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Jin Y, Fan Z. New insights into the interaction between m6A modification and lncRNA in cancer drug resistance. Cell Prolif 2024; 57:e13578. [PMID: 37961996 PMCID: PMC10984110 DOI: 10.1111/cpr.13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Drug resistance is perhaps the greatest obstacle in improving outcomes for cancer patients, leading to recurrence, progression and metastasis of various cancers. Exploring the underlying mechanism worth further study. N6-methyladenosine (m6A) is the most common RNA modification found in eukaryotes, playing a vital role in RNA translation, transportation, stability, degradation, splicing and processing. Long noncoding RNA (lncRNA) refers to a group of transcripts that are longer than 200 nucleotides (nt) and typically lack the ability to code for proteins. LncRNA has been identified to play a significant role in regulating multiple aspects of tumour development and progression, including proliferation, metastasis, metabolism, and resistance to treatment. In recent years, a growing body of evidence has emerged, highlighting the crucial role of the interplay between m6A modification and lncRNA in determining the sensitivity of cancer cells to chemotherapeutic agents. In this review, we focus on the recent advancements in the interaction between m6A modification and lncRNA in the modulation of cancer drug resistance. Additionally, we aim to explore the underlying mechanisms involved in this process. The objective of this review is to provide valuable insights and suggest potential future directions for the reversal of chemoresistance in cancer.
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Affiliation(s)
- Yizhou Jin
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of StomatologyCapital Medical UniversityBeijingChina
| | - Zhipeng Fan
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of StomatologyCapital Medical UniversityBeijingChina
- Beijing Laboratory of Oral HealthCapital Medical UniversityBeijingChina
- Research Unit of Tooth Development and RegenerationChinese Academy of Medical SciencesBeijingChina
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2
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Viñolas N, Mezquita L, Corral J, Cobo M, Gil-Moncayo F, Paz-Ares L, Remon J, Rodríguez M, Ruano-Raviña A, Conde E, Majem M, Garrido P, Felip E, Isla D, de Castro J. The role of sex and gender in the diagnosis and treatment of lung cancer: the 6th ICAPEM Annual Symposium. Clin Transl Oncol 2024; 26:352-362. [PMID: 37490262 DOI: 10.1007/s12094-023-03262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023]
Abstract
The incidence and mortality of lung cancer in women are rising, with both increasing by 124% between 2003 and 2019. The main risk factor for lung cancer is tobacco use, but indoor radon gas exposure is one of the leading causes in nonsmokers. The most recent evidence demonstrates that multiple factors can make women more susceptible to harm from these risk factors or carcinogens. For this consensus statement, the Association for Lung Cancer Research in Women (ICAPEM) invited a group of lung cancer experts to perform a detailed gender-based analysis of lung cancer. Clinically, female patients have different lung cancer profiles, and most actionable driver alterations are more prevalent in women, particularly in never-smokers. Additionally, the impact of certain therapies seems to be different. In the future, it will be necessary to carry out specific studies to improve the understanding of the role of certain biomarkers and gender in the prognosis and evolution of lung cancer.
