Thai cancer journal

The association of AFP, AST, ALT and Neutrophil to lymphocyte ratio for diagnosis hepatocellular carcinoma

2024-03-07T11:05:35+07:00

Alpha-fetoprotein (AFP) is a tumor marker widely used in the diagnosis and monitoring of hepatocellular carcinoma (HCC). However, it is not applicable to the diagnosis of HCC in all individuals due to the possibility that some liver cancer patients may have AFP levels within the reference range. Elevated levels of AFP have also been found in patients with other liver diseases. Based on this limitation, our study aimed to investigate the combination of routine blood examinations, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and neutrophil to lymphocyte ratio (NLR), with AFP to increase sensitivity and specificity in diagnosing HCC compared to other liver diseases. This research is a retrospective descriptive study. Data were collected from patients diagnosed with HCC and liver diseases, treated at the National Cancer Institute from January 1, 2019 to December 31, 2022. Results: In total, 203 patients were included, with 96 had HCC and 107 had liver diseases. The area under the ROC curve for HCC diagnosis of AFP, ALT, AST, and NLR were 0.77 (0.72–0.82), 0.70 (0.64–0.76), 0.62 (0.55–0.69), and 0.57 (0.51–0.64) with optimum cut-off values of 20.7 ng/mL, 26 IU/mL, 27 IU/mL and 1.724, respectively. Of all four cut-off values, AST had the highest diagnosing sensitivity for HCC at 83.3%, but with relatively low specificity (57%). AFP had the highest specificity for diagnosing HCC at 98.1%, but the lowest sensitivity at 55.2%. when used together, the combination of AFP and AST showed the highest area under the ROC curve values of 0.74 (0.68-0.79), with sensitivity at 49% and specificity at 98.1%, albeit with reduced sensitivity compared to AFP or AST alone. In patients with AFP levels below 20 ng/mL, AST also showed the maximum area under the ROC curve of 0.67 (0.59-0.75). In conclusion, the HCC diagnostic values of AFP, AST, ALT, and NLR, as well as the combined correlation analyzed from the data, demonstrate that AFP remains a good diagnostic marker for HCC. Although it exhibits relatively low sensitivity, it has very high specificity. AST aids in increasing sensitivity in the diagnosis of HCC.

Symptom distress and factors related to symptom distress in advanced cancer patient at Lopburi Cancer Hospital

2024-03-14T13:50:02+07:00

A cross-sectional study with retrospective data collection. Objective: To study the characteristics of disturbing symptoms and factors associated with disturbing symptoms in patients with advanced cancer. The sample consisted of 360 patients with advanced cancer of seven types, including lung, colon, breast, cervical, head and neck, liver and biliary tract, who received care at Lopburi Cancer Hospital between February 1, 2022-February 28, 2023. Patient medical records were collected and analyzed using descriptive statistics and chi-square tests. The results showed that the sample was diagnosed with advanced cancer, classified by organ as follows: lung: 32.4%, breast: 22.2%, head and neck cancer: 15.3%, colon: 12.2%, liver: 7.0%, cervix: 6.5% and biliary tract: 4.4%. The five most common disturbing symptoms in patients with advanced cancer were pain 84%, fatigue 73%, discomfort 68%, shortness of breath 55% and anxiety 48%. The three most associated factors with disturbing symptoms were location of metastasis, method of disturbing symptom management, and palliative performance scale. Specifically, 1. Breast cancer that metastasized to bone and breast cancer that did not metastasize to brain were associated with pain P=0.001, P=0.009, respectively; breast cancer that metastasized to bone was associated with fatigue P=0.042 and breast cancer that did not metastasize to brain was associated with discomfort P=0.046. 2. The method of disturbing symptom management was associated with fatigue and discomfort P=0.001. 3. Palliative performance scale was associated with pain, fatigue, and discomfort P=0.002, P=0.016, P=0.043, respectively. The three most important disturbing symptoms in patients with advanced cancer were pain, fatigue, and discomfort. The factors associated with disturbing symptoms were location of metastasis, method of disturbing symptom management, and palliative performance scale. Further studies are needed to explore the management of pain, fatigue, discomfort, shortness of breath, and anxiety in the future.

