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Yang Y, Gan F, Luo T, Lin Q, Yang W, Chen L, Zhang W, Liu Q, Gong C. Patient-reported outcome and survival in premenopausal hormone receptor-positive breast cancer patients at moderate to high risk: comparing toremifene with aromatase inhibitor in a real-world study. MedComm (Beijing) 2024; 5:e698. [PMID: 39286777 PMCID: PMC11401972 DOI: 10.1002/mco2.698] [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: 03/29/2024] [Revised: 06/21/2024] [Accepted: 06/28/2024] [Indexed: 09/19/2024] Open
Abstract
Toremifene, a selective estrogen receptor modulator, is commonly used in China for premenopausal breast cancer patients. This real-world study aimed to compare patient-reported outcome (PRO) and survival between toremifene and aromatase inhibitor (AI) plus ovarian function suppression (OFS) in patients with moderate-/high-risk premenopausal hormone receptor (HR)-positive breast cancer. The primary endpoint was PROs, assessed using SF-36 and EQ-5D-5L questionnaires between January and March 2023. A total of 392 patients were included, with 171 receiving toremifene and 221 receiving AI. The toremifene group showed significantly higher scores in the role physical (p = 0.034) and mental health (p = 0.009) dimensions of SF-36 and lower anxiety/depression (AD) scores (p = 0.038) in EQ-5D-5L compared to AI group. The estimated 5- and 8-year disease-free survival (DFS) rates were similar in toremifene and AI groups: 96.5% versus 91.9%, and 87.4% versus 87.8% (p = 0.39), respectively. Adverse event rates were similar in two groups, except for a greater risk of endometrial thickening (p < 0.001) and a lower occurrence of morning stiffness (p < 0.001) in the toremifene compared to the AI group. Premenopausal HR-positive breast cancer patients receiving toremifene plus OFS had better role physical and mental health outcomes and lower AD dimensions than those receiving AI plus OFS. Both treatments had comparable DFS and favorable tolerability profiles.
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Affiliation(s)
- Yaping Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Fengxia Gan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Ting Luo
- Institute for Breast Health Medicine, Cancer Center, Breast Center West China Hospital, Sichuan University Chengdu Sichuan China
| | - Qun Lin
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Wenqian Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Institute for Breast Health Medicine, Cancer Center, Breast Center West China Hospital, Sichuan University Chengdu Sichuan China
| | - Lili Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Wei Zhang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Qiang Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
| | - Chang Gong
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou Guangdong China
- Breast Tumor Center Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University Guangzhou Guangdong China
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Shi L, Zhang Z, Huang Y, Zheng Y. FOXCUT regulates the malignant phenotype of triple-negative breast Cancer via the miR-337-3p/ANP32E Axis. Genomics 2024; 116:110892. [PMID: 38944356 DOI: 10.1016/j.ygeno.2024.110892] [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: 12/21/2023] [Revised: 05/23/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND The lack of specific molecular targets and the rapid spread lead to a worse prognosis of triple-negative breast cancer (TNBC). Therefore, identifying new therapeutic and prognostic biomarkers helps to develop effective treatment strategies for TNBC. METHODS Through preliminary bioinformatics analysis, FOXCUT was found to be significantly overexpressed in breast cancer, especially in TNBC. Tissue samples were collected from 15 TNBC patients, and qRT-PCR was employed to validate the expression of FOXCUT in both TNBC patient tissues and TNBC cell lines. We also carried out the GSEA analysis and KEGG enrichment analysis of FOXCUT. Additionally, the effects of FOXCUT knockdown on TNBC cell malignant behaviors, and aerobic glycolysis were assessed by methods including CCK-8, Transwell, western blot, and Seahorse XF 96 analyses. Moreover, utilizing databases predicting interactions between ceRNAs, corresponding lncRNA-miRNA binding relationships, and miRNA-mRNA interactions were predicted. These predictions were subsequently validated through RNA immunoprecipitation and dual-luciferase reporter assays. RESULTS FOXCUT exhibited high expression in both TNBC tissues and cell lines, fostering cell malignant behaviors and glycolysis. FOXCUT was found to sponge miR-337-3p, while miR-337-3p negatively regulated the expression of ANP32E. Consequently, FOXCUT ultimately facilitated the malignant phenotype of TNBC by upregulating ANP32E expression. CONCLUSION This study elucidated the role of FOXCUT in elevating aerobic glycolysis levels in TNBC and driving malignant cancer cell development via the miR-337-3p/ANP32E regulatory axis.
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Affiliation(s)
- Lei Shi
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China
| | - Ziwen Zhang
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China
| | - Yuan Huang
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China
| | - Yabing Zheng
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China.
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Jin Z, Xu W, Yu K, Luo C, Luo X, Lian T, Liu C. The novel circFKBP8/miR-432-5p/E2F7 cascade functions as a regulatory network in breast cancer. Hereditas 2024; 161:27. [PMID: 39192374 DOI: 10.1186/s41065-024-00331-1] [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: 12/18/2023] [Accepted: 08/12/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Circular RNAs (circRNAs) are capable of affecting breast cancer (BC) development. However, the role and underneath mechanism of circFKBP8 (also known as hsa_circ_0000915) in BC remain largely unknown. METHODS Expression analyses were performed using quantitative real-time polymerase chain reaction (qRT-PCR), western blot, and immunohistochemistry (IHC) assays. Effects on cell functional phenotypes were determined by assessing cell proliferation, migratory capacity, invasion, and stemness in vitro. The relationship between microRNA (miR)-432-5p and circFKBP8 or E2F transcription factor 7 (E2F7) was examined by RNA pull-down, dual-luciferase reporter, and RNA immunoprecipitation (RIP) assays. Xenograft assays were used to identify the function of circFKBP8 in vivo. RESULTS CircFKBP8 was presented at high levels in BC tissues and cells. High circFKBP8 expression was associated with worse overall survival in BC patients. CircFKBP8 suppression inhibited BC cell proliferation, migratory capacity, invasion and stemness in vitro. CircFKBP8 suppression blocked xenograft tumor growth in vivo. Mechanistically, circFKBP8 functioned as a miR-432-5p sponge to modulate E2F7 expression. CircFKBP8 modulated BC cell malignant behaviors by miR-432-5p, and miR-432-5p affected these cell phenotypes through E2F7. CONCLUSION Our observations prove that circFKBP8 promotes BC malignant phenotypes through the miR-432-5p/E2F7 cascade, offering a promising therapeutic and prognostic target for BC.
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Affiliation(s)
- Zhongkui Jin
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Wang Xu
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Kunlin Yu
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Cailu Luo
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Xiaodan Luo
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Tao Lian
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China
| | - Changshan Liu
- Department of Breast Surgery, Yichun People's Hospital & The Affiliated Yichun Hospital of Nanchang University, No.1061 Jinxiu avenue, Yiyang New District 336000, Yichun, Jiangxi, China.
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Meng D, Dong Y, Shang Q, Sun Z. Anti-tumor effect and hepatotoxicity mechanisms of psoralen. Front Pharmacol 2024; 15:1442700. [PMID: 39161897 PMCID: PMC11331265 DOI: 10.3389/fphar.2024.1442700] [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: 06/02/2024] [Accepted: 07/18/2024] [Indexed: 08/21/2024] Open
Abstract
In recent years, natural products have gradually become an important source for new drug development due to their advantages of multi-components, multi-targets, and good safety profiles. Psoralen, a furanocoumarin compound extracted from the traditional Chinese medicine psoralea corylifolia, is widely distributed among various plants. It has attracted widespread attention in the research community due to its pharmacological activities, including antitumor, anti-inflammatory, antioxidant, and neuroprotective effects. Studies have shown that psoralen has broad spectrum anti-tumor activities, offering resistance to malignant tumors such as breast cancer, liver cancer, glioma, and osteosarcoma, making it a natural, novel potential antitumor drug. Psoralen mainly exerts its antitumor effects by inhibiting tumor cell proliferation, inducing apoptosis, inhibiting tumor cell migration, and reversing multidrug resistance, presenting a wide application prospect in the field of antitumor therapy. With the deepening research on psoralea corylifolia, its safety has attracted attention, and reports on the hepatotoxicity of psoralen have gradually increased. Therefore, this article reviews recent studies on the mechanism of antitumor effects of psoralen and focuses on the molecular mechanisms of its hepatotoxicity, providing insights for the clinical development of low-toxicity, high-efficiency antitumor drugs and the safety of clinical medication.
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Affiliation(s)
- Dandan Meng
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yanling Dong
- Department of Breast and Thyroid Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qingxin Shang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ziyuan Sun
- Department of Breast and Thyroid Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Zhao YX, Wang O, Song A, Wang LJ, Gong FY, Duan L, Yang HB, Pan H, Zhu HJ. The risk of concurrent malignancies in patients with multiple endocrine neoplasia type 1: insights into clinical characteristics of those with multiple endocrine neoplasia type 1. J Endocrinol Invest 2024; 47:1931-1939. [PMID: 38161202 DOI: 10.1007/s40618-023-02288-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Summarize and analyze the characteristics of patients with Multiple Endocrine Neoplasia type 1 (MEN-1) who were diagnosed with malignant tumors that do not belong to MEN-1 components. METHODS Clinical data from patients with MEN-1 who visited Peking Union Medical College Hospital between April 2012 and April 2022 were collected. We compared the clinical characteristics of patients with malignant tumors outside of their MEN-1 components to those without additional tumors. MEN-1 gene testing was performed on most of these patients using Sanger sequencing, whole-exome sequencing, or MLPA. RESULTS A total of 221 MEN-1 patients were diagnosed, of which 23 (10.40%) were found to have malignant tumors that did not belong to MEN-1 components, including papillary thyroid carcinoma (PTC) (4.52%), breast cancer (1.81%), urologic neoplasms (1.35%), primary hepatic carcinoma (PCC) (0.09%), meningeal sarcoma (0.05%), glioblastoma (0.05%), cervical cancer (0.05%), and lung carcinoma (0.05%). MEN-1 gene mutations were identified in 11 patients, including missense mutations, frameshift mutations, and splice mutations. The prevalence of each endocrine neoplasm, particularly gastroenteropancreatic neuroendocrine tumor, was higher in MEN-1 patients with other malignant tumors compared to MEN-1 patients without malignant tumors. CONCLUSION Our retrospective study revealed a higher incidence of non-MEN-1 component malignant tumors in MEN-1 patients, especially breast cancer, PTC, and urologic neoplasms. These patients also exhibit more severe clinical phenotypes of MEN-1.
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Affiliation(s)
- Yu Xing Zhao
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Ou Wang
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - An Song
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Lin Jie Wang
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Feng Ying Gong
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Lian Duan
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Hong Bo Yang
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Hui Pan
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China
| | - Hui Juan Zhu
- Key Laboratory of, Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
- Chinese Research Center for Behavior Medicine in Growth and Development, Beijing, 100730, Beijing, China.
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Xu W, Wang X, Yang L, Meng M, Sun C, Li W, Li J, Zheng L, Tang T, Jia W, Chen X. Consistency of CSCO AI with Multidisciplinary Clinical Decision-Making Teams in Breast Cancer: A Retrospective Study. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:413-422. [PMID: 39099625 PMCID: PMC11296359 DOI: 10.2147/bctt.s419433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 06/27/2024] [Indexed: 08/06/2024]
Abstract
Background The Chinese Society of Clinical Oncology Artificial Intelligence System (CSCO AI) serves as a clinical decision support system developed utilizing Chinese breast cancer data. Our study delved into the congruence between breast cancer treatment recommendations provided by CSCO AI and their practical application in clinical settings. Methods A retrospective analysis encompassed 537 breast cancer patients treated at the Second Affiliated Hospital of Anhui Medical University between January 2017 and December 2022. Proficient senior oncology researchers manually input patient data into the CSCO AI system. "Consistent" and "Inconsistent" treatment categories were defined by aligning our treatment protocols with the classification system in the CSCO AI recommendations. Cases that initially showed inconsistency underwent a second evaluation by the Multi-Disciplinary Treatment (MDT) team at the hospital. Concordance was achieved when MDTs' treatment suggestions were in the 'Consistent' categories. Results An impressive 80.4% concurrence was observed between actual treatment protocols and CSCO AI recommendations across all breast cancer patients. Notably, the alignment was markedly higher for stage I (85.02%) and stage III (88.46%) patients in contrast to stage II patients (76.06%, P=0.023). Moreover, there was a significant concordance between invasive ductal carcinoma and lobular carcinoma (88.46%). Interestingly, triple-negative breast cancer (TNBC) exhibited a high concordance rate (87.50%) compared to other molecular subtypes. When contrasting MDT-recommended treatments with CSCO AI decisions, an overall 92.4% agreement was established. Furthermore, a logistic multivariate analysis highlighted the statistical significance of age, menstrual status, tumor type, molecular subtype, tumor size, and TNM stage in influencing consistency. Conclusion In the realm of breast cancer treatment, the alignment between recommendations offered by CSCO AI and those from MDT is predominant. CSCO AI can be a useful tool for breast cancer treatment decisions.
