Circulating tumor cells (CTCs) serves a primary function in metastasis and recurrence of hepatocellular carcinoma (HCC). In the present study, in order to evaluate the analytical performance and clinical value of the liquid biopsy-based platform, a novel integrated subtraction enrichment and immunostaining-fluorescence in situ hybridization (iFISH®) platform was applied to analyze CTCs in patients with HCC undergoing liver transplantation (LT). In total, 30 patients with HCC undergoing LT and 10 healthy volunteers were enrolled. CTCs in peripheral blood that were obtained from each patient prior to LT and 3 months thereafter were detected using the iFISH® platform, and CellSearch® system was performed for each subject for comparison. Using iFISH® and CellSearch®, the percentage of CTCs in patients with pre-operative HCC were 70.00% and 26.67%, respectively. CTCs counted using iFISH® (iFISH-CTCs) were increased compared with CellSearch® (Cellsearch-CTCs) (P<0.01). A significant decrease in iFISH-CTCs was observed 3 months following LT (3.04±0.93/7.5 to 1.0±0.53/7.5 ml, P<0.05). Furthermore, patients with lower preoperative iFISH-CTCs level (<5/7.5 ml) had markedly increased recurrence-free survival compared with iFISH-CTCs (>5/7.5 ml, 15 vs. 5.5 months; P<0.01. iFISH® platform exhibits an increased analytical sensitivity, and may be used as a dynamic monitoring tool for CTCs, and CTCs may be a good prognostic indicator for patients with HCC undergoing LT.
Background United States Preventive Services Task Force (USPSTF) recommended against prostate specific antigen (PSA) screening in 2012, which was modified into shared decision making for men aged 55-70 with life expectancy over 10 years in 2018. We studied the trends in PSA screening in younger Black and White men with the implementation of 2012 and 2018 guidelines. Methods Younger Black and White men (aged 40-54 years) were identified using Behavioral Risk Factor Surveillance System database biennially from 2012 to 2020. Our primary outcome was PSA screening within two years of the survey. An adjusted logistic regression model with two-way interaction assessment between race and survey year was used to investigate the temporal trend of PSA screening in younger Black and White men. Results A total of 142,892 men were included. We saw steadily decreasing odds of PSA screening among both younger Black and White men in 2014, 2016, 2018, and 2020 compared to 2012 (for younger Black men: OR2014=0.77 [95%CI=0.62, 0.96], OR2016=0.51 [95%CI=0.41, 0.63], OR2018=0.33 [95%CI=0.27, 0.42], OR2020=0.25 [95%CI=0.18, 0.32]; and for younger White men: OR2014=0.81 [95%CI=0.76, 0.87], OR2016=0.66 [95%CI=0.61, 0.71], OR2018=0.41 [95%CI=0.37, 0.44], OR2020=0.36 [95%CI=0.33, 0.39]). Younger Black men showed brisker decrease in PSA screening in year 2016, 2018, and 2020 compared to younger White men (all p < 0.05). Conclusions PSA screening among younger men steadily decreased over the past decade since 2012 USPSTF guidelines, demonstrating a narrowing racial gap. How such observed trend translates to long-term clinical outcomes for younger Black men remains to be seen.
PURPOSE: Testing for pathogenic variants can aid in oncologic risk stratification and identification of targeted therapies. Despite known disparities in access to prostate cancer (PCa) care, little has been written about access to germline genetic testing (GGT) for Black men and other historically marginalized populations. This systematic review sought to delineate racial/ethnic disparities in GGT for PCa. METHODS: This systematic review identified articles published from January 1996 through May 2021 in PubMed, Web of Science, and Embase. We included studies that reported rates of GGT in men with PCa in the United States by race/ethnicity as reflective of routine clinical care or research. A narrative synthesis was performed. RESULTS: Of 4,309 unique records, 91 studies examining 50 unique study populations met inclusion criteria. Of these, four populations included men who received GGT through routine clinical care, accounting for 4,415 men (72.6% White and 7.2% Black). The other 46 populations included men who received GGT as part of a research study, accounting for 30,824 men (64.3% White and 21.6% Black). Of these 46 research populations, 19 used targeted methods to increase recruitment from a specific demographic. CONCLUSION: Most studies that report GGT rates by race/ethnicity are in research settings. Many of these studies used targeted recruitment methods and subsequently have a greater proportion of Black men than clinical and US population–based studies. Other historically marginalized populations are not well represented. There remains a knowledge gap regarding the extent of racial disparities in the use of GGT, particularly in the clinical setting.
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