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Li X, Hou X, Hernández-Wolters B, Prabahar K, Kord-Varkaneh H, Mei B. The effect of tamoxifen on estradiol, SHBG, IGF-1, and CRP in women with breast cancer or at risk of developing breast cancer: a meta-analysis of randomized controlled trials. Exp Gerontol 2024; 191:112431. [PMID: 38608792 DOI: 10.1016/j.exger.2024.112431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/07/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND AIM The effects of tamoxifen on the serum levels of hormones and acute phase reactants have been studied previously, but study results have been inconsistent, especially in women with breast cancer. Hence, we conducted this meta-analysis of randomized controlled trials (RCTs) to try to clarify the effects of tamoxifen on estradiol, insulin-like growth factor 1 (IGF-1), sex hormone binding globulin (SHBG), and C-reactive protein (CRP) serum levels in women with breast cancer or at risk of developing breast cancer. METHODS Databases were systematically searched up to December 2023. The meta-analysis was generated through a random-effects model and is presented as the weighted mean difference (WMD) and 95 % confidence intervals (CI). RESULTS Nine publications were included in the present meta-analysis. The comprehensive findings from the random-effects model revealed an elevation in estradiol (WMD: 13.04 pg/mL, 95 % CI: 0.79, 25.30, p = 0.037) and SHBG levels (WMD: 21.26 nmol/l, 95 % CI: 14.85, 27.68, p = 0.000), as well as a reduction in IGF-1 (WMD: -14.41 μg/L, 95 % CI: -24.23, -4.60, p = 0.004) and CRP concentrations (WMD: -1.17 mg/dL, 95 % CI: -2.29, -0.05, p = 0.039) following treatment with tamoxifen in women with breast cancer or at risk of developing breast cancer, with no impact on IGFBP-3 levels (WMD: 0.11 μg/mL, 95 % CI: -0.07, 0.30, p = 0.240). CONCLUSION Tamoxifen administration seems to increase estradiol and SHBG levels and reduce CRP and IGF-1 levels in women with breast cancer or at risk of developing breast cancer. Further studies are needed to determine whether these changes have any clinical relevance.
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Affiliation(s)
- XingDa Li
- Department of Oncology, 967th Hospital of the Joint Logistics Support Force of PLA, Dalian 116021, China
| | - XueJiao Hou
- Department of Oncology, 967th Hospital of the Joint Logistics Support Force of PLA, Dalian 116021, China
| | | | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Hamed Kord-Varkaneh
- Department of Nutrition and Food Hygiene, School of Medicine, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Bo Mei
- Department of Oncology, 967th Hospital of the Joint Logistics Support Force of PLA, Dalian 116021, China.
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2
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Guo Z, Xu C, Fang Z, Yu X, Yang K, Liu C, Ning X, Dong Z, Liu C. Inflammatory bowel disease and breast cancer: A two-sample bidirectional Mendelian randomization study. Medicine (Baltimore) 2024; 103:e38392. [PMID: 38847661 PMCID: PMC11155618 DOI: 10.1097/md.0000000000038392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024] Open
Abstract
There is a correlation between IBD and breast cancer according to previous observational studies. However, so far there is no evidence to support if there is a causal relationship between these 2 diseases. We acquired comprehensive Genome-Wide Association Study (GWAS) summary data on IBD (including ulcerative colitis [UC] and Crohn disease [CD]) as well as breast cancer of completely European descent from the IEU GWAS database. The estimation of bidirectional causality between IBD (including UC and CD) and breast cancer was achieved through the utilization of 2-sample Mendelian randomization (MR). The MR results were also assessed for any potential bias caused by heterogeneity and pleiotropy through sensitivity analyses. Our study found a bidirectional causal effect between IBD and breast cancer. Genetic susceptibility to IBD was associated with an increased risk of breast cancer (OR = 1.053, 95% CI: 1.016-1.090, P = .004). Similarly, the presence of breast cancer may increase the risk of IBD (OR = 1.111, 95% CI: 1.035-1.194, P = .004). Moreover, the bidirectional causal effect between IBD and breast cancer can be confirmed by another GWAS of IBD. Subtype analysis showed that CD was associated with breast cancer (OR = 1.050, 95% CI: 1.020-1.080, P < .001), but not UC and breast cancer. There was a suggestive association between breast cancer and UC (OR = 1.106, 95% CI: 1.011-1.209, P = .028), but not with CD. This study supports a bidirectional causal effect between IBD and breast cancer. There appear to be considerable differences in the specific associations of UC and CD with AD. Understanding that IBD including its specific subtypes and breast cancer constitute common risk factors can contribute to the clinical management of both diseases.
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Affiliation(s)
- Zihao Guo
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Changyu Xu
- Department of Ultrasound, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhihao Fang
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaoxiao Yu
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kai Yang
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Changxu Liu
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xinwei Ning
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhichao Dong
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chang Liu
- Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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3
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Navarro-Ibarra MJ, Saucedo-Tamayo MDS, Alemán-Mateo H, Parra-Sánchez H, Othón-Ontiveros P, Hernández J, Caire-Juvera G. Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors. Biol Res Nurs 2024; 26:231-239. [PMID: 37844913 DOI: 10.1177/10998004231207022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; β adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; β = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (β adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (β adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.
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Affiliation(s)
- María Jossé Navarro-Ibarra
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
- Departamento de Nutrición, Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Mexicali, Mexico
| | | | - Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | - Héctor Parra-Sánchez
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | | | - Jesús Hernández
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | - Graciela Caire-Juvera
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
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4
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Lyu DW. Immunomodulatory effects of exercise in cancer prevention and adjuvant therapy: a narrative review. Front Physiol 2024; 14:1292580. [PMID: 38239881 PMCID: PMC10794543 DOI: 10.3389/fphys.2023.1292580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Successful application of cancer immunotherapy has rekindled hope in cancer patients. However, a number of patients are unresponsive to immunotherapy and related treatments. This unresponsiveness in cancer patients toward different treatment regimens can be mainly attributed to severe immune dysfunction in such patients. Several reports indicate that physical exercise can significantly lead to improved cancer patient outcomes. Since exercise gets immense response from the immune system, it can be utilized to improve immune function. Leukocytes with enhanced functions are substantially mobilized into the circulation by a single bout of intense physical exercise. Chronic physical exercise results in greater muscle endurance and strength and improved cardiorespiratory function. This exercise regime is also useful in improving T-cell abundance and reducing dysfunctional T cells. The current available data strongly justify for future clinical trials to investigate physical exercise use as an adjuvant in cancer therapy; however, optimal parameters using exercise for a defined outcome are yet to be established. The components of the immune system associate with almost every tumorigenesis step. The inter-relationship between inflammation, cancer, and innate immunity has recently gained acceptance; however, the underlying cellular and molecular mechanisms behind this relationship are yet to be solved. Several studies suggest physical exercise-mediated induction of immune cells to elicit anti-tumorigenic effects. This indicates the potential of exercising in modulating the behavior of immune cells to inhibit tumor progression. However, further mechanistic details behind physical exercise-driven immunomodulation and anticancer effects have to be determined. This review aims to summarize and discuss the association between physical exercise and immune function modulation and the potential of exercise as an adjuvant therapy in cancer prevention and treatment.
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Affiliation(s)
- Da-wei Lyu
- Physical Education and Health School, East China Jiaotong University, Nanchang, Jiangxi, China
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5
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Cho HJ, Song S, Kim Z, Youn HJ, Cho J, Min JW, Kim YS, Choi SW, Lee JE. Associations of body mass index and weight change with circulating levels of high-sensitivity C-reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors. Asia Pac J Clin Oncol 2023; 19:113-125. [PMID: 35590398 DOI: 10.1111/ajco.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 01/20/2023]
Abstract
AIM This study examined the associations of body mass index (BMI) and weight change with inflammatory markers among breast cancer survivors in Korea. METHODS A total of 495 women were included who had been diagnosed with primary breast cancer and survived for at least 6 months since the surgery. Information on the body weight and height of the participants was collected both at the study enrollment and diagnosis. The plasma levels of inflammatory markers were measured, including high-sensitivity C-reactive protein, interleukin (IL)-6, IL-8, tumor necrosis factor-α, and adiponectin. A summary z-score was calculated by summing up the z-scores of each biomarker. The least-square means and 95% confidence intervals (CIs) were calculated using a generalized linear model and odds ratios (ORs) and 95% CIs for the elevated levels of inflammatory markers with a multivariate logistic regression model. RESULTS Participants with a BMI ≥27.5 kg/m2 at the study enrollment and at diagnosis were significantly associated with elevated summary z-scores compared to those with a BMI < 23 kg/m2 ; the ORs (95% CIs) were 5.42 (2.15-13.71) for current BMI and 3.66 (1.68-7.98) for BMI at diagnosis, respectively. Additionally, a weight loss > 5% since diagnosis was associated with a lower prevalence of high summary z-scores; the OR (95% CI) was .20 (.08-.52) compared to a stable weight. CONCLUSIONS A high BMI at diagnosis and current BMI with a greater degree were associated with unfavorable levels of inflammatory markers among breast cancer survivors. Additionally, weight loss since diagnosis was inversely associated with these markers.
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Affiliation(s)
- Hyun Jeong Cho
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Sihan Song
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jihyoung Cho
- Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jun Won Min
- Department of Surgery, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Yoo Seok Kim
- Department of Surgery, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sang-Woon Choi
- Chaum Life Center, CHA University, Seoul, Republic of Korea.,Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.,Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
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6
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Carroll JE, Nakamura ZM, Small BJ, Zhou X, Cohen HJ, Ahles TA, Ahn J, Bethea TN, Extermann M, Graham D, Isaacs C, Jim HS, Jacobsen PB, McDonald BC, Patel SK, Rentscher K, Root J, Saykin AJ, Tometich DB, Van Dyk K, Zhai W, Breen EC, Mandelblatt JS. Elevated C-Reactive Protein and Subsequent Patient-Reported Cognitive Problems in Older Breast Cancer Survivors: The Thinking and Living With Cancer Study. J Clin Oncol 2023; 41:295-306. [PMID: 36179271 PMCID: PMC9839283 DOI: 10.1200/jco.22.00406] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/24/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To examine longitudinal relationships between levels of C-reactive protein (CRP) and cognition in older breast cancer survivors and noncancer controls. METHODS English-speaking women age ≥ 60 years, newly diagnosed with primary breast cancer (stage 0-III), and frequency-matched controls were enrolled from September 2010 to March 2020; women with dementia, neurologic disorders, and other cancers were excluded. Assessments occurred presystemic therapy/enrollment and at annual visits up to 60 months. Cognition was measured using the Functional Assessment of Cancer Therapy-Cognitive Function and neuropsychological testing. Mixed linear effect models tested for survivor-control differences in natural log (ln)-transformed CRP at each visit. Random effect-lagged fluctuation models tested directional effects of ln-CRP on subsequent cognition. All models controlled for age, race, study site, cognitive reserve, obesity, and comorbidities; secondary analyses evaluated if depression or anxiety affected results. RESULTS There were 400 survivors and 329 controls with CRP specimens and follow-up data (average age of 67.7 years; range, 60-90 years). The majority of survivors had stage I (60.9%), estrogen receptor-positive (87.6%) tumors. Survivors had significantly higher adjusted mean ln-CRP than controls at baseline and 12-, 24-, and 60-month visits (all P < .05). Higher adjusted ln-CRP predicted lower participant-reported cognition on subsequent visits among survivors, but not controls (P interaction = .008); effects were unchanged by depression or anxiety. Overall, survivors had adjusted Functional Assessment of Cancer Therapy-Cognitive Function scores that were 9.5 and 14.2 points lower than controls at CRP levels of 3.0 and 10.0 mg/L. Survivors had poorer neuropsychological test performance (v controls), with significant interactions with CRP only for the Trails B test. CONCLUSION Longitudinal relationships between CRP and cognition in older breast cancer survivors suggest that chronic inflammation may play a role in development of cognitive problems. CRP testing could be clinically useful in survivorship care.