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Affiliation(s)
- Nuria Viñolas
- Department of Medical Oncology, Barcelona Clinic Hospital, Translational Genomics and Targeted Therapies in Solid Tumours, IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
| | - Laura Mezquita
- Department of Medical Oncology, Barcelona Clinic Hospital, Translational Genomics and Targeted Therapies in Solid Tumours, IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - Jesús Corral
- Department of Medical Oncology, Jerez de la Frontera University Hospital, Cádiz, Spain
| | - Manuel Cobo
- Department of Medical Oncology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Francisco Gil-Moncayo
- Department of Psycho-Oncology, Catalan Institute of Oncology-Hospitalet, Barcelona, Spain
| | - Luis Paz-Ares
- Department of Medical Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - Jordi Remon
- Department of Medical Oncology, HM Nou Delfos Hospital, Barcelona, Spain
| | - María Rodríguez
- Department of Thoracic Surgery, Clínica Universidad de Navarra, Madrid, Spain
| | - Alberto Ruano-Raviña
- Department of Medicine and Public Health, Santiago de Compostela University, Santiago de Compostela, Spain
| | - Esther Conde
- Pathology Department, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (Imas12), CIBERONC, Madrid, Spain
| | - Margarita Majem
- Department of Medical Oncology, Santa Creu y Sant Pau University Hospital, Barcelona, Spain
| | - Pilar Garrido
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Enriqueta Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Dolores Isla
- Department of Medical Oncology, Lozano Blesa University Clinical Hospital, Saragossa, Spain
| | - Javier de Castro
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
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3
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Asogwa OA, Quansah DY, Boakye D, Ezewuiro ON, Boateng D. Prevalence, patterns, and determinants of multimorbidity among childhood and adult cancer survivors: A systematic review. Crit Rev Oncol Hematol 2023; 192:104147. [PMID: 37778707 DOI: 10.1016/j.critrevonc.2023.104147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023] Open
Abstract
Development of multimorbidity is common among cancer survivors due to their previous cancer, treatments, or changes in lifestyle. We summarized evidence on the prevalence, patterns, and determinants of multimorbidity among childhood and adult cancer survivors. We searched PubMed and EMBASE databases for articles reporting prevalence, patterns, and determinants of multimorbidity in cancer survivors. Finally, 23/500 articles were included. There was a large variation in the prevalence of multimorbidity (13-89%) among cancer survivors. Bone marrow transplantation, radiation, female sex, lower level of physical activity, increasing age, minority ethnicity, low-income, and low-education were associated with a higher prevalence of multimorbidity. Patterns of multimorbidity were both concordant and discordant. In conclusion, multimorbidity is highly prevalent and a major concern among cancer survivors. A personalized care plan that takes into account the identified risk may be beneficial to reduce the burden of multimorbidity and improve the quality of life among cancer survivors.
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Affiliation(s)
- Ogechukwu A Asogwa
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne Switzerland Avenue de la Sallaz, CH-1011 Lausanne, Switzerland; Canadian Women Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Daniel Boakye
- School of Health & Life Sciences, University of the West of Scotland, Glasgow PA1 2BE, UK
| | | | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mori M, Yokoyama A, Shichida A, Sasuga K, Maekawa T, Moriyama T. Impact of Sex and Age on mRNA COVID-19 Vaccine-Related Side Effects in Japan. Microbiol Spectr 2022; 10:e0130922. [PMID: 36314943 PMCID: PMC9769945 DOI: 10.1128/spectrum.01309-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/05/2022] [Indexed: 12/24/2022] Open
Abstract
mRNA COVID-19 vaccination was initiated worldwide in late 2020, and its efficacy has been well reported. However, studies about vaccine-related side effects are sparse. A total of 262 health care workers who received mRNA COVID-19 vaccine BNT162b2 were recruited, and their vaccine-related side effects were investigated. Impact of sex and age on the side effects was statistically analyzed. A higher number of vaccine-related side effects among females versus males was identified (median 3 versus 2, P < 0.05, after the first dose, and 5 versus 2.5, P < 0.01, after the second dose). General fatigue, headache, chills, and fever were the culprit adverse symptoms. In multivariate analysis, females had an increasing number of side effects after receiving their first (B = 0.7; 95% confidence interval [CI], 0.2 to 1.2) and second (B = 1.5; 95% CI, 0.7 to 2.2) vaccine doses compared to that of males. In age analysis, the older group (≥60 years old) had a lower number of side effects than the younger group (B = -0.5 with a 95% CI of -1.1 to -0.02 after the first vaccine dose, and B = -2.1 with a 95% CI of -2.9 to -1.2 after the second vaccine dose). Additionally, prolonged time to recovery was found among females (P = 0.003 after the first dose; P = 0.008 after the second dose). Specifically, symptoms of general fatigue, headache, itching, swelling at the injection site, and dizziness were the culprit symptoms affecting recovery time. Several cutaneous and membranous symptoms, including "COVID arm," were identified among females. These results highlight the impact of sex and age on side effects from mRNA COVID-19 vaccine and will aid in creating a safer vaccine. IMPORTANCE We demonstrate sex- and age-related impact on mRNA COVID-19 vaccine-related side effects, with a higher number and frequency of side effects and prolonged time to recovery in females compared to males and negative correlation between age and vaccine-related side effects. Identification of unique age- and sex-specific adverse symptoms will provide the opportunity to better understand the nature of sex- and age-associated immunological differences and develop safer and more efficacious vaccines.
