Jakub Wnuk

Pancreatic cancer (PC) is considered one of the deadliest cancers worldwide, and the number of PC-related deaths is expected to increase. Early diagnosis of PC is crucial for improving treatment outcomes. Despite improvements in overall survival (OS) in metastatic and unresectable PC due to systemic therapy, there is still a need to search for novel therapies and factors predictive of response to treatment. Cancer profiling based on genome sequencing can be used to develop targeted therapies and improve prognostics and treatment outcomes. Therefore, this review was conducted to evaluate the clinical value of molecular subtyping in pancreatic cancer as a prognostic and predictive factor in pancreatic cancer. Due to its limitations, including the lack of a registered protocol and risk of bias assessment for the included studies and those whose results were not included, this study should be considered a narrative review with a structured search strategy rather than a systematic review.

Neuroendocrine tumors (NETs) are a diverse group of rare but clinically important neoplasms with increasing incidence and high biological heterogeneity. Heat shock proteins (HSPs) play a key role in the cellular response to stress, participating in the maintenance of proteome homeostasis and in the regulation of tumorigenesis processes such as proliferation, migration, apoptosis and development of resistance to therapy. This review analyzes the importance of HSPs in the diagnosis, prognosis and therapy of neuroendocrine tumors, as potential prognostic markers and targets of molecularly targeted therapy. The possibility of using HSP activity modulation to increase the efficacy of treatment, especially in cases refractory to standard therapeutic regimens, is emphasized. Due to the increasing clinical importance of NETs and limited therapeutic options in advanced forms, further exploration of the role of HSPs as biomarkers and therapeutic targets in this group of tumors is necessary.

Breast cancer is one of the most commonly diagnosed malignant tumours in women worldwide. Although modern medicine has led to advanced diagnostic methods and therapies that allow for increasingly effective treatment, the mechanisms underlying breast cancer development and progression remain the subject of intensive research. In the pathogenesis of this cancer, significant importance is attributed to interactions between tumour cells and the tumour microenvironment, in which soluble immune system mediators—cytokines—play a key role, including IL-21 and IL-22. These interleukins, by modulating the immune response, can both promote and inhibit tumour progression, and analysing their concentrations may prove helpful in diagnosis, disease progression prognosis, and the development of new therapies, including immunotherapy. The aim of this study was to determine the concentrations of IL-21 and IL-22 in a group of patients with invasive cancer, depending on the biological type of the tumour and its malignancy grade. The study involved 60 women with breast cancer and 20 women with benign breast lesions, and the analysis of IL-21 and IL-22 protein concentrations was performed using the enzyme-linked immunosorbent assay (ELISA) method. The analysis shows that the concentrations of IL-21 and IL-22 do not differ significantly depending on the malignancy grade of the tumour. However, a statistically significant negative correlation between the concentrations of IL-21 and IL-22 was observed exclusively in the group of patients with benign breast lesions. Due to the high heterogeneity of breast cancers, further research with a larger study group is necessary to better understand these parameters and possibly apply them clinically in patients with breast cancer.

Pancreatic cancer (PC) is the seventh most common cause of cancer-related death worldwide. The low survival rate may be due to late diagnosis and asymptomatic early-stage disease. Most patients are diagnosed at an advanced stage of the disease. The search for novel prognostic factors is still needed. Two miRNAs, miR-22-3p and miR-885-5p, which show increased expression in PC, were selected for this study. The aim of this study was to evaluate the utility of these miRNAs in the prognosis of PC. Other prognostic factors such as lipase-to-amylase ratio (LAR), neutrophil-to-lymphocyte ratio (NLR), and carbohydrate antigen 19-9 (CA19-9) were also evaluated in this study. This study was conducted in 50 patients previously diagnosed with pancreatic ductal adenocarcinoma in clinical stage (CS) III and IV. All patients underwent a complete medical history, physical examination, and routine laboratory tests including a complete blood count, C-reactive protein (CRP), CA19-9, lipase, and amylase. Two additional blood samples were taken from each patient to separate plasma and serum. Isolation of miRNA was performed using TRI reagent with cel-miR-39-3p as a spike-in control. Reverse transcription of miRNA was performed using a TaqMan Advanced miRNA cDNA Synthesis Kit. The relative expression levels of miR-22-3p and miR-885-5p were measured using RT-qPCR. Serum hsa-miR-22-3p was detected in 22 cases (44%), while hsa-miR-885-5p was detected in 33 cases (66%). There were no statistically significant differences in serum or plasma miRNA expression levels between patient groups based on clinical stage, gender, or BMI. There were no statistically significant differences in LAR between patients with different CS. For NLR, CRP and CA19-9 thresholds were determined using ROC analysis (6.63, 24.7 mg/L and 4691 U/mL, respectively). Cox’s F test for overall survival showed statistically significant differences between groups (p = 0.002 for NLR, p = 0.007 for CRP and p = 0.007 for CA19-9). Utility as prognostic biomarkers was confirmed in univariate and multivariate analysis for CA19-9, CRP, and NLR. The selected miRNAs and LAR were not confirmed as reliable prognostic markers in PC.