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Affiliation(s)
- Judith E. Carroll
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Zev M. Nakamura
- Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, NC
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Harvey J. Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Tim A. Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Traci N. Bethea
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Martine Extermann
- Department of Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
| | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | | | - Paul B. Jacobsen
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Brenna C. McDonald
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | | | - Kelly Rentscher
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - James Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | | | - Kathleen Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Elizabeth C. Breen
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Jeanne S. Mandelblatt
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
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7
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Friedenreich CM, Morielli AR, Lategan I, Ryder-Burbidge C, Yang L. Physical Activity and Breast Cancer Survival-Epidemiologic Evidence and Potential Biologic Mechanisms. Curr Nutr Rep 2022; 11:717-741. [PMID: 35953663 DOI: 10.1007/s13668-022-00431-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW To review the biologic mechanisms that may be operative between physical activity and survival after breast cancer. RECENT FINDINGS Physical activity decreases risk of mortality from breast cancer by up to 40%. Several biologic mechanisms have been hypothesized to explain this association. Previous cohort studies and randomized trials have examined the primary mechanisms that appear to be operative, which involve a decrease in sex hormone levels, insulin resistance, and inflammation. The evidence is still inconsistent and several limitations in the existing literature exist. Understanding the biologic mechanisms involved in the association of physical activity and breast cancer survival will provide more precision to physical activity guidelines for cancer survival. To achieve this objective, future research should include direct measurements of physical activity, sedentary behaviour, and health-related fitness to provide a more comprehensive assessment of these factors and their association with biomarkers and survival after breast cancer.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Irizelle Lategan
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Charlotte Ryder-Burbidge
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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8
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Ose J, Gigic B, Hardikar S, Lin T, Himbert C, Warby CA, Peoples AR, Lindley CL, Boehm J, Schrotz-King P, Figueiredo JC, Toriola AT, Siegel EM, Li CI, Ulrich A, Schneider M, Shibata D, Ulrich CM. Presurgery Adhesion Molecules and Angiogenesis Biomarkers Are Differently Associated with Outcomes in Colon and Rectal Cancer: Results from the ColoCare Study. Cancer Epidemiol Biomarkers Prev 2022; 31:1650-1660. [PMID: 35667092 PMCID: PMC9509698 DOI: 10.1158/1055-9965.epi-22-0092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/02/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Cell-to-cell adhesion and angiogenesis are hallmarks of cancer. No studies have examined associations of adhesion molecules and angiogenesis biomarkers with clinical outcomes in colorectal cancer. METHODS In presurgery serum from n = 426 patients with colorectal cancer (stage I-III), we investigated associations of CRP, SAA, adhesion molecules (sICAM-1, sVCAM-1), and angiogenesis markers (VEGF-A and VEGF-D) with overall survival (OS), disease-free survival (DFS), and risk of recurrence. We computed HRs and 95% confidence intervals; adjusted for age, sex, BMI, stage, site, and study site, stratified by tumor site in exploratory analyses. RESULTS N = 65 (15%) were deceased, and 39 patients (14%) had a recurrence after a median follow-up of 31 months. We observed significant associations of biomarkers with OS, DFS, and risk of recurrence on a continuous scale and comparing top to bottom tertile, with HRs ranging between 1.19 and 13.92. CRP was associated with risk of death and recurrence in patients in the top tertile compared with patients in the bottom tertile, for example, risk of recurrence HRQ3-Q1: 13.92 (1.72-112.56). Significant heterogeneity between biomarkers and clinical outcomes was observed in stratified analysis by tumor site for CRP, SAA, sICAM-1, sVCAM-1, and VEGF-D. VEGF-D was associated with a 3-fold increase in risk of death for rectal cancer (HRlog2: 3.26; 95% CI, 1.58-6.70) compared with no association for colon cancer (HRlog2: 0.78; 95% CI, 0.35-1.73; Pheterogenity = 0.01). CONCLUSIONS Adhesion molecules and angiogenesis biomarkers are independent prognostic markers for colorectal cancer, with differences by tumor site. IMPACT There is need for tailored treatment for colon and rectal cancer.
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Affiliation(s)
- Jennifer Ose
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Sheetal Hardikar
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Tengda Lin
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | - Caroline Himbert
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Anita R Peoples
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | | | | | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | | | | | - Erin M Siegel
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | | | - David Shibata
- University of Tennessee Health Science Center, Memphis, TN
| | - Cornelia M Ulrich
- University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
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9
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Connor AE, Dibble KE, Boone SD, Baumgartner KB, Baumgartner RN. Systemic inflammation and risk of all-cause mortality after invasive breast cancer diagnosis among Hispanic and non-Hispanic white women from New Mexico. Cancer Epidemiol 2022; 76:102092. [PMID: 34995871 PMCID: PMC9128602 DOI: 10.1016/j.canep.2021.102092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/22/2021] [Accepted: 12/22/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Soluble tumor necrosis factor receptor-II (sTNF-R2), a pro-inflammatory biomarker, is associated with obesity and breast cancer (BC). The association between sTNF-R2 and risk of mortality after BC has not been studied, specifically among Hispanic women, an at-risk population due to their high prevalence of obesity and poor prognosis. We examined the association between sTNF-R2 and mortality among Hispanic and non-Hispanic white (NHW) BC survivors. METHODS A total of 397 invasive BC survivors (96 Hispanic, 301 NHW) contributed baseline interview data and blood samples. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models adjusting for clinical factors including body mass index. RESULTS After a median follow-up time of 13 years, 133 deaths occurred. The association between high vs low levels of plasma sTNF-R2 and mortality was not statistically significant overall (HR, 1.32; 95% CI 0.89-1.98). However, when stratified the mortality risk among Hispanic women was nearly 3-fold (HR, 2.83; 95% CI 1.21-6.63), while risk among NHW women was attenuated (HR, 0.99; 95% CI 0.61-1.61) (p-interaction=0.10). CONCLUSION Our results suggest Hispanic BC survivors with high sTNF-R2 levels may have increased risk of mortality and could inform targeted interventions to reduce inflammation and improve outcomes.
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Affiliation(s)
- Avonne E. Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School
of Public Health, Baltimore, Maryland,Johns Hopkins Sidney Kimmel Comprehensive Cancer Center,
Baltimore, Maryland
| | - Kate E. Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School
of Public Health, Baltimore, Maryland
| | - Stephanie D. Boone
- Department of Epidemiology and Population Health and the
James Graham Brown Cancer Center, University of Louisville, Louisville,
Kentucky
| | - Kathy B. Baumgartner
- Department of Epidemiology and Population Health and the
James Graham Brown Cancer Center, University of Louisville, Louisville,
Kentucky
| | - Richard N. Baumgartner
- Department of Epidemiology and Population Health and the
James Graham Brown Cancer Center, University of Louisville, Louisville,
Kentucky
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10
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Significant Physical and Exercise-Related Variables for Exercise-Centred Lifestyle: Big Data Analysis for Gynaecological Cancer Patients. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5362406. [PMID: 34957306 PMCID: PMC8702331 DOI: 10.1155/2021/5362406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
This study investigated the characteristics of gynaecological cancers and is aimed at identifying significant risk variables using the National Health Insurance Sharing Service database to develop practical interventions for affected patients. Data regarding patients with uterine and ovarian cancer from the National Health Insurance Sharing Service database were collected and analysed using Student's t-test, logistic regression, and receiver operating characteristic curve analyses. Student's t-test analyses revealed that age, body mass index, blood pressure, and waist variables differed significantly among patients with uterine cancer. Gamma-glutamyl transpeptidase levels were higher in patients with ovarian cancer than in patients with uterine cancer. Physical fitness function tests reflected the status of patients with cancer. Moreover, physical disability was associated with an increased incidence of ovarian cancer. Intensive exercise for 20 min more than 1 time per week must be avoided to prevent uterine cancer. Receiver operating characteristic curve analyses showed that the optimal cutoff value for one-leg standing time, a prognostic and preventive factor in ovarian cancer, was 9.50 s (sensitivity, 94.9%; specificity, 96.9%). Controlling significant variables for each gynaecological cancer type in an individualised and optimised manner is recommended, including by maintenance of an adjusted exercise-centred lifestyle.
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11
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Stewart KL, Gigic B, Himbert C, Warby CA, Ose J, Lin T, Schrotz-King P, Boehm J, Jordan KC, Metos J, Schneider M, Figueiredo JC, Li CI, Shibata D, Siegel E, Toriola AT, Hardikar S, Ulrich CM. Association of Sugar Intake with Inflammation- and Angiogenesis-Related Biomarkers in Newly Diagnosed Colorectal Cancer Patients. Nutr Cancer 2021; 74:1636-1643. [PMID: 34369225 DOI: 10.1080/01635581.2021.1957133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Evidence suggests a positive association between sugar intake and colorectal cancer (CRC) outcomes. We sought to investigate inflammation and angiogenesis as underlying mechanisms behind increased sugar intake and worse CRC outcomes. Pre-surgery serum samples were obtained from 191 patients diagnosed with primary invasive stage I-IV CRC. Biomarkers of inflammation (CRP, SAA, IL-6, IL-8, MCP-1, TNFα) and angiogenesis (VEGFA, VEGFD, sICAM-1 and sVCAM-1) were analyzed (Meso-Scale-Discovery). Fructose, glucose, sucrose, and total sugar intake (calories/day, % total calories) were assessed by FFQ. Pearson's correlation and multiple linear regression analyses were performed. Patients were on average 64 years old, 64% were male, the majority was diagnosed with stage II-III (58%) cancers, and 67% were either overweight or obese. Among normal-weight individuals (BMI <25 kg/m2), we observed a significant inverse association between VEGFD and any type of sugar intake in cal/day (sucrose: p = 0.01, glucose and fructose: p < 0.001) and MCP-1 and fructose intake (p = 0.05). The magnitude of reduction in VEGF ranged between -1.24 for sucrose to 4.49 for glucose intake, and -2.64 for fructose intake for MCP-1 levels. Sugar intake was associated with some inflammation or angiogenesis biomarkers, among CRC patients; differences were observed by adiposity that warrant further investigation.Supplemental data for this article is available online at at 10.1080/01635581.2021.1957133.
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Affiliation(s)
- Kelly L Stewart
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Caroline Himbert
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Christy A Warby
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Jennifer Ose
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Tengda Lin
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jürgen Boehm
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kristine C Jordan
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Julie Metos
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David Shibata
- The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Erin Siegel
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Sheetal Hardikar
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
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12
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Possa LDO, Hinkelman JV, Santos CAD, Oliveira CAD, Faria BS, Hermsdorff HHM, Rosa CDOB. Association of dietary total antioxidant capacity with anthropometric indicators, C-reactive protein, and clinical outcomes in hospitalized oncologic patients. Nutrition 2021; 90:111359. [PMID: 34243042 DOI: 10.1016/j.nut.2021.111359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/03/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Many studies have shown an inverse association between higher dietary total antioxidant capacity (DTAC) and chronic non-communicable diseases, including cancer. The aim of this study was to evaluate the association of the DTAC with anthropometric and biochemical indicators and clinical outcomes in hospitalized patients with cancer. METHODS A cross-sectional study was carried out with 196 hospitalized patients diagnosed with cancer. The DTAC, determined by the ferric-reducing antioxidant power method, was calculated using a validated standard spreadsheet. Multivariate linear regression was used to assess the association, identifying anthropometric indicators that were associated with DTAC and the variables of interest. P < 0.05 was statistically significant. RESULTS The individuals included in the last tertile of DTAC presented lower occurrences of death (P = 0.032), constipation (P = 0.010), dysphagia (P = 0.010), painful swallowing and chewing (P = 0.019), and dehydration (P = 0.032) than individuals in the first tertile. The C-reactive protein values were significantly lower (P = 0.010) and handgrip strength values were higher (P = 0.037) in individuals in the third tertile than in the other participants. CONCLUSIONS DTAC was associated with a better prognosis of hospitalized cancer patients, considering signs and symptoms of nutritional impact, as well as the inflammatory state of the patients. These factors may influence the length of hospital stay and mortality. The findings of this research provide important information for a preventive and nutritional management perspective in this population.