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Affiliation(s)
- Masahiko Mori
- Department of Internal Medicine, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
| | - Aiko Yokoyama
- Regional Medical Cooperation Office, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
| | - Ayami Shichida
- Medical Administration Division, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
| | - Kimiko Sasuga
- Department of Medical Information, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
| | - Takafumi Maekawa
- Department of Surgery, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
- Department of Surgery, Fukuoka Central Hospital, Fukuoka, Fukuoka, Japan
| | - Tadayoshi Moriyama
- Department of Neurosurgery, Sasebo Memorial Hospital, Sasebo, Nagasaki, Japan
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Chen Z, Yi L, Peng Z, Zhou J, Zhang Z, Tao Y, Lin Z, He A, Jin M, Zuo M. Development and validation of a radiomic nomogram based on pretherapy dual-energy CT for distinguishing adenocarcinoma from squamous cell carcinoma of the lung. Front Oncol 2022; 12:949111. [PMID: 36505773 PMCID: PMC9727167 DOI: 10.3389/fonc.2022.949111] [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: 05/20/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Based on pretherapy dual-energy computed tomography (DECT) images, we developed and validated a nomogram combined with clinical parameters and radiomic features to predict the pathologic subtypes of non-small cell lung cancer (NSCLC) - adenocarcinoma (ADC) and squamous cell carcinoma (SCC). Methods A total of 129 pathologically confirmed NSCLC patients treated at the Second Affiliated Hospital of Nanchang University from October 2017 to October 2021 were retrospectively analyzed. Patients were randomly divided in a ratio of 7:3 (n=90) into training and validation cohorts (n=39). Patients' pretherapy clinical parameters were recorded. Radiomics features of the primary lesion were extracted from two sets of monoenergetic images (40 keV and 100 keV) in arterial phases (AP) and venous phases (VP). Features were selected successively through the intra-class correlation coefficient (ICC) and the least absolute shrinkage and selection operator (LASSO). Multivariate logistic regression analysis was then performed to establish predictive models. The prediction performance between models was evaluated and compared using the receiver operating characteristic (ROC) curve, DeLong test, and Akaike information criterion (AIC). A nomogram was developed based on the model with the best predictive performance to evaluate its calibration and clinical utility. Results A total of 87 ADC and 42 SCC patients were enrolled in this study. Among the five constructed models, the integrative model (AUC: Model 4 = 0.92, Model 5 = 0.93) combining clinical parameters and radiomic features had a higher AUC than the individual clinical models or radiomic models (AUC: Model 1 = 0.84, Model 2 = 0.79, Model 3 = 0.84). The combined clinical-venous phase radiomics model had the best predictive performance, goodness of fit, and parsimony; the area under the ROC curve (AUC) of the training and validation cohorts was 0.93 and 0.90, respectively, and the AIC value was 60.16. Then, this model was visualized as a nomogram. The calibration curves demonstrated it's good calibration, and decision curve analysis (DCA) proved its clinical utility. Conclusion The combined clinical-radiomics model based on pretherapy DECT showed good performance in distinguishing ADC and SCC of the lung. The nomogram constructed based on the best-performing combined clinical-venous phase radiomics model provides a relatively accurate, convenient and noninvasive method for predicting the pathological subtypes of ADC and SCC in NSCLC.
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Affiliation(s)
- Zhiyong Chen
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Yi
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhiwei Peng
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianzhong Zhou
- Department of Radiology, The Quzhou City People’s Hospital, Quzhou, Zhejiang, China
| | - Zhaotao Zhang
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yahong Tao
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ze Lin
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Anjing He
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mengni Jin
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Minjing Zuo
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China,*Correspondence: Minjing Zuo,
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Wang J, Liu J, Hou Q, Xu M. LINC02126 is a potential diagnostic, prognostic and immunotherapeutic target for lung adenocarcinoma. BMC Pulm Med 2022; 22:412. [DOI: 10.1186/s12890-022-02215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Adenocarcinoma has long been an independent histological class of lung cancer, which leads to high morbidity and mortality. We aimed to investigate the contribution of LINC02126 in lung adenocarcinoma.
