ABO blood types and head and neck cancer: a systematic review with meta-analysis of observational studies

Objectives
This research aims to explore the correlation between ABO blood groups and neoplasms in the head and neck region, specifically investigating the susceptibility of different blood groups to tumours.

Design
Systematic review and meta-analysis.

Data sources
CNKI, WANFANG DATA, PubMed, Web of Science and Embase databases were systematically searched from inception to January 2024.

Eligibility criteria
All studies of ABO blood type and head and neck tumours will be included in this study.

Data extraction and synthesis
A systematic literature review was performed using digital platforms on CNKI, WANFANG DATA, PubMed, Web of Science and Embase databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for meta-analysis. Two authors independently extracted the data and assessed the quality of included studies. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Comparisons were made between blood types A, B, AB and their combined group versus O, along with subgroup analyses. Systematic analysis was performed by using Review Manager V.5.4 and Stata V.18 statistical software.

Results
30 articles were included, involving 737 506 subjects, among which 21 382 were patients with head and neck tumours. The overall analysis indicated a significant association between type AB blood (OR 0.762, 95% CI 0.637 to 0.910) and a reduced risk of head and neck tumours. In the Caucasoid race, type A blood is significantly linked to an elevated likelihood of head and neck tumours (OR 1.353, 95% CI 1.076 to 1.702), while in the Mongoloid race, type AB blood is significantly linked to a reduced likelihood of developing tumours in the head and neck area (OR= 0.732, 95% CI 0.588 to 0.910). No significant associations were found in the subgroup analysis by gender. Regarding different types of cancer, type A blood is significantly associated with an increased risk of salivary gland tumours (OR 1.338, 95% CI 1.075 to 1.665), and type AB blood is significantly linked to a lower likelihood of nasopharyngeal carcinoma (OR 0.590, 95% CI 0.429 to 0.812).

Conclusion
A correlation exists between ABO blood groups and tumours in the head and neck region. However, the link between blood type and head and neck tumours requires further confirmation through more prospective studies.

PROSPERO registration number
CRD42024510176.

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Correlation of the treatment sensitivity of patient-derived organoids with treatment outcomes in patients with head and neck cancer (SOTO): protocol for a prospective observational study

Introduction
Organoids have been successfully used in several areas of cancer research and large living biobanks of patient-derived organoids (PDOs) have been developed from various malignancies. The characteristics of the original tumour tissue such as mutation signatures, phenotype and genetic diversity are well preserved in organoids, thus showing promising results for the use of this model in translational research. In this study, we aim to assess whether we can generate PDOs from head and neck squamous cell carcinoma (HNSCC) samples and whether PDOs can be used to predict treatment sensitivity in HNSCC patients as well as to explore potential biomarkers.

Methods and analysis
This is a prospective observational study at a single centre (Guy’s and St Thomas’ NHS Foundation Trust) to generate PDOs from patients’ samples to assess treatment response and to correlate with patients’ treatment outcomes. Patients will be included if they are diagnosed with HNSCC undergoing curative treatment (primary surgery or radiotherapy) or presenting with recurrent or metastatic cancers and they will be categorised into three groups (cohort 1: primary surgery, cohort 2: primary radiotherapy and cohort 3: recurrent/metastatic disease). Research tumour samples will be collected and processed into PDOs and chemosensitivity/radiosensitivity will be assessed using established methods. Moreover, blood and other biological samples (eg, saliva) will be collected at different time intervals during treatment and will be processed in the laboratory for plasma and peripheral blood mononuclear cell (PBMC) isolation. Plasma and saliva will be used for circulating tumour DNA analysis and PBMC will be stored for assessment of the peripheral immune characteristics of the patients as well as to perform co-culture experiments with PDOs. SOTO study (correlation of the treatment Sensitivity of patient-derived Organoids with Treatment Outcomes in patients with head and neck cancer) uses the collaboration of several specialties in head and neck cancer and has the potential to explore multiple areas of research with the aim of offering a valid and effective approach to personalised medicine for cancer patients.

Ethics and dissemination
This study was approved by North West-Greater Manchester South Research Ethics Committee (REC Ref: 22/NW/0023) on 21 March 2022. An informed consent will be obtained from all participants prior to inclusion in the study. Results will be disseminated via peer-reviewed publications and presentations at international conferences.

Trial registration number
NCT05400239.