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Affiliation(s)
- Weimin Xu
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Xinyu Wang
- School of Second Clinical Medicine, AnHui Medical University, Hefei, People’s Republic of China
| | - Lei Yang
- School of Second Clinical Medicine, AnHui Medical University, Hefei, People’s Republic of China
| | - Muzi Meng
- School of Medicine, American University of the Caribbean, Sint Maarten, Kingdom of the Netherlands
- General Surgery, BronxCare Health System, New York, NY, USA
| | - Chenyu Sun
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Wanwan Li
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Jia Li
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Lu Zheng
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Tong Tang
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - WenJun Jia
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Xiao Chen
- Department of Thyroid and Breast Surgery, The Affiliated Second Hospital of Anhui Medical University, Hefei, People’s Republic of China
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Xia H, Chen Y, Cao A, Wang Y, Huang X, Zhang S, Gu Y. Differentiating between benign and malignant breast lesions using dual-energy CT-based model: development and validation. Insights Imaging 2024; 15:173. [PMID: 38981953 PMCID: PMC11233492 DOI: 10.1186/s13244-024-01752-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/16/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVES To develop and validate a dual-energy CT (DECT)-based model for noninvasively differentiating between benign and malignant breast lesions detected on DECT. MATERIALS AND METHODS This study prospectively enrolled patients with suspected breast cancer who underwent dual-phase contrast-enhanced DECT from July 2022 to July 2023. Breast lesions were randomly divided into the training and test cohorts at a ratio of 7:3. Clinical characteristics, DECT-based morphological features, and DECT quantitative parameters were collected. Univariate analyses and multivariate logistic regression were performed to determine independent predictors of benign and malignant breast lesions. An individualized model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic ability of the model, whose calibration and clinical usefulness were assessed by calibration curve and decision curve analysis. RESULTS This study included 200 patients (mean age, 49.9 ± 11.9 years; age range, 22-83 years) with 222 breast lesions. Age, lesion shape, and the effective atomic number (Zeff) in the venous phase were significant independent predictors of breast lesions (all p < 0.05). The discriminative power of the model incorporating these three factors was high, with AUCs of 0.844 (95%CI 0.764-0.925) and 0.791 (95% CI 0.647-0.935) in the training and test cohorts, respectively. The constructed model showed a preferable fitting (all p > 0.05 by the Hosmer-Lemeshow test) and provided enhanced net benefits than simple default strategies within a wide range of threshold probabilities in both cohorts. CONCLUSION The DECT-based model showed a favorable diagnostic performance for noninvasive differentiation between benign and malignant breast lesions detected on DECT. CRITICAL RELEVANCE STATEMENT The combination of clinical and morphological characteristics and DECT-derived parameter have the potential to identify benign and malignant breast lesions and it may be useful for incidental breast lesions on DECT to decide if further work-up is needed. KEY POINTS It is important to characterize incidental breast lesions on DECT for patient management. DECT-based model can differentiate benign and malignant breast lesions with good performance. DECT-based model is a potential tool for distinguishing breast lesions detected on DECT.
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Affiliation(s)
- Han Xia
- Department of Radiology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yueyue Chen
- Department of Radiology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ayong Cao
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yu Wang
- Clinical and Technical Support, Philips Healthcare, Shanghai, 200072, China
| | - Xiaoyan Huang
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Shengjian Zhang
- Department of Radiology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Yajia Gu
- Department of Radiology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
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Shao ZM, Cai L, Wang S, Hu X, Shen K, Wang H, Li H, Feng J, Liu Q, Cheng J, Wu X, Wang X, Li H, Luo T, Liu J, Amin K, Slimane K, Qiao Y, Liu Y, Tong Z. BOLERO-5: a phase II study of everolimus and exemestane combination in Chinese post-menopausal women with ER + /HER2- advanced breast cancer. Discov Oncol 2024; 15:237. [PMID: 38904918 PMCID: PMC11192707 DOI: 10.1007/s12672-024-01027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND The global BOLERO-2 trial established the efficacy and safety of combination everolimus (EVE) and exemestane (EXE) in the treatment of estrogen receptor positive (ER +), HER2-, advanced breast cancer (ABC). BOLERO-5 investigated this combination in a Chinese population (NCT03312738). METHODS BOLERO-5 is a randomized, double-blind, multicenter, placebo controlled, phase II trial comparing EVE (10 mg/day) or placebo (PBO) in combination with EXE (25 mg/day). The primary endpoint was progression-free survival (PFS) per investigator assessment. Secondary endpoints included PFS per blinded independent review committee (BIRC), overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), pharmacokinetics, and safety. RESULTS A total of 159 patients were randomized to EVE + EXE (n = 80) or PBO + EXE (n = 79). By investigator assessment, treatment with EVE + EXE prolonged median PFS by 5.4 months (HR 0.52; 90% CI 0.38, 0.71), from 2.0 months (PBO + EXE; 90% CI 1.9, 3.6) to 7.4 months (EVE + EXE; 90% CI 5.5, 9.0). Similar results were observed following assessment by BIRC, with median PFS prolonged by 4.3 months. Treatment with EVE + EXE was also associated with improvements in ORR and CBR. No new safety signals were identified in BOLERO-5, with the incidence of adverse events in Chinese patients consistent with the safety profile of both drugs. CONCLUSION The efficacy and safety results of BOLERO-5 validate the findings from BOLERO-2, and further support the use of EVE + EXE in Chinese post-menopausal women with ER + , HER2- ABC. NCT03312738, registered 18 October 2017.
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Affiliation(s)
- Zhi-Ming Shao
- Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Li Cai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Shusen Wang
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xichun Hu
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Kunwei Shen
- Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haibo Wang
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Huiping Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | | | - Qiang Liu
- Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | - Xinhong Wu
- Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology and Hubei Provincial Clinical Research Center for Breast Cancer, Wuhan, China
| | | | - Hongyuan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Ting Luo
- West China Hospital, Sichuan University, Chengdu, China
| | - Jinping Liu
- Sichuan Provincial People's Hospital, Chengdu, China
| | | | | | - Yongping Qiao
- China Novartis Institutes for BioMedical Research, Beijing, China
| | - Yongmin Liu
- China Novartis Institutes for BioMedical Research, Beijing, China
| | - Zhongsheng Tong
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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Tian Z, Xiaolu Z, Jing Y, Min W, Jiaqian L, Shouli C, Yingyin W, Xiaoyuan D, Xiaoyan L, Guorong W. A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model. BMC Womens Health 2024; 24:352. [PMID: 38890676 PMCID: PMC11184704 DOI: 10.1186/s12905-024-03150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
PURPOSE The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during treatment. METHODS A prospective longitudinal study was conducted, including 225 newly diagnosed breast cancer patients in A tumor specialty three-class hospital in Southwest China. We measured sexual activity at the time of admission and diagnosis (T0) and one month (T1), three months (T2), six months (T3), and nine months (T4) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Multivariate binary logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories. RESULTS The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T1. The percentage of sexual activity was improved, from 51.4% at T2 to 63.1% at T4. The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the "low activity group" and 63.4% in the "high activity group." The multivariate binary logistic regression analysis revealed statistically significant and positive correlations between sexual activity and age (β = 0.085, OR = 1.089, 95%CI 1.035 ∼ 1.145, P = 0.001),libido(β = 0.774, OR = 2.168, 95%CI 1.337 ∼ 3.515, P = 0.002), vaginal lubrication(β = 1.254, OR = 33.503, 95%CI 2.000 ∼ 6.137, P<0.001). CONCLUSIONS Breast cancer patients exhibited varying levels of sexual activity during treatment; higher age was associated with increased sexual activity, which can contribute to the recovery of sexual function. Therefore, it is crucial to provide appropriate guidance on sexual health for younger patients.
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Affiliation(s)
- Zhang Tian
- Nursing Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Zhang Xiaolu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yang Jing
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Wen Min
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Liao Jiaqian
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Chen Shouli
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Wang Yingyin
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Deng Xiaoyuan
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Liu Xiaoyan
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wang Guorong
- Nursing Department, West China School of Public Health and West China Fourth Hospital,West China Nursing School, Sichuan University, Chengdu, Sichuan, 610041, China.
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An J, Steffen AD, Collins EG, Molina Y, Li X, Ferrans CE. Act or Wait? Presentation Delay in Symptomatic Breast Cancer in China. Cancer Nurs 2024:00002820-990000000-00258. [PMID: 38857168 DOI: 10.1097/ncc.0000000000001361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
BACKGROUND In Western countries, factors contributing to breast cancer presentation delay have been identified, but little is known about presentation delay in China, where culture and healthcare systems are quite different. OBJECTIVE To describe the delay interval among newly diagnosed breast cancer patients in China and to identify factors influencing delay, including the COVID-19 pandemic. METHODS Using a cross-sectional design, we recruited 154 participants within 3 months of pathological diagnosis of breast cancer. Data were collected using standardized scales and open-ended questions. RESULTS We found 44.8% of participants delayed ≥1 month, and 24.7% delayed ≥3 months before presentation, after self-discovery of symptoms. Logistic regression analysis showed that factors associated with longer delay (≥1 month) included preferring female physicians for breast examination, fewer negative emotions (afraid, anxious, distressed) regarding breast symptoms, more competing priorities, believing folk therapy can help treat lumps, and visiting a secondary or tertiary hospital instead of primary healthcare providers (P < .05 for all). Interaction tests showed perceived seriousness of symptoms significantly predicted delay of ≥1 month only when perceived healthcare access or trust in physicians was low. Patients (14%) reported delaying due to fear of COVID-19 infection and inability to leave home. CONCLUSIONS Presentation delays were substantial and multilevel barriers to timely presentation were identified, which would be expected to contribute to later-stage cancer at diagnosis. IMPLICATIONS FOR PRACTICE Findings suggest that nursing interventions and improved health policies are urgently needed in China, including breast cancer education to increase awareness.
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Affiliation(s)
- Jinghua An
- Author Affiliations: Rutgers Cancer Institute of New Jersey, New Brunswick (Dr An); College of Nursing (Drs An, Steffen, Collins, and Ferrans) and School of Public Health (Dr Molina), University of Illinois at Chicago; and School of Nursing, Xi'an Jiaotong University, Shaanxi, China (Dr Li)
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Jiang L, Xu J, Wu Y, Liu Y, Wang X, Hu Y. Effects of the "AI-TA" Mobile App With Intelligent Design on Psychological and Related Symptoms of Young Survivors of Breast Cancer: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e50783. [PMID: 38833298 PMCID: PMC11185911 DOI: 10.2196/50783] [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: 07/23/2023] [Revised: 01/28/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Young women often face substantial psychological challenges in the initial years following cancer diagnosis, leading to a comparatively lower quality of life than older survivors. While mobile apps have emerged as potential interventions, their effectiveness remains inconclusive due to the diversity in intervention types and variation in follow-up periods. Furthermore, there is a particular dearth of evidence regarding the efficacy of these apps' intelligent features in addressing psychological distress with these apps. OBJECTIVE This study aims to evaluate the effectiveness of a mobile app with intelligent design called "AI-TA" on cancer-related psychological health and ongoing symptoms with a randomized controlled design. METHODS Women aged 18 to 45 years diagnosed with breast cancer were randomly assigned to the intervention or control group. The intervention was AI-TA, which included 2-way web-based follow-up every 2 weeks. Both intention-to-treat (ITT) and per-protocol (PP) analyses employed repeated measurement analysis of variance. The participants' background features, primary outcomes (psychological distress and frequency, self-efficacy, and social support), and secondary outcomes (quality of life) were measured using multiple instruments at 3 time points (baseline, 1-month intervention, and 3-month intervention). RESULTS A total of 124 participants were randomly allocated to the control group (n=62, 50%) or intervention group (n=62, 50%). In total, 92.7% (115/124) of the participants completed the intervention. Significant improvements in psychological symptoms (Memorial Symptom Assessment Scale-Short Form) were observed in the ITT group from baseline to 1-month intervention relative to the control group (ITT vs control: 1.17 vs 1.23; P<.001), which persisted at 3-month follow-up (ITT vs control: 0.68 vs 0.91; P<.001). Both the ITT and PP groups exhibited greater improvements in self-efficacy (Cancer Behavior Inventory-Brief Version) than the control group at 1-month (ITT vs PP vs control: 82.83 vs 77.12 vs 65.35; P<.001) and 3-month intervention (ITT vs PP vs control: 92.83 vs 89.30 vs 85.65; P<.001). However, the change in social support (Social Support Rating Scale) did not increase significantly until 3-month intervention (ITT vs control: 50.09 vs 45.10; P=.002) (PP vs control: 49.78 vs 45.10; P<.001). All groups also experienced beneficial effects on quality of life (Functional Assessment of Cancer Therapy-Breast), which persisted at 3-month follow-up (P<.001). CONCLUSIONS The intelligent mobile app AI-TA incorporating intelligent design shows promise for reducing psychological and cancer-related symptoms among young survivors of breast cancer. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200058823; https://www.chictr.org.cn/showproj.html?proj=151195.
