Effects of neratinib on health-related quality of life in women with HER2-positive early-stage breast cancer: longitudinal analyses from the randomized phase III ExteNET trial

BACKGROUND

We report longitudinal health-related quality-of-life (HRQoL) data from the international, randomized, double-blind, placebo-controlled phase III ExteNET study, which demonstrated an invasive disease-free survival benefit of extended adjuvant therapy with neratinib over placebo in human epidermal growth factor receptor-2-positive early-stage breast cancer.

PATIENTS AND METHODS

Women (N  = 2840) with early-stage HER2-positive breast cancer who had completed trastuzumab-based adjuvant therapy were randomly assigned to neratinib 240  mg/day or placebo for 12  months. HRQoL was an exploratory end point. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) and EuroQol 5-Dimensions (EQ-5D) questionnaires at baseline and months 1, 3, 6, 9, and 12. Changes from baseline were compared using analysis of covariance with no imputation for missing values. Sensitivity analyses used alternative methods. Changes in HRQoL scores were regarded as clinically meaningful if they exceeded previously reported important differences (IDs).

RESULTS

Of the 2840 patients (intention-to-treat population), 2407 patients were evaluable for FACT-B (neratinib, N  = 1171; placebo, N  = 1236) and 2427 patients for EQ-5D (neratinib, N  = 1186; placebo, N  = 1241). Questionnaire completion rates exceeded 85%. Neratinib was associated with a decrease in global HRQoL scores at month 1 compared with placebo (adjusted mean differences: FACT-B total, -2.9 points; EQ-5D index, -0.02), after which between-group differences diminished at later time-points. Except for the FACT-B physical well-being (PWB) subscale at month 1; all between-group differences were less than reported IDs. The FACT-B breast cancer-specific subscale showed small improvements with neratinib at months 3-9, but all were less than IDs. Sensitivity analyses exploring missing data did not change the results.

CONCLUSIONS

Extended adjuvant neratinib was associated with a transient, reversible decrease in HRQoL during the first month of treatment, possibly linked to treatment-related diarrhea. With the exception of the PWB subscale at month 1, all neratinib-related HRQoL changes did not reach clinically meaningful thresholds. ClinicalTrials.gov: NCT00878709.

[Clinical manifestations and risk factors of poor prognosis of Acinetobacter baumannii intracranial infection]

Objective: To investigate the clinical features and risk factors for poor prognosis in patients with intracranial Acinetobacter baumannii infection. Methods: Retrospective analysis of data of patients who were hospitalized in the First Affiliated Hospital of AnHui Medical University between January 2011 and December 2017, and whose cerebral spinal fluid samples were positive for Acinetobacter baumannii and who were clinically demonstrated as intracranial infection during hospitalization was performed. Risk factors for poor prognosis were analyzed using single factor analysis and logistic regression analysis. Results: A total of 50 patients were included, with poor prognosis rate of 58% (29/50).92% of patients had history of craniotomy or operation of site adjacent to brain.Major type of intracranial infection was purulent meningitis.Fever rate was 100%.Multidrug resistant Acinetobacter baumannii accounted for 89.01%. Sensitivity to meropenem was only 9.09%.Shock, multi-drug resistant bacteria and no intrathecal injection were risk factors for poor prognosis of patient.Multi-factor logistic regression analysis showed "no intrathecal injection" was independent risk factor for poor prognosis of patients with intracranial Acinetobacter baumannii infection. Conclusions: Acinetobacter baumannii that induced intracranial infection is mostly highly drug-resistant bacterium, with high risk of post-infection poor prognosis.Clinically, it is essential to take proper peri-operative measures and early identify occurrence of intracranial infection.Reasonable application of anti-infection drug and external ventricle drainage, especially intrathecal injection of aminoglycosides, can be promoted as a kind of safe and effective means.