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Non-linear association of baseline viral load with on-treatment hepatocellular carcinoma risk in chronic hepatitis B: still needs further discussion

We read with great interest the recent article by Choi et al.1 By analysing the data of a multicentre historical cohort including 4693 adult patients with chronic hepatitis B (CHB), they concluded that patients with moderate baseline viral loads, particularly around 6 log10 IU/mL, demonstrated the highest on-treatment hepatocellular carcinoma (HCC) risk. Because this conclusion is interesting and different from the findings of some previous studies,2 3 which may affect the timing of treatment initiation for many patients with CHB, findings of this study should be cautiously viewed. Here, we highlight some points that need further discussion. First, the authors investigated the association between on-treatment HCC risk and various baseline characteristics. However, some indicators (recently emerging biomarkers: quantified hepatitis B surface antigen (HBsAg)4 5; common clinical characteristics: serum albumin,2 diabetes mellitus,6 family history of HCC,

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Circulating tumour DNA in patients with hepatocellular carcinoma across tumour stages and treatments

Objective
Circulating tumour DNA (ctDNA) is a promising non-invasive biomarker in cancer. We aim to assess the dynamic of ctDNA in patients with hepatocellular carcinoma (HCC).

Design
We analysed 772 plasmas from 173 patients with HCC collected at the time of diagnosis or treatment (n=502), 24 hours after locoregional treatment (n=154) and during follow-up (n=116). For controls, 56 plasmas from patients with chronic liver disease without HCC were analysed. All samples were analysed for cell free DNA (cfDNA) concentration, and for mutations in TERT promoter, CTNNB1, TP53, PIK3CA and NFE2L2 by sequencing and droplet-based digital PCR. Results were compared with 232 corresponding tumour samples.

Results
In patients with active HCC, 40.2% of the ctDNA was mutated vs 14.6% in patients with inactive HCC and 1.8% in controls (p

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Cause of death by fibrosis stage in 959 patients with biopsy-proven NAFLD

We have read with interest the study from Simon et al, where the authors observed a higher mortality rate among patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) compared with reference controls without NAFLD.1 Importantly, mortality rates exhibited a significant increase as the severity of NAFLD worsened, that is, from simple steatosis, non-fibrotic nonalcoholic steatohepatitis (NASH), non-cirrhotic fibrosis (ie, F1–F3, with or without NASH) to cirrhosis. The leading causes of death were attributable to extrahepatic cancers and liver cirrhosis, while cardiovascular disease and hepatocellular carcinoma had a comparatively lesser impact. This extensive study of patients with NAFLD reveals higher mortality rates across different NAFLD stages but does not stratify causes of death within the respective pre-cirrhotic fibrosis stages (F0–F3). Owing to the long natural history of NAFLD, for example, patients with F0 and F1 may never experience liver-related events.2–4 For that…

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Prospective cohort for early detection of liver cancer (Pearl): a study protocol

Introduction
Hepatocellular carcinoma (HCC) is the fastest-rising and fourth most common cause of cancer death worldwide. Liver cirrhosis is the largest underlying risk factor for HCC. Therefore, patients with cirrhosis should have regular ultrasound and biochemical screening to pick up early HCC. Early HCC can be cured; more advanced HCCs have limited treatment options and poor prognosis. Current screening methods are suboptimal with poor sensitivity in picking up early disease. In this study, the investigators aim to recruit people with liver cirrhosis into a Prospective cohort for early detection of liver cancer—the Pearl cohort. The investigators believe that by using state-of-the-art tests we can improve the detection of early HCC.

Methods and analysis
This is a UK-based prospective, longitudinal, diagnostic, prognostic, multicentre, non-CTIMP study. Aiming to recruit 3000 patients with liver cirrhosis without a HCC diagnosis, the Pearl cohort will be followed actively for 3 years from recruitment and then passively via registry data for ten years thereafter. Blood and urine samples will be taken and information from routine care will be gathered. These will be used to assess novel diagnostic approaches for the detection early HCC and to develop models to identify those most at risk for developing HCC.
Participants will be linked to national UK health registries to ensure long-term capture of HCC incidence and other relevant endpoints. Approximately 75 patients are predicted to develop de novo HCC within the 3-year follow up period. After this period, the study teams will obtain data on participants for at least 10 years after the last contact. This cohort will help develop an understanding of the incidence of HCC in a UK population stratified by underlying cirrhosis aetiology.

Ethics and dissemination
Ethical approval has been granted by REC and the trial is registered on ClinicalTrials.gov. The results will be published in peer-reviewed journals and presented at relevant meetings.

Trial registration number
NCT05541601.

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