Barretos Cancer Hospital

The oral microbiome, particularly Fusobacterium nucleatum (Fn), has been implicated in head and neck cancers (HNC), influencing local immunity and Human Papillomavirus (HPV) status. Here, we evaluated the presence of Fn and its association with HPV infection, TERT promoter (TERTp) mutations, and patient outcomes.

We analyzed 94 formalin-fixed paraffin-embedded (FFPE) tumor tissues from HNC patients previously evaluated for TERTp mutations. Fn DNA was detected using droplet digital PCR (ddPCR), and HPV status was determined via p16 immunohistochemistry in pre-treatment samples. Associations between Fn presence, clinicopathological features, HPV, and TERTp mutation status were assessed.

Tumors primarily originated from the oropharynx (70.2%) and oral cavity (29.8%). Tobacco and alcohol use were reported in 87.2% and 79.8% of cases, respectively. Fn was present in 59.6% of cases, with higher prevalence in oropharyngeal (62.1%) than oral cavity (53.6%) tumors. No significant associations were found between Fn and clinicopathological features, TERTp, or HPV status. However, patients with Fn positivity showed significantly improved cancer-specific survival (61.5% vs. 39.1%, p = 0.013), similar to HPV-positive patients (72.7% vs. 42.7%, p = 0.014).

The presence of Fusobacterium nucleatum in HNC correlates with longer survival, highlighting its potential as a prognostic marker.

Acute and chronic exposure to pesticides is associated with several negative effects on human health, such as an increased risk of cancer, including mature B-cell neoplasms such as chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). However, the biological mechanism linking pesticide exposure to the development of CLL and MM has not yet been elucidated. Thus, this study aimed to explore miRNA expression profiles in patients with CLL and MM who were occupationally exposed and not exposed to pesticides. For this purpose, 24 patients with MM and CLL were recruited from a cohort in Brazil and the miRNA expression profiles between the groups were analyzed using Nanostring technology. The study revealed the downregulation of miR-423-3p, miR-1193, miR-576-5p, miR-509-5p, miR-548b-3p, miR-1469, miR-329-3p, and miR-548j-3p, and the upregulation of miR-301b-5p and miR-548ah-5p in patients with CLL and MM were associated with occupational exposure to pesticides. The integrated network analysis of the differentially expressed miRNAs and their target genes in the exposed group demonstrated that miRNAs can participate in the regulation of signaling pathways, such as PI3K/Akt/mTOR and MAPK. Additionally, these miRNAs were found to be associated with an increased risk of developing neurological diseases and various types of cancer. In the present study, we demonstrate, for the first time, altered expression of plasma-derived miRNAs in patients with CLL and MM exposed to pesticides. The plasma miRNAs identified may serve as promising candidates for biomarkers of pesticides effects, potentially contributing to the emerging field of Precision Environmental Health.

This study assessed the timeline from the initial presentation of symptoms of major cancers to the arrival at and diagnosis by the reference center for pediatric oncology in Barretos, São Paulo, Brazil. The goal was to examine the flow of care within the healthcare system and identify disparities indicative of inequitable access to health services. We conducted a cross-sectional analysis of patient data over eight years. Quantitative variables were examined using median values, T-tests, Kruskal-Wallis tests, ANOVA, Bonferroni adjustments, and pairwise comparisons. Categorical variables were analyzed using the Chi-square test, with a significance threshold set at 5%. A total of 508 patients with malignant cancers were studied. Patients with hematologic cancers experienced the shortest median times from initial symptom perception (2 days), to the first healthcare visit (1 day), onward referral to a specialized center (30 days), and final diagnosis (35 days). This is in contrast to patients with central nervous system cancers (2, 3, 90, and 112.5 days respectively) and bone cancers (20, 7, 60, and 90 days respectively). Families from municipalities ranked lower on the GeoSES socioeconomic scale reported longer durations before recognizing initial symptoms (p-value = 0.037). Low initial diagnostic suspicion and systemic delays are primary obstacles that need addressing to enhance the diagnosis and treatment of pediatric cancer in Brazil's most populous state.