[The Occupational and Procreation Health of Road Sweeping Female Sanitation Workers in a District of a City]

Objective: To investigate occupational and procreation health of roadsweeping female sanitation workers in a city district. Methods: Using cross-sectional survey methods, all 303 the road sweeping female sanitation workers of one company were selected and interviewed face to face with questionnaires in june 2017. Data were analysed by SPSS22.0 statistical software. Results: The total prevalence of reproduction tract infection was 21.47%. The prevalence of uterine fibroids was 6.38%, and menstruation abnormal rate was 25.17%. The sanitation worker of menstruation abnormal rate was 31.03%, which were exposed low temperature, automobile exhaust and air contaminant at the same time, or else was 19.61%. There were statistical significance between them. (χ(2)=5.161, P<0.05) The sanitation worker of menstruation abnormal rate was 28.81%, which were not satisfied with women/s rights protection, or else was 11.67%. There were statistical significance between them. (χ(2)=7.435, P<0.01) . Conclusion: Female sanitation workers in the city district were exposed to many occupational hazards. The status of procreation health among road sweeping female sanitation workers in the city district is not optimistic. Occupational health protection and laborers's rights protection should be emphasized to improve health status of female sanitation workers.

[Fujian Tulou Family Cohort Study: study design and characteristics of participants and pedigrees in baseline investigation]

Objective: To describe the study design, the characteristics of participants as well as the pedigrees included in the baseline survey of Fujian Tulou Family Cohort Study. Methods: Fujian Tulou Family Cohort Study was a prospective open cohort study with a biological sample bank. A baseline survey was conducted in Tulou areas of Nanjing county in Fujian province from 2015 to 2018, including questionnaire survey, physical and biochemical indicators examinations, and blood sample collection in adults aged ≥18 years. In addition, family relationship of the participants was also recorded. The pedigree information of the juveniles under 18 years old were also collected. Results: The baseline survey included 2 727 individuals in two clans, of whom 2 373 (87.0%) were adults, and 2 126 participants completed questionnaires, physical examinations and biochemical tests. The average age of the 2 126 participants was (57.9±13.3) years, with 39.4% being males. The current smoking rates in male and female participants were 41.2% and 2.1%, respectively. The corresponding rates of current alcohol consumption were 19.0% and 2.6%. For common chronic diseases, the prevalence rates were 51.3% for hypertension, 9.7% for diabetes and 26.7% for hyperlipemia according to the self-reported disease diagnoses, health examination results and biochemical examination results in class Ⅱ or Ⅲ hospitals. Based on the family relationship information and genealogical data, 710 pedigrees were finally identified, consisting of 5 087 family members. The numbers of five, four, three, and two generations pedigrees were 3, 88, 238 and 381, respectively. The pairs of the first to the fifth degree relatives were 12 039, 2 662, 1 511, 202 and 31, respectively. Conclusion: The establishment of Fujian Tulou Family Cohort provides valuable resources for exploring the genetic risk factors, environmental risk factors and gene-environment interactions contributing to the risk of common chronic diseases.

[Research advance of microRNA in the pathogenesis of chronic rhinosinusitis]

Chronic rhinosinusitis (CRS) is a common disease of otorhinolaryngology head and neck surgery, manifested as nasal-sinus mucosal chronic inflammation. However, the pathogenesis of CRS is not clear. There are studies found that microRNA (miRNA) involved in CRS gene regulation. In this review, we summarize the expression of miRNAs in CRS, with the in-depth study of the role of miRNAs in CRS, and will further elucidate the pathogenesis of CRS.

Free electrons excited SPASER

Surface plasmon amplification by stimulated emission of radiation (SPASER) is discovered and used for realizing lasers at nanometer scale. The conventional gain media that are applied in SPASER are solid materials, such as organic dye or semiconductor, which limits the frequency range of SPASER. The free electrons could be considered as a kind of gain medium for emitting radiation. Here, we investigate theoretically the SPASER, which is excited by free electrons. We also demonstrate the tunable, deep-ultraviolet, and ultracompact laser numerically by having free electrons interact with surface plasmon polariton mode supported on metal surface. The output power density could reach about 30 W/μm² and the wavelength in deep ultraviolet could be widely tuned by varying the electron energy. This work offers a way of realizing integrated free electron laser in the ultraviolet frequency region.