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Affiliation(s)
- Luiza de Oliveira Possa
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
| | - Jéssica Viana Hinkelman
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
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13
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Leal LG, Lopes MA, Peres SB, Batista ML. Exercise Training as Therapeutic Approach in Cancer Cachexia: A Review of Potential Anti-inflammatory Effect on Muscle Wasting. Front Physiol 2021; 11:570170. [PMID: 33613297 PMCID: PMC7890241 DOI: 10.3389/fphys.2020.570170] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Cachexia is a multifactorial inflammatory syndrome with high prevalence in cancer patients. It is characterized by a metabolic chaos culminating in drastic reduction in body weight, mainly due to skeletal muscle and fat depletion. Currently, there is not a standard intervention for cachexia, but it is believed that a dynamic approach should be applied early in the course of the disease to maintain or slow the loss of physical function. The present review sought to explain the different clinical and experimental applications of different models of exercise and their contribution to a better prognosis of the disease. Here the advances in knowledge about the application of physical training in experimental models are elucidated, tests that contribute substantially to elucidate the cellular and biochemical mechanisms of exercise in different ways, as well as clinical trials that present not only the impacts of exercise in front cachexia but also the challenges of its application in clinical practice.
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Affiliation(s)
- Luana G Leal
- Integrated Group of Biotechnology, Laboratory of Adipose Tissue Biology, University of Mogi das Cruzes, Mogi das Cruzes, Brazil.,Technological Research Group, University of Mogi das Cruzes, Mogi das Cruzes, Brazil
| | - Magno A Lopes
- Laboratory of Metabolism of Bioactive Lipids, Institute of Physiology of the Czech Academy of Sciences, Prague, Czechia
| | - Sidney B Peres
- Department of Physiological Sciences, State University of Maringá, Maringá, Brazil
| | - Miguel L Batista
- Integrated Group of Biotechnology, Laboratory of Adipose Tissue Biology, University of Mogi das Cruzes, Mogi das Cruzes, Brazil.,Technological Research Group, University of Mogi das Cruzes, Mogi das Cruzes, Brazil
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14
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Links between Inflammation and Postoperative Cancer Recurrence. J Clin Med 2021; 10:jcm10020228. [PMID: 33435255 PMCID: PMC7827039 DOI: 10.3390/jcm10020228] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/24/2022] Open
Abstract
Despite complete resection, cancer recurrence frequently occurs in clinical practice. This indicates that cancer cells had already metastasized from their organ of origin at the time of resection or had circulated throughout the body via the lymphatic and vascular systems. To obtain this potential for metastasis, cancer cells must undergo essential and intrinsic processes that are supported by the tumor microenvironment. Cancer-associated inflammation may be engaged in cancer development, progression, and metastasis. Despite numerous reports detailing the interplays between cancer and its microenvironment via the inflammatory network, the status of cancer-associated inflammation remains difficult to recognize in clinical settings. In the current paper, we reviewed clinical reports on the relevance between inflammation and cancer recurrence after surgical resection, focusing on inflammatory indicators and cancer recurrence predictors according to cancer type and clinical indicators.
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15
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Bera A, Russ E, Manoharan MS, Eidelman O, Eklund M, Hueman M, Pollard HB, Hu H, Shriver CD, Srivastava M. Proteomic Analysis of Inflammatory Biomarkers Associated With Breast Cancer Recurrence. Mil Med 2020; 185:669-675. [PMID: 32074342 DOI: 10.1093/milmed/usz254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Breast cancer is the most frequent cancer detected for women, and while our ability to treat breast cancer has improved substantially over the years, recurrence remains a major obstacle. Standard screening for new and recurrent breast cancer involves clinical breast imaging. However, there is no clinically approved noninvasive body fluid test for the early detection of recurrent breast cancer. Materials and Method: In this study, we analyzed serum samples from both recurrent and nonrecurrent breast cancer patients by different proteomics methods to identify biomarkers in patients with recurrence of disease. RESULTS Comparative data analysis identified several histone deacetylase (HDAC) proteins, which were found at significantly higher levels in the serum of recurrent breast cancer patients: HDAC9 (C-term) (P = 0.0035), HDAC5 (C-term) (P = 0.013), small ubiquitin-like modifier 1 (N-term) (P = 0.017), embryonic stem cell-expressed Ras (inter) (P = 0.018), and HDAC7 (C-term) (P = 0.020). Chronic inflammation plays a critical role in the development of the breast cancer recurrence, and we identified several proinflammatory cytokines that were present at elevated levels only in recurrent breast cancer patient serum. CONCLUSIONS Our data indicated that the epigenetic regulation of inflammatory processes plays a critical role in breast cancer recurrence. The identified proteins could lay the groundwork for the development of a serum-based breast cancer recurrence assay.
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Affiliation(s)
- Alakesh Bera
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Eric Russ
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Muthu Saravanan Manoharan
- Department of Medicine/Infectious Diseases, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
| | - Ofer Eidelman
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Michael Eklund
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Matthew Hueman
- Murtha Cancer Center, Uniformed Services University/Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889
| | - Harvey B Pollard
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Hai Hu
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, 620 7th Street, Windber, PA 15963
| | - Craig D Shriver
- Murtha Cancer Center, Uniformed Services University/Walter Reed National Military Medical Center, 4494 North Palmer Road, Bethesda, MD 20889
| | - Meera Srivastava
- Department of Anatomy, Physiology, and Genetics, Uniformed Services University Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
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16
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Alizadeh AM, Isanejad A, Sadighi S, Mardani M, kalaghchi B, Hassan ZM. High-intensity interval training can modulate the systemic inflammation and HSP70 in the breast cancer: a randomized control trial. J Cancer Res Clin Oncol 2019; 145:2583-2593. [DOI: 10.1007/s00432-019-02996-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022]
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17
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Krok-Schoen JL, Brasky TM, Hunt RP, Rohan TE, Baker TA, Li W, Carbone L, Mackey RH, Snetselaar L, Lustberg M, Neuhouser ML. Dietary Long-Chain n-3 Fatty Acid Intake and Arthritis Risk in the Women's Health Initiative. J Acad Nutr Diet 2018; 118:2057-2069. [PMID: 29921541 PMCID: PMC6204099 DOI: 10.1016/j.jand.2018.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/03/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND The prevalence of arthritis in the United States is substantial and on the rise. Long-chain n-3 polyunsaturated fatty acids, which have anti-inflammatory properties, have been shown to provide therapeutic benefit to arthritis patients; however, to date few have examined these associations with arthritis risk. OBJECTIVE The study objective was to examine the associations of long-chain n-3 polyunsaturated fatty acids intake with osteoarthritis (OA) and rheumatoid arthritis (RA) risk among postmenopausal women. DESIGN This was a prospective cohort study. PARTICIPANTS The sample for this analysis consisted of 80,551 postmenopausal women, aged 55 to 79 years and with no history of arthritis, recruited into the Women's Health Initiative Observational Study and Clinical Trials cohort between 1993 and 1998. Women completed a 120-item food frequency questionnaire at baseline. MAIN OUTCOME MEASURES After a median follow-up of 8 years, 22,306 incident OA and 3,348 RA cases were identified. STATISTICAL ANALYSES PERFORMED Adjusted Cox regression models were used to estimate hazard ratios and 95% CI for the associations between dietary LCn-3PUFA intake and OA and RA risk. RESULTS Individual and total long-chain n-3 polyunsaturated fatty acids (Quintile 5 vs Quintile 1: hazard ratio 1.04, 95% CI 0.99 to 1.09 for OA; hazard ratio 1.01, 95% CI 0.90 to 1.13 for RA) were not associated with OA and RA risk. Further, no associations were observed between n-6 polyunsaturated fatty acids intake and either arthritis outcome. CONCLUSIONS This study is the first to examine associations of long-chain n-3 polyunsaturated fatty acids intake with OA risk and the largest to examine associations with RA risk. Despite their therapeutic potential, the study provides no evidence of benefit of these nutrients in relation to arthritis risk.
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Affiliation(s)
- Jessica L. Krok-Schoen
- The Ohio State University-James Comprehensive Cancer Center, Columbus, OH USA
- School of Health and Rehabilitation Sciences, The Ohio State College of Medicine, Columbus, OH USA
| | - Theodore M. Brasky
- The Ohio State University-James Comprehensive Cancer Center, Columbus, OH USA
| | - Rebecca P. Hunt
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York City, NY USA
| | - Tamara A. Baker
- University of Kansas Department of Psychology, Lawrence, KS USA
| | - Wenjun Li
- University of Massachusetts School of Medicine, Boston, MA USA
| | - Laura Carbone
- Medical College of Georgia at Augusta University, Augusta, GA USA
| | - Rachel H. Mackey
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA USA
| | - Linda Snetselaar
- The University of Iowa College of Public Health, Iowa City, IA USA
| | - Maryam Lustberg
- The Ohio State University-James Comprehensive Cancer Center, Columbus, OH USA
| | - Marian L. Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
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18
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Abstract
Weight, weight change and physical activity may affect prognosis among women who are diagnosed with breast cancer. Observational studies show associations between overweight/obesity and weight gain with several measures of reduced prognosis in women with breast cancer, and some suggestions of lower survival in women who are underweight or who experience unexplained weight loss after diagnosis. Observational studies have also shown an association between higher levels of physical activity and reduced breast cancer-specific and all-cause mortality, although a dose–response relationship has not been established. The effects of purposive dietary weight loss and increase in physical activity on survival or recurrence in breast cancer are not yet established, and randomised controlled trials are needed for definitive data. This paper presents the epidemiologic evidence on weight status, weight change, and physical activity and breast cancer survival; suggests potential mediating mechanisms; summarises evidence on weight loss interventions in breast cancer survivors; describes ongoing randomised clinical trials designed to test the effects of weight loss or physical activity on breast cancer survival; and provides information on available guidelines on weight and physical activity for cancer survivors.
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19
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Wu DC, Wang KY, Wang SSW, Huang CM, Lee YW, Chen MI, Chuang SA, Chen SH, Lu YW, Lin CC, Lee KW, Hsu WH, Wu KP, Chen YJ. Exploring the expression bar code of SAA variants for gastric cancer detection. Proteomics 2018; 17. [PMID: 28493537 DOI: 10.1002/pmic.201600356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 03/18/2017] [Accepted: 04/26/2017] [Indexed: 12/30/2022]
Abstract
We reported an integrated platform to explore serum protein variant pattern in cancer and its utility as a new class of biomarker panel for diagnosis. On the model study of serum amyloid A (SAA), we employed nanoprobe-based affinity mass spectrometry for enrichment, identification and quantitation of SAA variants from serum of 105 gastric cancer patients in comparison with 54 gastritis patients, 54 controls, and 120 patients from other cancer. The result revealed surprisingly heterogeneous and most comprehensive SAA bar code to date, which comprises 24 SAA variants including SAA1- and SAA2-encoded products, polymorphic isoforms, N-terminal-truncated forms, and three novel SAA oxidized isotypes, in which the variant-specific peptide sequence were also confirmed by LC-MS/MS. A diagnostic model was developed for dimension reduction and computational classification of the 24 SAA-variant bar code, providing good discrimination (AUC = 0.85 ± 3.2E-3) for differentiating gastric cancer group from gastritis and normal groups (sensitivity, 0.76; specificity, 0.81) and was validated with external validation cohort (sensitivity, 0.71; specificity, 0.74). Our platform not only shed light on the occurrence and modification extent of under-represented serum protein variants in cancer, but also suggested a new concept of diagnostic platform by serum protein variant profile.
