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Prognostic value of Ki-67 in patients with endometrial cancer in the Republic of Moldova

Sun, 01 Feb 2026 00:00:00 GMT

Title: Prognostic value of Ki-67 in patients with endometrial cancer in the Republic of Moldova Authors: Tripac, Irina; Stratan, Valentina; Tutuianu, Valeriu; Sitnic, Victor; Vlad, Catalin; Andrei, Patriciu; Cadariu, Achimas; Harasani, Klejda; Calleja-Agius, Jean; Dobrovolskaia, Aliona; Sukhin, Vladyslav; Bacalim, Lilia; Vladimir, Bucinskii; Pinzaru, Valeria; Nichitovici, Cristiana; Maritoi, Tatiana; Abdulraghimov, Ainura Abstract: Introduction/Background: Endometrial adenocarcinoma is characterized by a good prognosis. According to the National Cancer Registry of the Republic of Moldova, endometrial cancer has shown a rising trend in morbidity over the past five years. In 2024, 515 new cases were reported, with 92 deaths. Notably, over 77% of cases are diagnosed in early stages (I–II), which correlates with favorable 5-year survival rates—up to 95% in stage IA. However, survival decreases with advancing stage: 65–80% in stage IB and just over 50% in stage II. Treatment of endometrial cancer (EC) is still based on clinico-pathological parameters, which have limited role in risk stratification. There is a need for more determinant markers, such as Ki-67, to identify patients at higher risk of relapse. Methodology: 50 patients with EC were involved in this prospective study. The patients were treated and followed up at Institute Of Oncology of Moldova. Ki-67 was detected by immuno-histochemical exam and compared with other clinico-pathological criteria. Survival was assessed and compared by Kaplan-Meier curves. Results: Ki-67expression more than 49% was detected in 17 patients (22.4%). This analysis highlights the prognostic relevance of clinicopathological features and Ki-67 expression in stage I–II of EC. High differentiation grade and low Ki-67 index (<49%) are strongly associated with low-risk profiles, while low-grade tumors and elevated Ki-67 (>49%) correlate with high-risk groups. Deep myometrial invasion (>50%) and advanced disease stages (IB–II) significantly align with increased Ki-67 and higher risk categories. Although endometrioid histology predominates across all groups, non-endometrioid subtypes are more frequent in high-risk cases and were significantly associated with shorter Disease-Free Survival (DFS) but no significant correlation was detected between Ki-67 and DFS. Conclusion: Our study indicates that Ki-67 is significantly associated with poor tumour characteristics and shorter disease-free survival and may be a helpful tool as a part of a simple clinical molecular classification for EC.

Dissecting out cancer

Thu, 01 Jan 2026 00:00:00 GMT

Title: Dissecting out cancer Abstract: Cancer surgery remains a key treatment for solid malignancies, such as cancers of the breast, colon, pancreas, ovaries, uterus and many others. This is particularly crucial in low- and middle-income countries where access to other non-surgical newer therapies (for example, immunotherapy) is limited. With the growing global cancer burden, the demand for high-quality surgery is rising. As precision medicine advances, cancer surgeons need not only technical expertise but also an understanding of multidisciplinary cancer care, in addition to preventive and palliative care. [extract]

Attainment of global diabetes targets in 2021 : a pooled analysis of individual-level data from national surveys in 100 low-income, middle-income, and high-income countries