Methods
RNA sequencing data and clinical information were downloaded. Diagnostic efficiency and survival analysis of LINC02126 were performed, followed by functional analysis of genes co-expressed with LINC02126 and differentially expressed genes (DEGs) in different LINC02126 expression groups. Tumor immune microenvironment (TIME) cell infiltration and correlation analysis of tumor mutation burden were performed in different LINC02126 expression groups.
Results
In lung adenocarcinoma, the expression level of LINC02126 was significantly decreased. Significant expression differences of LINC02126 were found in some clinical variables, including T staging, M staging, sex, stage, and EGFR mutation. LINC02126 had potential diagnostic and prognostic value for patients. In the low LINC02126 expression group, the infiltration degree of most immune cells was significantly lower than that in the high LINC02126 expression group. Tumor mutation burden level and frequency of somatic mutation in patients with low LINC02126 expression group were significantly higher than in patients with high LINC02126 expression group.
Conclusions
LINC02126 could be considered as a diagnostic, prognostic and immunotherapeutic target for lung adenocarcinoma.
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7
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He M, Slee EA, Sun M, Hu C, Chang WT, Xu G, Lu X, Wang M. Defect in Ser312 phosphorylation of Tp53 dysregulates lipid metabolism for fatty accumulation and fatty liver susceptibility: Revealed by lipidomics. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1211:123491. [DOI: 10.1016/j.jchromb.2022.123491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 08/20/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022]
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8
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Stabellini N, Bruno DS, Dmukauskas M, Barda AJ, Cao L, Shanahan J, Waite K, Montero AJ, Barnholtz-Sloan JS. Sex differences in lung cancer treatment and outcomes at a large hybrid academic-community practice. JTO Clin Res Rep 2022; 3:100307. [PMID: 35400080 PMCID: PMC8983352 DOI: 10.1016/j.jtocrr.2022.100307] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022] Open
Abstract
Introduction Methods Results Conclusions
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9
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Abstract
Lung cancer represents the world's leading cause of cancer deaths. Sex differences in the incidence and mortality rates for various types of lung cancers have been identified, but the biological and endocrine mechanisms implicated in these disparities have not yet been determined. While some cancers such as lung adenocarcinoma are more commonly found among women than men, others like squamous cell carcinoma display the opposite pattern or show no sex differences. Associations of tobacco product use rates, susceptibility to carcinogens, occupational exposures, and indoor and outdoor air pollution have also been linked to differential rates of lung cancer occurrence and mortality between sexes. While roles for sex hormones in other types of cancers affecting women or men have been identified and described, little is known about the influence of sex hormones in lung cancer. One potential mechanism identified to date is the synergism between estrogen and some tobacco compounds, and oncogene mutations, in inducing the expression of metabolic enzymes, leading to enhanced formation of reactive oxygen species and DNA adducts, and subsequent lung carcinogenesis. In this review, we present the literature available regarding sex differences in cancer rates, associations of male and female sex hormones with lung cancer, the influence of exogenous hormone therapy in women, and potential mechanisms mediated by male and female sex hormone receptors in lung carcinogenesis. The influence of biological sex on lung disease has recently been established, thus new research incorporating this variable will shed light on the mechanisms behind the observed disparities in lung cancer rates, and potentially lead to the development of new therapeutics to treat this devastating disease.