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Affiliation(s)
- Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kai-Yi Wang
- Department of Chemistry, National Taiwan University, Taipei, Taiwan.,Nano Science and Technology Program, Taiwan International Graduate Program, Academia Sinica and National Taiwan University, Taipei, Taiwan
| | - Sophie S W Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Min Huang
- Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan
| | - Yi-Wei Lee
- Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan
| | | | - Szu-An Chuang
- Institute of Chemistry, Academia Sinica, Taipei, Taiwan
| | - Shu-Hua Chen
- Institute of Chemistry, Academia Sinica, Taipei, Taiwan
| | - Ying-Wei Lu
- Department of Chemistry, National Tsing Hua University, Hsinchu, Taiwan
| | - Chun-Cheng Lin
- Department of Chemistry, National Tsing Hua University, Hsinchu, Taiwan
| | - Ka-Wo Lee
- Department of Otolaryngology, Kaohsiung Medical University Hospital and Department of Otolaryngology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hung Hsu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Pin Wu
- Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan
| | - Yu-Ju Chen
- Department of Chemistry, National Taiwan University, Taipei, Taiwan.,Nano Science and Technology Program, Taiwan International Graduate Program, Academia Sinica and National Taiwan University, Taipei, Taiwan.,Institute of Chemistry, Academia Sinica, Taipei, Taiwan
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20
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Arda E, Yuksel I, Cakiroglu B, Akdeniz E, Cilesiz N. Valuation of Neutrophil/Lymphocyte Ratio in Renal Cell Carcinoma Grading and Progression. Cureus 2018. [PMID: 29541572 PMCID: PMC5844648 DOI: 10.7759/cureus.2051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introduction We investigated the association of the neutrophil/lymphocyte ratio (NLR) with tumor size and Fuhrman grade in nonmetastatic renal cell carcinoma (RCC) cases. Materials and methods Data of nonmetastatic RCC (T1-4N0M0) cases, operated between 2010 and 2016, were retrospectively reviewed and 103 patients were included in the study. The patients were divided into two groups according to tumor diameter (Group 1 T < 4 cm, Group 2 T ≥ 4 cm) and into three groups according to Fuhrman grade. Twenty-eight patients with a tumor diameter of 4 cm or less in Group 1 and 75 patients with a tumor diameter greater than 4 cm in Group 2 were compared. In both grouping systems, the NLR, mean platelet volume (MPV), red cell distribution width (RDW), white blood cell (WBC), red blood cell (RBC), platelet (PLT), lymphocyte, and neutrophil values and age were compared. Results There were no differences in age, MPV, RDW, neutrophil, WBC, RBC, PLT counts in groups of tumor diameter (Group 1 T < 4 cm, Group 2 T ≥ 4 cm). However, the lymphocyte amount was significantly higher in cases with a tumor diameter less than 4 cm compared to the cases with a tumor diameter greater than 4 cm (p = 0.015). It was observed that the NLR had a tendency to increase in patients with tumor size greater than 4 cm compared to patients with tumor size smaller than 4 cm (p = 0.029). There were no differences in age, MPV, RDW, lymphocyte, neutrophil, WBC, RBC, PLT counts, and the NLR in different Fuhrman-graded cases. Conclusions There is a linear relation between the tumor size and the NLR in nonmetastatic RCC cases. Therefore, the NLR is a cheap parameter that can be used to show the tumor size, and thus it can be used to get an idea about the prognosis of the patient.
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Affiliation(s)
- Ersan Arda
- Urology, Trakya University Medical Faculty
| | | | | | - Esra Akdeniz
- Biostatistics, Marmara University School of Medicine
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21
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Mills RC. Breast Cancer Survivors, Common Markers of Inflammation, and Exercise: A Narrative Review. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2017; 11:1178223417743976. [PMID: 29434469 PMCID: PMC5802700 DOI: 10.1177/1178223417743976] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/23/2017] [Indexed: 12/29/2022]
Abstract
Exercise may help positively improve inflammatory marker levels, therefore promoting better outcomes in breast cancer survivors. This narrative review is intended to provide an overview between inflammation and breast cancer, in addition to the effects exercise may have on common inflammatory markers that have been examined in both healthy populations and breast cancer survivors throughout the literature. The inconsistencies and gaps in the literature addressed may be important for future research to further understand the relationship between exercise and inflammation, as well as the underlying biological mechanisms that are responsible for these changes. For the purpose of organization, this review is structured into the following sections: (1) Breast Cancer Facts, Treatment-Related Side Effects, and General Exercise Benefits; (2) Effects of Exercise on Markers of Inflammation in Cancer-Free Populations; (3) Cancer and Markers of Inflammation; (4) Effects of Exercise on Markers of Inflammation in Breast Cancer Survivors; and (5) Conclusions.
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Affiliation(s)
- Robert Coleman Mills
- Robert Coleman Mills III, Duke University Medical Center, Box 2714, Durham, NC 27710, USA.
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22
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Winkels RM, Sturgeon KM, Kallan MJ, Dean LT, Zhang Z, Evangelisti M, Brown JC, Sarwer DB, Troxel AB, Denlinger C, Laudermilk M, Fornash A, DeMichele A, Chodosh LA, Schmitz KH. The women in steady exercise research (WISER) survivor trial: The innovative transdisciplinary design of a randomized controlled trial of exercise and weight-loss interventions among breast cancer survivors with lymphedema. Contemp Clin Trials 2017; 61:63-72. [PMID: 28739540 PMCID: PMC5817634 DOI: 10.1016/j.cct.2017.07.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/05/2017] [Accepted: 07/20/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Breast cancer survivors face dual challenges: long term sequelae of treatment, and risk of recurrent disease. Obesity and a sedentary lifestyle complicate both challenges. The WISER Survivor trial assessed the effects of exercise and/or weight-loss on lymphedema, biomarkers of breast cancer recurrence, and quality of life. We report on the innovative transdisciplinary design of this trial and report attrition rates. METHODS This one year trial randomized breast cancer survivors who had a BMI of ≥25kg/m2, were sedentary and had breast-cancer-related-lymphedema to 1) exercise (weight training and aerobic exercise) 2) weight-loss 3) exercise and weight-loss 4) or control group. Innovative aspects included: adaptation of a community-based weight training program to a largely home-based program; use of a commercial meal replacement system as part of the lifestyle modification weight-loss program; inclusion of measures of cost-effectiveness to enable economic evaluations; and alignment with a parallel mouse model for breast cancer recurrence to enable transdisciplinary research. In this model, mice bearing dormant residual tumor cells, which spontaneously relapse, were placed on a high-fat diet. Overweight animals were randomly assigned to exercise, calorie restriction, both, or control group and followed for cancer recurrence. The animal model will guide mechanistic biomarkers to be tested in the human trial. RESULTS & DISCUSSION 351 participants were randomized; 13 experienced breast cancer recurrence during the trial. Of the 338 participants without recurrence, 83% completed the trial. The WISER Survivor trial will show the effects of exercise and weight-loss on lymphedema outcomes, biomarkers of recurrence and quality of life. NCT ClinicalTrials.gov registration #: NCT01515124.
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Affiliation(s)
- Renate M Winkels
- Department of Public Health Sciences, Pennsylvania State University, Hershey, PA, United States
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, Pennsylvania State University, Hershey, PA, United States
| | - Michael J Kallan
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Zi Zhang
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States
| | - Margaret Evangelisti
- Center for Human Phenomic Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Justin C Brown
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States
| | - David B Sarwer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Andrea B Troxel
- Department of Population Health, New York University School of Medicine, New York City, NY, United States
| | - Crystal Denlinger
- Department of Hematology/Oncology, Fox Chase Cancer Centre, Philadelphia, PA, United States
| | | | - Anna Fornash
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States
| | - Angela DeMichele
- Division of Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Lewis A Chodosh
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Pennsylvania State University, Hershey, PA, United States.
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23
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Chen QY, Tang QN, Tang LQ, Chen WH, Guo SS, Liu LT, Li CF, Li Y, Liang YJ, Sun XS, Guo L, Mo HY, Sun R, Luo DH, Fan YY, He Y, Chen MY, Cao KJ, Qian CN, Guo X, Mai HQ. Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study. Cancer Res Treat 2017; 50:701-711. [PMID: 28707462 PMCID: PMC6056968 DOI: 10.4143/crt.2017.180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/03/2017] [Indexed: 12/15/2022] Open
Abstract
Purpose The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. Materials and Methods In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). Results The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. Conclusion The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
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Affiliation(s)
- Qiu-Yan Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Qing-Nan Tang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Lin-Quan Tang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Wen-Hui Chen
- Department of Oncology, the First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shan-Shan Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Li-Ting Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Chao-Feng Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Information Technology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yang Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yu-Jing Liang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xue-Song Sun
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ling Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hao-Yuan Mo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Rui Sun
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Dong-Hua Luo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yu-Ying Fan
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yan He
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ming-Yuan Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ka-Jia Cao
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Chao-Nan Qian
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xiang Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hai-Qiang Mai
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
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24
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Otunctemur A, Dursun M, Besiroglu H, Ozer K, Horsanali O, Ozbek E. Clinical Significance of Preoperative Neutrophil - to - Lymphocyte Ratio in Renal Cell Carcinoma. Int Braz J Urol 2017; 42:678-84. [PMID: 27564277 PMCID: PMC5006762 DOI: 10.1590/s1677-5538.ibju.2015.0397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/23/2016] [Indexed: 12/26/2022] Open
Abstract
Introduction: We investigated the prognostic significance of the neutrophil-to-lymphocyte ratio on tumor stage and Fuhrman nuclear grade in renal cell carcinoma. Methods: The records of 432 patients with RCC who underwent radical or partial nephrectomy between 2005 and 2014 were retrospectively reviewed. Patients were classified as group lower tumor stage(T1 + T2) and higher(T3 + T4). As like tumor stage, Fuhrman nuclear grade were classified lower (G1+G2) and higher(G3+G4) too. The best NLR cut off value was 3.01. Two sample t-test or Mann–Whitney U-test used for the continuous variables and a chi-square test or Fisher's exact test used for the categorical variables. Results: Among the 432 total patients analyzed in our study, there were 275 males (63.7%) and 157 females (36.3%). Mean laboratory values were CRP 2.73 ± 1.93 mg/dL (normal less than 0.3), neutrophil count 4,23 ± 1.46/μL, lymphocyte count 1,61 ± 0,61/μL and NLR 2.64 ± 1.24. According to our data, statistically pretreatment NLR significantly correlated with CRP (p<0.0001). And tumor patologic stage (p=0.08), tumor histologic grade (p<0.001) was significantly associated with NLR. Discussion: We compared the relationship of preoperative NLR and NC parameters with RCC tumor stage and grade. And NLR were found to have statistically significant higher T stage and grade at RCC. Further studies with more patients are needed to confirm our study.
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Affiliation(s)
- Alper Otunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Murat Dursun
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Besiroglu
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Kutan Ozer
- Department of Urology, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ozan Horsanali
- Department of Urology, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Emin Ozbek
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
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25
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Larouche D, Hanna M, Chang SL, Jacob S, Têtu B, Diorio C. Evaluation of Antioxidant Intakes in Relation to Inflammatory Markers Expression Within the Normal Breast Tissue of Breast Cancer Patients. Integr Cancer Ther 2016; 16:485-495. [PMID: 27903840 PMCID: PMC5739140 DOI: 10.1177/1534735416676584] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic inflammation may be a causative factor in breast cancer. One possible underlying mechanism is the generation of oxidative stress, which may favor tumorigenic processes. Antioxidant consumption may, therefore, help reduce tissue inflammation levels. However, few studies have explored this relation in breast tissue. We aimed to evaluate correlations between antioxidant (vitamin A/retinol, vitamin C, vitamin E, β-carotene, α-carotene, lycopene, lutein/zeaxanthin, β-cryptoxanthin, selenium, and zinc) intakes and protein expression levels of interleukin (IL)-6, tumor necrosis factor-α, C-reactive protein, cyclooxygenase-2, leptin, serum amyloid A1, signal transducer and activator of transcription 3, IL-8, IL-10, lactoferrin, and transforming growth factor-β measured in the normal breast tissue of 160 women diagnosed with breast cancer. Antioxidant intakes were collected using a self-administered food frequency questionnaire. Inflammation marker expression was assessed by immunohistochemistry. Correlations between antioxidant intakes and inflammatory marker expression were evaluated using Spearman's partial correlation coefficients ( r) for all women and for premenopausal and postmenopausal women separately. After Bonferroni correction, negative correlations were observed between dietary β-tocopherol and IL-10 expression in all women combined ( r = -0.26, P = .003) and among postmenopausal women ( r = -0.39, P = .003). For all women, a negative correlation was found between total zinc intakes and IL-10 ( r = -0.26, P = .002). Among postmenopausal women, dietary selenium intake was negatively correlated with the expression of lactoferrin ( r = -0.39, P = .003). No associations were observed in premenopausal women. Our findings suggest that consumption of specific antioxidants, including β-tocopherol, zinc, and selenium, may act on the breast tissue through mechanisms affecting the expression of some inflammation markers, particularly among postmenopausal women.