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Affiliation(s)
- Lulu Jiang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jiehui Xu
- Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanwei Wu
- Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyan Liu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yun Hu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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12
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Chen J, Huang Z, Jiang Y, Wu H, Tian H, Cui C, Shi S, Tang S, Xu J, Xu D, Dong F. Diagnostic Performance of Deep Learning in Video-Based Ultrasonography for Breast Cancer: A Retrospective Multicentre Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:722-728. [PMID: 38369431 DOI: 10.1016/j.ultrasmedbio.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Although ultrasound is a common tool for breast cancer screening, its accuracy is often operator-dependent. In this study, we proposed a new automated deep-learning framework that extracts video-based ultrasound data for breast cancer screening. METHODS Our framework incorporates DenseNet121, MobileNet, and Xception as backbones for both video- and image-based models. We used data from 3907 patients to train and evaluate the models, which were tested using video- and image-based methods, as well as reader studies with human experts. RESULTS This study evaluated 3907 female patients aged 22 to 86 years. The results indicated that the MobileNet video model achieved an AUROC of 0.961 in prospective data testing, surpassing the DenseNet121 video model. In real-world data testing, it demonstrated an accuracy of 92.59%, outperforming both the DenseNet121 and Xception video models, and exceeding the 76.00% to 85.60% accuracy range of human experts. Additionally, the MobileNet video model exceeded the performance of image models and other video models across all evaluation metrics, including accuracy, sensitivity, specificity, F1 score, and AUC. Its exceptional performance, particularly suitable for resource-limited clinical settings, demonstrates its potential for clinical application in breast cancer screening. CONCLUSIONS The level of expertise reached by the video models was greater than that achieved by image-based models. We have developed an artificial intelligence framework based on videos that may be able to aid breast cancer diagnosis and alleviate the shortage of experienced experts.
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Affiliation(s)
- Jing Chen
- Ultrasound Department, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | | | - Yitao Jiang
- Research and development department, Illuminate, LLC, Shenzhen, Guangdong, China
| | - Huaiyu Wu
- Ultrasound Department, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Hongtian Tian
- Ultrasound Department, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Chen Cui
- Research and development department, Illuminate, LLC, Shenzhen, Guangdong, China
| | - Siyuan Shi
- Research and development department, Illuminate, LLC, Shenzhen, Guangdong, China
| | | | - Jinfeng Xu
- Ultrasound Department, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Dong Xu
- Institute of Basic Medicine and Cancer (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Fajin Dong
- Ultrasound Department, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, Guangdong, China; Jinan University, Guangzhou, Guangdong, China.
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Wu B, Li Y, Shi B, Zhang X, Lai Y, Cui F, Bai X, Xiang W, Geng G, Liu B, Jiao M, Wu Q, Yang H, Zhang C, Liu X, Tian Y, Li H. Temporal trends of breast cancer burden in the Western Pacific Region from 1990 to 2044: Implications from the Global Burden of Disease Study 2019. J Adv Res 2024; 59:189-199. [PMID: 37422280 PMCID: PMC11082062 DOI: 10.1016/j.jare.2023.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023] Open
Abstract
INTRODUCTION Breast cancer (BC) is a malignant disease that occurs worldwide and poses serious health burden. OBJECTIVES To assess the prevalence of BC burden in the Western Pacific region (WPR) from 1990 to 2019, and to predict trends from 2020 to 2044. To analyze the driving factors and put forward the region-oriented improvement. METHODS Based on the Global Burden of Disease Study 2019, BC cases, deaths, disability-adjusted life years (DALYs) cases, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate in WPR from 1990 to 2019 was obtained and analysed. Age-period-cohort (APC) model was used to analyze age, period, and cohort effects in BC, and Bayesian APC (BAPC) was used to predict trends over the next 25 years. RESULTS In conclusion, BC incidence and deaths in the WPR have increased rapidly over the past 30 years and are expected to continue to increase between 2020 and 2044. Among behavioral and metabolic factors, high body-mass index was the main risk factor for BC mortality in middle-income countries, whereas alcohol use was the main risk factor in Japan. Age is a key factor in the development of BC, with 40 years being the critical point. Incidence trends coincide with the course of economic development. CONCLUSIONS The BC burden remains an essential public health issue in the WPR and will increase substantially in the future. More efforts should be made in middle-income countries to prompt the health behavior and minimize the burden of BC because these nations accounts for the majority of BC burden in the WPR.
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Affiliation(s)
- Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China.
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China; Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bei Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Mingli Jiao
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Yang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chenxi Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yulu Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyu Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
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Alkarak S, Badheeb AM, Al-Dowais A, Alhabes H, Almahwiti K, Aman AA, Alhajlan MA, Seada I, Alshamrani SA, Alhussein B. Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study. Cureus 2024; 16:e58324. [PMID: 38752053 PMCID: PMC11095821 DOI: 10.7759/cureus.58324] [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] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Early detection of breast cancer is crucial for effective treatment and minimizing mortality, requiring effective screening methods like self-examination, clinical examination, and mammography. However, not all women in Saudi Arabia comply with these examinations, and studies examining its practice and barriers of low uptake are scant. The aim of this study is to investigate factors influencing breast cancer screening behavior among women in Saudi Arabia. Methods This cross-sectional study involving 806 women from October to November 2022 used an online questionnaire for the data collection process, including questions about demographic characteristics, awareness assessment, breast cancer screening behavior, symptoms, risk factors, and screening programs. Factors affecting the screening behavior were analyzed using the logistic regression model with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 806 women who participated in the study, 479 (59.4%) were under 40 years old, and half of them were urban residents (n = 394, 48.9%). Only 134 subjects (16.6%) had a history of breast screening. Social media (n = 519, 64.5%) was the predominant source of screening information. The primary obstacles to breast cancer screening were the absence of tumor symptoms (n = 333, 41.3%), insufficient knowledge about early detection (n = 249, 31%), lack of time (n = 245, 30%), fear of discovering a tumor (n = 187, 23%), and lack of awareness about screening centers (n = 155, 19%). In regression analysis, predictive factors for breast cancer screening behavior were as follows: age over 40 years old (AOR: 2.56; 95% CI: 1.70-3.87), residents of big cities (AOR: 3.57; 95% CI: 1.02-12.56), positive family history of breast cancer (AOR: 2.53; 95% CI: 1.50-4.28), proximity to the screening center (AOR: 2.56; 95% CI: 1.22-5.39), and using contraceptive pills for more than five years (AOR: 1.78; 95% CI: 1.04-3.04), and were statistically significant (all p-values < 0.05). Conclusions In this study, the most perceived barriers to BSE were the absence of tumor symptoms, followed by insufficient knowledge about early detection, lack of time, fear of discovering a tumor, and lack of awareness about screening centers. Additionally, the predictive factors for breast cancer screening behavior were as follows: age over 40 years old, residents of big cities, positive family history of breast cancer, proximity to the screening center, and using contraceptive pills for more than five years. Given the identified factors affecting breast self-examination behavior in this study, public education initiatives are crucial for raising awareness, facilitating self-examination, and ultimately improving health outcomes and reducing breast cancer treatment costs in society.
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Affiliation(s)
- Samer Alkarak
- General Surgery, King Khalid University Hospital, Najran, SAU
| | - Ahmed M Badheeb
- Oncology, Oncology Center, King Khalid University Hospital, Najran, SAU
| | - Ali Al-Dowais
- E-Health, Eradah Complex Psychiatric & Addiction, King Khalid University Hospital, Najran, SAU
| | - Hessa Alhabes
- Surgery, King Khalid University Hospital, Najran, SAU
| | | | | | - Mana A Alhajlan
- General Surgery, King Khalid University Hospital, Najran, SAU
| | - Islam Seada
- Cardiac Surgery, King Khalid University Hospital, Najran, SAU
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Zhu L, Zhou Q, Huang Z, Yang Y, Yang Y, Du Y, Zhao Y, Yu X, Li T, Chen W. Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study. Int J Womens Health 2024; 16:509-518. [PMID: 38533523 PMCID: PMC10964776 DOI: 10.2147/ijwh.s453857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition. Methods From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0. Results The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness. Conclusion This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.
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Affiliation(s)
- Lingling Zhu
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Qiang Zhou
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Ziyue Huang
- Mianyang Maternal and Child Health Care Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Yuan Yang
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, People’s Republic of China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Ying Yang
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yao Du
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yuqian Zhao
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Xiaoping Yu
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, 610106, People’s Republic of China
| | - Tingyuan Li
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
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Bai S, Song D, Chen M, Lai X, Xu J, Dong F. The association between mammographic density and breast cancer risk in Chinese women: a systematic review and meta-analysis. BMC Womens Health 2024; 24:131. [PMID: 38378562 PMCID: PMC10877813 DOI: 10.1186/s12905-024-02960-0] [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: 11/13/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women. METHODS The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases. RESULTS Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I. CONCLUSIONS For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
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Affiliation(s)
- Song Bai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Di Song
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Ming Chen
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Xiaoshu Lai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
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Hu W, Bao J, Yang X, Ye M. Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study. BMC Public Health 2024; 24:425. [PMID: 38336690 PMCID: PMC10858503 DOI: 10.1186/s12889-024-18000-3] [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: 09/23/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties. METHODS The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability. RESULTS The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855. CONCLUSIONS The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.
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Affiliation(s)
- Wenqi Hu
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Jiahui Bao
- The First Affiliated Hospital of China Medical University, Liaoning, China
| | | | - Mao Ye
- The First Affiliated Hospital of China Medical University, Liaoning, China.
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18
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Bao Y, Yan Z, Shi N, Tian X, Li J, Li T, Cheng X, Lv J. LCN2: Versatile players in breast cancer. Biomed Pharmacother 2024; 171:116091. [PMID: 38171248 DOI: 10.1016/j.biopha.2023.116091] [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: 10/07/2023] [Revised: 12/06/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
Lipocalin 2 (LCN2) is a secreted glycoprotein that is produced by immune cells, including neutrophils and macrophages. It serves various functions such as transporting hydrophobic ligands across the cellular membrane, regulating immune responses, keeping iron balance, and fostering epithelial cell differentiation. LCN2 plays a crucial role in several physiological processes. LCN2 expression is upregulated in a variety of human diseases and cancers. High levels of LCN2 are specifically linked to breast cancer (BC) cell proliferation, apoptosis, invasion, migration, angiogenesis, immune regulation, chemotherapy resistance, and prognosis. As a result, LCN2 has gained attention as a potential therapeutic target for BC. This article offered an in-depth review of the advancement of LCN2 in the context of BC occurrence and development.
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Affiliation(s)
- Yuxiang Bao
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563099, China
| | - Zhongliang Yan
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563099, China
| | - Nianmei Shi
- The First Clinical Institute, Zunyi Medical University, Zunyi, Guizhou 563006, China
| | - Xiaoyan Tian
- The First Clinical Institute, Zunyi Medical University, Zunyi, Guizhou 563006, China
| | - Jiayang Li
- Office of Drug Clinical Trial Institution, the Affiliated Hospital of Zunyi Medical University, Zunyi 563099, China
| | - Taolang Li
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563099, China
| | - Xiaoming Cheng
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563099, China.
| | - Junyuan Lv
- Department of General Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563099, China; Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China.
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19
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Zhang W, Yu Y, Yang F. Single-cell combined with bulk-RNA data reveal a pattern related to angiogenesis in breast cancer patients: Individualized medicine. ENVIRONMENTAL TOXICOLOGY 2024; 39:695-707. [PMID: 37647361 DOI: 10.1002/tox.23947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/02/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
Angiogenesis contributes to tumor progression, aggressive behavior, and metastasis. Although several endothelial dysfunction genes (angiogenesis-related genes [ARGs]) have been identified as diagnostic biomarkers of breast cancer in a few studies, the mixed effects of ARGs have not been thoroughly investigated. The RNA sequencing data and patient survival datasets of breast cancer were obtained for further analysis. MSigDB website includes angiogenesis-related mechanisms. The consensus clustering analysis identifies 1082 breast cancer patients as three clusters. differential expression genes (DEGs) were identified by limma package. GO combined with gene set enrichment analysis (GSEA) to identify cytogenetic functions between two predefined clusters. Then Serpin Family F Member 1 (SERPINF1), angiomotin (AMOT), promyelocytic leukemia (PML), and BTG anti-proliferation factor 1 (BTG) were selected to construct prediction models using random forest survival analysis. External validation was performed using the GSE58812 triple-negative breast cancer cohort as the validation set. The median scoring system was used to discern the high- and low-risk groups, and there was a significant difference in their diagnostic results. Immunological infiltration scores were calculated using single sample gene set enrichment analysis (ssGSEA) and xCell algorithms, and consciousness scores were calculated using the R package "oncoPredict" for drugs in the Genomics of Drug Sensitivity in Cancer (GDSC) database. In addition, the single-cell analysis of seven triple-negative breast cancers using scRNA-seq information from GSE118389 demonstrated the interpretation of SERPINF1, AMOT, PML, and BTG1. In conclusion, this investigation engineered ARG-centric disease paradigms that not only prognosticated prospective therapeutic compounds, but also projected their mechanistic trajectories, thereby facilitating the proposition of tailored treatments within diverse patient cohorts diagnosed with breast cancer.
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Affiliation(s)
- Wei Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yan Yu
- Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Fan Yang
- Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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20
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Huang C, Jin H. Progress and perspective of organoid technology in breast cancer research. Chin Med J (Engl) 2024:00029330-990000000-00903. [PMID: 38185826 PMCID: PMC11407818 DOI: 10.1097/cm9.0000000000002889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Indexed: 01/09/2024] Open
Abstract
ABSTRACT Breast cancer, a malignant tumor with a high incidence in women, lacks in vitro research models that can represent the biological functions of breast tumors in vivo. As a new biological tool, the organoid model has unique advantages over traditional methods, such as cell culture and patient-derived xenografts. Combining organoids with other emerging technologies, such as gene engineering and microfluidic chip technology, provides an effective method to compensate for the deficiencies in organoid models of breast cancer in vivo. The emergence of breast cancer organoids has provided new tools and research directions in precision medicine, personality therapy, and drug research. In this review, we summarized the merits and demerits of organoids compared to traditional biological models, explored the latest developments in the combination of new technologies and organoid models, and discussed the construction methods and application prospects of different breast organoid models.
