Clinical Medicine & Research current issue

Serum Squamous Cell Carcinoma Markers: A Case-Control Study for Cervical Cancer

2026-01-08T06:38:27-08:00

Objective: To determine whether serum squamous cell carcinoma antigen (SCC-Ag) is predictive of treatment response in patients with squamous cell cervical carcinoma (SCC) undergoing chemoradiation therapy, and to establish the mean normal serum SCC-Ag level in age-matched, apparently healthy female controls.

Methods: Patients with histologically confirmed cervical SCC scheduled for concurrent chemoradiation were recruited (75 cases, alongside 75 age-matched apparently healthy controls, N = 150). Blood samples were collected before treatment and 6 weeks post-external beam radiotherapy to assess serum SCC-Ag levels, which were correlated with tumor stage and grade. Age-matched apparently healthy controls were also phlebotomized at baseline and 12 weeks later to determine normal SCC-Ag levels. Serum SCC-Ag was analyzed using Alinity i SCC reagent and analyzer (Abbott Laboratories, Chicago, IL, USA). The manufacturer's reference value for SCC-Ag is ≤1.5 ng/ml. Treatment response was assessed via pre- and post-treatment abdominopelvic computed tomography scans and classified as either complete or partial response. Data analysis was performed using SPSS v22.0, and logistic regression was used to evaluate predictors of treatment response. A P value <0.05 was considered statistically significant.

Results: The mean age was 55.1 ± 11.6 years for cases and 55.5 ± 11.4 years for controls. Among cervical cancer patients, the median pre-treatment SCC-Ag level was 7.4 ng/ml, and post-treatment was 1.2 ng/ml, both significantly higher than in controls (0.4 ng/ml and 0.5 ng/ml, respectively). Vaginal bleeding was the most common symptom (94.7%), and 68% presented with locally advanced disease. SCC histology was confirmed in 94.7% of cases, and 61% showed either complete or partial treatment response. Median SCC-Ag levels were significantly associated with disease stage (P<0.001) but not with tumor grade (P=0.159). Logistic regression identified tumor size as a significant predictor of treatment response, while pre-treatment SCC-Ag and SCC-Ag reduction rate were not.

Conclusion: Serum SCC-Ag levels were normal among all healthy controls and some patients with prior treatment. SCC-Ag correlated with disease stage but was not predictive of treatment response in patients undergoing chemoradiation. Tumor size was the only significant predictor of treatment response.

Intersection of Metastatic Cancer, Chemotherapy, and Reported Physical Abuse/Assault-Related Trauma: A Nationwide Analysis

Shour, A. R., Rhodes, H. X., Puthoff, D., Sharma, R., Onitilo, A. A. — 2026-01-08T06:38:27-08:00

Background/Purpose: We explored the complex relationship between the presence of metastatic cancer and undergoing cancer chemotherapy in adults with moderate to severe trauma and risk of reported physical abuse/assault-related trauma as defined in the American College of Surgeons Trauma Quality Programs Participant (ACS-TQP) dataset. We analyzed how these specific health conditions are associated with vulnerability to assault-related trauma, addressing a significant knowledge gap in existing literature.

Methods: We utilized retrospective data from the ACS-TQP from 2017-2019 (N=27,531). The outcome was the report of physical abuse/assault-related trauma (no/yes). We focused on adults (aged ≥ 18 years) diagnosed with moderate to severe physical trauma (Injury Severity Scale: 9-75) who either had metastatic cancer (exposure) or were currently receiving chemotherapy (intervention), adjusting for predisposing factors and need for care factors based on Anderson's Model of Health Service Utilization. We used descriptive statistics, Fisher's exact test, chi-square analysis, and logistic regression using Stata.v18, with a statistical significance of P≤0.05.

Results: We found 0.19% of 27,531 overall patients reported assault-related trauma, with 16,261 (0.16%) among those with moderate to severe trauma. Among these, a substantial majority with metastatic cancer reported assault-related trauma compared to those without metastatic cancer (84.62% vs. 15.38%; P value: 0.040). Patients receiving chemotherapy reported less frequent assault-related trauma than those not receiving it (26.92% vs. 73.08%; P value = 0.045). In the adjusted model, patients with metastatic cancer had significantly higher odds of reporting assault-related trauma than those without metastatic cancer (OR:7.847; 95% CI: 1.021-60.337; P<0.05). Chemotherapy was associated with a lower adjusted odds of assault-related trauma (OR 0.31, 95% CI: 0.08–1.14), but this did not reach statistical significance.