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Affiliation(s)
- Nathalie Fuentes
- National Institute of Allergy and Infectious Diseases, Bethesda, MD 20852, USA
| | - Miguel Silva Rodriguez
- Department of Environmental and Occupational Health, Indiana University, School of Public Health, Bloomington, IN 47405, USA
| | - Patricia Silveyra
- Department of Environmental and Occupational Health, Indiana University, School of Public Health, Bloomington, IN 47405, USA
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10
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Baiu I, Titan AL, Martin LW, Wolf A, Backhus L. The role of gender in non-small cell lung cancer: a narrative review. J Thorac Dis 2021; 13:3816-3826. [PMID: 34277072 PMCID: PMC8264700 DOI: 10.21037/jtd-20-3128] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/12/2021] [Indexed: 12/24/2022]
Abstract
The role of gender in the development, treatment and prognosis of thoracic malignancies has been underappreciated and understudied. While most research has been grounded in tobacco-related malignancies, the incidence of non-smoking related lung cancer is on the rise and disproportionately affecting women. Recent research studies have unveiled critical differences between men and women with regard to risk factors, timeliness of diagnosis, incongruent screening practices, molecular and genetic mechanisms, as well as response to treatment and survival. These studies also highlight the increasingly recognized need for targeted therapies that account for variations in the response and complications as a function of gender. Similarly, screening recommendations continue to evolve as the role of gender is starting to be ellucidated. As women have been underrepresented in clinical trials until recently, the data regarding optimal care and outcomes is still lagging behind. Understanding the underlying similarities and differences between men and women is paramount to providing adequate care and prognostication to patients of either gender. This review provides an overview of the critical role that gender plays in the care of patients with non-small cell lung cancer and other thoracic malignancies, with an emphasis on the need for increased awareness and further research to continue elucidating these disparities.
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Affiliation(s)
- Ioana Baiu
- Department of Surgery, Stanford University Hospital, Stanford, CA, USA
| | - Ashley L Titan
- Department of Surgery, Stanford University Hospital, Stanford, CA, USA
| | - Linda W Martin
- Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Andrea Wolf
- Department of Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Leah Backhus
- Department of Surgery, Stanford University Hospital, Stanford, CA, USA
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Reyes-García J, Montaño LM, Carbajal-García A, Wang YX. Sex Hormones and Lung Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1304:259-321. [PMID: 34019274 DOI: 10.1007/978-3-030-68748-9_15] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inflammation is a characteristic marker in numerous lung disorders. Several immune cells, such as macrophages, dendritic cells, eosinophils, as well as T and B lymphocytes, synthetize and release cytokines involved in the inflammatory process. Gender differences in the incidence and severity of inflammatory lung ailments including asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF), lung cancer (LC), and infectious related illnesses have been reported. Moreover, the effects of sex hormones on both androgens and estrogens, such as testosterone (TES) and 17β-estradiol (E2), driving characteristic inflammatory patterns in those lung inflammatory diseases have been investigated. In general, androgens seem to display anti-inflammatory actions, whereas estrogens produce pro-inflammatory effects. For instance, androgens regulate negatively inflammation in asthma by targeting type 2 innate lymphoid cells (ILC2s) and T-helper (Th)-2 cells to attenuate interleukin (IL)-17A-mediated responses and leukotriene (LT) biosynthesis pathway. Estrogens may promote neutrophilic inflammation in subjects with asthma and COPD. Moreover, the activation of estrogen receptors might induce tumorigenesis. In this chapter, we summarize the most recent advances in the functional roles and associated signaling pathways of inflammatory cellular responses in asthma, COPD, PF, LC, and newly occurring COVID-19 disease. We also meticulously deliberate the influence of sex steroids on the development and progress of these common and severe lung diseases.
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Affiliation(s)
- Jorge Reyes-García
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA
| | - Luis M Montaño
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico
| | - Abril Carbajal-García
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico
| | - Yong-Xiao Wang
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA.
