSI (<83) <i>versus</i> the high LDSI score (≥83) patients with BC symptoms (19.8% <i>versus</i> 36.8%, log-rank <i>p</i>-value=0.048). A similar figure was seen in BC as the LDSI predicted 25-year OS in female patients with BC (44.4% <i>versus</i> 71.4%, log-rank <i>p</i>-value=0.048).</p><p><strong>Conclusion: </strong>This study found a significant long-term outcome effect for LDS events on both women with BC symptoms and patients with BC. These findings suggest that further research is needed to substantiate whether LDSI approach could be an important addition to PS events screening criteria for preventative or early BC care.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 3","pages":"434-444"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response-survival Association Differs by Hepatic Reserve in Unresectable HCC Receiving Atezolizumab Plus Bevacizumab.","authors":"Akifumi Kuwano, Masayoshi Yada, Kosuke Tanaka, Taikan Hamamoto, Kazuki Kurosaka, Hideo Suzuki, Kenta Motomura","doi":"10.21873/cdp.10556","DOIUrl":"10.21873/cdp.10556","url":null,"abstract":"<p><strong>Background/aim: </strong>Evidence supporting atezolizumab plus bevacizumab (Atez/Bev) for unresectable hepatocellular carcinoma (uHCC) in patients with Child-Pugh B (CP-B) liver function is limited. We investigated whether the prognostic significance of radiologic response differs according to hepatic reserve and evaluated the impact of baseline neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 105 consecutive patients with uHCC treated with Atez/Bev (CP-A, n=82; CP-B, n=23). Tumor response was assessed by modified RECIST, and overall survival (OS) was estimated using Kaplan-Meier methods. Baseline NLR was evaluated using a prespecified cut-off of 2.56.</p><p><strong>Results: </strong>Response was not evaluable more often in CP-B than in CP-A (21.7% <i>vs</i>. 4.8%). In CP-A, objective response and disease control were each associated with longer OS (<i>p</i>=0.002 and <i>p</i>=0.003, respectively). In CP-B, neither objective response nor disease control was significantly associated with OS; OS was similar for stable disease and objective response (10.6 <i>vs</i>. 10.7 months). Across the cohort, NLR <2.56 was associated with longer OS and remained prognostic in both CP-A and CP-B.</p><p><strong>Conclusion: </strong>The prognostic meaning of radiologic response differed according to hepatic reserve. While objective response is strongly associated with survival in CP-A, disease stabilization may represent clinically meaningful benefit in CP-B. Baseline NLR may aid risk stratification in CP-B uHCC treated with Atez/Bev.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 3","pages":"559-569"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Diagnostic Value of the UF-5000 Parameter Atyp.C in Upper Tract Urothelial Carcinoma.","authors":"Ryu Shigehisa, Satoshi Fukata, Keisuke Sugimoto, Shiori Miyazaki, Shinji Tokuhiro, Anantya Pustimbara, Chiaki Kawada, Sho Shimasaki, Erika Yamashita, Yoshitaka Kurano, Kaya Atagi, Daigo Takemori, Shinkuro Yamamoto, Hiroto Osakabe, Tomoya Nao, Tsutomu Shimamoto, Hideo Fukuhara, Nobutaka Shimizu, Shingo Ashida, Keiji Inoue","doi":"10.21873/cdp.10549","DOIUrl":"10.21873/cdp.10549","url":null,"abstract":"<p><strong>Background/aim: </strong>Urine cytology is widely used for diagnosing urothelial carcinoma. However, it has limited sensitivity, particularly in upper tract urothelial carcinoma. The UF-5000 automated urine analyzer includes the research parameter Atyp.C, which quantifies cells with a high nuclear-to-cytoplasmic ratio. Although it has been utilized in bladder cancer, its application has not been evaluated in upper tract urothelial carcinoma. This study compared the diagnostic performance of urine cytology versus Atyp.C and assessed the advantage of combining them.</p><p><strong>Patients and methods: </strong>This retrospective study included 41 patients with pathologically confirmed upper tract urothelial carcinoma without concomitant bladder cancer, as confirmed via cystoscopy. The sensitivities of urine cytology (Class ≥III), Atyp.C (≥0.1), and their combined use were compared.</p><p><strong>Results: </strong>Positive findings on urine cytology were detected in 11/41 patients (26.8%) and Atyp.C was observed in 9/41 (22.0%). When either test yielded a positive result, the detection rate increased to 17/41 (41.5%). A paired comparison using McNemar's test demonstrated that the combined cytology-Atyp.C approach detected significantly more upper tract urothelial carcinoma cases than urine cytology alone (6 <i>vs</i>. 0 discordant pairs, <i>p</i>=0.041).</p><p><strong>Conclusion: </strong>The sensitivity of Atyp.C was similar to that of urine cytology. Some patients without hydronephrosis presented with Atyp.C positivity. However, this finding may be overlooked in routine clinical practice. Although its performance is lower than that reported in bladder cancer, Atyp.C is non-invasive and does not require additional procedures. Hence, it can be clinically useful for upper tract urothelial carcinoma diagnosis. Nevertheless, to validate this notion, prospective studies should be conducted.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 3","pages":"493-501"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pretreatment White Blood Cell Count and Early Progression in Non-small Cell Lung Cancer.","authors":"Yutaka Takahara, Ryudai Abe, Sumito Nagae, Takuya Tanaka, Yoko Ishige, Ikuyo Shionoya, Kouichi Yamamura, Masafumi Nojiri, Masaharu Iguchi","doi":"10.21873/cdp.10550","DOIUrl":"10.21873/cdp.10550","url":null,"abstract":"<p><strong>Background/aim: </strong>Elevated white blood cell (WBC) counts, frequently observed in patients with non-small cell lung cancer (NSCLC), are associated with poor prognosis; however, their relevance in the era of immune checkpoint inhibitor (ICI)-based therapy remains unclear.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 103 patients with advanced or recurrent NSCLC. Patients were stratified according to the presence of leukocytosis (WBC ≥10,000/μl). Clinical characteristics, treatment responses, progression-free survival (PFS), and overall survival (OS) were compared between groups. Multivariate Cox proportional hazards models were used to identify independent prognostic factors.</p><p><strong>Results: </strong>Patients with elevated WBC counts were younger, had higher C-reactive protein (CRP) levels, tended to have a higher frequency of PD-L1 tumor proportion score (TPS) positivity at baseline, and exhibited a significantly lower objective response rate to first-line therapy (<i>p=</i>0.044). Kaplan-Meier analysis showed that elevated WBC counts were significantly associated with shorter PFS (<i>p<</i>0.001). In multivariate Cox analysis, an elevated WBC count remained independently associated with poorer PFS [hazard ratio (HR)=4.625, 95% confidence interval (CI)=1.969-10.864, <i>p</i><0.001]. An optimal CRP cutoff value of 0.555 mg/dL was identified <i>via</i> receiver operating characteristic analysis. Elevated CRP levels were independently associated with worse OS (HR=2.251, 95%CI=1.110-4.567, <i>p=</i>0.025) and PFS (HR=1.729, 95%CI=1.080-2.769, <i>p=</i>0.023).</p><p><strong>Conclusion: </strong>Pretreatment leukocytosis was associated with early disease progression in NSCLC, even in PD-L1-positive cases. Furthermore, elevated CRP levels provided additional prognostic stratification for PFS and OS. Thus, WBC count and CRP may serve as practical and readily accessible tools for early treatment evaluation and risk stratification in the management of NSCLC in the ICI era.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 3","pages":"502-509"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}