Sarcopenia as a Risk Factor for Future Hip Fracture: A Meta-Analysis of Prospective Cohort Studies

OBJECTIVE

Our study aims to determine whether sarcopenia is a predictive factor of future hip fractures.

DESIGN

Systematic review and meta-analysis. Set: We searched for potentially suitable articles in PubMed, Cochrane library, Medline and EMBASE from inception to March 2020. The quality of the research was assessed by the Newcastle-Ottawa Scale (NOS). Finally, a meta-analysis was conducted with the Stata software.

PARTICIPANTS

Older community-dwelling residents.

MEASUREMENTS

Hip fracture due to sarcopenia.

RESULTS

We retrieved 2129 studies through our search strategy, and five studies with 23,359 individuals were analyzed in our pooled analyses. Sarcopenia increases the risk of future hip fractures with a pooled hazard ratio (HR) of 1.42 (95% CI: 1.18-1.71, P <0.001, I2 = 37.7%). In addition, in subgroup analyses based on different definitions of sarcopenia, sarcopenia was associated with the risk of future hip fractures with the Asian Working Group for Sarcopenia (AWGS) criteria with a pooled HR of 2.13(95% CI: 1.33-3.43). When subgroup analyses were conducted by sex, sarcopenia was associated with the risk for future hip fractures in females with pooled HRs of 1.69 (95% CI: 1.18-2.43). Sarcopenia was associated with the risk of future hip fractures in the group with a follow-up period of more than 5 years, with a pooled HR of 1.32 (95% CI: 1.08-1.61), and in the group with a follow-up period of less than 5 years, with a pooled HR of 2.13 (95% CI: 1.33-3.43).

CONCLUSIONS

Sarcopenia could significantly increase the risk of future hip fracture in old people; thus, it is necessary to prevent hip fractures in individuals with sarcopenia.

Activation of the STAT1 Pathway Accelerates Periodontitis in Nos3-/- Mice

Early studies on the etiology and pathogenesis of hypertension have shown that it has a considerable association with inflammation and the immune response as well as periodontitis. Clinical studies have also shown that hypertension can promote the periodontal tissue destruction caused by periodontitis. However, the underlying mechanisms remain unclear. This study aimed to explore the possible mechanisms of how hypertension aggravates periodontitis. Treatment with or without the signal transducer and activator of transcription 1 (STAT1) inhibitor fludarabine was performed in an endothelial nitric oxide synthase gene knockout-related (Nos3^-/-) mouse model with the hypertension phenotype of periodontitis induced by bacteria. Micro-computed tomography, immunohistochemistry, Western blot, quantitative reverse transcription polymerase chain reaction, immunofluorescence, and ELISA were performed. We demonstrated that Nos3^-/--related hypertension increases bone resorption and periodontal destruction in periodontitis lesion areas, which can be inhibited by the STAT1 inhibitor. Experimental data also showed that Nos3^-/- significantly increased macrophage infiltration and proinflammatory cytokine expression in the periodontitis lesion area, which is dependent on the angiotensin II-induced STAT1 pathway. Inhibition of STAT1 in vivo can decrease the expression of proinflammatory cytokines and macrophage infiltration. Furthermore, data in this study showed that Nos3^-/--related hypertension further downregulated the STAT3 anti-inflammatory function and its downstream chemokine expression in a STAT1-dependent manner. By applying RAW 264.7 and L929 cell lines and monocytes isolated from Nos3^-/- mice, we confirmed that activation of the STAT1 pathway inhibits STAT3 and its downstream pathway and promotes inflammatory cytokine expression in vitro. Collectively, our current study demonstrated that STAT1 plays an indispensable role in the Nos3^-/--related hypertension with aggravation of periodontitis, suggesting that STAT1 may be a key target for the treatment of periodontitis with hypertension.