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Affiliation(s)
- Danielle Larouche
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada.,3 Faculté de médecine de l'Université Laval, Quebec, QC, Canada
| | - Mirette Hanna
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada.,3 Faculté de médecine de l'Université Laval, Quebec, QC, Canada
| | - Sue-Ling Chang
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada
| | - Simon Jacob
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada.,3 Faculté de médecine de l'Université Laval, Quebec, QC, Canada.,4 Service de pathologie, Hôpital du Saint-Sacrement, Quebec, QC, Canada.,5 Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Quebec, QC, Canada
| | - Bernard Têtu
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada.,3 Faculté de médecine de l'Université Laval, Quebec, QC, Canada.,4 Service de pathologie, Hôpital du Saint-Sacrement, Quebec, QC, Canada.,5 Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Quebec, QC, Canada
| | - Caroline Diorio
- 1 Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, Quebec, QC, Canada.,2 Centre de recherche sur le cancer de l'Université Laval, Quebec, QC, Canada.,3 Faculté de médecine de l'Université Laval, Quebec, QC, Canada.,5 Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Quebec, QC, Canada
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26
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Guinan EM, Doyle SL, O’Neill L, Dunne MR, Foley EK, O’Sullivan J, Reynolds JV, Hussey J. Effects of a multimodal rehabilitation programme on inflammation and oxidative stress in oesophageal cancer survivors: the ReStOre feasibility study. Support Care Cancer 2016; 25:749-756. [DOI: 10.1007/s00520-016-3455-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/10/2016] [Indexed: 12/27/2022]
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27
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Dieli-Conwright CM, Wong L, Waliany S, Bernstein L, Salehian B, Mortimer JE. An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy. Cancer 2016; 122:2646-53. [PMID: 27219902 PMCID: PMC4992442 DOI: 10.1002/cncr.30104] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/23/2016] [Accepted: 04/13/2016] [Indexed: 12/02/2022]
Abstract
BACKGROUND The authors sought to determine the effect of chemotherapy on the development of metabolic syndrome (MetS) in premenopausal and postmenopausal women undergoing (neo)adjuvant therapy for early‐stage breast cancer. METHODS A total of 86 women with early‐stage (AJCC stage I‐III) breast cancer who were free from clinically diagnosed MetS (defined as 3 of 5 components of MetS) were prospectively tested for the presence of the 5 components of MetS within 1 week before initiating and after completing (neo)adjuvant chemotherapy. The 5 components of MetS measured were waist circumference; blood pressure; and fasting levels of blood glucose, triglycerides, and high‐density lipoprotein cholesterol. Anthropometrics (body weight, percentage body fat, fat mass), lipid profile (total cholesterol, low‐density lipoprotein cholesterol), glucose metabolism (insulin, homeostatic model assessment of insulin resistance, glycated hemoglobin), and inflammation (C‐reactive protein) also were examined before initiating and after completing treatment. RESULTS The current study included 46 premenopausal and 40 postmenopausal women. All individual MetS components and the overall MetS score were found to be statistically significantly increased (P<.01) after chemotherapy. Body weight, percentage body fat, fat mass, lipids, glucose metabolism, and inflammation also were found to be statistically significantly increased (P<.01). CONCLUSIONS A 12‐week to 18‐week course of chemotherapy appears to statistically significantly increase MetS and related anthropometrics, biomarkers of glucose metabolism, and inflammation in patients with early‐stage breast cancer with no preexisting MetS. Lifestyle interventions such as diet and exercise may be preventive approaches for use during chemotherapy to reduce the onset of MetS in patients with breast cancer. Cancer 2016. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Cancer 2016;122:2646–2653. © 2016 American Cancer Society. Patients with breast cancer who receive (neo)adjuvant chemotherapy experience an impaired metabolic presentation as noted by worsened components of metabolic syndrome, anthropometrics, and biomarkers of glucose metabolism. Lifestyle interventions such as diet and exercise may be preventive approaches for use during chemotherapy to reduce the onset of metabolic syndrome in patients with breast cancer.
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Affiliation(s)
| | - Louise Wong
- Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Sarah Waliany
- Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Leslie Bernstein
- Beckman Research Institute, Division of Cancer Etiology, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Behrouz Salehian
- Department of Clinical Diabetes, Endocrinology and Metabolism, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Joanne E Mortimer
- Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
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28
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Asegaonkar SB, Asegaonkar BN, Takalkar UV, Advani S, Thorat AP. C-Reactive Protein and Breast Cancer: New Insights from Old Molecule. Int J Breast Cancer 2015; 2015:145647. [PMID: 26693355 PMCID: PMC4674617 DOI: 10.1155/2015/145647] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/10/2015] [Indexed: 12/12/2022] Open
Abstract
Recently an association between breast cancer and inflammation has emerged as the seventh hallmark of cancer. Chronic inflammation is a key contributor in the development and progression of carcinogenesis. Inflammatory pathways play an important role in the causation of breast cancer. C-reactive protein (CRP) an acute-phase reactant inflammatory protein is synthesized in hepatocytes in response to cytokines that are released from leucocytes within the tumor microenvironment. Several epidemiological studies appraised an association of CRP with breast cancer risk with inconsistent findings. Elevated levels at the time of diagnosis of breast cancer indicate aggressiveness of the tumor. CRP is also a well-established independent prognostic marker. Breast cancer survivors with the state of chronic inflammation are at risk of recurrence and metabolic disturbances. CRP lowering agents along with chemotherapeutic drugs will improve the survival of breast cancer patients. Also, it is a risk predictor for subsequent cardiotoxicity in patients receiving chemotherapy. The present review is aimed at elucidating the role of C-reactive protein, as an inflammatory risk marker and prognostic predictor of breast cancer. It also focuses on conflicting views on the role of CRP in breast cancer and its impact on therapeutic interventions.
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29
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Suman S, Sharma PK, Rai G, Mishra S, Arora D, Gupta P, Shukla Y. Current perspectives of molecular pathways involved in chronic inflammation-mediated breast cancer. Biochem Biophys Res Commun 2015; 472:401-9. [PMID: 26522220 DOI: 10.1016/j.bbrc.2015.10.133] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 10/25/2015] [Indexed: 02/07/2023]
Abstract
Inflammation has multifaceted role in cancer progression including initiation, promotion and invasion by affecting the immune surveillance and associated signaling pathways. Inflammation facilitates the over-expression of cytokines, chemokines and growth factors involved in progression of different cancers including breast cancer progression. Deregulation of biological processes such as oxidative stress, angiogenesis, and autophagy elicit favorable immune response towards chronic inflammation. Apart from the role in carcinogenesis, chronic inflammation also favors the emergence of drug resistance clones by inducing the growth of breast cancer stem-like cells. Immunomodulation mediated by cytokines, chemokines and several other growth factors present in the tumor microenvironment regulate chronic inflammatory response and alter crosstalk among various signaling pathways such as NF-κB, Nrf-2, JAK-STAT, Akt and MAPKs involved in the progression of breast cancer. In this review, we focused on cellular and molecular processes involved in chronic inflammation, crosstalk among different signaling pathways and their association in breast cancer pathogenesis.
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Affiliation(s)
- Shankar Suman
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Pradeep Kumar Sharma
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India.
| | - Girish Rai
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Sanjay Mishra
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Deepika Arora
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Department of Bioscience, Integral University, Lucknow 226026, Uttar Pradesh, India
| | - Prachi Gupta
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Yogeshwer Shukla
- Proteomics & Environmental Carcinogenesis Laboratory, Food, Drug and Chemical Toxicology Group, CSIR-Indian Institute of Toxicology Research, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India; Academy of Scientific and Innovative Research, CSIR-IITR Campus, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India.
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30
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Dieli-Conwright CM, Orozco BZ. Exercise after breast cancer treatment: current perspectives. BREAST CANCER-TARGETS AND THERAPY 2015; 7:353-62. [PMID: 26543382 PMCID: PMC4622557 DOI: 10.2147/bctt.s82039] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer.
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Affiliation(s)
- Christina M Dieli-Conwright
- Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA
| | - Breanna Z Orozco
- Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA
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31
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Babaei Z, Moslemi D, Parsian H, Khafri S, Pouramir M, Mosapour A. Relationship of obesity with serum concentrations of leptin, CRP and IL-6 in breast cancer survivors. J Egypt Natl Canc Inst 2015; 27:223-9. [PMID: 26462194 DOI: 10.1016/j.jnci.2015.09.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 08/25/2015] [Accepted: 09/03/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Several mechanisms have been proposed to explain the adverse effect of obesity on quality of life among women with breast cancer, including alteration in some inflammatory markers. The aim of this study was to determine the status of serum levels of leptin, IL-6 and CRP in obese, overweight and normal weight breast cancer survivors in order to determine the relationship between inflammatory markers' levels and obesity. MATERIALS AND METHODS This cross-sectional study was done on 75 women with breast cancer, 30 obese, 15 overweight and 30 normal weight patients. Serum leptin, IL-6, CRP, total protein, albumin and lipid profile as well as anthropometric parameters were measured in three groups. RESULTS Serum leptin levels of obese patients were significantly higher than those of overweight and normal weight patients (P<0.05). Higher serum CRP and lower albumin levels were observed in obese patients in comparison with normal weight patients (P<0.05). HDL-C level was significantly different between overweight and normal weight patients (P<0.05). Significant differences in serum IL-6 levels were not observed between the study groups (P>0.05). Moreover, multiple regression analysis showed that leptin was significantly associated with BMI (P<0.001), while albumin was negatively correlated with BMI (P<0.05). CRP levels were significantly correlated with BMI and waist-to-hip ratio (WHR) (P<0.05). CONCLUSIONS In conclusion, high leptin levels and alteration in acute phase proteins in obese patients may exaggerate the inflammation status. As inflammation has the potential to increase the susceptibility of the patients to metastasis development, it is necessary to decline its rate.
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Affiliation(s)
- Zeinab Babaei
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Dariush Moslemi
- Department of Radiation Oncology, Babol University of Medical Sciences, Babol, Iran
| | - Hadi Parsian
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Soraya Khafri
- Department of Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Mahdi Pouramir
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abbas Mosapour
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
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Zhang XY, Zhang G, Jiang Y, Liu D, Li MZ, Zhong Q, Zeng SQ, Liu WL, Zeng MS. The prognostic value of serum C-reactive protein-bound serum amyloid A in early-stage lung cancer. CHINESE JOURNAL OF CANCER 2015; 34:335-49. [PMID: 26264146 PMCID: PMC4593389 DOI: 10.1186/s40880-015-0039-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/03/2015] [Indexed: 01/12/2023]
Abstract
Background Elevated levels of serum C-reactive protein (CRP) have been reported to have prognostic significance in lung cancer patients. This study aimed to further identify CRP-bound components as prognostic markers for lung cancer and validate their prognostic value. Methods CRP-bound components obtained from the serum samples from lung cancer patients or healthy controls were analyzed by differential proteomics analysis. CRP-bound serum amyloid A (CRP-SAA) was evaluated by co-immunoprecipitation (IP). Serum samples from two independent cohorts with lung cancer (retrospective cohort, 242 patients; prospective cohort, 222 patients) and healthy controls (159 subjects) were used to evaluate the prognostic value of CRP-SAA by enzyme-linked immunosorbent assay. Results CRP-SAA was identified specifically in serum samples from lung cancer patients by proteomic analysis. CRP binding to SAA was confirmed by co-IP in serum samples from lung cancer patients and cell culture media. The level of CRP-SAA was significantly higher in patients than in healthy controls (0.37 ± 0.58 vs. 0.03 ± 0.04, P < 0.001). Elevated CRP-SAA levels were significantly associated with severe clinical features of lung cancer. The elevation of CRP-SAA was associated with lower survival rates for both the retrospective (hazard ration [HR] = 2.181, 95% confidence interval [CI] = 1.641–2.897, P < 0.001) and the prospective cohorts (HR = 2.744, 95% CI = 1.810–4.161, P < 0.001). Multivariate Cox analysis showed that CRP-SAA was an independent prognostic marker for lung cancer. Remarkably, in stages I–II patients, only CRP-SAA, not total SAA or CRP, showed significant association with overall survival in two cohorts. Moreover, univariate and multivariate Cox analyses also showed that only CRP-SAA could be used as an independent prognostic marker for early-stage lung cancer patients. Conclusion CRP-SAA could be a better prognostic marker for lung cancer than total SAA or CRP, especially in early-stage patients.