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Affiliation(s)
- Changsheng Huang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
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21
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Chen SP, Li P, Pan YF, Jiang X. Case report: Rare presentation of double primary malignancies of the lung and thyroid: a difficult diagnosis. Front Oncol 2024; 13:1251492. [PMID: 38260838 PMCID: PMC10801227 DOI: 10.3389/fonc.2023.1251492] [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: 07/01/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
This report describes a rare case of double primary cancer in a female patient aged 49 years who died 2 years after diagnosis. The patient was diagnosed with BRAFV600E-mutant metastatic papillary thyroid carcinoma (PTC) and ALK fusion-positive metastatic lung adenocarcinoma. She presented with multifocal thyroid lesions and underwent radical thyroidectomy and bilateral cervical lymphadenectomy. Thyroid ultrasound revealed the presence of five hypoechoic nodules with irregular margins and microcalcifications; an irregular inhomogeneous hypoechoic level IV cervical lymph node was also found on the right side. Histological analysis confirmed the presence of metastatic PTC, and the tumor tested positive for the BRAFV600E mutation. Ultrasound of the neck, which was performed 4 months postdischarge, revealed enlargement of the left-sided cervical lymph nodes; a biopsy from these nodes confirmed a diagnosis of metastatic PTC. Positron emission tomography-computed tomography scans revealed the presence of multiple pulmonary hypermetabolic foci scattered across bilateral lung fields. Multiple hypermetabolic foci were also observed in the lymph nodes on both sides of the neck, axillae, and mediastinum; in addition, there was evidence of bone destruction with hypermetabolic foci. Supplementary reports from the histological and immunohistochemical analyses of cervical lymph node tissue obtained during primary surgery confirmed the presence of metastatic PTC and poorly differentiated lung adenocarcinoma. In particular, one enlarged cervical lymph node located on the right side of the neck demonstrated tumor components of both PTC and lung adenocarcinoma. Pathological analysis of axillary lymph node puncture biopsy confirmed the presence of metastatic lung adenocarcinoma, and gene analysis revealed the presence of ALK fusion. The patient received targeted therapy based on a multidisciplinary discussion. However, she had a poor prognosis and died 2 years after the diagnosis. The initial thyroid ultrasound findings were reviewed retrospectively; the findings suggested that the possibility of double primary cancers should be considered in cases where the enlarged cervical lymph nodes are highly suspicious of PTC and present as inhomogeneous hypoechoic masses with irregular morphology.
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Affiliation(s)
- Shun-Ping Chen
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peng Li
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-Fei Pan
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xin Jiang
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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22
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Yang JX, Yang YQ, Hu WY, Yang L, Wu J, Wen XX, Yu J, Huang ML, Xu DD, Tie DC, Wang L, Li FF, Li NL. A Phase II Study of Neoadjuvant PLD/Cyclophosphamide and Sequential nab-Paclitaxel Plus Dual HER2 Blockade in HER2-Positive Breast Cancer. Oncologist 2024; 29:e15-e24. [PMID: 37279780 PMCID: PMC10769796 DOI: 10.1093/oncolo/oyad160] [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: 01/30/2023] [Accepted: 05/01/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Neoadjuvant trastuzumab/pertuzumab (HP) plus chemotherapy for HER2-positive breast cancer (BC) achieved promising efficacy. The additional cardiotoxicity still existed. Brecan study evaluated the efficacy and safety of neoadjuvant pegylated liposomal doxorubicin (PLD)/cyclophosphamide and sequential nab-paclitaxel based on HP (PLD/C/HP-nabP/HP). PATIENTS AND METHODS Brecan was a single-arm phase II study. Eligible patients with stages IIA-IIIC HER2-positive BC received 4 cycles of PLD, cyclophosphamide, and HP, followed by 4 cycles of nab-paclitaxel and HP. Definitive surgery was scheduled after 21 days for patients completing treatment or experiencing intolerable toxicity. The primary endpoint was the pathological complete response (pCR). RESULTS Between January 2020 and December 2021, 96 patients were enrolled. Ninety-five (99.0%) patients received 8 cycles of neoadjuvant therapy and all underwent surgery with 45 (46.9%) breast-conserving surgery and 51 (53.1%) mastectomy. The pCR was 80.2% (95%CI, 71.2%-87.0%). Four (4.2%) experienced left ventricular insufficiency with an absolute decline in LVEF (43%-49%). No congestive heart failure and ≥grade 3 cardiac toxicity occurred. The objective response rate was 85.4% (95%CI, 77.0%-91.1%), including 57 (59.4%) complete responses and 25 (26.0%) partial responses. The disease control rate was 99.0% (95%CI, 94.3%-99.8%). For overall safety, ≥grade 3 AEs occurred in 30 (31.3%) and mainly included neutropenia (30.2%) and asthenia (8.3%). No treatment-related deaths occurred. Notably, age of >30 (P = .01; OR = 5.086; 95%CI, 1.44-17.965) and HER2 IHC 3+ (P = .02; OR = 4.398; 95%CI, 1.286-15.002) were independent predictors for superior pCR (ClinicalTrials.gov Identifier NCT05346107). CONCLUSION Brecan study demonstrated the encouraging safety and efficacy of neoadjuvant PLD/C/HP-nabP/HP, suggesting a potential therapeutic option in HER2-positive BC.
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Affiliation(s)
- Ji-Xin Yang
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Yu-Qing Yang
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Wen-Yu Hu
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Lu Yang
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Jiang Wu
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Xin-Xin Wen
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Jing Yu
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Mei-Ling Huang
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Dong-Dong Xu
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Dan-Chen Tie
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Lei Wang
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
| | - Fan-Fan Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, People’s Republic of China
| | - Nan-Lin Li
- Department of Thyroid Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, People’s Republic of China
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23
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Nooreen Z, Tandon S, Wal A, Rai AK. An Updated Insight into Phytomolecules and Novel Approaches used in the Management of Breast Cancer. Curr Drug Targets 2024; 25:201-219. [PMID: 38231060 DOI: 10.2174/0113894501277556231221072938] [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: 08/16/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 01/18/2024]
Abstract
Breast cancer is a widespread condition that kills more women from cancer-related causes than any other type of cancer globally. Women who have estrogen-dependent, initial metastatic breast cancer frequently receive treatment with surgery, radiation therapy, and chemotherapy. They may also get more specialized treatments like tamoxifen or aromatase inhibitors (anastrozole or letrozole). The World Health Organisation reported in 2012 that by 2030, breast cancer will be more common worldwide. There are several phytochemicals, such as isoflavones, coumestans, lignans, and prenylflavonoides. Isoflavones have been shown in studies to prevent the spread of breast cancer and to trigger apoptosis. Targeting BCs in metastatic breast cancer may be made possible by combining well-formulated phytochemicals in nanoparticles or other novel drug delivery agents with currently accepted endocrine and/or conventional chemotherapies. Cell signaling, regulation of cell cycles, oxidative stress action, and inflammation could be positively impacted by phytoconstituents. They have the ability to alter non-coding RNAs, to prevent the proliferation and regeneration of cancer cells. The availability of novel approaches helps in disease targeting, safety, effectiveness and efficacy. The current literature helps to know the available drugs i.e. phytoconstituents or novel drug delivery like nanoparticle, microsphere, micelles, liposomes and neosomes. The literature has been taken from PubMed, Google Scholar, SciFinder, or other internet sites.
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Affiliation(s)
- Zulfa Nooreen
- PSIT-Pranveer Singh Institute of Technology (Pharmacy), Bhautipratapur, Uttar Pradseh 209305, India
| | - Sudeep Tandon
- Phytochemistry Division, CSIR-Central Institute of Medicinal and Aromatic Plants, P.O.- CIMAP, Lucknow-226015, India
| | - Ankita Wal
- PSIT-Pranveer Singh Institute of Technology (Pharmacy), Bhautipratapur, Uttar Pradseh 209305, India
| | - Awani Kumar Rai
- PSIT-Pranveer Singh Institute of Technology (Pharmacy), Bhautipratapur, Uttar Pradseh 209305, India
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24
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Zhang X, Wang J, Li H. RTKN2 knockdown alleviates the malignancy of breast cancer cells by regulating the Wnt/β-catenin pathway. Sci Rep 2023; 13:23023. [PMID: 38155217 PMCID: PMC10754922 DOI: 10.1038/s41598-023-50153-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023] Open
Abstract
RTKN2 is a new effector protein of Rho GTPase, and has been indicated to be a tumor inhibitor in colon cancer. In this article, we explored the function of RTKN2 in BC cell development. RTKN2 expression in BC tissues and BC cell lines was evaluated by RT-qPCR and Western blot assay. CCK-8, Wound-healing and Transwell assays were carried out to examine the role of RTKN2 knockdown on proliferation, the migratory ability and the invasive ability of BC cells. FCM and Western blot assay were performed to measure the function of RTKN2 silencing on BC cell apoptosis. In addition, the regulatory effect of RTKN2 on Wnt/β-catenin pathway was studied via Western blot assay. RTKN2 expression was elevated in BC tissues and BC cells. Down-regulation of RTKN2 restrained BC cell progression by suppressing cell proliferation, migratory ability, invasive ability, and inducing apoptosis. In addition, reduced of RTKN2 sharply reduced the expressing levels of Wnt3A, β-catenin, C-Myc, and Cyclin D1, suggesting that RTKN2 silencing blocked the motivation of Wnt/β-catenin pathway in BC development. The in vivo experiment also confirmed the inhibitory effect of RTKN2 on BC tumors. Our study confirmed that RTKN2 was highly expressed in BC. Moreover, RTKN2 knockdown suppressed the development of BC through affecting the Wnt/β-catenin pathway. Hence, we deduced that RTKN2 was a possible treatment target for BC.
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Affiliation(s)
- Xiaomei Zhang
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Jian Wang
- Department of Ultrasound, Shandong Province Coal Taishan Sanatorium, Taian, 271000, Shandong, China
| | - Haiying Li
- Department of Ultrasound, Qilu Hospital of Shandong Univesity, No. 107, Wenhuaxi Rd., Jinan, 250012, Shandong, China.
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25
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Ma X, Zhou L, Wu Q, Jia L, Diao X, Kang Q, Huang X, Liu Y, Hu T, Long M. Loss of Human Epidermal Receptor 2 Expression in Formalin-Fixed Paraffin-Embedded Breast Cancer Samples and the Rescuing Effect of Enhanced Antigen Retrieval and Signal Amplification. Life (Basel) 2023; 14:31. [PMID: 38255647 PMCID: PMC10820269 DOI: 10.3390/life14010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/19/2023] [Accepted: 11/25/2023] [Indexed: 01/24/2024] Open
Abstract
As an important therapeutic target in breast cancer, HER2 expression assessed by immunohistochemistry plays a critical role in breast cancer treatment. Recent advances in HER2 antibody-drug conjugate therapy have enabled patients with HER2-low expression breast cancer to benefit from the drugs. However, it is not known whether the HER2-low expression in breast cancer FFPE blocks would be lost as storage time increased. In this study, we aimed to assess the loss of HER2 antigenicity in stored FFPE blocks of breast cancer and the rescue effect of modifying the protocol of antigen staining. We selected archived HER2-low breast cancer FFPE blocks with stored time ranging from 1 year to over 15 years and re-detected the expression of HER2. Our study showed that HER2 antigenicity loss increased with storage time and could cause false negativity in HER2-low detection. Moreover, we showed that by either increasing the antigen retrieval time or applying the tyramide signal amplification (TSA) kit, the HER2 signal can be rescued and detected in about half of the cases with HER2-low loss without causing false positivity.
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Affiliation(s)
- Xiuli Ma
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Lixin Zhou
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Qi Wu
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Ling Jia
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Xinting Diao
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Qiang Kang
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Xiaozheng Huang
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Yiqiang Liu
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
| | - Taobo Hu
- Department of Breast Surgery, Peking University People’s Hospital, Beijing 100044, China
| | - Mengping Long
- Department of Pathology, Peking University Cancer Hospital, Beijing 100083, China; (X.M.); (L.Z.); (Q.W.); (L.J.); (X.D.); (Q.K.); (X.H.); (Y.L.)