Clinical significance of perioperative EMT-CTC in rectal cancer patients receiving open/laparoscopic surgery

The objective of this study was to explore the clinical significance of perioperative CTCs (circulating tumor cells) counts and EMT-CTCs (epithelial-mesenchymal transition-CTCs) in rectal cancer patients. A total of 30 patients with rectal cancer who underwent radical resection of rectal cancer at the Guangxi Zhuang Autonomous Region People's hospital were enrolled. Five ml peripheral blood was withdrawn from 30 patients with rectal cancer before the operation and seven days after the operation and at the corresponding time also from 20 healthy volunteers. CanPatrol™ CTC detection technique was used to enrich and identify CTCs and IER3 expression simultaneously. We found out that the preoperative total CTCs were correlated with lymph node metastasis (p=0.008) and tumor size, and mixed CTCs were closely correlated with lymph node metastasis (p=0.009). The number of IER3-positive total CTCs and mesenchymal CTCs were statistically associated with tumor size, p=0.034 and 0.043, respectively. The number of CTCs varied significantly before and after the operation in all patients (p=0.049). There were significant differences in CTCs variations between the open operation group and the laparoscopic operation group. In the laparoscopic operation group, the average number of single-cell CTCs was 6.9 before operation and 3.5 after the operation (p=0.013). In the open operation group, the average number of single-cell CTCs was 5.9 before operation and 4.2 after the operation. To conclude, surgery is associated with a decrease of CTCs in rectal cancer patients, especially in patients receiving laparoscopic surgery. The number of CTCs before the operation in rectal cancer patients is related to the size of tumors and regional lymph node metastasis. CTCs detection and characterization may be useful for clinical staging and lymph node dissection during operation.

Effect of local watershed landscapes on the nitrogen and phosphorus concentrations in the waterbodies of reservoir bays

Reservoir bays, which are affected by the reservoir and watershed characteristics, are the initial and most sensitive areas in the evolution process of reservoir water quality. However, the relationship between the watershed characteristics and nitrogen and phosphorus concentrations in reservoir bays is poorly understood. We selected 66 bays from the Danjiangkou Reservoir and sampled twice per year (storage and discharge periods) from 2015 to 2018 to monitor the total nitrogen (TN) and total phosphorus (TP) concentration in the waterbodies of the reservoir bays. Four types of watershed characteristic indices (topographic variables, soil variables, land-use composition, and landscape patterns) around these bays were obtained. We quantified the relationship between the TN and TP concentrations and watershed characteristics in the waterbodies of the reservoir bays using partial least squares regression (PLSR). The results showed that the mean concentrations of TN and TP in the storage period (TN:1.69 mg·L^-1, TP:0.088 mg·L^-1) were higher than those in the discharge period (TN:1.22 mg·L^-1, TP:0.063 mg·L^-1). The optimal PLSR models explained 67.9% and 82.5% of the TN concentration variability, and 65.4% and 67.2% of the TP concentration variability during the storage and discharge period, respectively. Based on the variable importance in the projection (VIP) values, soil erodibility had significant effects on the TN and TP concentrations. The key factors affecting the TN concentration were the slope gradient, basin relief, topographic wetness index, forest and agricultural land use, whereas the factors controlling the TP concentration were the landscape shape index, edge density, Shannon's diversity index and grass land use, although the TP concentration was also controlled by the patch density and contagion during the storage period, and by mean patch size and largest patch index during the discharge period. This study provides critical insights into sustainable landscape planning and effective reservoir water quality management.

Potential correlation between EDN1 gene polymorphisms with preeclampsia

OBJECTIVE

To explore the potential correlation between endothelin 1 (EDN1) gene polymorphisms with preeclampsia (PE).

PATIENTS AND METHODS

The single nucleotide polymorphisms (SNPs) of 248 PE patients and 232 healthy controls were genotyped by Polymerase Chain Reaction (PCR). The possible association between EDN1 polymorphisms and PE was revealed through the t-test and the Chi-square test.

RESULTS

PE risk was significantly correlated with the C allele of polymorphism rs5370 in EDN1. The polymorphism rs5370 in EDN1 was remarkably associated with the onset of severe PE, rather than mild PE. The markedly increased risk of early-onset PE was related to the C allele of polymorphism rs5370 in EDN1, while no significant difference in the allele frequency of polymorphism rs1800541 was detected between the PE group and the control group. In the co-dominant model, the CC genotype of polymorphism rs5370 in EDN1 was associated with the increased PE risk. PE risk in the population carrying TC genotype was 1.59 times higher than those with TT/CC genotype, while polymorphism rs1800541 had no apparent association with PE risk. In the severe PE group, there was an evident difference in the genotype frequency between the dominant and over-dominant models of polymorphism rs5370. In the recessive model, the raised risk of early-onset PE was notably correlated with the TT/CC genotype compared with that of TT genotype. However, no evident association with the genotype frequency of polymorphism rs1800541 was observed between PE patients and controls.