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Affiliation(s)
- Xue-Yan Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Pathogenic Biology, Guangzhou Hoffmann Institute of Immunology, School of Basic Sciences, Guangzhou Medical University, Guangzhou, Guangdong, 510182, P.R. China.
| | - Ge Zhang
- Department of Microbial and Biochemical Pharmacy, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, 510006, P.R. China.
| | - Ying Jiang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, Beijing Institute of Radiation Medicine, Beijing, 102206, P.R. China.
| | - Dan Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China.
| | - Man-Zhi Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China.
| | - Qian Zhong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China.
| | - Shan-Qi Zeng
- Department of Gastrointestinal Surgery, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510180, P.R. China.
| | - Wan-Li Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China.
| | - Mu-Sheng Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China. .,Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P.R. China.
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Sproull M, Kramp T, Tandle A, Shankavaram U, Camphausen K. Serum Amyloid A as a Biomarker for Radiation Exposure. Radiat Res 2015; 184:14-23. [PMID: 26114330 DOI: 10.1667/rr13927.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is a need for minimally invasive biomarkers that can accurately and quickly quantify radiation exposure. Radiation-responsive proteins have applications in clinical medicine and for mass population screenings after a nuclear or radiological incident where the level of radiation exposure and exposure pattern complicate medical triage for first responders. In this study, we evaluated the efficacy of the acute phase protein serum amyloid A (SAA) as a biomarker for radiation exposure using plasma from irradiated mice. Ten-week-old female C57BL6 mice received a 1-8 Gy single whole-body or partial-body dose from a Pantak X-ray source at a dose rate of 2.28 Gy/min. Plasma was collected by mandibular or cardiac puncture at 6, 24, 48 and 72 h or 1-3 weeks postirradiation. SAA levels were determined using a commercially available ELISA assay. Data was pooled to generate SAA μg/ml threshold values correlating plasma SAA levels with radiation dose. SAA levels were statistically significant over control at all exposures between 2 and 8 Gy at 24 h postirradiation but not at 6, 48 and 72 h or 1-3 weeks postirradiation. SAA levels at 1 Gy were not significantly elevated over control at all time points. Total-body-irradiated (TBI) SAA levels at 24 h were used to generate a dose prediction model that successfully differentiated TBI mice into dose received cohorts of control/1 Gy and ≥ 2 Gy groups with a high degree of accuracy in a blind study. Dose prediction of partial-body exposures based on the TBI model correlated increasing predictive accuracy with percentage of body exposure to radiation. Our findings indicate that plasma SAA levels might be a useful biomarker for radiation exposure in a variety of total- and partial-body irradiation settings.
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Affiliation(s)
- Mary Sproull
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Tamalee Kramp
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Anita Tandle
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Uma Shankavaram
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Kevin Camphausen
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
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Morizane S, Yumioka T, Yamaguchi N, Masago T, Honda M, Sejima T, Takenaka A. Risk stratification model, including preoperative serum C-reactive protein and estimated glomerular filtration rate levels, in patients with upper urinary tract urothelial carcinoma undergoing radical nephroureterectomy. Int Urol Nephrol 2015; 47:1335-41. [DOI: 10.1007/s11255-015-1033-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
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Aveseh M, Nikooie R, Aminaie M. Exercise-induced changes in tumour LDH-B and MCT1 expression are modulated by oestrogen-related receptor alpha in breast cancer-bearing BALB/c mice. J Physiol 2015; 593:2635-48. [PMID: 25907793 PMCID: PMC4500349 DOI: 10.1113/jp270463] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 04/15/2015] [Indexed: 12/15/2022] Open
Abstract
KEY POINTS Monocarboxylate transporters (MCTs) and lactate dehydrogenase A (LDH-A) play important roles in sustaining the glycolytic phenotype seen in cancer. Endurance training improves aerobic capacity; however, whether endurance training alters the metabolic phenotype of a solid tumour, from the perspective of lactate metabolism, is yet to be proven. This study showed that endurance training decreases expression of the MCT1 basigin (CD147) and LDH-A , and also increases LDH-B expression in solid tumours and attenuates tumour lactate metabolism. Similar results for MCT1 and LDH-B were found with inhibition of the oestrogen-related receptor alpha (ERRα). The training effects were not additive to the ERRα effects on MCT1 and LDH-B expression in the tumour, which indicated that exercise-induced alterations in MCT1 and LDH-B expression were modulated by ERRα. These results suggest that endurance training could be a useful tool in cancer therapy, especially in basal-like and luminal-like breast carcinomas. ABSTRACT Several factors, including overexpression of lactate dehydrogenase (LDH) and monocarboxylate transporters (MCTs), promote an aerobic lactate production that allows some cancer cells to sustain higher proliferation rates in hostile environments outside the cell. To elucidate the effect of endurance training on the metabolic phenotype of solid tumours, we focused on the tumour expression of LDH-A, LDH-B, MCT1, MCT4, oestrogen-related receptor alpha (ERRα) and LDH isozymes in control (C), trained (T), control+XCT790 (CX) and trained+XCT790 (TX) mice. First, we found that the metabolically altered tumours from the trained animals exhibited lower values for lactate concentration than the control group. The decreased lactate concentration was associated with a shift in the tumour LDH isozyme profile towards LDH-1. These exercise-induced changes were also associated with decreases in the expression of the tumour MCT1, ERRα and CD147 in the trained animals. Secondly, the inhibition of ERRα by treatment of MC4-L2 human breast cancer cells with XCT790 (inverse agonist ligand of ERRα) before injection into the animals not only increased LDH-B expression in the tumour, but also decreased MCT1 expression in the CX group in comparison to the C group. The effects of ERRα inhibition were not additive to the training effects on the expressions of MCT1 and LDH-B in the solid tumours. In conclusion, our results suggest that exercise-induced suppression of ERRα expression modulates alterations in solid tumour expression of LDH-B and MCT1 and contributes towards the prevention of tumour development.
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Affiliation(s)
- Malihe Aveseh
- Neuroscience Research Centre, Institute of Neuropharmacology, Kerman University of Medical SciencesKerman, Iran
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of KermanKerman, Iran
| | - Rohollah Nikooie
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of KermanKerman, Iran
| | - Mohsen Aminaie
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of KermanKerman, Iran
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Brasky TM, Rodabough RJ, Liu J, Kurta ML, Wise LA, Orchard TS, Cohn DE, Belury MA, White E, Manson JE, Neuhouser ML. Long-chain ω-3 fatty acid intake and endometrial cancer risk in the Women's Health Initiative. Am J Clin Nutr 2015; 101:824-34. [PMID: 25739930 PMCID: PMC4381777 DOI: 10.3945/ajcn.114.098988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/05/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Inflammation may be important in endometrial cancer development. Long-chain ω-3 (n-3) polyunsaturated fatty acids (LCω-3PUFAs) may reduce inflammation and, therefore, reduce cancer risk. Because body mass is associated with both inflammation and endometrial cancer risk, it may modify the association of fat intake on risk. OBJECTIVE We examined whether intakes of LCω-3PUFAs were associated with endometrial cancer risk overall and stratified by body size and histologic subtype. DESIGN Women were n = 87,360 participants of the Women's Health Initiative Observational Study and Clinical Trials who were aged 50-79 y, had an intact uterus, and completed a baseline food-frequency questionnaire. After 13 y of follow-up, n = 1253 incident invasive endometrial cancers were identified. Cox regression models were used to estimate HRs and 95% CIs for the association of intakes of individual ω-3 fatty acids and fish with endometrial cancer risk. RESULTS Intakes of individual LCω-3PUFAs were associated with 15-23% linear reductions in endometrial cancer risk. In women with body mass index (BMI; in kg/m(2)) <25, those in the upper compared with lowest quintiles of total LCω-3PUFA intake (sum of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) had significantly reduced endometrial cancer risk (HR: 0.59; 95% CI: 0.40, 0.82; P-trend = 0.001), whereas there was little evidence of an association in overweight or obese women. The reduction in risk observed in normal-weight women was further specific to type I cancers. CONCLUSIONS Long-chain ω-3 intake was associated with reduced endometrial cancer risk only in normal-weight women. Additional studies that use biomarkers of ω-3 intake are needed to more accurately estimate their effects on endometrial cancer risk. This trial was registered at clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Theodore M Brasky
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Rebecca J Rodabough
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Jingmin Liu
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Michelle L Kurta
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Lauren A Wise
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Tonya S Orchard
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - David E Cohn
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Martha A Belury
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Emily White
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - JoAnn E Manson
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Marian L Neuhouser
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
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Abstract
UNLABELLED There has been an increase in the cancer survivor population in the United States over the past several decades primarily due to improvements in early detection of first malignancies and effective treatment modalities. A wealth of evidence has demonstrated that regular physical activity is associated with a lower risk of death, all-cause mortality, cancer recurrence, and several chronic diseases, including type 2 diabetes and cardiovascular disease, common comorbid conditions in people who have survived cancer. Physical activity also is a central component of weight management. METHODS This review summarizes the current physical activity recommendations and the evidence linking physical activity to improvements in weight management, physiological effects, and psychological health outcomes for cancer survivors. RESULTS The available literature suggests physical activity is safe and is positively associated with weight management, cardiorespiratory fitness, muscular strength and endurance, quality of life, fatigue, and other psychosocial factors in cancer survivors. Yet relationships related to specific cancer diagnoses, treatments, and underlying cardiometabolic mechanisms associated with survival have not been thoroughly examined in randomized controlled trials. Furthermore, factors that influence adherence to physical activity behaviors must be identified to develop effective exercise programs. The use of objective measures of physical activity and the standardization of reporting outcome measures within intervention trials are needed to complement this effort. CONCLUSIONS Healthcare providers should consider individual differences among cancer survivors and tailor physical activity programs to meet the individual needs of the patient to assist in the adoption and maintenance of a physically active lifestyle.