[An analysis of the evaluation results of symptom checklist 90 for occupational females in different industries]

Objective: To evaluate the mental health of occupational females in different industries. Methods: We investigated the psychologic status of Chinese occupational females using symptom checklist 90. And statistical software was applied to analyze results of symptom checklist 90. Results: There were 41, 166 effec-tive questionnaires. The number of positive questionnaires was 14 361, and the positive rate was 34.89%. The positive rate of obsessive-compulsive factor was 24.07%. The positive rate of somatization factor was 16.12%. The positive rate of depression was 15.50%. The median positive item number was 20 (IQR: 34) , and the median split of positive symptoms was 2.11 (IQR: 0.37) . There were differences in the positive rate of SCL-90 scale among different age groups, different regions and different industries, the difference was statistically significant (P<0.05) . The positive rate of SCL-90 for the occupational females was 34.89%. The top three factors of the high-est positive SCL-90 were obsessive-compulsive symptoms, somatization and depression. Conclusion: There were differences in the psychological status of occupational females for different regions, different ages and different occupations.

[Effect of serum growth hormone releasing hormone levels on cognitive function in patients with moderate-severe obstructive sleep apnea-hypopnea syndrome]

Objective: To investigate the effect of GHRH on the cognitive function of OSAHS patients by detecting the serum GHRH levels and assessing their cognitive function in patients with OSAHS. Methods: A total of 70 moderate-severe OSAHS patientsand 32 adults with snoring from October 2013 to May 2017 were enrolled for overnight polysomnography(PSG) and cognitive function assessment. Blood samples were taken at the next morning and serum GHRH levels were measured by ELISA. Results: There was no significant difference between OSAHS group (318.73±186.66)pg/ml and control group (291.48±147.36)pg/ml. Compared with control group, the serum GHRH levels were significantly increased in OSAHS patients without cognitive impairment (370.31±197.33)pg/ml, and evidently decreased in those with cognitive impairment (193.63±70.97)pg/ml (both P<0.05). The cognitive function of OSAHS patients was influenced by serum GHRH levels (OR=0.42, 95%CI: 0.24-0.73), body mass index (OR=2.23, 95%CI: 1.03-4.79), and daily sleepiness score (OR=1.80, 95%CI: 1.04-3.09). Conclusion: Serum GHRH levels in patients with moderate-severe OSAHS may play a protective role in patients' cognitive function.

[Prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors: an analysis of 9944 cases]

Objective: To investigate the prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors. Methods: From June to September, 2016, a cross-sectional survey was used to select 9 944 female workers from six districts of Beijing and then a face-to-face questionnaire survey was performed. Univariate analysis using chi-square test and multivariate logistic regression analysis were used to investigate the risk factors for reproductive system diseases. Results: The age of 9944 female workers ranged from 18 to 65 years (mean 35.53±9.52 years) , and among them, 7 351 (73.92%) were married. The overall prevalence rate of reproductive system diseases among these 9944 female workers during the past three months was 28.29%, and the prevalence rates of hyperplasia of mammary glands, vaginitis, and hysteromyoma were 15.54%, 11.25%, and 6.77%, respectively. After adjustment for age, marital status, education level, and annual family income, the multivariate logistic regression analysis showed that frequent overtime work (odds ratio[OR]=1.119, 95% confidence interval[CI]: 1.070-1.343) , frequent night shifts (OR=1.198, 95%CI: 1.054-1.361) , standing for a long time (OR=1.197, 95%CI: 1.063-1.347) , sitting for a long time (OR=1.327, 95%CI: 1.191-1.479) , heavy workload (OR=1.429, 95%CI: 1.262-1.615) , exposure to lead (OR=1.696, 95%CI: 1.307-2.201) , exposure to mercury (OR=1.452, 95%CI: 1.086-1.940) , and exposure to ionizing radiation (OR=1.679, 95%CI: 1.424-1.980) were associated with reproductive system diseases. Conclusion: The prevalence of reproductive system diseases among female workers in Beijing is not optimistic. Reproductive system diseases are associated with frequent overtime work, frequent night shifts, standing for a long time, sitting for a long time, heavy workload, and exposure to lead, mercury, and ionizing radiation.