Development of online media for brachytherapy services in Udonthani Cancer Hospital

2024-04-03T15:39:13+07:00

Brachytherapy is one of the radiation therapy technique used to treat cancer. By means of deliver a precise amount of radiation dose directly to the cancerous tumor, makes it an effective treatment option. Patient preparation is crucial in this process. The process have been made to educate and provide before receiving service including QR code-based instruction. However, these formats are not interesting, which may not be engaging by patients. As a result, some patients may have difficulty understanding and correctly implementing the instructions. To overcome these problems, there was an interest in developing the online media, to create an effective method in patients treated with brachytherapy. This is a research and development project based on the ADDIE Model, which is Molenda's definition of media production. The purpose of this project is to create a digital platform for brachytherapy services at the Udonthani Cancer Hospital [UDCH]. The sample consisted of 42 cervical and endometrial cancer patients who received brachytherapy services at UDCH. This study was conducted from October 2022 to March 2023. The media content was verified by three subject-matter experts and three media experts, the efficiency was determined based on to Meguigans criteria, and a pre- and post- knowledge were compared by using the Wilcoxon Signed-Rank test. User satisfaction with online media was assessed. Results; The research showed that the development model is online media, demonstration Program format, presented with Motion Infographic. The media quality was characterized as highly favorable (93.80%, x ̅ 4.69, S.D=0.39). Line, Facebook and YouTube were employed as the internet distribution channels. The video media's efficiency was 1.76 and higher than Meguigans' standard threshold of 1.00. The average post- knowledge scores significance higher than pre-knowledge scores (P< 0.001). The satisfaction was especially high (89.40 %, x ̅=4.47, S.D.=0.52). Conclusion; According to the findings, the developed online media for brachytherapy services at UDCH demonstrated excellent quality and efficacy. As a result, this media is suitable for the radiology nurse to use for educating or offering the adequate and comprehension for brachytherapy, in order to prepare and practice prior to, during, and after therapy. This way reduce the severity of complications

The comparison of diagnostic ability between half time bone scan image via Bone evolution software by GE: NM 670 with standard image

2024-04-04T17:45:46+07:00

A bone scan is a diagnosis of bone abnormalities which are important in the examination of patients with various types of cancer to find the spread of cancer to the bone. The bone scan took a long time for the patient to be examined. Therefore, software was invented to reduce the time of bone scan examination while maintaining normal scan image quality. There is software called “Bone evolution” of GE machines that can scan bone scans in half of the normal time or inject only half of the normal dose of radiopharmaceuticals, and produce image quality as same as normal one did. To determine whether a bone scan image at half of the time of a normal scan using the Bone evolution software of a GE NM670 can diagnose lesions not different from a normal scan. A randomized controlled trial in patients undergoing bone scans for metastasis at the nuclear medicine department, Lopburi Cancer Hospital. A total of 84 patients were selected between September 2018-October 2019 to compare the number of lesions, lesion locations, and image quality, which was categorized as good, medium, and poor between the two scanned images. The data were analyzed by computer program SPSS using basic statistics namely, percentage, mean, and standard deviation. To compare the data of 2 groups, wilcoxon match Paired sign rank test was utilized. The number of lesions from the normal scans was greater than the half-time scans without a statistically significant difference (P<0.001). The number of lesion locations from the normal scans was less than the half-time scans with a statistically significant difference (P<0.001). The image quality of the normal scan was better than that of the half-time scan with a statistically significant difference (P<0.001).Normal scans ensure better diagnosis for doctors. Consequently, half-time scans programmed with Bone evolution could not be substituted for normal scans.

Incidence of deep vein thrombosis in patients with gynecologic malignancy

2024-04-05T13:53:37+07:00

Venous thromboembolism (VTE) is a serious complication and morbidity and increase mortality. VTE, also known as pulmonary embolism (PE) and deep vein thrombosis (DVT). The incidence of VTE in patients with gynecologic malignancy is higher than other cancer. This study aimed to evaluate the incidence of DVT in patients with gynecologic malignancy. This retrospective descriptive study was conducted between Oct 1, 2022-Sep 30, 2023 in patients with gynecologic malignancy who underwent venous Doppler ultrasound of lower extremities at Ubonratchathani cancer hospital. The medical records of enrolled patients were reviewed including age, BMI, underlying disease, diagnosis, history of chemotherapy, previous radiation, location of DVT, symptomatic or asymptomatic of DVT and treatment. Total number of patients with gynecologic malignancy at Ubonratchathani cancer hospital was 2,388 patients. There were 48 gynecologic patients who underwent venous Doppler ultrasound of lower extremities. Only 29 patients with gynecologic malignancy were enrolled in this study. We found 11 patients with DVT. The incidence of DVT in patients with gynecologic malignancy in this study was 37.93%. Most of DVT were found in cervical cancer (63.64%), the second from endometrial cancer (27.27%). The most common histologic cell type in this study were adenocarcinoma (54.54%) and the second were squamous cell carcinoma (27.27%). Most of patients were advanced stage and presented with leg edema. Common location of DVT were common femoral vein (CFV) and superficial femoral vein (SFV). The patients with gynecologic malignancy have a higher risk of DVT. Therefore, increased awareness in cancer patients may prevent VTE and decreased morbidity and mortality.