• Chondroblastoma: the relationship between local invasiveness, recurrence, and histopathological features.
    1 week ago
    This study aims to assess the histopathological and clinical characteristics of chondroblastomas (CBs), with particular emphasis on the correlation between local invasion and mitotic activity, cytological atypia, and recurrence.

    A retrospective analysis was performed on 26 cases of CB diagnosed between 2016 and 2024 and pathologically evaluated at a tertiary oncology center, with surgical procedures performed across 2 tertiary oncology referral centers. Clinical, radiological, and histopathological data were reviewed. For comparative analysis, tumors were grouped as non-infiltrative (confined to the bone) or infiltrative (showing invasion of the bone cortex and/or extracortical connective tissues). Tumors were assessed for cytological atypia, mitotic index, matrix production, calcification, aneurysmal bone cyst formation, and invasion pattern. Immunohistochemical staining for S100, DOG1, and Ki-67 was conducted. Statistical analyses included t-tests, Mann-Whitney U, chi-square, and correlation analyses.

    The mean age at diagnosis was 17.7 years, with a male-to-female ratio of 1.36 : 1. The femur was identified as the most common site. Invasion beyond the bone cortex was observed in 16 patients (61.5%), including 4 instances of soft tissue involvement. Invasive tumors showed significant association with moderate cytological atypia (P = .022), higher mitotic index (P = .023), and lower extremity location (P = .02). A positive correlation was identified between mitotic index and both atypia (P = .001) and tumor invasiveness. Recurrence occurred in four patients (15.4%), all presenting invasive tumors. No metastases were reported during the mean follow-up period of 38.9 months.

    Although CB typically manifests benign behavior, a subset of these tumors demonstrates locally aggressive characteristics, such as cortical and soft tissue invasion. Elevated mitotic activity and moderate cytological atypia may serve as histopathological markers for local aggressiveness.   Cite this article as: Aygün MİŞ, .omunoğlu C, Doğan B, Adaş M, Tanrıtanır R. Chondroblastoma: the relationship between local invasiveness, recurrence, and histopathological features. Acta Orthop Traumatol Turc., 2026; 60(4), 0407, doi: 10.5152/j.aott.2026.25407.
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  • Diagnostic Value of Serum HE4, TFF3, and CA72-4 for Gastric Cancer Stratified by Helicobacter pylori Infection Status.
    1 week ago
    Gastric cancer remains a leading cause of cancer-related mortality worldwide. Helicobacter pylori (Hp) infection is a major risk factor, but the diagnostic performance of serum biomarkers may vary according to Hp infection status. This study aimed to evaluate the diagnostic value of serum human epididymis protein 4 (HE4), trefoil factor 3 (TFF3), and carbohydrate antigen 72-4 (CA72-4), individually and in combination, for gastric cancer stratified by Hp infection status using a propensity score-matched retrospective case-control design.

    This retrospective study was conducted at Jinshazhou Hospital of Guangzhou University of Chinese Medicine, from January 2022 to December 2025. Propensity score matching (1:1 nearest neighbor matching, caliper 0.1) was performed to balance age, sex, body mass index (BMI), smoking history, alcohol consumption history, chronic kidney disease, chronic liver disease, and Hp infection status between groups. After matching, 268 gastric cancer patients and 268 healthy controls were included. Serum levels of HE4, TFF3, and CA72-4 were measured. Between-group comparisons of each marker, stratified by Hp status, were performed. Logistic regression was used to construct combined diagnostic models, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the area under the curve (AUC).

    After matching, all covariates achieved good balance with standardized mean differences <0.1. In the total population, serum levels of HE4, TFF3, and CA72-4 were significantly higher in the gastric cancer group than in the control group (all p < 0.001). Multivariate logistic regression identified all three markers as independent risk factors for gastric cancer (HE4: odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.03-1.06; TFF3: OR = 1.19, 95% CI: 1.13-1.26; CA72-4: OR = 1.46, 95% CI: 1.34-1.62; all p < 0.001). The combined model yielded an AUC of 0.899 (0.872-0.925) in the total population, significantly superior to any single marker (all p < 0.001). After stratification by Hp status, the AUC of TFF3 was significantly higher in Hp-positive individuals than in Hp-negative individuals (p < 0.001); no significant differences were observed for HE4 or CA72-4 between the two strata (p > 0.05).