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26
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Wei Q, Xu Y, Liu W, Guan X. Cost-effectiveness of abemaciclib plus endocrine therapy in high-risk HR+/HER2-early breast cancer in China. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:91. [PMID: 38012661 PMCID: PMC10683222 DOI: 10.1186/s12962-023-00499-9] [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: 08/02/2023] [Accepted: 11/17/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE The aim of this article is to evaluate the cost-effectiveness of abemaciclib plus endocrine therapy (ABE + ET) vs. ET as adjuvant treatment for high-risk hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) early breast cancer in China. METHODS From the perspective of the Chinese health care system, a 5-state Markov model was developed with a lifetime horizon. Data of the monarchE phase III clinical trial were used to model the invasive disease-free survival (iDFS) and standard parameters models were used for data extrapolation. Costs were obtained from national data sources, expert opinions and published literature using 2023 US dollars and discounted by 5%. The results were evaluated in terms of life-years (LYs) and quality-adjusted life-years (QALYs). Sensitivity analyses and scenario analyses were performed to test the robustness of the basic results. RESULTS In the base-case analysis result, the model projected improved outcomes (by 0.65 LYs and 0.72 QALYs) and increased costs (by $16,057.72) for incremental cost-effectiveness ratios (ICERs) of $24,841/LY and $22,385/QALY for ABE + ET vs. ET patients. The results in scenario analysis estimated the ICERs of ABE + ET treatment to be $16,959/LY and $15,264/QALY in a mixture cure model, and $13,560/LY and $12,191/QALY in a non-mixture cure model. The model was sensitive to outcome discount rate and utility of iDFS. CONCLUSION ABE + ET might not have an economic advantage over ET at a willingness-to-pay (WTP) threshold of one time the per capita GDP in China, but was expected to be more cost-effective at a WTP threshold of three times the per capita GDP. Further analysis will be conducted once data from longer-term studies become available.
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Affiliation(s)
- Qiran Wei
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
- Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - YuTing Xu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
- Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Wei Liu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
- Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Xin Guan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China.
- Center for Pharmacoeconomics and Outcomes Research of China Pharmaceutical University, Nanjing, 211198, Jiangsu, China.
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27
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Lu C, Zhan Y, Jiang Y, Liao J, Qiu Z. Exosome-derived ANXA9 functions as an oncogene in breast cancer. J Pathol Clin Res 2023; 9:378-390. [PMID: 37294149 PMCID: PMC10397375 DOI: 10.1002/cjp2.334] [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: 03/14/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
Breast cancer (BCA) is one of the most prevalent cancers among women. Emerging evidence has revealed that Annexin A-9 (ANXA9) plays a crucial function in the development of some cancers. Notably, ANXA9 has been reported to be a new prognostic biomarker for gastric and colorectal cancers. However, its expression and biological function in BCA have not yet been investigated. Using online bioinformatics tools such as TIMER, GEPIA, HPA, and UALCAN, we predicted ANXA9 expression and its correlation with the clinicopathological characteristics of BCA patients. RT-qPCR and western blot were utilized to measure ANXA9 mRNA and ANXA9 protein expression in BCA patient tissues and cells. BCA-derived exosomes were identified by transmission electron microscopy. Functional assays were employed to evaluate the biological role of ANXA9 in BCA cell proliferation, migration, invasion, and apoptosis. A tumor xenograft in vivo model was utilized to assess the role of ANXA9 in tumor growth in mice. Bioinformatics and functional screening analysis revealed that ANXA9 was highly expressed in BCA patient tissues, with median ANXA9 expression 1.5- to 2-fold higher than in normal tissues (p < 0.05). RT-qPCR confirmed that ANXA9 expression in BCA tissues was around 1.5-fold higher than the adjacent normal tissues (p < 0.001). ANXA9 expression in different subtypes of BCA also showed a difference, and ANXA9 was found to be mostly significantly upregulated in luminal BCA relative to normal tissues or other histological subtypes (p < 0.001). Moreover, ANXA9 expression was elevated in different races, ages, clinical stages, node metastasis status, and menopause status groups relative to the normal group (p < 0.001). Furthermore, ANXA9 was found to be secreted by BCA tissue-derived exosomes and its expression was upregulated 1- to 7-fold in BCA cells treated with exosomes (p < 0.001), while its expression in MCF10A cells was not significantly altered by treatment with exosomes (p > 0.05). ANXA9 silencing induced a significant decrease of around 30% in the colony number of BCA cells (p < 0.01). The number of migrated and invaded BCA cells also decreased by around 65 and 68%, respectively, after silencing ANXA9 (p < 0.01). Tumor size was significantly reduced (nearly half) in the LV-sh-ANXA9 group relative to the LV-NC group in the xenograft model (p < 0.01), suggesting that ANXA9 silencing repressed tumor progression in BCA progression in vitro and in vivo. In conclusion, exosome-derived ANXA9 functions as an oncogene that facilitates the proliferation, migration, and invasiveness of BCA cells and enhances tumor growth in BCA development, which may provide a new prognostic and therapeutic biomarker for BCA patients.
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Affiliation(s)
- Cuiping Lu
- Department of Medical OncologyLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanFujianPR China
| | - Ying Zhan
- Department of Medical OncologyLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanFujianPR China
| | - Yunshan Jiang
- Department of Medical OncologyLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanFujianPR China
| | - Jianrong Liao
- Department of Medical OncologyLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanFujianPR China
| | - Zidan Qiu
- Department of Medical OncologyLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanFujianPR China
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Wang DQ, Wang YY, Shi YL, Zeng B, Lin ZJ, Deng Q, Ming J. Correlation between connexin 43 expression in circulating tumor cells and biological characteristics of breast cancer. Heliyon 2023; 9:e18697. [PMID: 37583757 PMCID: PMC10424078 DOI: 10.1016/j.heliyon.2023.e18697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023] Open
Abstract
Background Connexin 43 (Cx43) has been closely linked to the occurrence and progression of breast cancer. Distant metastasis of breast cancer is aided by the epithelial-mesenchymal transition of circulating tumor cells (CTCs). However, the impact of Cx43 expression on CTCs and the extent of its role in the disease remain unclear. Methods We determined CTCs in 156 patients, who had breast cancer with a disease course of two or more years. We also measured the expression of Cx43 in the CTCs. The CTCs were detected in the blood of 139 of these patients. These 139 patients were divided into two groups: the Cx43 group and the non-Cx43 group based on their Cx43 expression. Results Overall, Cx43 expression was found in 83 of the 139 patients (59.7%, 83/139 cases). The two groups significantly differed in terms of the number of mixed biphenotypic type CTCs and the total number of CTCs (P < 0.05). There were significant correlations between Cx43 expression and Ki67 expression, tumor size, lymph node metastasis, and TNM stage (P < 0.05 for all). The data suggested that patients with Cx43 expression had a higher risk of distant metastasis and had later-stage disease. The difference in Cx43 expression between patients with and without epidermal growth factor receptor 2 (Her2) overexpression was statistically significant (P < 0.05). The difference in disease-free survival (DFS) between the two groups was statistically significant (P = 0.03), and the Cx43 group had a shorter duration of DFS. Univariate Cox regression analysis revealed that Cx43 expression, Her2 expression, and tumor size were significantly correlated with DFS (P = 0.03, 0.0023, and 0.01, respectively). Conclusion Cx43 expression in the CTCs of patients with breast cancer is a cancer-promoting factor.
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Affiliation(s)
- Dan-Qing Wang
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
| | - Yuan-Yuan Wang
- Department of Emergency, Xi'an Central Hospital, Xi'an 710003, People's Republic of China
| | - Yan-Ling Shi
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
| | - Bin Zeng
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
| | - Zi-Jing Lin
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
| | - Qin Deng
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
| | - Jia Ming
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China
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Zhang Q, Cai Y, Yu S, Tang L, Li W, Yao S, Zheng X, Liu J, Chen G, Gan C, Xu J, Cheng H. Effects of fear of cancer recurrence on subjective physical and mental health in breast cancer patients: The intermediary role of heart rate variability. Cancer Med 2023; 12:16570-16579. [PMID: 37325894 PMCID: PMC10469646 DOI: 10.1002/cam4.6250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/17/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) and psychological distress are common psychological problems in breast cancer (BC) patients and ultimately affecting their health-related quality of life (HRQoL). Heart rate variability (HRV) can reflect the activity of the parasympathetic nervous system. However, the pathways through which HRV influences between FCR and HRQoL are unclear. This study preliminarily explored the intermediary role of HRV in FCR and HRQoL in BC patients. METHODS A total of 101 BC patients participated in this study. HRV parameters were measured by a 5-min dynamic electrocardiogram. FCR, psychological distress and HRQoL were evaluated by the Fear of disease progression simplified scale (FOP-Q-SF), Distress thermometer and SF-36 concise health survey. The intermediary effect model was established to test the intermediary effect of high frequency-HRV (HF-HRV) on FCR and HRQoL. RESULTS FCR and psychological distress were negatively correlated with HRV in the time domain, negatively correlated with HF-HRV in the frequency domain, and positively correlated with low frequency/high frequency (LF/HF). HF-HRV had a partial mediating effect on the FCR and physical health and mental health, with effects of 30.23% and 9.53%, respectively. CONCLUSION FCR and psychological distress are correlated with HRV parameters in the time domain and the frequency domain, and we preliminarily believe that parasympathetic nerves play an important intermediary role between FCR and subjective physical and mental health. This may provide intervention information for improving the HRQoL of BC patients.
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Affiliation(s)
- Qianqian Zhang
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Yinlian Cai
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Sheng Yu
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Lingxue Tang
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Wen Li
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Senbang Yao
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Xucai Zheng
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and Medicine, University of Science and Technology of China230601AnhuiHefeiChina
| | - Jianjun Liu
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and Medicine, University of Science and Technology of China230601AnhuiHefeiChina
| | - Gongpu Chen
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and Medicine, University of Science and Technology of China230601AnhuiHefeiChina
| | - Chen Gan
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Jian Xu
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Huaidong Cheng
- Department of OncologyThe Second Hospital of Anhui Medical UniversityHefeiChina
- Shenzhen Clinical Medical School of Southern Medical University.ShenzhenChina
- Department of OncologyShenzhen Hospital of Southern Medical University518000GuangdongShenzhenChina
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Ng B, Puspitaningtyas H, Wiranata JA, Hutajulu SH, Widodo I, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Breast cancer incidence in Yogyakarta, Indonesia from 2008-2019: A cross-sectional study using trend analysis and geographical information system. PLoS One 2023; 18:e0288073. [PMID: 37406000 DOI: 10.1371/journal.pone.0288073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Breast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia. METHODS The study used breast cancer case data from the Yogyakarta Population-Based Cancer Registry (PBCR) from 2008 to 2019. The catchment areas of the PBCR included the 48 subdistricts of 3 districts (Sleman, Yogyakarta City, and Bantul). Age-standardized incidence rates (ASR) were calculated for each subdistrict. Joinpoint regression was used to detect any significant changes in trends over time. Global Moran's and Local Indicators of Spatial Association (LISA) analyses were performed to identify any spatial clusters or outliers. RESULTS The subdistricts had a median ASR of 41.9, with a range of 15.3-70.4. The majority of cases were diagnosed at a late stage, with Yogyakarta City having the highest proportion of diagnoses at stage 4. The study observed a significant increasing trend in breast cancer incidence over the study period the fastest of which is in Yogyakarta City with an average annual percentage change of 18.77%, with Sleman having an 18.21% and Bantul having 8.94% average changes each year (p <0.05). We also found a significant positive spatial autocorrelation of breast cancer incidence rates in the province (I = 0.581, p <0.001). LISA analysis identified 11 subdistricts which were high-high clusters in the central area of Yogyakarta City and six low-low clusters in the southeast region of the catchment area in the Bantul and Sleman Districts. No spatial outliers were identified. CONCLUSIONS We found significant spatial clustering of BC ASR in the Yogyakarta Province, and there was a trend of increasing ASR across the region. These findings can inform resource allocation for public health efforts to high-risk areas and develop targeted prevention and early detection strategies. Further res is needed to understand the factors driving the observed temporal and spatial patterns of breast cancer incidence in Yogyakarta Province, Indonesia.
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Affiliation(s)
- Bryant Ng
- Faculty of Medicine, Medicine Study Program, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Herindita Puspitaningtyas
- Faculty of Medicine, Doctorate Program of Health and Medical Science, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Master Program in Clinical Epidemiology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Medical Oncology, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Irianiwati Widodo
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Tao L, Zhong T, Hu X, Fu L, Li J. Higher family and individual resilience and lower perceived stress alleviate psychological distress in female breast cancer survivors with fertility intention: a cross-sectional study. Support Care Cancer 2023; 31:408. [PMID: 37347320 DOI: 10.1007/s00520-023-07853-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE The aim of this study was to explore how family resilience and individual resilience reduce perceived stress and psychological distress in young female breast cancer survivors with fertility intention. METHODS From June 2020 to June 2021, female breast cancer survivors were selected from the cancer centers of 10 tertiary Level A general hospitals in five cities of Sichuan Province. The survivors completed the Chinese versions of the Family Resilience Assessment Scale, Connor-Davidson Resilience Scale, Perceived Stress Scale, and a self-report distress thermometer. A multiple mediation effects test and structural equation modeling were used to explore the relationships among family resilience, individual resilience, perceived stress, and psychological distress. RESULTS The direct effect of family resilience on perceived stress was β = -0.320 (95% confidence interval -0.365, -0.271, P < 0.01). The direct effect of family resilience on psychological distress was β = -0.263 (95% confidence interval -0.363, -0.153, P < 0.001). The direct effect of family resilience on individual resilience was β = 0.593 (95% confidence interval 0.542-0.640, P < 0.001). The indirect effect of family resilience on psychological distress was β = -0.322 (95% confidence interval -0.373, -0.274, P < 0.001). Both perceived stress and individual resilience mediated the relationship between family resilience and psychological distress. Furthermore, a partial mediating effect of perceived stress and individual resilience on family resilience and psychological distress was observed. CONCLUSION Young female breast cancer survivors in China experience moderate levels of psychological distress.