CONCLUSIONS

EDN1 gene polymorphism rs5370 is correlated with the increased risk of PE.

Survival comparision of three-dimensional radiotherapy alone with concurrent chemoradiotherapy for non-surgical esophageal carcinoma

PURPOSE

Radiotherapy is the main treatment method for patients with locally advanced, unresectable esophageal cancer. The aim of this study is to compare overall survival (OS) using 3D radiotherapy (3DRT) alone with concurrent chemoradiotherapy (CCRT) in 296 non-surgical esophageal carcinoma patients.

PATENTS AND METHODS

Over 10 years, of the 480 patients with esophageal carcinoma treated with 3DRT with or without chemotherapy, 148 patients each comprised 3DRT and CCRT groups after propensity score matching.

RESULTS

The 5- and 10-year OS (P=0.337) and PFS (P=0.715) rates for 3DRT alone were 22.0%, 14.4% and 26.1%, 23.2%, respectively, compared with 28.8%, 18.6% and 34.7%, 29.1% for CCRT, respectively. CCRT did not improve 5-year and 10-year OS or PFS in 60-70Gy group (OS: 27.5% and 25.2%; 17.9% and 17.0%, P=0.938; PFS: 38.3% and 31.8%; 31.9% and 27.8%, P=0.890) nor reduce 10-year hematogenous metastasis (31.7% and 28.3%, P=0.698). CCRT improved 5-year OS and PFS of 50.0-59.9Gy group (OS: 33.3% and 12.0%, P=0.029; PFS: 33.1% and 10.6%, P=0.081). For 3DRT, the 5-year OS and PFS rates were significantly better in the 60-70Gy group (P=0.017) compared with 50.0-59.9Gy group (P=0.002). For CCRT group, 5-year OS and PFS favored the 50.0-59.9Gy group, but the difference was insignificant. Major toxicities were greater with CCRT compared with 3DRT.

CONCLUSION

For non-surgical esophageal carcinoma patients, 3DRT combined with CCRT was effective in prolonging both OS and PFS.

Quantum Liquid with Strong Orbital Fluctuations: The Case of a Pyroxene Family

We discuss quasi-one-dimensional magnetic Mott insulators from the pyroxene family where spin and orbital degrees of freedom remain tightly bound. We analyze their excitation spectrum and outline the conditions under which the orbital degrees of freedom become liberated so that the corresponding excitations become dispersive and the spectral weight shifts to energies much smaller than the exchange integral.

Magnetic-Field Control of Topological Electronic Response near Room Temperature in Correlated Kagome Magnets

Strongly correlated kagome magnets are promising candidates for achieving controllable topological devices owing to the rich interplay between inherent Dirac fermions and correlation-driven magnetism. Here we report tunable local magnetism and its intriguing control of topological electronic response near room temperature in the kagome magnet Fe_{3}Sn_{2} using small angle neutron scattering, muon spin rotation, and magnetoresistivity measurement techniques. The average bulk spin direction and magnetic domain texture can be tuned effectively by small magnetic fields. Magnetoresistivity, in response, exhibits a measurable degree of anisotropic weak localization behavior, which allows the direct control of Dirac fermions with strong electron correlations. Our work points to a novel platform for manipulating emergent phenomena in strongly correlated topological materials relevant to future applications.

Genetic and sex hormone analysis of infertile men

Objective

Genetic defects and endocrine-related factors are the leading causes of male infertility. This study was performed to analyze the genetic characteristics and sex hormone levels in different types of male infertility.

Methods

A total of 423 men with infertility underwent genetic and sex hormone analysis at The Sixth Affiliated Hospital of Guangzhou Medical University.

Results

The incidences of abnormal karyotypes in patients with male infertility, azoospermia, and oligoasthenozoospermia were 6.94%, 22.40%, 15.09%, respectively. Among men with azoospermia, Klinefelter syndrome (47,XXY) was identified in 60.71% (17/28) of those with abnormal karyotypes. Additionally, the levels of follicle-stimulating hormone and human luteinizing hormone were significantly higher in men with azoospermia showing abnormal karyotypes than in men of the other study groups. The serum testosterone level in men with azoospermia showing abnormal karyotypes was lower than that in men of the other study groups.