[A meta-analysis of Symptom Checklist-90 assessment results in Chinese nurses]

Objective: To investigate the application of Symptom Checklist-90 (SCL-90) in Chinese nurses. Methods: We performed a literature search for articles in Chinese on the mental health of nurses investigated using the SCL-90 that were published from January 2007 to December 2016. A total of 129 articles were included, involving 178 groups of valid samples as well as 36316 subjects in 27 provinces or cities in China. The metafor package of R 3.2.1 software and Excel were used for meta-analysis and data statistics. Results: Heterogeneity was identified for the nine factors included in the literature data (Q test: P<0.05; I(2) test >40%) , so a random effects model was used. For all factors except interpersonal relationship factor, the 95% confidence intervals of the pooled effect sizes did not include 0. For all factors except interpersonal relationship factor (Egger test: P<0.05) , no significant asymmetry or incompleteness appeared in the funnel plots. The fail-safe number of each factor was much larger than 5k+10. The merger scores and mean values of nine factors were higher than the national norm. Conclusion: The SCL-90 is widely used in the study of mental status of Chinese nurses, but the SCL-90 norm for nurses is lacking.

Millimeter-wave system-on-chip advancement for fusion plasma diagnostics

Recent advances in radio-frequency system-on-chip technology have provided mm-wave fusion plasma diagnostics with the capability to overcome major challenges such as space inefficiency, inflexible installation, sensitivity, susceptibility to EMI, and prohibitively high cost of conventional discrete component assemblies as higher imaging resolution and data accuracy are achieved by increasing the number of channels. Nowadays, shrinking transistor gate lengths on fabrication techniques have enabled hundreds of GHz operation, which is suitable for millimeter-wave diagnostics on current and future tokamaks. The Davis Millimeter Wave Research Center (DMRC) has successfully developed V-band (55-75 GHz) transmitter and receiver chips for Microwave Imaging Reflectometer (MIR) instruments. The transmitter can illuminate 8 different frequencies simultaneously within 55-75 GHz. Moreover, the receiver has the capability to amplify the reflected signal (>30 dB) while offering 10-30× reduction in noise temperature compared to current MIR instruments. Plasma diagnostics requires ultra-wideband (more than 20 GHz) operation which is approximately nine times wider bandwidth than the recent commercial impetus for communication systems. Current efforts are underway for gallium-arsenide monolithic microwave integrated circuit receiver chips at W-band (75-110 GHz) and F-band (90-140 GHz) permitting measurements at higher toroidal magnetic fields.

Liquid crystal polymer receiver modules for electron cyclotron emission imaging on the DIII-D tokamak

A new generation of millimeter-wave heterodyne imaging receiver arrays has been developed and demonstrated on the DIII-D electron cyclotron emission imaging (ECEI) system. Improved circuit integration, improved noise performance, and enhanced shielding from out-of-band emission are made possible by using advanced liquid crystal polymer (LCP) substrates and monolithic microwave integrated circuit (MMIC) receiver chips. This array exhibits ∼15 dB additional gain and >30× reduction in noise temperature compared to previous generation ECEI arrays. Each LCP horn-waveguide module houses a 3 × 3 mm GaAs MMIC receiver chip, which consists of a low noise millimeter-wave preamplifier, balanced mixer, and IF amplifier together with a local oscillator multiplier chain driven at ∼12 GHz. A proof-of-principle partial LCP instrument with 5 poloidal channels was installed on DIII-D in 2017, with a full proof-of-principle system (20 poloidal × 8 radial channels) installed and commissioned in early 2018. The enhanced shielding of the LCP modules is seen to greatly reduce the sensitivity of ECEI signals to out-of-band microwave noise which has plagued previous ECEI studies on DIII-D. The LCP ECEI system is expected to be a valuable diagnostic tool for pedestal region measurements, focusing particularly on electron temperature evolution during edge localized mode bursting.

[High resolution diffusion-weighted imaging for characterising nasopharyngeal carcinoma]