Thu, 01 Jan 2026 00:00:00 GMT

Title: Attainment of global diabetes targets in 2021 : a pooled analysis of individual-level data from national surveys in 100 low-income, middle-income, and high-income countries Authors: Chung, Grace S.; Si, Yajuan; Aryal, Krishna; Bahendeka, Silver; Banegas, José R.; Bärnighausen, Till; Barreto, Marta; Basit, Abdul; Bello-Chavolla, Omar Yaxmehen; Bovet, Pascal; Brant, Luisa CC; Carrillo-Larco, Rodrigo M.; Chori, Babangida S.; Cífková, Renata; Cuschieri, Sarah; Damasceno, Albertino; Dorobantu, Maria; Farzadfar, Farshad; Geldsetzer, Pascal; Gurung, Mongal Singh; Guwatudde, David; Hambleton, Ian R.; Heidemann, Christin; Houinato, Dismand; Issanov, Alpamys; J⊘rgensen, Jutta; Karki, Khem; Labadarios, Demetre; Lee, Jinkook; Lou, Zeyu; Lunet, Nuno; Makrilakis, Konstantinos; Malta, Deborah C.; Martins, João S.; Mwangi, Kibachio Joseph; Odili, Augustine N.; Orazumbekova, Binur; Perman, Gastón; Quesnel-Crooks, Sarah; Quitana, Hedley Knewjen; Raxworthy, Timothy; Rodríguez-Artalejo, Fernando; Moghaddam, Sahar Saeedi; Sarria-Santamera, Antonio; Sewpal, Ronel; Sibai, Abla; Sim, Xueling; Sousa-Uva, Mafalda; Sturua, Lela; Sulola, Mubarak A.; Touloumi, Giota; Varghese, Jithin Sam; Venkataraman, Kavita; Zhang, Yuan S.; Zheng, Mingqian; Atun, Rifat; Vollmer, Sebastian; Marcus, Maja E.; Theilmann, Michaela; Ali, Mohammed K.; Gregg, Edward W.; Davies, Justine; Goehler, Jennifer Manne; Flood, David Abstract: Background: WHO launched the Global Diabetes Compact in 2021 to improve worldwide diabetes outcomes by scaling up access to comprehensive, affordable, and high-quality care. This initiative established population diabetes metrics and targets for countries to attain by 2030, namely, 80% of all people with diabetes are diagnosed; and, among people with diagnosed diabetes, 80% have good glycaemic control (HbA₁c <8·0%), 80% have good blood pressure control (<140/90 mm Hg), and 60% of people older than 40 years use statins. We aimed to estimate attainment of global diabetes targets worldwide and across country and individual characteristics in 2021.; Methods: We analysed pooled, individual participant data from nationally representative household health surveys done in 100 low-income, middle-income, and high-income countries between 2010 and 2023. The sample included non-pregnant adults aged 30–69 years. Diabetes was defined as use of glucose-lowering medications or biochemical evidence of diabetes (fasting plasma glucose ≥7·0 mmol/L or HbA₁c ≥6·5% [48 mmol/mol]). The primary outcomes were the proportion of people attaining each diabetes metric. We analysed data using hierarchical Bayesian logistic regression models with the survey year set to 2021. We estimated the age-standardised proportion attaining each metric across the pooled dataset, by country-level characteristics such as World Bank income group, by country, and by individual-level characteristics including age, sex, educational attainment, and BMI.; Findings: In 2021, across the pooled dataset, the age-standardised proportion of people with diabetes who had been diagnosed was 63·2% (95% CI 61·8–64·6). Among those diagnosed, 63·2% (62·1–64·4) achieved glycaemic control (HbA1c <8·0%), 70·8% (69·8–71·9) achieved blood pressure control (<140/90 mm Hg), and 31·8% (30·4–33·2) were using statins. Of the 100 included countries, eight met the target for diabetes diagnosis, seven met the target for glycaemic control, 15 met the target for blood pressure control, and eight met the target for statin use. By country income group, the age-standardised proportion of people with diabetes who had been diagnosed ranged from 35·3% (33·5–37·1) in low-income countries to 69·9% (68·3–71·5) in high-income countries. Among those with diagnosed diabetes, glycaemic control ranged from 56·0% (54·2–57·8) in lower-middle-income countries to 73·7% (72·7–74·6) in high-income countries; blood pressure control ranged from 58·3% (57·3–59·4) in lower-middle-income countries to 82·4% (81·4–83·4) in high-income countries; and statin use ranged from 9·7% (8·0–11·4) in low-income countries to 58·7% (57·4–59·9) in high-income countries. Across individual-level characteristics, patterns of inequities were observed in the attainment of each metric.

The impact and burden of spinal fractures in a small island state : pre-, acute, and post-COVID-19 trends from Malta

Thu, 01 Jan 2026 00:00:00 GMT

Title: The impact and burden of spinal fractures in a small island state : pre-, acute, and post-COVID-19 trends from Malta Authors: Grech, Stephan; Cuschieri, Andrea; Mintoff, Franziska; Pisani, Darryl; Cuschieri, Sarah Abstract: Background: Spinal fractures represent a significant cause of morbidity, requiring both acute and long-term care. Data on their epidemiology in small state settings are limited. This study aimed to describe the population burden, clinical characteristics, and healthcare impact of spinal fractures in Malta over a five-year period.; Methods: A retrospective analysis was conducted using the Hospital Activity Analysis (HAA) database of Mater Dei Hospital, Malta, between 2019 and 2024. Data included demographics, fracture type (ICD-10), length of stay (LOS), admission and discharge source, mechanism of injury, need for intensive care unit (ITU) admission, spinal cord injury, and co-morbidities. Fracture types were grouped as cervical, thoracic, lumbar single-level, or multilevel fractures. Descriptive statistics, chi-square, t-tests, and logistic regression were applied, with p<0.05 considered significant.; Results: A total of 640 spinal fractures were recorded (56% males, 44% females). Lumbar single-level fractures were most common (38%), followed by multi-level fractures (30%). Falls were the predominant mechanism (53%). While 90% were admitted directly from home, only 70% were discharged home, with 16% requiring transfer to rehabilitation. The longest LOS was for cervical single-level fractures (15.7 days, p=0.019). ITU admission was uncommon (4%), predominantly in multi-level fractures, which also had the highest spinal cord injury prevalence (36%). Co-morbidities were frequent (71%), particularly cardiovascular disease (49%). Logistic regression showed multimorbidity was positively associated with single-level fractures (OR 1.66, 95% CI: 1.04–2.67, p=0.035).; Conclusions: Spinal fractures in Malta impose a substantial burden, extending beyond acute care into rehabilitation. Falls were the leading cause, and multimorbidity significantly influenced fracture patterns. These findings underscore the need for integrated fall-prevention strategies, chronic disease management, and strengthened rehabilitation services in small-state healthcare systems.