ABSTRACT
Detection of biomarkers for tracking disease progression is becoming increasingly important in biomedicine. Using saliva as a diagnostic sample appears to be a safe, cost-effective, and non-invasive approach. Salivary interleukin-8 levels demonstrate specific changes associated with diseases such as obstructive pulmonary disease, squamous cell carcinoma, oral cancer, and breast cancer. Traditional protein detection methods, such as enzyme-linked immunosorbent assay (ELISA), mass spectrometry, and Western blot are often expensive, complex, and time-consuming. In this study, an optical fiber-based biosensor was developed to detect salivary IL-8 protein in a label-free manner. The biosensor was able to achieve an ultra-low limit detection of 0.91 fM. Moreover, the tested concentration range was wide: from 273 aM to 59 fM. As a proof-of-concept for detecting the protein in real clinical samples, the detection was carried out in artificial saliva. It was possible to achieve high sensitivity for the target protein and minimal signal alterations for the control proteins.
ABSTRACT
Background: Although there are numerous sources of epidemiologic information on breast cancer in Kazakhstan, none of them have specifically examined the burden of this disease. Therefore, this article aims to provide an overview of the breast cancer prevalence, incidence, mortality, and distribution and changes over time in Kazakhstan based on nationwide large-scale healthcare data from the National Registry in order to encourage more research on the impact of various diseases at the regional and national levels. Methods: The study cohort included all adult women older than 25 years who were diagnosed with breast cancer in any clinical setting of the Republic of Kazakhstan during the period of 2014-2019. The data were extracted from the Unified Nationwide Electronic Health System (UNEHS) to get an overview of descriptive statistics, incidence, prevalence, and mortality rate calculations and the Cox proportional hazards regression model. All survival functions and factors associated with mortality were tested for significance. Results: The cohort population (n = 55,465) comprised subjects with the age at the diagnosis of breast cancer from 25 to 97 years, with a mean of 55.7 ± 12.0 years. The majority of the study population belonged to the age group 45-59 years, which is 44.8% of the cohort. The all-cause mortality rate of the cohort is 16%. The prevalence rate increased from 30.4 per 10,000 population in 2014 to 50.6 in 2019. The incidence rate varied from 4.5 per 10,000 population in 2015 to 7.3 in 2016. Mortality rates were stable and high in the senile age patients (75-89 years old). Breast cancer mortality was positively associated with women who had been diagnosed with diabetes, HR 1.2 (95% CI, 1.1-2.3), whereas it was negatively associated with arterial hypertension, HR 0.4 (95% CI, 0.4-0.5). Conclusion: Overall, Kazakhstan is experiencing an increase in the incidence of breast cancer cases, but the mortality rate has started to decline. The switch to population mammography screening could reduce the breast cancer mortality rate. These findings should be utilized to help Kazakhstan determine what cancer control priorities should be utilized, including the need to implement efficient and affordable screening and prevention programs.