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Huang A, Kandhi S, Sun D. Roles of Genetic Predisposition in the Sex Bias of Pulmonary Pathophysiology, as a Function of Estrogens : Sex Matters in the Prevalence of Lung Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1303:107-127. [PMID: 33788190 DOI: 10.1007/978-3-030-63046-1_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In addition to studies focused on estrogen mediation of sex-different regulation of systemic circulations, there is now increasing clinical relevance and research interests in the pulmonary circulation, in terms of sex differences in the morbidity and mortality of lung diseases such as inherent-, allergic- and inflammatory-based events. Thus, female predisposition to pulmonary artery hypertension (PAH) is an inevitable topic. To better understand the nature of sexual differentiation in the pulmonary circulation, and how heritable factors, in vivo- and/or in vitro-altered estrogen circumstances and changes in the live environment work in concert to discern the sex bias, this chapter reviews pulmonary events characterized by sex-different features, concomitant with exploration of how alterations of genetic expression and estrogen metabolisms trigger the female-predominant pathological signaling. We address the following: PAH (Sect.7.2) is characterized as an estrogenic promotion of its incidence (Sect. 7.2.2), as a function of specific germline mutations, and as an estrogen-elicited protection of its prognosis (Sect.7.2.1). More detail is provided to introduce a less recognized gene of Ephx2 that encodes soluble epoxide hydrolase (sEH) to degrade epoxyeicosatrienic acids (EETs). As a susceptible target of estrogen, Ephx2/sEH expression is downregulated by an estrogen-dependent epigenetic mechanism. Increases in pulmonary EETs then evoke a potentiation of PAH generation, but mitigation of its progression, a phenomenon similar to the estrogen-paradox regulation of PAH. Additionally, the female susceptibility to chronic obstructive pulmonary diseases (Sect. 7.3) and asthma (Sect.7.4), but less preference to COVID-19 (Sect. 7.5), and roles of estrogen in their pathogeneses are briefly discussed.
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Affiliation(s)
- An Huang
- Department of Physiology, New York Medical College, Valhalla, NY, USA.
| | - Sharath Kandhi
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - Dong Sun
- Department of Physiology, New York Medical College, Valhalla, NY, USA
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13
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Zhou J, Wang H, Sun Q, Liu X, Wu Z, Wang X, Fang W, Ma Z. miR-224-5p-enriched exosomes promote tumorigenesis by directly targeting androgen receptor in non-small cell lung cancer. MOLECULAR THERAPY. NUCLEIC ACIDS 2021; 23:1217-1228. [PMID: 33664999 PMCID: PMC7899953 DOI: 10.1016/j.omtn.2021.01.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/24/2021] [Indexed: 02/07/2023]
Abstract
Non-small cell lung cancer (NSCLC) is the most common form of cancer, resulting in cancer-related deaths worldwide. Exosomes, a subclass of extracellular vesicles, are produced and secreted from various types of cells, including cancer cells. Cancer-derived exosomes can deliver nucleic acids, proteins, and lipids to provide a favorable microenvironment that supports tumor growth through enhancing cell proliferation and metastasis. Our results showed that miR-224-5p was upregulated in NSCLC patient tissues and cell lines, with a tumor-promoting phenotype. Meanwhile, exosome-derived miR-224-5p induced cell proliferation and metastasis in NSCLC and human lung cells. Moreover, we characterized the androgen receptor (AR) as a direct target of miR-224-5p. Tumor xenograft assay experiments revealed that overexpression of miR-224-5p drove NSCLC tumor growth via the suppression of AR and the mediation of epithelial-mesenchymal transition (EMT). Collectively, our results suggest that miR-224-5p-enriched exosomes promote tumorigenesis by directly targeting AR in NSCLC, which may provide novel potential therapeutic and preventive targets for NSCLC.
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Affiliation(s)
- Jinbao Zhou
- Lab for Noncoding RNA & Cancer, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Hongshu Wang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Qiangling Sun
- Department of Thoracic Surgery, Thoracic Cancer Institute, Shanghai Chest Hospital, Jiaotong University Medical School, Shanghai 200030, China
| | - Xiaomin Liu
- Lab for Noncoding RNA & Cancer, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Zong Wu
- Lab for Noncoding RNA & Cancer, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Xianyi Wang
- Lab for Noncoding RNA & Cancer, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Wentao Fang
- Department of Thoracic Surgery, Thoracic Cancer Institute, Shanghai Chest Hospital, Jiaotong University Medical School, Shanghai 200030, China
| | - Zhongliang Ma
- Lab for Noncoding RNA & Cancer, School of Life Sciences, Shanghai University, Shanghai 200444, China
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Brigham E, Allbright K, Harris D. Health Disparities in Environmental and Occupational Lung Disease. Clin Chest Med 2021; 41:623-639. [PMID: 33153683 DOI: 10.1016/j.ccm.2020.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pulmonary health disparities disproportionately impact disadvantaged and vulnerable populations. This article focuses on disparities in disease prevalence, morbidity, and mortality for asthma, chronic obstructive pulmonary disease, pneumoconiosis, and lung cancer. Disparities are categorized by race, age, sex, socioeconomic status, and geographic region. Each category highlights differences in risk factors for the development and severity of lung disease. Risk factors include social, behavioral, economic, and biologic determinants of health (occupational/environmental exposures, psychosocial stressors, smoking, health literacy, health care provider bias, and health care access). Many of these risk factors are complex and inter-related; strategies proposed to decrease disparities require multilevel approaches.