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Affiliation(s)
- David O Garcia
- Canyon Ranch Center for Prevention and Health Promotion, Mel & Enid Zuckerman College of Public Health, Division of Health Promotion Sciences, University of Arizona, Tucson, Arizona
| | - Cynthia A Thomson
- Canyon Ranch Center for Prevention and Health Promotion, Mel & Enid Zuckerman College of Public Health, Division of Health Promotion Sciences, University of Arizona, Tucson, Arizona
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George SM, Alfano CM, Neuhouser ML, Smith AW, Baumgartner RN, Baumgartner KB, Bernstein L, Ballard-Barbash R. Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors. J Cancer Surviv 2014; 8:680-7. [PMID: 25001403 PMCID: PMC6993811 DOI: 10.1007/s11764-014-0381-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/25/2014] [Indexed: 01/29/2023]
Abstract
PURPOSE A comprehensive understanding of the role of modifiable health behaviors in effective management of cancer-related fatigue is needed. Among breast cancer survivors, we examined how postdiagnosis diet quality, independently and jointly with physical activity, is related to fatigue, and the potential mediating role of inflammation. METHODS Seven hundred seventy women diagnosed with stage 0-IIIA breast cancer in the Health, Eating, Activity, and Lifestyle study completed food frequency and physical activity questionnaires 30 months postdiagnosis. We scored diet quality using the Healthy Eating Index 2010 (HEI-2010). Serum concentrations of C-reactive protein (CRP) were measured in fasting 30-ml blood samples. Multidimensional fatigue was measured 41 months postdiagnosis using the 22-item revised Piper Fatigue Scale. In multivariate linear models, we determined whether fatigue was associated HEI-2010 quartiles (Q1-Q4), and a variable jointly reflecting HEI quartiles and physical activity levels. RESULTS Survivors with better-quality diets (Q4 vs. Q1) had lower total fatigue (4.1 vs. 4.8, p-contrast = 0.003) and subscale scores (behavioral severity 3.4 vs. 4.2, p-contrast = 0.003; affective meaning 3.9 vs. 4.8, p-contrast = 0.007; sensory 4.4 vs. 5.2, p-contrast = 0.003; cognitive 4.6 vs. 5.0, p-contrast = 0.046). Least squares estimates of fatigue were similar in models including CRP. Compared to survivors with poor-quality diets and no physical activity, survivors with better-quality diets and meeting physical activity recommendations had significantly lower behavioral severity (3.2 vs. 4.7, p-contrast = 0.002) and sensory (3.8 vs. 4.8. p-contrast = 0.006) fatigue scores. CONCLUSION In this large breast cancer survivor cohort, postdiagnosis diet quality was inversely and independently associated with fatigue. IMPLICATIONS FOR CANCER SURVIVORS Future interventions designed to improve multiple energy balance behaviors can provide insight into their associations with fatigue.
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Affiliation(s)
- Stephanie M George
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, MSC 9762, Bethesda, MD, 20892-9762, USA,
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Tsai MS, Chen HP, Hung CM, Lee PH, Lin CL, Kao CH. Hospitalization for Inflammatory Bowel Disease is Associated with Increased Risk of Breast Cancer: A Nationwide Cohort Study of an Asian Population. Ann Surg Oncol 2014; 22:1996-2002. [PMID: 25354573 DOI: 10.1245/s10434-014-4198-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Indexed: 12/28/2022]
Abstract
PURPOSE To learn whether women with inflammatory bowel disease (IBD) exhibit a higher risk of breast cancer. METHODS We identified 4,856 women with IBD symptoms from 1998 to 2008 and 19,424 control patients without the disorder, frequency matched by age, sex, and admission year. Both cohorts were followed-up until the end of 2010 to estimate the risk of breast cancer. RESULTS Overall, the incidence of breast cancer was similar in the IBD and control cohorts (1.31 vs. 1.25 per 1,000 person-years). The adjusted hazard ratio of breast cancer was 0.95 (95 % confidence interval 0.66-1.36) for the IBD patients. Further analysis revealed that neither Crohn disease nor ulcerative colitis was associated with the risk of developing breast cancer in women. The age-specific analysis indicated that the incidence of breast cancer was highest in the 45- to 65-year-old age group in both cohorts. The incidence of breast cancer was significantly increased in patients who required hospitalization twice or more per year, compared with the control cohort (adjusted hazard ratio 8.45; 95 % confidence interval 4.64-15.4). Moreover, age-specific analysis showed that patients aged less than 65 years old (≤44 or 45-65 years of age) exhibited a strong association between IBD hospitalization and breast cancer risk. CONCLUSIONS The risk of breast cancer was positively proportional to the frequency of admission for IBD. Therefore, careful surveillance of breast cancer should be sought for female IBD patients with 2 or more annual hospitalizations.
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Affiliation(s)
- Ming-Shian Tsai
- Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
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Connor AE, Baumgartner RN, Baumgartner KB, Pinkston CM, Boone SD, John EM, Torres-Mejía G, Hines LM, Giuliano AR, Wolff RK, Slattery ML. Associations between ALOX, COX, and CRP polymorphisms and breast cancer among Hispanic and non-Hispanic white women: The breast cancer health disparities study. Mol Carcinog 2014; 54:1541-53. [PMID: 25339205 DOI: 10.1002/mc.22228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/08/2014] [Accepted: 08/14/2014] [Indexed: 12/21/2022]
Abstract
Chronic inflammation is suggested to be associated with specific cancer sites, including breast cancer. Recent research has focused on the roles of genes involved in the leukotriene/lipoxygenase and prostaglandin/cyclooxygenase pathways in breast cancer etiology. We hypothesized that genes in ALOX/COX pathways and CRP polymorphisms would be associated with breast cancer risk and mortality in our sample of Hispanic/Native American (NA) (1430 cases, 1599 controls) and non-Hispanic white (NHW) (2093 cases, 2610 controls) women. A total of 104 Ancestral Informative Markers was used to distinguish European and NA ancestry. The adaptive rank truncated product (ARTP) method was used to determine the significance of associations for each gene and the inflammation pathway with breast cancer risk and by NA ancestry. Overall, the pathway was associated with breast cancer risk (PARTP = 0.01). Two-way interactions with NA ancestry (P(adj) < 0.05) were observed for ALOX12 (rs2292350, rs2271316) and PTGS1 (rs10306194). We observed increases in breast cancer risk in stratified analyses by tertiles of polyunsaturated fat intake for ALOX12 polymorphisms; the largest increase in risk was among women in the highest tertile with ALOX12 rs9904779CC (Odds Ratio (OR), 1.49; 95% Confidence Interval (CI) 1.14-1.94, P(adj) = 0.01). In a sub-analysis stratified by NSAIDs use, two-way interactions with NSAIDs use were found for ALOX12 rs9904779 (P(adj) = 0.02), rs434473 (P(adj ) = 0.02), and rs1126667 (P(adj) = 0.01); ORs for ALOX12 polymorphisms ranged from 1.55 to 1.64 among regular users. Associations were not observed with breast cancer mortality. These findings could support advances in the discovery of new pathways related to inflammation for breast cancer treatment.
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Affiliation(s)
- Avonne E Connor
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Richard N Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Christina M Pinkston
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Stephanie D Boone
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California.,Division of Epidemiology, Department of Health Research and Policy, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Gabriela Torres-Mejía
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, Mexico
| | - Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | - Anna R Giuliano
- H. Lee Moffit Cancer Center & Research Institute, Tampa, Florida
| | - Roger K Wolff
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
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Brasky TM, Liu J, White E, Peters U, Potter JD, Walter RB, Baik CS, Lane DS, Manson JE, Vitolins MZ, Allison MA, Tang JY, Wactawski-Wende J. Non-steroidal anti-inflammatory drugs and cancer risk in women: results from the Women's Health Initiative. Int J Cancer 2014; 135:1869-83. [PMID: 24599876 PMCID: PMC5592086 DOI: 10.1002/ijc.28823] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 02/17/2014] [Indexed: 12/12/2022]
Abstract
The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risks of cancers at several sites in some studies; however, we recently reported no association between their use and total cancer risk in women in a prospective study. Here we examine the association between NSAIDs and total and site-specific cancer incidence in the large, prospective Women's Health Initiative (WHI). Women (129,013) were recruited to participate in the WHI at 40 US clinical centers from 1993 to 1998 and followed prospectively. After 9.7 years of follow-up, 12,998 incident, first primary, invasive cancers were diagnosed. NSAID use was systematically collected at study visits. We used Cox proportional hazards regression models to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between NSAIDs use and total and site-specific cancer risk. Relative to non-use, consistent use (i.e., use at baseline and year 3 of follow-up) of any NSAID was not associated with total cancer risk (HR 1.00, 95% CI: 0.94-1.06). Results for individual NSAIDs were similar to the aggregate measure. In site-specific analyses, NSAIDs were associated with reduced risks of colorectal cancer, ovarian cancer, and melanoma. Our study confirms a chemopreventive benefit for colorectal cancer in women and gives preliminary evidence for a reduction of the risk of some rarer cancers. NSAIDs' benefit on cancer risk was therefore limited to specific sites and not evident when total cancer risk was examined. This information may be of importance when NSAIDs are considered as chemopreventive agents.
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Affiliation(s)
- Theodore M. Brasky
- The Ohio State University College of Medicine, Department of Internal Medicine, Division of Cancer Prevention and Control; Columbus, OH
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
| | - Jingmin Liu
- Fred Hutchinson Cancer Research Center, WHI Clinical Coordinating Center; Seattle, WA
| | - Emily White
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
- University of Washington, Department of Epidemiology; Seattle, WA
| | - Ulrike Peters
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
| | - John D. Potter
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Roland B. Walter
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
- University of Washington, Department of Epidemiology; Seattle, WA
- University of Washington, Division of Hematology/Department of Medicine; Seattle, WA
| | - Christina S. Baik
- Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
| | - Dorothy S. Lane
- Stony Brook University School of Medicine, Department of Preventive Medicine; Stony Brook, NY
| | - JoAnn E. Manson
- Harvard Medical School and Brigham and Women’s Hospital, Department of Medicine; Boston, MA
| | - Mara Z. Vitolins
- Wake Forest School of Medicine, Division of Public Health Sciences; Winston-Salem, NC
| | - Matthew A. Allison
- University of California - San Diego School of Medicine, Department of Family and Preventive Medicine, Division of Preventive Medicine; San Diego, CA
| | - Jean Y. Tang
- Stanford University School of Medicine, Department of Dermatology; Redwood City, CA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University at Buffalo, SUNY; Buffalo, NY
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Immunological and hormonal effects of exercise: implications for cancer cachexia. Curr Opin Support Palliat Care 2014; 7:376-82. [PMID: 24157716 DOI: 10.1097/spc.0000000000000010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW There is increasing interest in the use of therapeutic exercise for cancer cachexia. Apart from the directly beneficial effects on muscle, exercise has the potential to attenuate some of the immunological and hormonal abnormalities found in cachexia. This review summarizes the findings of recent studies, which have explored such effects in patients with cancer, and discusses their relevance to patients with cancer cachexia. RECENT FINDINGS Our search identified 11 studies in patients with breast, colorectal, lung, and prostate cancer, predominantly with early stage disease or following primary curative treatment. Overall, exercise was associated with reduced levels of C-reactive protein (CRP), but not other markers of systemic inflammation. There was no consistent impact on levels of glucose, insulin or measures of insulin sensitivity or, in patients with prostate cancer, on levels of testosterone. SUMMARY There is limited scope to extrapolate these findings to patients with cancer cachexia, who are more likely to have advanced disease, higher levels of systemic inflammation, and greater degrees of metabolic dysfunction. Studies specific to this group are required to explore what, if any, changes exercise can make to levels of CRP and other immune and hormonal biomarkers, along with their potential clinical relevance.
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Brenner DR, Scherer D, Muir K, Schildkraut J, Boffetta P, Spitz MR, Le Marchand L, Chan AT, Goode EL, Ulrich CM, Hung RJ. A review of the application of inflammatory biomarkers in epidemiologic cancer research. Cancer Epidemiol Biomarkers Prev 2014; 23:1729-51. [PMID: 24962838 DOI: 10.1158/1055-9965.epi-14-0064] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Inflammation is a facilitating process for multiple cancer types. It is believed to affect cancer development and progression through several etiologic pathways, including increased levels of DNA adduct formation, increased angiogenesis, and altered antiapoptotic signaling. This review highlights the application of inflammatory biomarkers in epidemiologic studies and discusses the various cellular mediators of inflammation characterizing the innate immune system response to infection and chronic insult from environmental factors. Included is a review of six classes of inflammation-related biomarkers: cytokines/chemokines, immune-related effectors, acute-phase proteins, reactive oxygen and nitrogen species, prostaglandins and cyclooxygenase-related factors, and mediators such as transcription factors and growth factors. For each of these biomarkers, we provide a brief overview of the etiologic role in the inflammation response and how they have been related to cancer etiology and progression within the literature. We provide a discussion of the common techniques available for quantification of each marker, including strengths, weaknesses, and potential pitfalls. Subsequently, we highlight a few under-studied measures to characterize the inflammatory response and their potential utility in epidemiologic studies of cancer. Finally, we suggest integrative methods for future studies to apply multifaceted approaches to examine the relationship between inflammatory markers and their roles in cancer development.
