The tumor-node-metastasis (TNM) classification, the presence of a mucinous component, and signet ring cells are well-known criteria for identifying patients at a high risk for recurrence and determining the therapeutic approach for early-stage colon cancer (eCC). Nevertheless, recurrence can unexpectedly occur in some eCC cases after surgical resection. The aims of the present study were to evaluate the relation of dysregulated MACC1, c-MET, and NM23-H1 expression with the histopathological features of tumors in recurrence formation in eCC cases. A total of 100 sporadic eCC patients without poor prognosis factors were evaluated in this study. The relationship between the altered expression of MACC1, c-MET, and NM23-H1 and pathological microenvironmental features, including the presence of tumor budding and desmoplasia, were assessed. The primary outcomes, including 5-year overall survival (OS) and disease-free survival (DFS), were also measured. Compared with nonrecurrent patients, the expression level of MACC1 was 8.27-fold higher, and NM23-H1 was 11.36-fold lower in patients with recurrence during the 5-year follow-up (p = 0.0345 and p = 0.0301, respectively). In addition, the coexistence of high MACC1 and low NM23-H1 expression and tumor budding was associated with short OS (p < 0.001). We suggest that the combination of reduced NM23-H1, induced MACC1, and the presence of tumor budding are promising biomarkers for the prediction of recurrence and may aid the stratification of patients with stage II colon cancer for adjuvant chemotherapy.

The critical risk factors that influence production-oriented projects in the United Arab Emirates: a 'best-worst method' (BWM) analysis

Aim: Primary hyperparathyroidism (PHP) is commonly caused by adenomas. Studies have shown mild inflammation in PHP and elevated levels of some inflammatory markers to support this. In addition, excess parathyroid hormone (PTH) and calcium (Ca) cause atherosclerosis by disrupting endothelial function. Mean platelet volume (MPV) describes the size and indirect activity of platelets and its value is expected to increase with inflammation and associated atherosclerosis. Neutrophil to lymphocyte ratio (NLR) is another parameter associated with inflammatory response. This study was performed to investigate the MPV and NLR levels in PHP developing from a single parathyroid adenoma. Method: Patient records from 2016-2021 were retrospectively scanned from the computer system and 40 patients with PHP developing from a single parathyroid adenoma were selected based on exclusion criteria. The values of PTH, Ca, 25-Hydroxyvitamin D, phosphorus, MPV and number of blood cells were recorded. NLR was calculated. The results were compared with the results of 36 healthy controls. Results: MPV (8.7±0.6 fl and 7.6±0.6 fl, respectively; p=0.001) and NLR (2.6±1.7 and 1.7±0.8, respectively; p=0.000) were higher in the PHP group compared to the control group. Ca and PTH correlated positively with MPV (p=0.003 and p=0.000, respectively) and NLR (p=0.011 and p=0.023, respectively). Conclusion: MPV and NLR were found to be higher in patients with PHP developing from a single adenoma than in healthy individuals.

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