    The diagnostic value of serum HE4, TFF3, and CA72-4 for gastric cancer varies according to Hp infection status. In Hp-positive patients, TFF3 demonstrates significantly higher diagnostic performance compared with Hp-negative individuals. HE4 and CA72-4 demonstrate stable performance across Hp strata, with no statistically significant differences observed. The combined detection of these biomarkers demonstrates favorable diagnostic performance regardless of Hp status. These findings suggest that Hp status-stratified testing provides an auxiliary strategy for optimizing differential diagnosis of gastric cancer.
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  • The Effect of Electromyographic Biofeedback Relaxation Training on Pain Catastrophizing and Fatigue Levels in Lung Cancer Patients Undergoing Combined Chemoradiotherapy.
    1 week ago
    Lung cancer patients undergoing combined chemoradiotherapy often experience pain, fatigue, sleep disturbances, and decreased quality of life. Among these, pain catastrophizing, as a negative cognitive pattern, can exacerbate symptom experience. Similarly, fatigue and sleep disturbances are also influenced by psychological and cognitive factors, yet conventional supportive care provides limited intervention at the psychological and cognitive levels. This study aims to investigate the impact of electromyographic biofeedback relaxation training on pain catastrophizing and fatigue levels in lung cancer patients undergoing combined chemoradiotherapy.

    This study employed a single-center, retrospective cohort design. Through a review of medical records from March 2020 to March 2022, patients who had received structured electromyographic biofeedback relaxation training undergoing chemoradiotherapy were assigned to an observation group (n = 78). Patients without such records, receiving only routine supportive care, were classified as a control group (n = 109). The training consisted of six sessions over two weeks. Outcomes, including pain catastrophizing (Pain Catastrophizing Scale), pain intensity (Visual Analogue Scale), sleep quality (European Organisation for Research and Treatment of Cancer), and quality of life (Functional Assessment of Chronic Illness Therapy-Fatigue), were assessed before and after the intervention period.

    After the intervention, the pain catastrophism scores, pain intensity scores, and sleep disturbance scores of the observation group were significantly lower than those of the control group, while the fatigue score was significantly higher than that of the control group (all p < 0.05). Furthermore, the observation group also showed significantly better scores and total scores on multiple dimensions of quality of life (including physical well-being, social/family well-being, emotional health, functional well-being, and fatigue subscales) than the control group (p < 0.05).

    Supplementing routine combined chemoradiotherapy management with electromyographic biofeedback relaxation training was associated with lower levels of pain catastrophizing and fatigue, improved sleep quality, and enhanced overall quality of life in lung cancer patients. This intervention may represent a safe and feasible non-pharmacological support strategy for symptom management in lung cancer patients undergoing combined chemoradiotherapy.
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  • Radiotherapy Reconstitutes the Collapsed miRNome of Progressive Neuroblastoma and Promotes a Favorable Tumor Evolutionary Shift.
    1 week ago
    Progressive disease (PD) remains the dominant barrier to cure in high-risk neuroblastoma (HR-NB), driven in part by profound post-transcriptional deregulation that fuels clonal evolution, stemness, immune evasion, and therapy resistance. In this study, we define the molecular architecture of PD-associated microRNA (miR) collapse and demonstrate that radiotherapy (RT) acts as a potent post-transcriptional reprogrammer capable of reversing this trajectory.

    miRNome profiling was performed in HR-NB tumors from patients during diagnosis (Dx), intensive multi-modal clinical therapy (IMCT) defiant PD, or residual disease after incorporating RT with IMCT (RD-RT). miRs' expression profiles were validated with selective miR-320a, miR-423, miR-483-3p, miR-122-5p, miR-3184-5p, miR-21-5p qPCR. RT-influenced changes in cell-identity were investigated by assessing histomorphological alterations (H&E) and multiplex immunofluorescence (mIF) for Ki-67, PD-L1, SOX2, CD44 or p53.

