The Schlafen 11 (SLFN11) protein has recently emerged as pivotal in DNA damage conditions, with predictive potential for tumor response to cytotoxic chemotherapies. Recent discoveries also showed that the programmed death ligand 1 (PD-L1) protein can be found on malignant cells, providing an immune evasion mechanism exploited by different tumors. Additionally, excessive generation of free radicals, redox imbalance, and consequential DNA damage can affect intestinal cell homeostasis and lead to neoplastic transformation. Therefore, our study aimed to investigate the significance of SLFN11 and PD-L1 proteins and redox status parameters as prognostic biomarkers in CRC patients. This study included a total of 155 CRC patients. SLFN11 and PD-L1 serum levels were measured with ELISA and evaluated based on redox status parameters, sociodemographic and clinical characteristics, and survival. The following redox status parameters were investigated: spectrophotometrically measured superoxide dismutase (SOD), sulfhydryl (SH) groups, advanced oxidation protein products (AOPP), malondialdehyde (MDA), pro-oxidant–antioxidant balance (PAB), and superoxide anion (O₂^•–). The prooxidative score, antioxidative score, and OXY-SCORE were also calculated. The results showed significantly shorter survival in patients with higher OXY-SCOREs and higher levels of serum SLFN11, while only histopathology-analysis-related factors showed significant prognostic value. OXY-SCORE and SLFN11 levels may harbor prognostic potential in CRC patients.

Locally advanced rectal cancer (LARC) presents a clinical challenge due to lack of reliable molecular biomarkers for early diagnosis, prognosis, and prediction of response to neoadjuvant chemoradiotherapy (nCRT). Long non-coding RNAs (lncRNAs) have emerged as promising candidates due to their characteristics and regulatory roles. H19, NEAT1, MALAT1 and HOTAIR are lncRNAs deregulated in gastrointestinal cancers, with insufficient data on their biomarker potential in LARC. The study aimed to analyze the diagnostic, prognostic and predictive utility of H19, NEAT1, MALAT1 and HOTAIR in LARC. Relative expression was evaluated by RT-qPCR in tumor and non-tumor tissues from 25 LARC patients before and after nCRT. H19, NEAT1, and MALAT1 showed significantly altered expression in tumor tissue, as well as non-tumor tissue before and after nCRT. H19 expression was significantly higher in tumor vs. non-tumor tissue before treatment and demonstrated moderate potential to discriminate between tumor and non-tumor. None of the lncRNAs showed statistically significant predictive values for nCRT response or association with treatment outcomes in our study, which was limited by the small number of responders. Our results suggest that H19 might be considered as a potential therapeutic target in LARC. Further studies with larger patient groups are required to confirm its diagnostic and prognostic utility.

Colorectal cancer (CRC) is a leading cause of morbidity and mortality worldwide, with varying trends in tumor pathology depending on geographic and demographic factors. The aim of this study was to describe trends in tumor pathology in Serbian patients with colorectal cancer (CRC) over a 14-year period, from 2003 to 2016. The study included patients referred from local units to the tertiary center for CRC treatment during the entire observation period, as well as patients diagnosed within the national screening program during the last four years. Resections were performed in 2462 patients (1465 men, 60% and 997 women, 40%) with an average age of 62±12 years, and the incidence was equally distributed between genders. Rectal tumors were noted in 54% of patients, while in 46% of patients tumors were found in the colon (32% in the left and 14% in the right colon). The majority of patients were in an advanced stage of the disease, with only 12% of cases with Dukes A stadium. Patients with early-onset disease represented between 11% and 22% of all cases per year. Among early-onset patients, women were significantly overrepresented (P=0.013), patients were diagnosed at significantly later stages (P=0.033), tumors were significantly less differentiated (P=0.001) and tumors of the right colon were overrepresented (P<0.001). A group of patients who underwent neoadjuvant chemoradiotherapy consisted of 235 men and 88 women with an average age of 60±12 years. Within this group, 20% of patients had a good response, 37% a moderate response, and 43% a poor response. The study has provided valuable insight into trends in tumor pathology in Serbian CRC patients and confirmed the beneficial effects of the introduction of the national screening program.

Inflammatory fibroid polyp (IFP) or Vanek’s tumor is a rare benign submucosal lesion of the gastrointestinal tract that may radiologically mimic mesenchymal gastric tumors, particularly gastrointestinal stromal tumors. We present the case of a 65-year-old patient with a contrast-enhancing gastric submucosal mass detected on computed tomography, initially interpreted as a suspected mesenchymal neoplasm. CT imaging demonstrated a well-defined enhancing lesion arising from the gastric wall without evidence of metastatic disease. Surgical resection was performed because imaging findings were considered highly suggestive of GIST. Gross intraoperative appearance and pathological examination, however, established the final diagnosis of gastric inflammatory fibroid polyp (Vanek’s tumor). Histopathological analysis demonstrated characteristic spindle-cell proliferation with inflammatory eosinophil-rich infiltrates, while immunohistochemistry excluded GIST. This case highlights the diagnostic challenge in differentiating IFP from other gastric submucosal neoplasms based solely on imaging findings and emphasizes the importance of histopathological confirmation for definitive diagnosis.

Background/Objectives: Schlafen 11 (SLFN11) encodes a DNA damage response protein implicated in sensitivity to DNA-damaging therapies and has been proposed as a predictive biomarker in several malignancies. This study aimed to characterize SLFN11 expression and evaluate its prognostic and predictive significance in locally advanced rectal cancer (LARC). Methods: Publicly available datasets were interrogated using UCSC Xena, GEPIA2, TNMplot, KMplot, ROC Plotter, and GEO databases. SLFN11 expression was assessed by quantitative real-time PCR in paired tumor and adjacent non-tumor tissues collected before and after neoadjuvant chemoradiotherapy (nCRT) from 26 patients with LARC. Associations with clinicopathological characteristics, pathological response, and survival outcomes were analyzed. Results: Publicly available datasets demonstrated lower SLFN11 expression in rectal tumor tissues compared with non-tumor tissues. In our cohort, no significant differences in SLFN11 expression were observed between paired tumor and adjacent non-tumor tissues either before or after nCRT. However, SLFN11 expression increased significantly following nCRT in both tissue types. Nevertheless, neither bioinformatic analyses nor our cohort demonstrated a significant association between SLFN11 expression and survival outcomes. Likewise, no significant predictive value of SLFN11 expression for response to nCRT was observed in ROC Plotter analysis, most GEO datasets, or our clinical cohort. The prognostic and predictive findings should be considered exploratory due to limited statistical power. Conclusions: Although SLFN11 expression is reduced in rectal tumor tissues and appears to be influenced by nCRT, its prognostic and predictive value in LARC remains uncertain. Larger studies are warranted to clarify its biological and clinical significance.