Conclusions

Azoospermia is closely associated with chromosome abnormalities. The levels of testosterone, human luteinizing hormone, and follicle-stimulating hormone in men with azoospermia showing abnormal karyotypes provide a clinical reference for genetic counseling and assisted reproduction.

[Distribution and drug resistance of pathogens in infected organ donors from donation after the citizen death]

Objective: To investigate the distribution and drug resistance of pathogens in infected organ donors from donation after the citizen death (DCD). Methods: Clinical data of 217 DCD donors from January 2013 to June 2017 were retrospectively analyzed.The phlegm, urine, blood and drainage fluid from all of the donors were routinely cultured.The infection rate of the donors, the composition ratio of pathogens and the distribution of specimen sources were observed and the drug resistance was analyzed. Results: Of all the 217 donors, 128 were infected and the infection rate was 59%.A total of 218 pathogens were isolated from these infected donors, including 55.5% (121/218) of gram-negative pathogens, 33.5% (73/218) of gram-positive pathogens followed by 11.0% (24/218) of fungi.The pathogenic specimens were mainly derived from sputum samples (72.5%), followed by urine (15.6%). The mainly two gram-negative pathogens were Klebsiella pneumonia and Acinetobacter baumannii.Klebsiella pneumonia exhibited varying degree of resistance to commonly used antibiotics, whereas susceptible to imipenem and meropenem.Acine-tobacterbaumannii was highly resistant to most of the antibiotics, and the drug resistance rate of imipenem and meropenem was over 60%, displaying a tendency of multi-drug resistance.Staphylococcus aureus, as the mainly gram-positive pathogen, was generally resistant to penicillin and clindamycin, but still sensitive to tovancomycin, teicoplanin and linezolid. Conclusions: DCD donors have a high infection rate, and respiratory infection is most common. Gram-negative pathogens are the primary pathogens causing infection in DCD donors.Klebsiella pneumonia maintain susceptible to imipenem and meropenem, while Acinetobacter baumannii reveals a tendency of multi-drug resistance.Gram-positive pathogens are still sensitive to vancomycin, teicoplanin and linezolid.

Performance of novel infection phase-dependent antigens in syphilis serodiagnosis and treatment efficacy determination

OBJECTIVE

The objective of this study was to screen new antigens for syphilis serodiagnosis.

METHODS

First, we determined whether the Treponema pallidum proteins Tp0971, Tp0768 and Tp0462 were infection phase-dependent antigens by observing serum reactivity differences in New Zealand rabbits infected with activated or inactivated T. pallidum. A non-infection phase-dependent antigen, the Tp92 membrane protein, was used as the negative control. Next, Tp0971-, Tp0768- and Tp0462-based ELISA was performed on 2138 human serum samples and compared with the T. pallidum passive particle agglutination assay (TPPA) and LiZhu™ Tp-ELISA. In addition, another 60 paired serum samples from patients at follow-up were analysed to evaluate the relationships between titre changes and differences in the A450 nm values of the Tp0971, Tp0768, Tp0462 and Tp92 antibodies measured by ELISA.

RESULTS

Compared with Tp92 (negative control), Tp0971, Tp0768 and Tp0462 were determined to be infection phase-dependent antigens. Compared with those of the TPPA, the sensitivities of Tp0971-, Tp0768- and Tp0462-based ELISA were 96.4%, 96.9% and 93.0%, respectively, and the specificities were 97.7%, 95.4% and 98.9%, respectively, resulting in consistencies of 97.1%, 96.2% and 95.9%, respectively. Compared with those of the LiZhu™ Tp-ELISA, the consistencies of Tp0971-, Tp0768- and Tp0462-based ELISA were 95.1%, 94.2% and 94.0%, respectively, with kappa values of 0.902, 0.884 and 0.880, respectively. Tp0971, Tp0768 and Tp0462 demonstrated high sensitivities and specificities, as well as high conformity to the TPPA and LiZhu™ Tp-ELISA. Moreover, a significantly positive Spearman rank correlation coefficient (0.82,*P < 0.05) was found between the difference in the A450 nm values of the Tp0971 antibody and the RPR titre change.

CONCLUSION

The infection phase-dependent antigens Tp0971, Tp0768 and Tp0462 are promising for syphilis diagnosis, and Tp0971 may be utilized to monitor curative effects during syphilis treatment.