Conclusion: In this large trauma cohort, metastatic cancer was associated with higher odds of assault-related trauma, while chemotherapy showed a reduced risk only in unadjusted analyses. Our findings highlight the higher vulnerability of patients with metastatic cancer and support further investigation into potential protective associations with active treatment.

Artificial Intelligence in the Diagnosis, Treatment, and Prognosis of Hypopharyngeal Carcinoma: A Scoping Review

Zhang, Y. — 2026-01-08T06:38:27-08:00

Hypopharyngeal carcinoma (HPC) has one of the poorest prognoses among all types of head and neck squamous cell carcinoma (HNSCC). Artificial intelligence (AI) is a scientific field that is in the spotlight, especially in the last decade, and AI has also been widely used in the research field of HPC. This scoping review aimed to describe the improvement of HPC clinical cares brought by AI. Literatures utilizing AI and machine learning in HPC were searched in PubMed, EMBASE, and Web of Science, and 116 articles from 1987 to 2024 were retrieved. After removing duplicate and irrelevant articles, 85 were further selected for detailed review. AI helps analyze large amounts of data from HPC patients and develop models to facilitate clinical practice. The emergence of AI improves the endoscopic, radiologic, and pathologic diagnosis accuracy of HPC and guides personalized treatment and prognosis prediction. However, there are certain unmet challenges that need to be further elucidated, like interpreting the AI algorithms into features that can be observed by humans and promoting the AI models in larger and multi-centered cohorts.

Acephalgic Migraine Presenting as Episodic Fatigue and Nausea: A Case Report

Oliveira, D. G. — 2026-01-08T06:38:27-08:00

Acephalgic migraine (AM), or migraine aura without headache, is a subtype of migraine, characterized by transient neurological symptoms without the accompanying headache phase. Its diagnosis remains challenging due to varied clinical presentation and the tendency to misattribute symptoms to other neurological, psychiatric, or systemic disorders. This case report describes a female patient, age 38 years, presenting with episodic, incapacitating fatigue, nausea, and cognitive dysfunction, initially leading to an extensive but inconclusive diagnostic workup. Partial symptom relief with ondansetron, but not with metoclopramide, suggested involvement of migraine-associated pathways. A detailed history revealed a family history of migraine and specific triggers, including dietary and hormonal factors. A therapeutic trial with triptans led to dramatic symptom resolution, supporting an AM diagnosis. Retrospectively, the patient was able to identify additional aura symptoms, reinforcing the diagnosis. This case underscores the diagnostic challenge of AM and migraine aura variants. It also highlights the pivotal role of careful history-taking, patient–physician communication, and clinical reasoning in the evaluation of atypical symptom presentations. Clinician awareness of migraine spectrum disorders is essential to prevent misdiagnosis, reduce unnecessary testing, and improve patient outcomes. Further research is needed to refine diagnostic criteria and optimize management strategies.

Voriconazole-induced Hypoglycemia in a Non-diabetic Patient: A Rare Cause

Patel, G. R., Singh, V. — 2026-01-08T06:38:27-08:00

Voriconazole-induced hypoglycemia in non-diabetic patients has rarely been reported. We describe a non-diabetic man, aged 50 years, without hepatic or renal dysfunction who developed severe prolonged hypoglycemia about 28 hours after initiating therapeutic dose of intravenous (IV) voriconazole therapy for invasive pulmonary aspergillosis. He required continuous IV infusion of dextrose solutions to maintain euglycemia. He recovered from hypoglycemia after discontinuation of voriconazole. Higher than normal plasma insulin (30.4 μU/mL) as well as C-peptide (10.04 ng/mL) levels were observed, which reached normal levels after he recovered from hypoglycemia. The temporal association between voriconazole administration and hypoglycemia occurrence led to probability that it was voriconazole-induced. The voriconazole trough level (8.9 μg/mL) checked during the hypoglycemia episode was elevated. The mechanism of hypoglycemia may be strongly attributed to insulinemia resulting from high voriconazole concentration. There is a possibility of genetic polymorphisms in the hepatic cytochrome P450 2C19 isoenzyme in this patient, which altered the voriconazole metabolism, causing high trough levels associated with hypoglycemia. This case suggests that voriconazole has a propensity to alter glucose homeostasis in the absence of liver and kidney dysfunction, and it may induce hypoglycemia without drug over dosage or drug interaction that clinicians should be vigilant about.