    IMCT-defying PD displayed a loss of 167 miRs, and none upregulated, corresponding an evolutionary fingerprint for pathways governing cancer stem cell (CSC) maintenance, epithelial to mesenchymal transition (EMT), metabolic rewiring, proliferative fitness, and immune suppression. Strikingly, adding RT reversed 146 of these miRs and induced additional 179 RT-specific miRs, restoring regulatory networks governing apoptosis, p53-mediated DNA-damage response, differentiation/mesenchymal to epithelial transition (MET), and immune visibility. Individual miR-qPCR analysis of miR-320a, miR-483-3p, miR-3184-5p miR-21-5p, and miR-122-5p validated and corroborated the array expression outcomes. Histologic and mIF remarkably substantiated these miR signatures, showing that RT transforms poorly differentiated, plastic, PD-L1+/SOX2+/CD44+ CSC-like PD tumors into differentiated, lineage-stabilized, immune-permissive states characterized by neuropil restoration, ganglioneuroma-like maturation, marginal yet measurable loss of SOX2/CD44, suppression of PD-L1, complete collapse of Ki-67+ proliferative compartments, and significant induction of p53.

    Collectively, our findings indicated that RT could be a global regulator of tumor state transitions, reinstating miR-mediated governance lost during PD evolution and redirecting tumor fate toward regression. Our results provide proof-of-concept evidence that RT delivers powerful molecular benefits beyond local control, introducing a conceptual framework for miR-guided RT personalization, biomarker development, and rational combination strategies to improve outcomes in HR-NB.
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  • LRRC3-DT Inhibits Malignant Behaviors of Hepatocellular Carcinoma and is Associated With CCDC81 Expression.
    1 week ago
    Enhancer RNAs (eRNAs) are important regulators of tumor development and progression. Nevertheless, the diagnostic utility of circulating eRNAs in hepatocellular carcinoma (HCC) remains unclear.

    This was a retrospective study. The recently identified eRNA, leucine-rich repeat-containing 3 divergent transcript (LRRC3-DT), was analyzed in serum samples, tissue specimens, and various cell lines. Its diagnostic performance was evaluated alone and in combination with alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) using receiver operating characteristic (ROC) curve analysis. Functional investigations were performed to assess the biological role of LRRC3-DT by overexpressing and knocking down this eRNA in HCC cell lines. Furthermore, using transcriptome sequencing, potential target genes of LRRC3-DT were identified.

    The serum levels of LRRC3-DT were significantly lower in patients diagnosed with HCC than in healthy controls. When LRRC3-DT was assessed alongside AFP and PIVKA-II, the combination improved sensitivity for the detection of HCC. Despite earlier research indicating that LRRC3-DT is present primarily in the nucleus and is strongly associated with tumor proliferation, invasion, and apoptosis, the serum levels of LRRC3-DT were similar between patients with HCC and those with benign liver diseases in the present study. These findings indicate limited specificity in distinguishing between these two conditions.

    Serum LRRC3-DT represents a potential auxiliary biomarker for early HCC screening; its combined use with other indicators improved diagnostic performance. However, it cannot individually discriminate HCC from benign liver disorders, and additional validation studies are warranted to confirm its differential diagnostic value.
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  • TMEM61 Promotes Malignant Behaviors and Maintains Genomic Stability in Ovarian Cancer Cells.
    1 week ago
    Transmembrane protein 61 (TMEM61) has previously been reported in several malignancies. However, its function in ovarian cancer remains unclear. Here, we aimed to investigate the role and underlying mechanisms of TMEM61 in ovarian cancer cells.

    Differentially expressed genes were identified by analyzing transcriptomic data of 426 ovarian cancer tissues from The Cancer Genome Atlas database and 88 normal ovarian tissues from the Genotype-Tissue Expression database using the web-based analytical tool GEPIA2. The effects of TMEM61 knockdown on ovarian cancer cell invasion, migration, and proliferation were evaluated using Transwell, wound healing, and Cell Counting Kit-8 assays. The effect of TMEM61 knockdown on DNA damage and cytosolic DNA accumulation was assessed using immunofluorescence and comet assays. TMEM61 and programmed death-ligand 1 (PD-L1) expression levels were assessed using immunoblotting and reverse transcription-quantitative polymerase chain reaction.