Identification of a Constitutively Active Mutant Mouse IRAK2 by Retroviral Expression Screening

To identify the importance of IRAK2 kinase activity in TLR-mediated signaling pathways, we constructed a retroviral vector harboring either a mouse IRAK2 gene (IRAK2-WT) or with its mutant with loss of function of its ATP-binding site (IRAK2-KD). Further, we comparatively analyzed for the gain of function and modulations in TLR-mediated signaling pathways in IRAK2 knockout (IRAK2-KO) macrophages upon introduction of the IRAK2-WT retroviral constructs. The pBS/IRAK2-KD with the ATP-binding site mutation in IRAK2 was obtained by using site-specific mutagenesis. The recombinants were identified with appropriate double digestion and sequence analysis. The recombinant vector constructs were transfected by lipofection into phoenix packaging cells. The viral vectors (10⁷ cfu/mL) with the construct were allowed to infect IRAK2-KO macrophages. The results showed that IRAK2-WT gene overexpressed in the IRAK2-KO macrophages exhibited a modified IRAK2 expression upon LPS induction. However, the modification was absent with IRAK2-KD construct on LPS stimulation; instead, the IRAK2 protein stability was reduced considerably. The results further show that the LPS-induced effect on the stability of IRAK2 is dependent of IRAK4 stimulation.

Environmental exposure to polycyclic aromatic hydrocarbons, kitchen ventilation, fractional exhaled nitric oxide, and risk of diabetes among Chinese females

Diabetes is related to exposure to polycyclic aromatic hydrocarbons (PAHs), inflammation in the body, and housing characters. However, associations of urinary monohydroxy-PAHs (OH-PAHs) or fractional exhaled nitric oxide (FeNO) with diabetes risk in relation to housing characters are unclear. In this study, 2645 individuals were drawn from the baseline survey of the Wuhan-Zhuhai Cohort Study. Associations of diabetes with urinary OH-PAHs or FeNO among cooking participants were estimated using logistic regression models. Among women with self-cooking meals, urinary OH-PAH levels were positively associated with diabetes risk (P < .05); the cooking women with high FeNO (≥25 ppb) had a 59% increase in the risk of diabetes (OR: 1.59, 95% CI: 1.06, 2.38), compared with those with low FeNO (<25 ppb). The cooking women with use of kitchen exhaust fans/hoods had a 52% decrease in the risk of diabetes (OR: 0.48, 95% CI: 0.27, 0.84), compared with those with nonuse of kitchen exhaust fans/hoods. The results indicated that the cooking women had an elevated risk of diabetes, which may be partly explained by an increase in the PAH body burden and higher inflammatory responses. Use of kitchen exhaust fan/hood can be associated with a lower risk of diabetes.

Serological evaluation of antigen Tp0693 for diagnosis of syphilis

The aim of the present study was to evaluate the diagnostic value of the Treponema pallidum (Tp) antigen Tp0693 for syphilis. ELISA was used to examine the serum levels of Tp0693. The sample-to-cutoff ratio (S/CO) value was used to generate a receiver operating characteristic (ROC) curve. A correlation analysis was performed to compare the detection efficacy of Tp0693-specific ELISA, Treponema pallidum Particle Agglutination (TPPA), Tolulized Red Unheated Serum test (TRUST) and LiZhu™ Tp-ELISA. The area under the ROC curve was 0.99, indicating good diagnostic efficacy. When the diagnostic specificity reached 100%, the diagnostic sensitivity was up to 93.5%. Tp0693-specific ELISA results were not correlated with those of TPPA, TRUST and LiZhu™ Tp-ELISA (correlation coefficient, 0.122, 0.114 and 0.025, respectively). The latent syphilis rate was highest (12%, 9/75) for all syphilis specimens with a S/CO in the grey area. In conclusion, for syphilis specimens with a S/CO in the grey area, TPPA should be used for further confirmation of the diagnosis. Tp0693 may be used as a diagnostic antigen for syphilis; however, further study regarding its potential use is required.

Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer: a multicenter randomized phase III trial

Background

The optimal chemotherapy regimen administered currently with radiation in patients with stage III non-small cell lung cancer (NSCLC) remains unclear. A multicenter phase III trial was conducted to compare the efficacy of concurrent thoracic radiation therapy with either etoposide/cisplatin (EP) or carboplatin/paclitaxel (PC) in patients with stage III NSCLC.