Aim: The aim of this study was to investigate the frequency, quantity and quality of subjective sleep problems, and their correlation with accompanying factors in cancer patients undergoing systemic therapy. Materials and methods: The study included 100 patients – 50 females and 50 males – undergoing oncological treatment who filled out an anonymous questionnaire specifically designed for this research. Results: 88% of the respondents reported the duration of sleep in the range of 5 to 9 hours. 48% of the respondents declared a deterioration in the quality of sleep after the diagnosis of cancer. Following the onset of sleep problems, 66% of respondents did not pursue any treatment. Among the examined patients, symptoms of insomnia were reported by 18%, and symptoms of hypersomnia – by 6%. Mixed sleep disorders were reported by 11% of respondents. The patients undergoing surgical treatment reported a statistically significantly lower quality of sleep compared to the patients not undergoing surgery (median score in the quantitative scale 6 vs. 7 on a scale of 1–10, where 1 indicated the worst quality of sleep and 10 indicated the best quality of sleep; p = 0.04). A very small percentage of patients sought pharmacotherapy or specialist help for sleep disorders, which precludes drawing statistically significant conclusions about the impact of these interventions on sleep quality. Conclusions: Sleep problems are often reported by patients during oncological treatment (48%). The main sleep-related complaints were advanced sleep phase disorders. Due to the frequent occurrence of sleep disorders among patients, it is important to conduct a thorough medical interview to diagnose them and implement appropriate treatment.

Introduction. A novel coronavirus, causing severe acute respiratory syndrome 2 (SARS-CoV-2) has spread globally since its emergence in December 2019. The mRNA SARS-CoV-2 vaccines have been proven to be an efficient and safe disease control means among adult patients without immunocompromising conditions. However, cancer patients were among the group of people that was initially excluded from the registration trials. Material and methods. 60 patients, enrolled to this study, had been voluntarily vaccinated either with the BNT162b2 or mRNA-1273 SARS-CoV-2 vaccine between March and June 2021 and have been undergoing systemic treatment in the Clinical Oncology Unit of the University Clinical Center of the Medical University of Silesia in Katowice, Poland. Patients received 2 injections of vaccine 21 days apart and were tested with ElecsysR Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, France) for the presence of anti-S-protein antibodies in the patients’ serum. The serum samples were collected 2 to 8 weeks after receiving the second dose of vaccine. Results. The BNT162b2 vaccine was administered to 57 patients, while the mRNA-1273 vaccine – to 3 patients. Seroconversion was achieved in 83.33% of patients. The median amount of anti-S-protein antibodies was 75,9 U/ml.There were no statistically significant differences in terms of age between the group with seroconversion and the group without seroconversion (Mann-Whitney U-test p = 0.762). There was no statistically significant correlation between neither the BMI (Spearman test, p = 0.079) norage (Spearman test, p = 0.762) and anti-S-protein antibody levels. Just as the diagnosis (primary tumor localization), clinical stage, type of modality (chemotherapy, chemoradiotherapy, immunotherapy) and the goal of treatment (radical, palliative) were not statistically significant in terms of anti-S-protein antibody levels. Conclusions. Due to the high number of unresponsive or poorly responsive results, patients undergoing systemic therapy should be advised to maintain other measures of disease control such as distancing, usage of masks. Nevertheless, implementing mRNA SARS-CoV-2 vaccinesinimmunocompromised patientsduring systemic therapyis reasoned, valuable and safe. Introduction. A novel coronavirus, causing severe acute respiratory syndrome 2 (SARS-CoV-2) has spread globally since its emergence in December 2019. The mRNA SARS-CoV-2 vaccines have been proven to be an efficient and safe disease control means among adult patients without immunocompromising conditions. However, cancer patients were among the group of people that was initially excluded from the registration trials. Material and methods. 60 patients, enrolled to this study, had been voluntarily vaccinated either with the BNT162b2 or mRNA-1273 SARS-CoV-2 vaccine between March and June 2021 and have been undergoing systemic treatment in the Clinical Oncology Unit of the University Clinical Center of the Medical University of Silesia in Katowice, Poland. Patients received 2 injections of vaccine 21 days apart and were tested with ElecsysR Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, France) for the presence of anti-S-protein antibodies in the patients’ serum. The serum samples were collected 2 to 8 weeks after receiving the second dose of vaccine. Results. The BNT162b2 vaccine was administered to 57 patients, while the mRNA-1273 vaccine – to 3 patients. Seroconversion was achieved in 83.33% of patients. The median amount of anti-S-protein antibodies was 75,9 U/ml.There were no statistically significant differences in terms of age between the group with seroconversion and the group without seroconversion (Mann-Whitney U-test p = 0.762). There was no statistically significant correlation between neither the BMI (Spearman test, p = 0.079) norage (Spearman test, p = 0.762) and anti-S-protein antibody levels. Just as the diagnosis (primary tumor localization), clinical stage, type of modality (chemotherapy, chemoradiotherapy, immunotherapy) and the goal of treatment (radical, palliative) were not statistically significant in terms of anti-S-protein antibody levels. Conclusions. Due to the high number of unresponsive or poorly responsive results, patients undergoing systemic therapy should be advised to maintain other measures of disease control such as distancing, usage of masks. Nevertheless, implementing mRNA SARS-CoV-2 vaccinesinimmunocompromised patientsduring systemic therapyis reasoned, valuable and safe.