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Affiliation(s)
- Darren R Brenner
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada. Department of Cancer Epidemiology and Prevention, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Dominique Scherer
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
| | | | | | - Paolo Boffetta
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York
| | | | | | - Andrew T Chan
- Dana Farber/Harvard Cancer Center, Boston, Massachusetts
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Cornelia M Ulrich
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada.
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Schmidt ME, Wiskemann J, Steindorf K. Exercise in breast cancer patients: impact on health. BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.14.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY As a consequence of breast cancer diagnosis and treatment side effects, many patients reduce their physical activity, resulting in physical deconditioning. However, it has been shown that both aerobic and resistance exercise are feasible and safe throughout the breast cancer continuum. Exercise can reduce fatigue, depression and anxiety, improve quality of life and self-esteem, as well as cardiorespiratory fitness, muscle strength, physical functioning and body composition. In addition, as early-stage breast cancer patients may be at higher risk for cardiac events owing to cardiotoxic therapy, exercise can mitigate cardiovascular impairments. There is increasing evidence that higher physical activity levels are associated with improved overall survival after breast cancer; therefore, patients should receive support and be encouraged to engage in exercise training during and after cancer treatment.
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Affiliation(s)
- Martina E Schmidt
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim Wiskemann
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, University of Heidelberg Medical Center, Heidelberg, Germany
| | - Karen Steindorf
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
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High STAT1 mRNA levels but not its tyrosine phosphorylation are associated with macrophage infiltration and bad prognosis in breast cancer. BMC Cancer 2014; 14:257. [PMID: 24725474 PMCID: PMC4021106 DOI: 10.1186/1471-2407-14-257] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 04/08/2014] [Indexed: 12/22/2022] Open
Abstract
Background STAT1 has been attributed a function as tumor suppressor. However, in breast cancer data from microarray analysis indicated a predictive value of high mRNA expression levels of STAT1 and STAT1 target genes belonging to the interferon-related signature for a poor response to therapy. To clarify this issue we have determined STAT1 expression levels and activation by different methods, and investigated their association with tumor infiltration by immune cells. Additionally, we evaluated the interrelationship of these parameters and their significance for predicting disease outcome. Methods Expression of STAT1, its target genes SOCS1, IRF1, CXCL9, CXCL10, CXCL11, IFIT1, IFITM1, MX1 and genes characteristic for immune cell infiltration (CD68, CD163, PD-L1, PD-L2, PD-1, CD45, IFN-γ, FOXP3) was determined by RT-PCR in two independent cohorts comprising 132 breast cancer patients. For a subset of patients, protein levels of total as well as serine and tyrosine-phosphorylated STAT1 were ascertained by immunohistochemistry or immunoblotting and protein levels of CXCL10 by ELISA. Results mRNA expression levels of STAT1 and STAT1 target genes, as well as protein levels of total and serine-phosphorylated STAT1 correlated with each other in neoplastic tissue. However, there was no association between tumor levels of STAT1 mRNA and tyrosine-phosphorylated STAT1 and between CXCL10 serum levels and CXCL10 expression in the tumor. Tumors with increased STAT1 mRNA amounts exhibited elevated expression of genes characteristic for tumor-associated macrophages and immunosuppressive T lymphocytes. Survival analysis revealed an association of high STAT1 mRNA levels and bad prognosis in both cohorts. A similar prognostically relevant correlation with unfavorable outcome was evident for CXCL10, MX1, CD68, CD163, IFN-γ, and PD-L2 expression in at least one collective. By contrast, activation of STAT1 as assessed by the level of STAT1-Y701 phosphorylation was linked to positive outcome. In multivariate Cox regression, the predictive power of STAT1 mRNA expression was lost when including expression of CXCL10, MX1 and CD68 as confounders. Conclusions Our study confirms distinct prognostic relevance of STAT1 expression levels and STAT1 tyrosine phosphorylation in breast cancer patients and identifies an association of high STAT1 levels with elevated expression of STAT1 target genes and markers for infiltrating immune cells.
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Abstract
OBJECTIVE The aim of this study was to assess the risk of metabolic syndrome (MetS) in postmenopausal breast cancer survivors as compared with postmenopausal women without breast cancer. METHODS In this cross-sectional study, 104 postmenopausal breast cancer survivors were compared with 208 postmenopausal women (controls) attending a university hospital. Eligibility criteria included the following: amenorrhea longer than 12 months and aged 45 years or older, treated for breast cancer, and metastasis-free for at least 5 years. The control group consisted of women with amenorrhea longer than 12 months and aged 45 years or older and without breast cancer, matched by age and menopause status (in a proportion of 1:2 as sample calculation). Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, and C-reactive protein, were measured. Women showing three or more diagnostic criteria were diagnosed as having MetS: waist circumference of 88 cm or larger, blood pressure of 130/85 mm Hg or higher, triglycerides level of 150 mg/dL or higher, high-density lipoprotein cholesterol level lower than 50 mg/dL, and glucose level of 100 mg/dL or higher. For statistical analysis, Student's t test, χ2 test, and logistic regression (odds ratio [OR]) were used. RESULTS The mean (SD) age of breast cancer survivors was 60.6 (8.6) years, with a mean (SD) follow-up of 9.4 (4.4) years. A higher percentage of breast cancer survivors (46.2%) were obese as compared with controls (32.7%; P < 0.05), and a smaller percentage showed optimal values for low-density lipoprotein cholesterol, glucose, and C-reactive protein versus controls (P < 0.05). MetS was diagnosed in 50% of breast cancer survivors and in 37.5% of control group women (P < 0.05). Among the MetS diagnostic criteria, the most prevalent was abdominal obesity (waist circumference >88 cm), affecting 62.5% and 67.8% of the participants, respectively. In the control group, breast cancer survivors had a higher risk for MetS (OR, 1.66; 95% CI, 1.04-2.68), dysglycemia (OR, 1.05; 95% CI, 1.09-3.03), and hypertension (OR, 1.71; 95% CI, 1.02-2.89). CONCLUSIONS Postmenopausal breast cancer survivors present a higher risk of developing MetS as compared with women without breast cancer.
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47
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Brasky TM, Neuhouser ML, Cohn DE, White E. Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort. Am J Clin Nutr 2014; 99:599-608. [PMID: 24500149 PMCID: PMC3927693 DOI: 10.3945/ajcn.113.070524] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Inflammation plays an important role in endometrial cancer etiology. Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs), derived from marine sources, are thought to be antiinflammatory; however, several studies of fish consumption suggest an increase in risk. OBJECTIVE This study examined whether intakes of long-chain ω-3 PUFAs, including eicosapentaenoic acid (EPA; 20:5ω-3) and docosahexaenoic acid (DHA; 22:6ω-3), from diet and supplements and intake of fish are associated with endometrial cancer risk. DESIGN Between 2000 and 2002, 22,494 women aged 50-76 y, living in western Washington State, were recruited to the VITamins And Lifestyle cohort study. Incident endometrial cancers (n = 263) were identified through the Surveillance, Epidemiology, and End Results cancer registry after 9 y of follow-up. Multivariable-adjusted HRs and 95% CIs for the association of intakes of individual long-chain ω-3 PUFAs and fish with endometrial cancer risk were estimated by using Cox proportional hazards. RESULTS Women in the highest compared with the lowest quintile of dietary EPA + DHA intake had a 79% increased risk of endometrial cancer (95% CI: 16%, 175%; P-trend = 0.026). Results were similar for EPA and DHA measured individually and for fish intake. When data were stratified by body mass index (in kg/m²; <25 or ≥ 25), increases in risk of long-chain ω-3 PUFAs were restricted to overweight and obese women, and statistically significant reductions in risk were observed for normal-weight women. CONCLUSIONS The overall increased risk reported here confirms the findings of several prior observational studies of fish intake, which observed similar increases in risk. Randomized trials are needed to confirm these findings.
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Affiliation(s)
- Theodore M Brasky
- Department of Internal Medicine, Division of Cancer Prevention and Control (TMB) and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology (DEC), The Ohio State University College of Medicine, Columbus, OH, and the Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, WA (MLN and EW)
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Marinac C, Patterson RE, Villasenor A, Flatt SW, Pierce JP. Mechanisms of association between physical functioning and breast cancer mortality: evidence from the Women's Healthy Eating and Living Study. J Cancer Surviv 2014; 8:402-9. [PMID: 24570214 DOI: 10.1007/s11764-013-0334-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Low physical functioning among breast cancer survivors appears to reduce survival, although the mechanisms underlying these associations are not clear. We examined inflammation as a possible biological mediator of association between low physical functioning and mortality after breast cancer. METHODS Analysis included 2,892 participants from the Women's Healthy Eating and Living Study. All measures were collected at study baseline. Physical function was assessed by the Short Form 36 (SF-36) Health Survey Physical Function subscale. Low physical function was defined as the bottom tertile of the subscale score. Inflammation was measured as serum concentration of C-reactive protein (CRP). Cox proportional hazards modeled the associations of low physical function and the putative mediator (i.e., CRP) with all-cause and breast cancer-specific mortality. RESULTS There were 293 deaths during study follow up, with 243 due to breast cancer. Low physical functioning was associated with a 50 % higher risk of all-cause mortality (HR, 1.49; 95 % CI, 1.2-1.9) and a 40 % higher risk of breast cancer-specific mortality (HR, 1.39; 95 % CI, 1.1-1.8), after adjustment for covariates. The addition of CRP did not markedly change the all-cause mortality hazard ratio attributed to low physical functioning. However, the addition of CRP modestly attenuated the breast cancer-specific mortality hazard ratio such that it was no longer statistically significant. CONCLUSIONS Interventions to improve physical functioning may prevent early morbidity and mortality among breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Functional status measure may be a valuable indicator of long-term health outcomes among breast cancer survivors.
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Affiliation(s)
- Catherine Marinac
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA
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Imayama I, Alfano CM, Neuhouser ML, George SM, Wilder Smith A, Baumgartner RN, Baumgartner KB, Bernstein L, Wang CY, Duggan C, Ballard-Barbash R, McTiernan A. Weight, inflammation, cancer-related symptoms and health related quality of life among breast cancer survivors. Breast Cancer Res Treat 2014; 140:159-76. [PMID: 23797178 DOI: 10.1007/s10549-013-2594-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/30/2013] [Indexed: 11/28/2022]
Abstract
Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.
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Affiliation(s)
- Ikuyo Imayama
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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50
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Effect of a diet and physical activity intervention on body weight and nutritional patterns in overweight and obese breast cancer survivors. Med Oncol 2013; 31:783. [PMID: 24310809 DOI: 10.1007/s12032-013-0783-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 11/22/2013] [Indexed: 12/21/2022]
Abstract
Energy restriction from a low-calorie diet and increased energy expenditure induced by physical activity (PA) could promote weight loss/maintenance and be important determinants of breast cancer (BC) prognosis. The aim of this study was to assess participation and adherence of overweight and obese BC survivors to a lifestyle intervention and to demonstrate the capacity of this intervention to induce weight loss and nutritional changes. This single-arm pre-post study, which involved one-hourly weekly diet sessions delivered by a dietician and 75-min bi-weekly PA sessions of moderate-to-high intensity led by PA monitors, was offered to overweight and obese BC survivors shortly after treatment. Before and after the intervention, anthropometry, dietary information, quality of life (QoL) and cardiorespiratory fitness (CRF) were collected. A total of 112 BC survivors were invited to participate: 42 of them started the intervention and 37 completed it. Participants attended more than 90 % of the sessions offered and showed a significant weight loss of 5.6 ± 2.0 kg, as well as significant decreases in body mass index, fat mass and waist circumference. Significant decreases in total energy (-25 %), fat (-35 %), saturated fat (-37 %) and carbohydrate (-21 %) intakes were observed while QoL and CRF showed significant increases. This feasibility study demonstrated the success of a short-term diet and PA intervention to induce weight loss and promote healthful changes in BC survivors. Assessing the long-term effects of these changes, and in particular their possible impact of BC prognosis, and designing interventions reaching a wider number of BC survivors are still issues to be addressed.
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