Objective: To evaluate the characteristics of high resolution diffusion-weighted imaging(DWI) using readout segmentation of long variable echo trains (RESOLVE ) for nasopharyngeal carcinoma (NPC). Methods: A total of 131 with newly diagnosed NPC patients from the 5th Affiliated Hospital of Sun Yat-sen University were included in this study from October 2013 to April 2016.DWI using RESOLVE technique was performed. The signal intensity (SI(lesion)), and mean(ADC(mean)), maximum(ADC(max)), minimum (ADC(min))ADCs of NPC were calculated. The signal intensity (SI(normal))and ADC (ADC(normal))of normal nasopharyngeal tissue were calculated. These quantitative parameters of NPC and normal nasopharyngeal tissue were compared.Statistical difference of ADC(mean), ADC(max) and ADC(min) between the clinical tumor stages were assessed. Results: On the DWI, all NPCs were clearly shown as high signal intensity relative to the surrounding normal nasopharyngeal structure(F=70.019, P=0.000). The ADC(mean)(F=20.442, P=0.000), ADC(max)(F=35.374, P=0.000), ADC(min)(F=61.534, P=0.000) in the carcinoma were significantly lower compared with that of normal nasopharyngeal structure. There was no statistically significant difference of ADC(mean), ADC(max) and ADC(min) (P>0.05)in different clinical stages of NPC. Conclusion: NPC can be clearly detected by RESOLVE-DWI, but the ADC(mean), ADC(max) and ADC(min) can not be used for differentiating the clinical stage of NPC.

[Data analysis on hepatitis B through pilot surveillance reporting system in Henan province, 2012-2016]

Objective: To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province. Methods: A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city, Linzhou of Anyang city, Shanyang district of Jiaozuo city, Shaoling district of Luohe city, Yongcheng of Shangqiu city, Pingqiao district of Xinyang city in Henan province. Subjects under study were those reported hepatitis B cases, from 2012 to 2016. Cases diagnosed in 2011 were chosen as controls. Data on classification of hepatitis B, time that HBsAg became positive and ALT value of the cases were analyzed annually. 5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B. Based on the 2016 data from the monitoring system, the incidence of acute hepatitis B in Henan province was estimated. Results: The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially. A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016, with a reduction of 84.90%(14 804/17 436) in these six monitoring sites. The number of unclassified hepatitis B cases also dropped sharply. In 2011, 36.87% of the cases were unclassified, but the figure reduced to 0.08% in 2016, from the six sites. The rate on ALT detection also gradually improved. The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared. From 2013 to 2016, 777 blood samples were collected from six pilot sites. 29.34% (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention. Conclusions: Since the development of the pilot surveillance program, the quality of reporting system on hepatitis B had been improved, as well as the accuracy of diagnosis. Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.

[Correlation of Genetic Polymorphism, Alcoholic Beverage Type and Ethanol Metabolism]

OBJECTIVES

To explore the effects of ADH1B and ALDH2 gene polymorphism and type of alcoholic beverage on ethanol metabolism, to provide data support for cases involving the interpretation of ethanol metabolism or back calculation of blood ethanol concentration in forensic practice.

METHODS

A total of 81 volunteers were selected. The genotypes of ADH1B, ADH1C and ALDH2 were obtained by a multiplex SNaPshot genotyping method. Each subject was administered with 1.0 g/kg of alcohol. About 1 mL venous blood was collected before and after the alcohol consumption at 30 min, 45 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 5 h, 6 h, 7 h and 8 h, respectively. The concentrations of ethanol and acetaldehyde in blood were determined by headspace gas chromatography. The peak times of blood ethanol concentration （T_max）, the peak mass concentrations of ethanol （C_max）, the area under curve （AUC） of ethanol （AUC_ethanol）, AUC_acetaldehyde and ethanol elimination rates （_β） were calculated. In order to eliminate the influence of ADH1C, the ADH1C*1/*1 carriers were grouped based on the genotype of ADH1B and ALDH2. The data of each group were evaluated by one-way analysis of variance and pairwise comparison tests were performed by least significant difference method. The gene interactions were evaluated by two-way analysis of variance. Each parameter of three kinds of alcoholic beverage （white wine, red wine and beer） among groups was analysed by variance analysis with randomized block design.

RESULTS

There were no differences in the value of T_max and C_max between the groups with different ADH1B and ALDH2 genotype. The differences in the values of AUC_ethanol, _β and AUC_acetaldehyde among some groups carrying different ADH1B and ALDH2 genotype had statistical significance, while no significant difference was observed in these parameters when one individual taking same dose of different alcoholic beverage type.

CONCLUSIONS

The ethanol metabolism is associated with the related gene polymorphism, which is barely affected by alcoholic beverage type.