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Affiliation(s)
- Lin Tao
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Ting Zhong
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Xiaoxia Hu
- Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, Breast Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Lan Fu
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Junying Li
- Thoracic Oncology Ward, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
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Wang M, Xiong HP, Sheng K, Sun XB, Zhao XQ, Liu QR. Perioperative Administration of Pregabalin and Esketamine to Prevent Chronic Pain After Breast Cancer Surgery: A Randomized Controlled Trial. Drug Des Devel Ther 2023; 17:1699-1706. [PMID: 37313456 PMCID: PMC10259464 DOI: 10.2147/dddt.s413273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023] Open
Abstract
Background Perioperative multimodal analgesia can prevent chronic pain after breast cancer surgery. This study aimed to investigate the efficacy of combined perioperative oral pregabalin and postoperative esketamine in preventing chronic pain after breast cancer surgery. Methods Ninety patients undergoing elective breast cancer surgery were randomized into the combined pregabalin and esketamine group (EP group) and the general anesthesia alone group (Control group). The EP group received 150 mg of oral pregabalin 1 h before surgery and twice daily for seven days postoperatively, and a patient-controlled analgesia pump after surgery that delivered 100 μg sufentanil + 1.25 mg/kg esketamine + 4 mg tropisetron in 100 mL saline solution intravenously. The Control group received placebo capsules before and after the surgery and routine postoperative analgesia (100 μg sufentanil + 4 mg tropisetron in 100 mL saline solution). The primary outcome was the incidence of chronic pain three and six months after surgery. Secondary outcomes included acute postoperative pain, postoperative opioid consumption, and incidence of adverse events. Results The incidence of chronic pain in the EP group was significantly lower than in the Control group three (14.3% vs 46.3%, P = 0.005) and six (7.1% vs 31.7%, P = 0.009) months postoperatively. The rest numerical rating scale (NRS) pain scores 1-3 days postoperatively and coughing NRS pain scores 1-7 days postoperatively in the EP group were significantly lower than in the Control group (all P ˂ 0.05). The cumulative sufentanil consumption in the EP group during postoperative 0-12, 12-24, and 24-48, 0-24, and 0-48 hours were significantly lower than in the Control group (all P ˂ 0.05). Conclusion Combined perioperative oral pregabalin and postoperative esketamine effectively prevented chronic pain after breast cancer surgery, improved acute postoperative pain, and reduced postoperative opioid consumption.
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Affiliation(s)
- Miao Wang
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
| | - Hua-Ping Xiong
- Department of Anesthesiology, Wuxi Maternal and Child Health Hospital, Wuxi School of Medicine, Jiangnan University, Jiangsu, 214002, People’s Republic of China
| | - Kai Sheng
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
| | - Xing-Bing Sun
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
| | - Xiao-Qian Zhao
- Department of Breast Diseases, Wuxi Maternal and Child Health Hospital, Wuxi School of Medicine, Jiangnan University, Jiangsu, 214002, People’s Republic of China
| | - Qing-Ren Liu
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
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Mubarik S, Wang F, Nadeem AA, Fawad M, Yu C. Breast cancer epidemiology and sociodemographic differences in BRICS-plus countries from 1990 to 2019: An age period cohort analysis. SSM Popul Health 2023; 22:101418. [PMID: 37215157 PMCID: PMC10193025 DOI: 10.1016/j.ssmph.2023.101418] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Background Breast cancer (BC) is a major health concern in the BRICS-plus, a group of developing nations consisting of Brazil, Russia, India, China, South Africa, and 30 other Asian countries, with nearly half of the world's population. This study aims to identify potential risk factors contributing to the burden of BC by assessing its epidemiological and socio-demographic changes. Methods Data on BC outcomes were obtained from the 2019 Global Burden of Disease Survey. The age-period-cohort (APC) modeling technique was used to evaluate the nonlinear impacts of age, cohort, and period on BC outcomes and reported risk attributable mortality and disability adjusted life years (DALYs) rate changes between 1990 and 2019. Results In 2019, there were 0.90 million female BC cases and 0.35 million deaths in the BRICS-plus region, with China and India having the largest proportion of incident cases and deaths, followed by Pakistan. Lesotho experienced the highest annualized rates of change (AROC: 2.61%; 95%UI: 1.99-2.99) in the past three decades. Birth cohorts' impact on BC varies greatly between the BRICS-plus nations, with Pakistan suffering the largest risk increase in the most recent cohort. High body mass index (BMI), high fasting plasma glucose (FPG), and a diet high in red meat contributed to the highest death and DALYs rates in most BRICS-plus nations in 2019, and there was a strong negative link between SDI and death and DALYs rate. Conclusions The study found that the burden of BC varies significantly between BRICS-plus regions. Thus, BRICS-plus nations should prioritise BC prevention, raise public awareness, and implement screening efficiency measures to reduce the burden of BC in the future, as well as strengthen public health policies and initiatives for important populations based on their characteristics and adaptability.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Fang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Adeel Ahmad Nadeem
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, 430072, China
| | - Muhammad Fawad
- School of Public Health and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
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Long Y, Zhang W, Zheng M, Xie Q, Liu H, Hu X, Zhang X, Huang W, Gao X, Jiang C, Jiang C, Gao D, Deng J. Association between breast nodules, anxiety, depression and metabolic risk factors in a Chinese cohort. Front Psychiatry 2023; 14:944354. [PMID: 37275984 PMCID: PMC10232859 DOI: 10.3389/fpsyt.2023.944354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Background The relationship between anxiety, depression, and metabolic parameters and the incidence of breast nodules is unclear. This study aims to investigate the association between female breast nodules and anxiety, depression and metabolic factors. Methods This cross-sectional study recruited 857 individuals with biological indicators and breast ultrasound data from the Daping hospital from April 2021 to February 2022. Serum samples were used to measure fasting blood glucose, uric acid, triglycerides, total cholesterol, urea nitrogen, alanine transaminase, aspartate transaminase, albumin, high-density lipoprotein, low-density lipoprotein. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the level of anxiety and depression. Result The positive rate of breast nodules in women aged 40 to 49 years old was significantly higher than that of other age women. The proportion of participants aged 40-49 years old in the group with breast nodules was significantly higher than that in the group without breast nodules (34.6% vs. 16.9%, p<0.001). Breast nodules in postmenopausal women were significantly lower than those in premenopausal women (26.4% vs. 73.6%, p = 0.026). The SAS scores of women with breast nodules were higher than those of the no-nodules group (40.99 ± 8.45 vs. 38.94 ± 6.89, p<0.001), same as the SDS scores (41.97 ± 10.33 vs. 38.91 ± 7.60, p < 0.001). The number of women suffering from anxiety in the group of breast nodules was significantly higher than that in control (13.8% vs. 4.5%, p < 0.001), and the number of depression in the group of breast nodules was also significantly higher than that of in control (14.4% vs. 4.5%, p < 0.001). Women with breast nodules showed a slightly lower uric acid level than those without breast nodules (290.11 ± 65.32 vs. 301.43 ± 65.93 umol/L, p = 0.016). Multivariable logistic regression analysis showed that age, menopausal status, anxiety and depression status were significantly associated with the presence of breast nodules, but there was no significant difference in uric acid. Conclusion Our findings offer insight into the occurrence of depression and anxiety in the breast nodules of Chinese women. Anxiety and depression status, age and menopausal status may be the independent risk factors for the occurrence of breast nodules.
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Affiliation(s)
- Yan Long
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wei Zhang
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Maolan Zheng
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qian Xie
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - He Liu
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaotong Hu
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xuelan Zhang
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wei Huang
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xia Gao
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chunmao Jiang
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Can Jiang
- Department of Sleep and Psychology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dong Gao
- Department of Sleep and Psychology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Juan Deng
- Department of Health Management, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Geriatric Medicine, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Fan L, Sui XY, Jin X, Zhang WJ, Zhou P, Shao ZM. High expression of TLR3 in triple-negative breast cancer predicts better prognosis-data from the Fudan University Shanghai Cancer Center cohort and tissue microarrays. BMC Cancer 2023; 23:298. [PMID: 37005579 PMCID: PMC10067281 DOI: 10.1186/s12885-023-10721-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 03/08/2023] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION We have previously reported that Toll-like receptor 3 (TLR3) acts as a suppressor gene for breast cancer initiation and progression. In this study, we evaluated the role of TLR3 in breast cancer using our original Fudan University Shanghai Cancer Center (FUSCC) datasets and breast cancer tissue microarrays. METHODS Using FUSCC multiomics datasets on triple- negative breast cancer (TNBC), we compared the mRNA expression of TLR3 in TNBC tissue and the adjacent normal tissue. A Kaplan-Meier plotter was performed to investigate the expression of TLR3 on prognosis in the FUSCC TNBC cohort. We performed immunohistochemical staining to analyze TLR3 protein expression in the TNBC tissue microarrays. Furthermore, bioinformatics analysis was performed using the Cancer Genome Atlas (TCGA) data to verify the results of our FUSCC study. The relationship between TLR3 and clinicopathological features was analyzed with logistic regression and the Wilcoxon signed-rank test. The association between clinical characteristics and overall survival in TCGA patients was assessed using the Kaplan-Meier method and Cox regression analysis. Gene set enrichment analysis (GSEA) was performed to identify signaling pathways that are differentially activated in breast cancer. RESULTS The mRNA expression of TLR3 was lower in TNBC tissue than in the adjacent normal tissue in the FUSCC datasets. The TLR3 had high expression in immunomodulatory (IM) and mesenchymal-like (MES) subtypes and low expression in luminal androgen receptor (LAR) and basal-like immune-suppressed (BLIS) subtypes. High expression of TLR3 in TNBC predicted better prognosis in the FUSCC TNBC cohort. Immunohistochemical staining of the tissue microarrays showed that TLR3 had lower expression in breast cancer tissues than in the adject normal tissues. Furthermore, the TLR3 expression was positively associated with B cell, CD4 + T cells, CD8 + T cells, neutrophils, macrophages, and myeloid dendritic cells. Bioinformatic analysis using high-throughput RNA-sequencing data from the TCGA demonstrated that the reduced expression of TLR3 in breast cancer was associated with advanced clinicopathological characteristics, survival time, and poor prognosis. CONCLUSIONS TLR3 has low expression in TNBC tissue. High expression of TLR3 in triple-negative breast cancer predicts better prognosis. TLR3 expression may be a potential prognostic molecular marker of poor survival in breast cancer.
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Affiliation(s)
- Lei Fan
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xin-Yi Sui
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xi Jin
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wen-Juan Zhang
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Peng Zhou
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Parkway Health, Shanghai, China.
- Runshangshan Medical Center, Shanghai, China.
| | - Zhi-Ming Shao
- Department of Breast Surgery, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Zhang X, Gong N, Li N, Zhang Y, Du Q, Zou W, Chen J, Zheng J, Zhang M. Why breast cancer patients avoid communicating disease-related information to their dependent children: A qualitative study. J Clin Nurs 2023; 32:1230-1239. [PMID: 35403320 DOI: 10.1111/jocn.16281] [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: 10/27/2021] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES This qualitative study explores why breast cancer patients do not share disease-related information with their dependent children. BACKGROUND 'Open' communication between breast cancer patients and their children is beneficial to both. However, some still try to avoid discussing their diagnosis and related information with their children. Some worries lie in communicating with dependent children, but the underlying cause remains unclear. DESIGN Qualitative descriptive study. METHODS Semi-structured interview was used in this study. Twenty breast cancer patients with children (aged 8-18 years) were recruited at two urban tertiary hospitals in mainland China. Qualitative content analysis was conducted to analyse and identify themes and subthemes. This study followed the COREQ checklist for qualitative studies. RESULTS Three main themes were identified: (1) Uncertainty about the future: Their struggles with cancer remain a sensitive subject with their children. They described the uncertainty surrounding their disease prognosis and their children's response. They were also unsure whether, when and how to inform their children of their conditions; (2) Useless and risky for their children to know the truth: They considered it useless because their children can neither understand nor change the existing facts. They were concerned that it could affect their children's emotional state, character and academic performance; and (3) All for their children's sake: They were willing to take care of their affairs without troubling their dependent children as much as possible. CONCLUSION Most mothers delayed communicating disease-related information to their dependent children. However, they often underestimated children's abilities and ignored their thoughts and wishes. Motherhood leads to avoidance and concealment in discussing health issues with their children. RELEVANCE TO CLINICAL PRACTICE Mothers should try to understand their children's views towards cancer earlier. Healthcare professionals, especially nurses, should provide further consultation and intervention services to assist mothers and their children.