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Affiliation(s)
- Emily Brigham
- Division of Pulmonary and Critical Care, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA. https://twitter.com/emily_brigham
| | - Kassandra Allbright
- Department of Medicine, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA
| | - Drew Harris
- Division of Pulmonary and Critical Care and Public Health Sciences, University of Virginia, Pulmonary Clinic 2nd Floor, 1221 Lee Street, Charlottesville, VA 22903, USA.
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15
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Comparison of Clinical Characteristics and Outcomes in Relapsed Versus De Novo Metastatic Non-Small Cell Lung Cancer. Am J Clin Oncol 2019; 42:75-81. [PMID: 30211724 DOI: 10.1097/coc.0000000000000483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To compare the clinical characteristics and outcomes between relapsed and de novo metastatic non-small cell lung cancer (NSCLC). MATERIALS AND METHODS We reviewed all NSCLC diagnoses between January 1999 and December 2013 in the institutional Glans-Look Lung Cancer Database, which contains demographic, clinical, pathologic, treatment, and outcome information. Patients with distant metastasis at diagnosis (American Joint Committee on Cancer [AJCC] eighth edition, stage IV), the "de novo" cohort, were compared with the "relapsed" cohort, consisting of patients diagnosed with early stage disease (stage I/II) undergoing curative intent treatment and subsequently experiencing metastatic relapse. Survival analysis, along with univariate and multivariable analysis was performed. RESULTS A total of 185 relapsed and 3039 de novo patients were identified. Significantly different patterns of smoking history, histology, systemic therapy use, and disease extent were observed between the relapsed and de novo cohorts. Median overall survival from time of metastasis was significantly longer in relapsed than in de novo disease (8.9 vs. 3.7 mo, P<0.001). Relapsed patients demonstrated significant improvements in outcomes over time. In multivariate analysis, de novo metastatic disease continued to bode a worse prognosis (adjusted hazard ratio [HR], 1.4) as did male sex (HR, 1.2), never-smoking history (HR, 1.2), and presence of extrapulmonary metastases (HR, 1.3). Systemic therapy receipt conferred better outcome (HR, 0.4), although the impact of relapsed versus de novo disease on outcomes persisted regardless of systemic therapy receipt. CONCLUSIONS Relapsed and de novo patients represent significantly different subpopulations within metastatic NSCLC with the latter exhibiting poorer survival. This information facilitates discussions about prognosis with patients and supports screening initiatives aimed at reducing de novo disease.
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16
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Akhtar-Danesh N, Akhtar-Danseh GG, Seow HY, Shakeel S, Finley C. Trends in Survival Based on Treatment Modality in Non-Small Cell Lung Cancer Patients: A Population-Based Study. Cancer Invest 2019; 37:355-366. [PMID: 31437020 DOI: 10.1080/07357907.2019.1653465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objectives: We examined the trends in survival based on treatment modality among non-small cell lung cancer (NSCLC) patients in the province of Ontario, Canada, from 2007 to 2015. Methods: We investigated the trends in survival based on treatment modality. Results: Among 56,417 identified patients, the mean age at diagnosis was 70.1 years (SD = 10.7). Treatment modalities varied significantly over time (p<.001). Overall, 23.0% of patients received surgical treatments. We observed more than 20% increase in five-year survival rates for all surgical groups over time. Conclusions: Patients undergoing sublobar/lobar resections had higher survival rate.