[The impact of weight management and related diuretic medication intervention based on body weight changes on cardiac function and re-hospitalization rate in patients with chronic congestive heart failure]

Objective: To explore the impact of weight management and related medication intervention based on body weight changes on cardiac function among patients with chronic congestive heart failure (CHF). Methods: Using prospective, randomized, controlled study methods, consecutive CHF patients, who hospitalized in our department from June 2014 to June 2016 (n=350), were randomly divided into intervention group (n=175) and control group (n=175). Patients in the intervention group received weight management guidance and the post discharge diuretic drugs regimen was adjusted based on body weight changes. The control group received routine medical care post discharge. Left ventricular ejection fraction (LVEF), B type natriuretic peptide precursor (NT-proBNP), 6 minutes walk distance and NYHA classification at one day before discharge and after 6 months were compared between the two groups respectively. Results: Follow-up visit data were not available from 6 patients in the control and intervention group respectively. NYHA classification, LVEF, NT-proBNP and 6 minutes walk distance were similar between the two groups at one day before discharge (all P>0.05). After 6 months, the LVEF and 6 minutes walk distance were significantly higher while NT-proBNP level was significantly lower in the intervention group compared to the control group (all P<0.01). Meanwhile, the LVEF and 6 minutes walk distance were significantly increased, while NT-proBNP was significantly reduced at 6 months post discharge compared to one day before discharge in the intervention group (all P<0.01). The LVEF was also significantly improved (P=0.035), but the NT-proBNP and 6 minutes walk distance were similar (P were 0.328 and 0.807 respectively) at 6 months after discharge compared to one day before discharge in the control group. The NYHA classification was significantly lower in intervention group and in control group at 6 months after discharge compared to one day before discharge (Z=5.154, P<0.01 and Z=10.497, P<0.01), and the NYHA classification improved more in the intervention group than in control group at 6 months after discharge (Z=9.235, P<0.01). The re-hospitalization rate of CHF patients in intervention group was 11.83% (20/169), which was significantly lower than the control group (33.14% (56/169), χ(2)=21.99, P<0.01). At 6 months follow up, body weight remained unchanged in the intervention group, while body weight tended to be higher in the control group compared to one day before discharge. Conclusion: The weight management and diuretic drug regimen adjudgment intervention based on body weight changes can improve cardiac function and reduced re-hospitalization rate in CHF patients.

MicroRNA-related genetic variants in iron regulatory genes, dietary iron intake, microRNAs and lung cancer risk

Background

Genetic variations in MicroRNA (miRNA) binding sites may alter structural accessibility of miRNA binding sites to modulate risk of cancer. This large-scale integrative multistage study was aimed to evaluate the interplay of genetic variations in miRNA binding sites of iron regulatory pathway, dietary iron intake and lung cancer (LC) risk.

Patients and methods

The interplay of genetic variant, dietary iron intake and LC risk was assessed in large-scale case-control study. Functional characterization of the validated SNP and analysis of target miRNAs were performed.

Results

We found that the miRNA binding site SNP rs1062980 in 3' UTR of Iron-Responsive Element Binding protein 2 gene (IREB2) was associated with a 14% reduced LC risk (P value = 4.9×10 - 9). Comparing to AA genotype, GG genotype was associated with a 27% reduced LC risk. This association was evident in males and ever-smokers but not in females and never-smokers. Higher level of dietary iron intake was significantly associated with 39% reduced LC risk (P value = 2.0×10 - 8). This association was only present in individuals with AG + AA genotypes with a 46% reduced risk (P value = 1.0×10 - 10), but not in GG genotype. The eQTL-analysis showed that rs1062980 significantly alters IREB2 expression level. Rs1062980 is predicted to alter a miR-29 binding site on IREB2 and indeed the expression of miR-29 is inversely correlated with IREB2 expression. Further, we found that higher circulating miR-29a level was significantly associated with 78% increased LC risk.

Conclusion

The miRNA binding site SNP rs1062980 in iron regulatory pathway, which may alter the expression of IREB2 potentially through modulating the binding of miR-29a, together with dietary iron intake may modify risk of LC both individually and jointly. These discoveries reveal novel pathway for understanding lung cancer tumorigenesis and risk stratification.