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Affiliation(s)
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, China
| | - Na Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Qianqian Du
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Wenjie Zou
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jing Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Junyi Zheng
- Office for Medical Development and Management, Xiamen University, Xiamen, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Huang C, Cai Y, Guo Y, Jia J, Shi T. Effect of a family-involvement combined aerobic and resistance exercise protocol on cancer-related fatigue in patients with breast cancer during postoperative chemotherapy: study protocol for a quasi-randomised controlled trial. BMJ Open 2023; 13:e064850. [PMID: 36997256 PMCID: PMC10069511 DOI: 10.1136/bmjopen-2022-064850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the most common and debilitating side effects experienced by patients with breast cancer (BC) during postoperative chemotherapy. Family-involvement combined aerobic and resistance exercise has been introduced as a promising non-pharmacological intervention for CRF symptom relief and improving patients' muscle strength, exercise completion, family intimacy and adaptability and quality of life. However, evidence for the practice of home participation in combined aerobic and resistance exercise for the management of CRF in patients with BC is lacking. METHODS AND ANALYSIS We present a protocol for a quasi-randomised controlled trial involving an 8-week intervention. Seventy patients with BC will be recruited from a tertiary care centre in China. Participants from the first oncology department will be assigned to the family-involvement combined aerobic and resistance exercise group (n=28), while participants from the second oncology department will be assigned to the control group that will receive standard exercise guidance (n=28). The primary outcome will be the Piper Fatigue Scale-Revised (R-PFS) score. The secondary outcomes will include muscle strength, exercise completion, family intimacy and adaptability and quality of life, which will be evaluated by the stand-up and sit-down chair test, grip test, exercise completion rate, Family Adaptability and Cohesion Scale, Second Edition-Chinese Version (FACESⅡ-CV) and Functional Assessment of Cancer Therapy -Breast (FACT-B) scale. Analysis of covariance will be applied for comparisons between groups, and paired t-tests will be used for comparison of data before and after exercise within a group. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (PJ-KS-KY-2021-288). The results of this study will be published via peer-reviewed publications and presentations at conferences. TRAIL REGISTRATION NUMBER ChiCTR2200055793.
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Affiliation(s)
- Chuhan Huang
- Department of Nursing, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yingjie Cai
- Department of Nursing, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yufei Guo
- Department of Nursing, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jingjing Jia
- Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Tieying Shi
- Department of Nursing, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Gao S, Zhang W, Ma J, Ni X. PHF6 recruits BPTF to promote HIF-dependent pathway and progression in YAP-high breast cancer. J Transl Med 2023; 21:220. [PMID: 36967443 PMCID: PMC10040131 DOI: 10.1186/s12967-023-04031-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 03/01/2023] [Indexed: 03/27/2023] Open
Abstract
Background Aberrant epigenetic remodeling events contribute to progression and metastasis of breast cancer (Bca). The specific mechanims that epigenetic factors rely on to mediate tumor aggressiveness remain unclear. We aimed to elucidate the roles of epigenetic protein PHF6 in breast tumorigenesis. Methods Published datasets and tissue samples with PHF6 staining were used to investigate the clinical relevance of PHF6 in Bca. CCK-8, clony formation assays were used to assess cell growth capacity. Cell migration and invasion abilities were measured by Transwell assay. The gene mRNA and protein levels were measured by quantitative real-time PCR and western blot. Chromatin immunoprecipitation (ChIP)-qPCR assays were used to investigate transcriptional relationships among genes. The Co-immunoprecipitation (Co-IP) assay was used to validate interactions between proteins. The CRISPR/Cas9 editing technology was used to construct double HIF knockout (HIF-DKO) cells. The subcutaneous xenograft model and orthotopic implantation tumor model were used to asess in vivo tumor growth. Results In this study, we utilized MTT assay to screen that PHF6 is required for Bca growth. PHF6 promotes Bca proliferation and migration. By analyzing The Cancer Genome Atlas breast cancer (TCGA-Bca) cohort, we found that PHF6 was significantly higher in tumor versus normal tissues. Mechanistically, PHF6 physically interacts with HIF-1α and HIF-2α to potentiate HIF-driven transcriptional events to initiate breast tumorigenesis. HIF-DKO abolished PHF6-mediated breast tumor growth, and PHF6 deficiency in turn impaired HIF transcriptional effects. Besides, hypoxia could also rely on YAP activation, but not HIF, to sustain PHF6 expressions in Bca cells. In addition, PHF6 recuits BPTF to mediate epigenetic remodeling to augment HIF transcriptional activity. Targeting PHF6 or BPTF inhibitor (AU1) is effective in mice models. Lastly, PHF6 correlated with HIF target gene expression in human breast tumors, which is an independent prognostic regulator. Conclusions Collectively, this study identified PHF6 as a prognostic epigenetic regulator for Bca, functioning as a HIF coactivator. The fundamental mechanisms underlying YAP/PHF6/HIF axis in breast tumors endowed novel epigenegtic targets for Bca treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-023-04031-8.
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Affiliation(s)
- Sheng Gao
- grid.459791.70000 0004 1757 7869Department of Breast, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004 China
| | - Wensheng Zhang
- grid.8547.e0000 0001 0125 2443State Key Laboratory of Genetic Engineering, MOE Engineering Research Center of Gene Technology, Key Laboratory of Reproduction Regulation of NPFPC and Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai, 200438 China
| | - Jingjing Ma
- grid.412676.00000 0004 1799 0784Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210004 China
| | - Xiaojian Ni
- grid.413087.90000 0004 1755 3939Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032 China
- grid.413087.90000 0004 1755 3939Cancer Center, ZhongShan Hospital, Fudan University, Shanghai, 200032 China
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Cai T, Zhou T, Huang Q, Wu F, Ni F, Yuan C. Cancer-related symptoms among young and middle-aged women undergoing chemotherapy for breast cancer: Application of latent class analysis and network analysis. Eur J Oncol Nurs 2023; 63:102287. [PMID: 36889245 DOI: 10.1016/j.ejon.2023.102287] [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: 11/06/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To identify subgroups and symptom networks of cancer-related symptoms for women under 60 years who are undergoing chemotherapy for breast cancer. METHODS A cross-sectional survey in Mainland China was conducted between August 2020 and November 2021. Participants completed questionnaires that collected demographic and clinical characteristics and featured the PROMIS-57 and the PROMIS-Cognitive Function Short Form. RESULTS A total of 1033 participants were included in the analysis, and three-class model was identified: "severe symptom group" (17.6%; Class 1), "moderately severe anxiety, depression, and pain-interference group" (38.0%; Class 2), and "mild symptom group" (44.4%; Class 3). Patients who were in menopause (OR = 3.05, P < .001), undergoing a combination of medical treatments (OR = 2.39, P = .003), and who had experienced complications (OR = 1.86, P = .009) were more likely to belong to Class 1. However, having two or more children increased the likelihood of belonging to Class 2. Additionally, network analysis showed that severe fatigue level was the core symptom among the full sample. As for Class 1, feeling helpless and severe fatigue level were the core symptoms. Regarding Class 2, the impact of pain interfere on the ability to participate in social activities and feeling hopeless were found to be the targeted symptoms for intervention. CONCLUSION Menopause, receiving a combination of medical treatments, and experiencing complications characterize the group with the most symptom disturbance. Moreover, different interventions should be performed for core symptoms in patients with varied symptom disturbances.
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Affiliation(s)
- Tingting Cai
- Fudan University, School of Nursing, Shanghai, China
| | - Tingting Zhou
- Fudan University, School of Nursing, Shanghai, China
| | - Qingmei Huang
- Fudan University, School of Nursing, Shanghai, China
| | - Fulei Wu
- Fudan University, School of Nursing, Shanghai, China
| | - Feixia Ni
- Fudan University, School of Nursing, Shanghai, China
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Combination Analysis of Ferroptosis and Immune Status Predicts Patients Survival in Breast Invasive Ductal Carcinoma. Biomolecules 2023; 13:biom13010147. [PMID: 36671532 PMCID: PMC9855618 DOI: 10.3390/biom13010147] [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: 11/15/2022] [Revised: 01/01/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Ferroptosis is a new form of iron-dependent cell death and plays an important role during the occurrence and development of various tumors. Increasingly, evidence shows a convincing interaction between ferroptosis and tumor immunity, which affects cancer patients' prognoses. These two processes cooperatively regulate different developmental stages of tumors and could be considered important tumor therapeutic targets. However, reliable prognostic markers screened based on the combination of ferroptosis and tumor immune status have not been well characterized. Here, we chose the ssGSEA and ESTIMATE algorithms to evaluate the ferroptosis and immune status of a TCGA breast invasive ductal carcinoma (IDC) cohort, which revealed their correlation characteristics as well as patients' prognoses. The WGCNA algorithm was used to identify genes related to both ferroptosis and immunity. Univariate COX, LASSO regression, and multivariate Cox regression models were used to screen prognostic-related genes and construct prognostic risk models. Based on the ferroptosis and immune scores, the cohort was divided into three groups: a high-ferroptosis/low-immune group, a low-ferroptosis/high-immune group, and a mixed group. These three groups exhibited distinctive survival characteristics, as well as unique clinical phenotypes, immune characteristics, and activated signaling pathways. Among them, low-ferroptosis and high-immune statuses were favorable factors for the survival rates of patients. A total of 34 differentially expressed genes related to ferroptosis-immunity were identified among the three groups. After univariate, Lasso regression, and multivariate stepwise screening, two key prognostic genes (GNAI2, PSME1) were identified. Meanwhile, a risk prognosis model was constructed, which can predict the overall survival rate in the validation set. Lastly, we verified the importance of model genes in three independent GEO cohorts. In short, we constructed a prognostic model that assists in patient risk stratification based on ferroptosis-immune-related genes in IDC. This model helps assess patients' prognoses and guide individualized treatment, which also further eelucidatesthe molecular mechanisms of IDC.
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Zhou Z, Zhang Y, Li Y, Jiang C, Wu Y, Shang L, Huang Y, Cheng S. Metabolic syndrome is a risk factor for breast cancer patients receiving neoadjuvant chemotherapy: A case-control study. Front Oncol 2023; 12:1080054. [PMID: 36686748 PMCID: PMC9845900 DOI: 10.3389/fonc.2022.1080054] [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: 10/25/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Purpose To investigate the impact of metabolic syndrome (MetS) on pathologic complete response (pCR) and clinical outcomes in breast cancer (BC) patients who received neoadjuvant chemotherapy (NAC). Methods We analyzed 221 female BC patients at Harbin Medical University Cancer Hospital who received NAC and divided them into MetS and non-MetS groups according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria to investigate the association between MetS and clinicopathological characteristics, pathologic response, and long-term survival and to observe the changes in metabolic parameters after NAC. Results A total of 53 (24.0%) BC patients achieved pCR after NAC in our study. MetS status was an independent predictor of pCR, and pCR was more difficult to obtain in the MetS group than the non-MetS group (P=0.028). All metabolic parameters deteriorated significantly after NAC, especially the blood lipid index (P<0.010). The median follow-up time was 6 years. After adjusting for other prognostic factors, MetS was found to be strongly associated with an increased risk of recurrence (P=0.007) and mortality (P=0.004) in BC patients receiving NAC. Compared to individuals without any MetS component, the risk of death and disease progression increased sharply as the number of MetS components increased. Conclusions In BC patients who received NAC, MetS was associated with poor outcomes, including a lower pCR rate and increased risks of recurrence and mortality.
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Affiliation(s)
- Zhaoyue Zhou
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yue Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yue Li
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Cong Jiang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yang Wu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lingmin Shang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuanxi Huang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China,*Correspondence: Shaoqiang Cheng, ; Yuanxi Huang,
| | - Shaoqiang Cheng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China,*Correspondence: Shaoqiang Cheng, ; Yuanxi Huang,
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Li GQ, Xie SJ, Wu SG, He ZY. Impact of the 21-gene expression assay on treatment decisions and clinical outcomes in breast cancer with one to three positive lymph nodes. Front Endocrinol (Lausanne) 2023; 14:1103949. [PMID: 36875478 PMCID: PMC9980792 DOI: 10.3389/fendo.2023.1103949] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND To assess the practice patterns of the recurrence score (RS) based on the 21-gene expression assay on adjuvant chemotherapy recommendations and survival outcomes in estrogen receptor-positive (ER+)/HER2- breast cancer (BC) with one to three positive lymph nodes (N1). METHODS We included patients with T1-2N1M0 and ER+/HER2- BC diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results Oncotype DX Database. Breast cancer-specific survival (BCSS) and overall survival (OS) were assessed. RESULTS We included 35,137 patients in this study. There were 21.2% of patients who had RS testing in 2010, which was significantly increased to 36.8% in 2015 (P < 0.001). Performance of the 21-gene testing was associated with older age, lower tumor grade, T1 stage, lower number of positive lymph nodes, and progesterone receptor-positive disease (all P < 0.05). In those without 21-gene testing, age was the main factor significantly related to the receipt of chemotherapy, whereas RS was the main factor significantly related to chemotherapy receipt in those with 21-gene testing. The probability of chemotherapy receipt in those without 21-gene testing was 64.1% and was decreased to 30.8% in those with 21-gene testing. On multivariate prognostic analysis, the performance of 21-gene testing was associated with better BCSS (P < 0.001) and OS (P < 0.001) compared with those without 21-gene testing. Similar results were found after propensity score matching. CONCLUSIONS The 21-gene expression assay is frequently and increasingly used for chemotherapy decision-making in ER+/HER2- BC with N1 disease. Performance of the 21-gene testing is associated with improved survival outcomes. Our study supports the routine use of 21-gene testing in the clinical practice of this population.