Introduction.Difficulties in advanced pancreatic ductal adenocarcinoma (PDAC) treatment require a constant search for novel prognostic factors. The aim of this study is to determine the role of various morphological parameters in pre­dicting the prognosis of advanced PDAC during systemic therapy with a FOLFIRINOX regimen. Material and methods.The data of 52 patients, treated with FOLFIRINOX chemotherapy due to metastatic PDAC were analyzed retrospectively in this study. Results.The median time of overall survival (OS) in the group of patients with neutrophil-to-lymphocyte ratio (NLR) ≥3 was 5.8 months, compared to 14.5 months in patients with NLR < 3. Median progression-free survival (PFS) in patients with NLR ≥ 3 was 4.1 months, compared to 8.5 months in patients with NLR < 3. There were no statistically significant differences among patients concerning the lymphocyte-to-monocyte ratio (LMR) and platelets-to-lymphocyte ratio (PLR). Conclusions.Higher NLR is a negative prognostic factor in metastatic PDAC. Introduction.Difficulties in advanced pancreatic ductal adenocarcinoma (PDAC) treatment require a constant search for novel prognostic factors. The aim of this study is to determine the role of various morphological parameters in pre­dicting the prognosis of advanced PDAC during systemic therapy with a FOLFIRINOX regimen. Material and methods.The data of 52 patients, treated with FOLFIRINOX chemotherapy due to metastatic PDAC were analyzed retrospectively in this study. Results.The median time of overall survival (OS) in the group of patients with neutrophil-to-lymphocyte ratio (NLR) ≥3 was 5.8 months, compared to 14.5 months in patients with NLR < 3. Median progression-free survival (PFS) in patients with NLR ≥ 3 was 4.1 months, compared to 8.5 months in patients with NLR < 3. There were no statistically significant differences among patients concerning the lymphocyte-to-monocyte ratio (LMR) and platelets-to-lymphocyte ratio (PLR). Conclusions.Higher NLR is a negative prognostic factor in metastatic PDAC.

Pancreatic cancer (PC) is considered to be the seventh most common cause of cancer-related deaths. The number of deaths caused by PC is estimated to increase in the future. An early diagnosis of PC is crucial for improving treatment outcomes. The most common histopathological subtype of PC is pancreatic ductal adenocarcinoma (PDAC). MicroRNAs (miRNAs)—which are endogenous non-coding RNAs involved in the posttranscriptional regulation of multiple gene expression—constitute useful diagnostic and prognostic biomarkers in various neoplasms, including PDAC. Circulating miRNAs detected in a patient’s serum or plasma are drawing more and more attention. Hence, this review aims at evaluating the clinical value of circulating miRNA in the screening, diagnosis, prognosis and monitoring of pancreatic ductal adenocarcinoma therapy.

Introduction: Systemic treatment of pancreatic adenocarcinoma in the population of people over 65 years old is a challenge resulting from both the extremely unfavourable prognosis of this cancer and the particularly high sensitivity to the toxicity of chemotherapy in the elderly. This article...

Objective: Antibiotics are the mainstay of therapy for acute exacerbation of chronic rhinosinusitis. However, no treatment guidelines exist. Most clinicians follow the recommendations for acute bacterial rhinosinusitis, usually caused by Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis, and treat with amoxicillin or amoxicillin-clavulanate.Method: Medical data of 810 patients who had undergone endoscopic sinus surgery were analysed retrospectively. The results of bacterial cultures and treatment course were assessed in 152 patients who presented with acute exacerbation of chronic rhinosinusitis within 6 months of endoscopic sinus surgery.Results: The most common bacterial species present were Staphylococcus aureus (36 per cent), Pseudomonas aeruginosa (13 per cent) and Escherichia coli (11 per cent). Most of the isolates showed resistance or intermediate sensitivity to amoxicillin-clavulanate. Targeted antibiotic therapy was significantly more effective than empiric therapy (71 per cent versus 42 per cent). The most effective antibiotics were fluoroquinolones.Conclusion: Acute exacerbation of chronic rhinosinusitis shows different microbiology than acute bacterial rhinosinusitis and requires a different therapeutic approach. It is optimally treated with culture-directed antibiotic therapy.