    TMEM61 exhibited very low expression in normal ovarian tissues, but its expression was significantly upregulated in ovarian cancer tissues. TMEM61 knockdown significantly inhibited the proliferation, migration, and invasion of ovarian cancer cells; induced DNA damage and cytoplasmic DNA accumulation; and upregulated PD-L1 expression in ovarian cancer cells.

    TMEM61 promotes malignant behavior and maintains genomic stability in ovarian cancer cells. TMEM61 may serve as a potential biomarker and molecular target for ovarian cancer.
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  • [The prevalence of sleep disorders and related factors in patients with oral and maxillofacial malignant tumors].
    1 week ago
    To investigate the current status of sleep disorders in patients with oral and maxillofacial malignant tumors and analyze the influencing factors, so as to provide a basis for clinical intervention.

    A convenience sampling method was used to recruit 487 patients with oral and maxillofacial malignant tumors in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from December 2023 to December 2024. The Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck 35 (EORTC QLQ-HN35) were used to evaluate sleep quality, psychological state, and symptom burden. Spearman rank correlation analysis and multivariate logistic regression analysis were used to explore the correlation.

    84.6% of the patients had sleep disorders, and the use rate of hypnotic drugs in the recurrence group was significantly higher than that in the primary group (P<0.05). The total PSQI score in the recurrence group was positively correlated with sensory perception and dry mouth (P<0.05). The total PSQI scores of the two groups were positively correlated with pain, swallowing, speech, eating during social communication, dental problems, mouth opening, social interaction, disease perception, and the use of painkillers (P<0.05), and negatively correlated with weight loss (P<0.05). Multivariate logistic regression analysis showed that unemployment, smoking, anxiety, oral pain, speech disorders, dental problems, and disease perception were risk factors for sleep disorders in newly diagnosed patients; unemployment, swallowing disorders, and disease perception were risk factors for sleep disorders in recurrent patients.

    The incidence of sleep disorders in patients with oral and maxillofacial malignant tumors is high, which is closely related to psychological state, oral dysfunction, and disease perception. Early intervention in symptom clusters is needed clinically to improve sleep quality and quality of life.
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  • [Prognostic impact of HPV and adjuvant therapy interaction in oral squamous cell carcinoma].
    1 week ago
    To investigate the impact of human papillomavirus (HPV) infection on postoperative recurrence in patients with oral squamous cell carcinoma(OSCC), and to analyze its interaction with adjuvant radiotherapy and chemotherapy as well as the predictive value for recurrence.

    A retrospective case-control study was conducted involving 168 postoperative OSCC patients from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Univariate and multivariate logistic regression analyses were used to assess the association between HPV infection, confounding factors and postoperative recurrence. Interaction analysis was performed to clarify the synergistic effect of HPV with radiotherapy and chemotherapy, and recurrence prediction models were constructed and validated.

    Univariate analysis showed that HPV positivity (OR=0.46, 95%CI: 0.21-0.98) and adjuvant radiotherapy (OR=0.48, 95%CI: 0.24-0.93) were negatively correlated with recurrence risk. Multivariate analysis confirmed that HPV positivity (OR=0.37, 95%CI: 0.16-0.88) and adjuvant radiotherapy (OR=0.30, 95%CI: 0.13-0.67) remained protective factors against recurrence, while adjuvant chemotherapy increased recurrence risk (OR=3.76, 95%CI: 1.50-9.41). A significant additive interaction was observed between HPV positivity and adjuvant radiotherapy, and combined intervention further reduced recurrence risk (OR=0.06, 95%CI: 0.01-0.38), with no significant interaction with adjuvant chemotherapy. Prediction models showed that the AUC of the basic clinical feature model was 0.859, which increased to 0.887 after adding HPV status, and achieved the best predictive performance after introducing the HPV-radiotherapy interaction term (AUC=0.894, compared with the basic model, P=0.031 6). The interaction term was the variable with the highest predictive value in the model.