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Affiliation(s)
- Guan-Qiao Li
- Department of Breast Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Shang-Jin Xie
- Department of General Surgery, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- *Correspondence: San-Gang Wu, ; Zhen-Yu He,
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
- *Correspondence: San-Gang Wu, ; Zhen-Yu He,
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Yu M, Xu L, Lei B, Sun S, Yang Y. Tetrachlorobisphenol A and bisphenol AF induced cell migration by activating PI3K/Akt signaling pathway via G protein-coupled estrogen receptor 1 in SK-BR-3 cells. ENVIRONMENTAL TOXICOLOGY 2023; 38:126-135. [PMID: 36190352 DOI: 10.1002/tox.23669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Different subtypes of breast cancer express positively G protein-coupled estrogen receptor 1 (GPER1). Our previous studies found that tetrachlorobisphenol A (TCBPA) and bisphenol AF (BPAF) significantly promoted SK-BR-3 cell proliferation by activating GPER1-regulated signals. The present study further investigated the effects of TCBPA and BPAF on the migration of SK-BR-3 cells and examined the role of phosphatidylinositol 3-kinase-protein kinase B (PI3K/Akt) and its downstream signal targets in this process. We found that low-concentration BPAF and TCBPA markedly accelerated the migration of SK-BR-3 cells and elevated the mRNA levels of target genes associated with PI3K/Akt and mitogen-activated protein kinase (MAPK) signals. TCBPA- and BPAF-induced upregulation of target genes was significantly reduced by GPER1 inhibitor G15, the PI3K/Akt inhibitor wortmannin (WM), and the epidermal growth factor receptor (EGFR) inhibitor ZD1839 (ZD). G15 and WM also decreased cell migration induced by TCBPA and BPAF. The findings revealed that TCBPA and BPAF promoted SK-BR-3 cell migration ability by activating PI3K/Akt signaling pathway via GPER1-EGFR.
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Affiliation(s)
- Mengjie Yu
- Institute of Environmental Pollution and Health, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, People's Republic of China
| | - Lanbing Xu
- Institute of Environmental Pollution and Health, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, People's Republic of China
| | - Bingli Lei
- Institute of Environmental Pollution and Health, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, People's Republic of China
| | - Su Sun
- Institute of Environmental Pollution and Health, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, People's Republic of China
| | - Yingxin Yang
- Institute of Environmental Pollution and Health, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, People's Republic of China
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Yi C, Wu S, Duan Q, Liu L, Li L, Luo Y, Wang A. Ferroptosis-dependent breast cancer cell-derived exosomes inhibit migration and invasion of breast cancer cells by suppressing M2 macrophage polarization. PeerJ 2023; 11:e15060. [PMID: 36949762 PMCID: PMC10026718 DOI: 10.7717/peerj.15060] [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: 08/02/2022] [Accepted: 02/22/2023] [Indexed: 03/19/2023] Open
Abstract
Aim Ferroptosis, a novel type of iron-dependent cell death, plays a vital role in breast cancer progression. However, the function of ferroptosis-induced cancer cell-derived exosomes in breast cancer remains unclear. In this study, we attempted to investigate the impact of breast cancer cells-derived exosomes induced by ferroptosis on the polarization of macrophages and the progression of breast cancer. Methods Erastin was used to induce ferroptosis and breast cancer cell-derived exosomes were identified by transmission electron microscopy. Western blot, quantitative reverse transcription PCR, immunofluorescence, flow cytometry, and ELISA were used to determine the role of exosomes in macrophage polarization. Transwell assays were used to detect breast cancer cell migration, and invasion. Results Our results showed that erastin promoted ferroptosis in breast cancer cells with increased Fe2+ level and ROS production. Breast cancer cell-derived exosomes induced by ferroptosis were successfully isolated and verified to be internalized by macrophages. In addition, ferroptosis-induced breast cancer cell-derived exosomes (Fe-exo) remarkably diminished M2 marker, Arg-1 expression. The ratio of CD206+ macrophages was significantly decreased after Fe-exo treatment. CD206 protein expression and Arg-1 level were dramatically reduced in M2 macrophages incubated by Fe-exo. Moreover, autophagy PCR array showed that the expression of 84 autophagy-related genes were altered after macrophages were incubated by Fe-exo. Furthermore, macrophages incubated by Fe-exo repressed the migration and invasion of breast cancer cells. Conclusion Ferroptosis-dependent cancer cell-derived exosomes inhibited M2 polarization of macrophages, which in turn inhibited migration and invasion of breast cancer cells. This study provides novel therapeutic strategies for patients with breast cancer.
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Affiliation(s)
- Chenghao Yi
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Shilong Wu
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Qianyu Duan
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Lei Liu
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Li Li
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Yonghui Luo
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
| | - Anan Wang
- Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, The People’s Republic of China
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Li Y, Chen H, He J, Fan Z, Zhang H. The outcome of neoadjuvant chemotherapy and the current trend of surgical treatment in young women with breast cancer: A multicenter real-world study (CSBrS-012). Front Public Health 2023; 11:1100421. [PMID: 36895689 PMCID: PMC9988895 DOI: 10.3389/fpubh.2023.1100421] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/01/2023] [Indexed: 02/23/2023] Open
Abstract
Background and objectives The relationship between age and the outcome of breast cancer neoadjuvant chemotherapy (NAC) remains controversial, and little is known about the choice of surgical treatment for young patients. In this multicenter real-world study, we sought to analyze the outcome of NAC as well as the current status and trend of surgical decision-making after NAC in young breast cancer patients. Methods The medical records of patients from 20 hospitals in different regions of China were collected retrospectively. The study population included females diagnosed with cT1-4N0-3M0 breast cancer who received NAC from January 2010 to December 2020. Results A total of 9,643 eligible patients were included, 1,945 (20.2%) of whom were ≤40 years old. Young patients tend to have a higher tumor stage and a higher proportion of Luminal B and triple-negative breast cancer (TNBC) tumors compared with the >40-year-old group. The breast pathological complete response (pCR) rate in the young group was 20.3%, and Luminal B tumor was more likely to obtain pCR in young patients. The implementation rate of breast-conserving surgery (BCS) and breast reconstruction surgery was higher in young patients and tended to increase over time. In different regions of China, there were great differences in the choice of surgical treatment after NAC among young patients. Conclusion Breast cancer in young women has unique clinical characteristics, but age does not affect the overall pCR rate. In China, the BCS rate after NAC is increasing over time but is still at a low level.
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Affiliation(s)
- Yijun Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Heyan Chen
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jianjun He
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhimin Fan
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Identification and validation of DNA methylation markers to predict axillary lymph node metastasis of breast cancer. PLoS One 2022; 17:e0278270. [PMID: 36454866 PMCID: PMC9714834 DOI: 10.1371/journal.pone.0278270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/12/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Axillary lymph node metastasis (ALNM) is one of the most important prognostic factors for breast cancer patients, and DNA methylation is involved in ALNM of breast cancer. However, the methylation profile of breast cancer ALNM remains unknown. METHODS Breast cancer tissues were collected from patients with and without ALNM. We investigated the genome-wide DNA methylation profile in breast cancer with and without ALNM using reduced representation bisulfite sequencing (RRBS). Then, differentially methylated regions (DMRs) were verified by targeted bisulfite sequencing. RESULTS A total of 21491 DMRs were identified between the lymph node positive group and negative group. Compared to the LN-negative breast cancer, LN-positive breast cancer had 10,920 hypermethylated DMRs and 10,571 hypomethylated DMRs. Then, 10 DMRs in the gene promoter region were detected by targeted bisulfite sequencing, these gene included HOXA5, PTOV1-AS1, RHOF, PAX6, GSTP1, RASGRF2, AKR1B1, BNIP3, CRMP1, ING5. Compared with negative lymph node, the promoter methylation levels of RASGRF2, AKR1B1 and CRMP1 increased in positive lymph node, while the promoter methylation level of RHOF decreased in positive lymph node. In addition, Cancer Genome Atlas (TCGA) data showed that RASGRF2, AKR1B1 and CRMP1 were low expressed in breast Cancer tissues, while RHOF was high expressed in breast Cancer tissues. Furthermore, in addition to highly methylated AKR1B1, RASGRF2 and CRMP1 gene promoters, BNIP3, GSTP1, HOXA5 and PAX6 gene promoters were also methylated in ER-positive and HER2-negative breast cancer with ALNM. CONCLUSIONS When compared to negative lymph node breast cancer, the positive lymph node breast cancer has a differential methylation status. Promoter methylation of RASGRF2, AKR1B1, CRMP1 and RHOF in lymph node positive breast cancer tissues was significantly different from that in lymph node negative breast cancer tissues. AKR1B1, RASGRF2, CRMP1, BNIP3, GSTP1, HOXA5 and PAX6 genes were methylated in ER-positive and HER2-negative breast cancer with ALNM. The study provides an important biological base for understanding breast cancer with ALNM and developing therapeutic targets for breast cancer with ALNM.
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Xie L, Zhang J, Yan H, Cai Y, Xu L. β-elemene induced apoptosis and senescence of triple-negative breast cancer cells through IGF1/IGF1R pathway. Tissue Cell 2022; 79:101914. [DOI: 10.1016/j.tice.2022.101914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/24/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
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Li T, Li J, Heard R, Gandomkar Z, Ren J, Dai M, Brennan P. Understanding mammographic breast density profile in China: A Sino-Australian comparative study of breast density using real-world data from cancer screening programs. Asia Pac J Clin Oncol 2022; 18:696-705. [PMID: 35238173 PMCID: PMC9790382 DOI: 10.1111/ajco.13763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/27/2022] [Indexed: 12/30/2022]
Abstract
AIM This study aims at understanding mammographic density profile in China by comparing the density between women in China and Australia. METHODS Data of 3250 women aged 45-69 were obtained from the Cancer Screening Program in Urban China and data of 1384 Australian counterparts at same age range were gathered from the Lifepool project. Demographic and reproductive details and mammograms for each cohort were collected. Mammographic density was assessed using AutoDensity, and two metrics, percentage density (PD) and dense area (DA), were applied. T-tests were used to compare the means of mammographic density between two populations of all, premenopausal, and postmenopausal women. Two-way ANOVA was conducted to examine interactions of population (Chinese/Australian) and each variable of interest upon mammographic density. RESULTS Chinese women had 9.61%, 8.20%, and 9.28% higher PD than their Australian counterparts in all, premenopausal, and postmenopausal women, respectively (all p < 0.001). The mean differences in DA between two population were 1.81 cm2 (p < 0.001), 0.55 cm2 (p = 0.472), and 1.76 cm2 (p = 0.003) for all, premenopausal, and postmenopausal women, respectively. There were significant interactions between population and age (F[4, 4624] = 4.12, p = 0.003), BMI (F[2, 4628] = 3.92, p = 0.020), age at first birth (F[1, 4250] = 11.69, p < 0.001), breastfeeding history (F[1, 4479] = 17.79, p < 0.001), and breastfeeding duration (F[1, 3526] = 66.90, p < 0.001) upon PD. Interaction was only found for breastfeeding history (F[1, 4479] = 4.79, p = 0.029) and breastfeeding duration (F[1, 3526] = 17.72, p < 0.001) for DA. CONCLUSIONS Both PD and DA were found to be higher in Chinese women compared to Australian women. The density difference by menopause status was shown and breastfeeding history affected breast density differently in both populations.
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Affiliation(s)
- Tong Li
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Jing Li
- Department of Diagnostic RadiologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Rob Heard
- School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Ziba Gandomkar
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Jiansong Ren
- Office of Cancer ScreeningNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Min Dai
- Office of Cancer ScreeningNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Patrick Brennan
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
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Peng Y, Huang X, Wang H. lncRNA ACTA2-AS1 predicts malignancy and poor prognosis of triple-negative breast cancer and regulates tumor progression via modulating miR-532-5p. BMC Mol Cell Biol 2022; 23:34. [PMID: 35896973 PMCID: PMC9327331 DOI: 10.1186/s12860-022-00432-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/13/2022] [Indexed: 11/22/2022] Open
Abstract
Background Dysregulation of ACTA2-AS1 and miR-532-5p and their functions in various cancers have been widely reported. Their potential of serving as biomarkers in triple-negative breast cancer (TNBC) remains unknown. This study aimed to evaluate the function of ACTA2-AS1 and miR-532-5p and their potential of serving as biomarkers in TNBC. Results The TNBC tissues were collected from 119 patients, where the reduced level of ACTA2-AS1 and increased level of miR-532-5p were observed by PCR and showed a significantly negative correlation (P < 0.001). Both ACTA2-AS1 and miR-532-5p were closely associated with the malignant development and poor prognosis of TNBC patients. Moreover, in TNBC cell, overexpressing ACTA2-AS1 was found to suppress cell proliferation and metastasis, which was reversed by the upregulation of miR-532-5p. Conclusions ACTA2-AS1 and miR-532-5p could act as biomarkers of TNBC predicting the progression and prognosis of patients. ACTA2-AS1 served as a tumor suppressor of TNBC which was mediated by miR-532-5p. Supplementary Information The online version contains supplementary material available at 10.1186/s12860-022-00432-7.
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Pan L, Huang Z, Zhan Q, Zhang X, Tang W, Zheng W. Long term effect of INTRABEAM single irradiation on the expression of miRNAs inMCF-7 cells. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.100464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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