Patients and methods

Patients were randomly received 60-66 Gy of thoracic radiation therapy concurrent with either etoposide 50 mg/m2 on days 1-5 and cisplatin 50 mg/m2 on days 1 and 8 every 4 weeks for two cycles (EP arm), or paclitaxel 45 mg/m2 and carboplatin (AUC 2) on day 1 weekly (PC arm). The primary end point was overall survival (OS). The study was designed with 80% power to detect a 17% superiority in 3-year OS with a type I error rate of 0.05.

Results

A total of 200 patients were randomized and 191 patients were treated (95 in the EP arm and 96 in the PC arm). With a median follow-up time of 73 months, the 3-year OS was significantly higher in the EP arm than that of the PC arm. The estimated difference was 15.0% (95% CI 2.0%-28.0%) and P value of 0.024. Median survival times were 23.3 months in the EP arm and 20.7 months in the PC arm (log-rank test P = 0.095, HR 0.76, 95%CI 0.55-1.05). The incidence of Grade ≥2 radiation pneumonitis was higher in the PC arm (33.3% versus 18.9%, P = 0.036), while the incidence of Grade ≥3 esophagitis was higher in the EP arm (20.0% versus 6.3%, P = 0.009).

Conclusion

EP might be superior to weekly PC in terms of OS in the setting of concurrent chemoradiation for unresectable stage III NSCLC.

Trial registration ID

NCT01494558.

Abstract P1-01-07: Maintenance of genomic integrity in dormant circulating tumor cells

More than 67% of deaths in breast cancer patients occur after the initial 5-year survival period while residual disease can be dormant for periods longer than 20 years. Patients are asymptomatic because circulating tumor cells (CTCs) remain dormant and are undetectable by current clinical tools. Dormant CTCs may retain their long-term tumor-initiating (LTI) potential by adhering to their original genome, unlike rapidly cycling cancer cells that are known to have increased genomic instability. We hypothesized that hyperactive mechanisms of DNA repair preserve the genomic make-up of dormant CTCs allowing them to retain their LTI potential, ultimately causing disease relapse.

We isolated and characterized breast cancer CTCs by mutiparametric flow cytometry and DEPArrayTM. Individually isolated breast cancer CTCs had a large proportion (&gt;40%) of dormant (Ki67-/PCNA-) cells. Dormant CTCs had a lower incidence of double-strand DNA breaks (DSB) than proliferating cells as assessed by the phosphorylation status of Serine139 on gamma H2AX. This observation was further validated in a panel of eight genetically distinct breast cancer cell lines. Second, to understand whether dormant cells are inherently more resistant to DSB, we induced DSB in breast cancer cells by UV radiation and bleomycin treatment, and measured residual DSB at regular intervals. Results showed that besides being more resistant to DSB de novo, dormant breast cancer cells were also more efficient repairing their DNA. There are two distinct phases of DSB repair - early [within 2 hours of DSB using Non-Homologous End Joining (NHEJ) methods] and late [evident after 24 hours using Homologous Recombination (HR)]. Unlike proliferating (S-G2M) cells, dormant (G0) cells lack the sister chromatid and repair their DNA exclusively by NHEJ methods. Therefore, and third, we investigated key players of the NHEJ pathway and examined their roles in maintaining genomic integrity. We found that the human telomere-associated protein RIF1, a mediator of alternative NHEJ, was significantly up-regulated in a dormant CTC subset. Dormant sub-populations of breast cancer cells confirmed RIF1 foci formation in areas of DNA damage. Fourth, mis-sense mutation of RIF1 in CAMA-1 cells (ΔRIF1 E1598K) as well as shRNA mediated RIF1 knockdown in HCC1954 and ZR-75-1 cell lines attenuated resistance of the dormant subset to UV and bleomycin treatment. Finally, RIF1 knockdown activated both p38 and pERK pathways albeit to varying degrees in multiple cell lines resulting in metastatic inefficiency in xenograft and syngeneic mouse models.

Collectively, these findings suggest that RIF1 may play functional roles in maintaining the genomic integrity of dormant CTCs and be a potential biomarker of breast cancer CTC survival while in circulation.

Citation Format: Boral D, Vishnoi M, Liu HN, Yin W, Marchetti D, Hong DS, Scamardo A. Maintenance of genomic integrity in dormant circulating tumor cells [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-01-07.