    HPV positivity is an important protective factor against postoperative recurrence in OSCC patients, and exhibits a synergistic effect when combined with adjuvant radiotherapy. The prediction model integrating HPV status and its interaction with radiotherapy has the optimal recurrence predictive efficacy.
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  • Risk of Infertility Due to Vitamin D Deficiency among Women with Polycystic Ovarian Syndrome.
    1 week ago
    Polycystic ovary syndrome (PCOS) is a common endocrine disorder and a leading cause of infertility in reproductive-aged women. Emerging evidence suggests that vitamin D deficiency may exacerbate PCOS-related reproductive and metabolic disturbances. This study aimed to assess the prevalence of vitamin D deficiency among infertile women with PCOS and explore its association with subfertility. This cross-sectional study was conducted at the Department of Infertility, Bangladesh Medical University (BMU), from November 2019 to April 2025. Total 155 infertile women aged 18-40 years; diagnosed with PCOS using the revised Rotterdam criteria (2003) were enrolled. Participants with other known causes of infertility were excluded. Data on demographic variables, clinical features, hormonal profile, glucose metabolism and serum 25(OH) vitamin D levels collected and analyzed. The mean age of participants was 28.34±3.5 years, with a mean BMI of 23.46±3.2 kg/m². Primary subfertility was observed in 69.68% (n=108) of cases. Vitamin D deficiency (<20 ng/ml) was present in 47.10% (n=73) and 40.65% (n=63) had insufficient levels (20-29 ng/ml); only 12.26% (n=19) had sufficient vitamin D (>29 ng/ml). The mean HOMA-IR was 1.88, indicating prevalent insulin resistance. Most participants were normoglycemic with a mean HbA1c of 5.42%. A high prevalence of vitamin D deficiency and insufficiency observed among infertile women with PCOS, particularly among those with primary subfertility. Vitamin D status may represent a modifiable factor in the management of PCOS-related infertility.
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  • Diagnostic and Risk Stratification Value of Serum 8-Hydroxy-2-Deoxyguanosine in Women with Suspected Breast Carcinoma in Bangladesh: A Cross-Sectional Analytical Study.
    1 week ago
    Breast carcinoma is a leading cause of carcinoma-related morbidity and mortality among women worldwide, with a rising burden in low- and middle-income countries. Early differentiation between malignant and benign breast lesions remains a major challenge in resource-constrained settings, where access to imaging and histopathology is often limited. Oxidative DNA damage plays a key role in carcinogenesis and serum 8-hydroxy-2-deoxyguanosine (8-OHdG) has emerged as a potential non-invasive biomarker; however, evidence from Bangladesh is scarce. The objective of this study was to evaluate the diagnostic value of serum 8-hydroxy-2-deoxyguanosine and its association with clinicodemographic and histopathological characteristics among women with suspected breast carcinoma. This cross-sectional analytical study was conducted among 81 women presenting with clinically suspected breast lumps at Bangladesh Medical University, Dhaka, Bangladesh from July 2023 to June 2024. Participants underwent histopathological examination and were classified into breast carcinoma (n=42) and benign breast disease (n=39) groups. Serum 8-OHdG levels were measured using an enzyme-linked immunosorbent assay. Diagnostic performance was assessed using receiver operating characteristic analysis. Associations between 8-OHdG and clinical variables were examined using correlation analysis and multivariable logistic regression. The mean age of participants was higher in the breast carcinoma group compared with the benign group (44.33±9.03 vs 35.59±10.43 years; p=0.0003). Serum 8-OHdG levels were significantly elevated in breast carcinoma (7.40±1.57 ng/mL) compared with benign disease (5.16±1.53 ng/mL; p<0.001. At a cut-off value of 6.0 ng/mL, serum 8-OHdG showed a sensitivity of 71.4% and specificity of 69.2%, with an overall diagnostic accuracy of 70.4%. Increasing age, postmenopausal status and family history were significantly associated with malignancy. Serum 8-OHdG is significantly elevated in breast carcinoma and demonstrates good sensitivity for differentiating malignant from benign breast lesions. It may serve as a practical, non-invasive biomarker for diagnostic triage, particularly in resource-limited settings.
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