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Affiliation(s)
- Noori Akhtar-Danesh
- School of Nursing, McMaster University , Hamilton , Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University , Hamilton , Canada
| | | | - Hsien Yeang Seow
- Department of Health Research Methods, Evidence, and Impact, McMaster University , Hamilton , Canada.,Department of Oncology, McMaster University , Hamilton , Canada
| | - Saad Shakeel
- School of Medicine, University of Toronto , Toronto , Canada
| | - Christian Finley
- Department of Surgery, Division of Thoracic Surgery, McMaster University , Hamilton , Canada
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Radkiewicz C, Dickman PW, Johansson ALV, Wagenius G, Edgren G, Lambe M. Sex and survival in non-small cell lung cancer: A nationwide cohort study. PLoS One 2019; 14:e0219206. [PMID: 31247015 PMCID: PMC6597110 DOI: 10.1371/journal.pone.0219206] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/18/2019] [Indexed: 12/25/2022] Open
Abstract
Aim To in detail delineate sex differences in non-small cell lung cancer outcome and investigate possible underlying drivers. Methods We performed a nationwide, population-based cohort study using data on all incident cases of lung squamous cell carcinoma (n = 10,325) and adenocarcinoma (n = 23,465) recorded in the Swedish Lung Cancer Register in 2002–2016. Flexible parametric models were applied to compute adjusted female-to-male hazard ratios (aHRs) and standardized survival proportions over follow-up including age, calendar year, education, marital status, birth country, health care region, performance status, smoking history, comorbidities, and tumor location in the final model. Results Women presented with better performance status, were younger, and more often never-smokers. Women with adenocarcinoma also had lower comorbidity burden, less advanced stage, and were more often EGFR positive. Men with adenocarcinoma had a consistently poorer lung cancer-specific survival across stage; HR 0.69; 95% CI 0.63–0.76 (stage IA-IIB) to 0.94; 95% CI 0.88–0.99 (stage IIIB-IV), remaining largely unchanged after adjustments; aHR 0.74; 95% CI 0.66–0.82 to 0.84; 95% CI 0.81–0.87. The same pattern was observed in squamous cell carcinoma, except in stage IIIA disease, where we found no sex differences in survival. Conclusions Men with non-small cell lung cancer have a consistently poorer prognosis, even after careful adjustments for a wide range of prognostic factors. While the pattern was similar in both squamous cell and adenocarcinoma, it was larger and more consistent in the latter.
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Affiliation(s)
- Cecilia Radkiewicz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- * E-mail:
| | - Paul William Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Louise Viktoria Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Cancer Registry of Norway, Oslo, Norway
| | - Gunnar Wagenius
- Cancer Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Gustaf Edgren
- Department of Medicine Solna, Clinical Epidemiology Division T2, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Södersjukhuset, Stockholm, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Regional Cancer Center Uppsala-Örebro, Uppsala, Sweden
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18
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Khozin S, Carson KR, Zhi J, Tucker M, Lee SE, Light DE, Curtis MD, Bralic M, Kaganman I, Gossai A, Hofmeister P, Torres AZ, Miksad RA, Blumenthal GM, Pazdur R, Abernethy AP. Real-World Outcomes of Patients with Metastatic Non-Small Cell Lung Cancer Treated with Programmed Cell Death Protein 1 Inhibitors in the Year Following U.S. Regulatory Approval. Oncologist 2018; 24:648-656. [PMID: 30591549 DOI: 10.1634/theoncologist.2018-0307] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/15/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence from cancer clinical trials has strong internal validity but can be difficult to generalize to real-world patient populations. Here we analyzed real-world outcomes of patients with metastatic non-small cell lung cancer (mNSCLC) treated with programmed cell death protein 1 (PD-1) inhibitors in the first year following U.S. regulatory approval. MATERIALS AND METHODS This retrospective study leveraged electronic health record (EHR) data collected during routine patient care in community cancer care clinics. The cohort included patients with mNSCLC who had received nivolumab or pembrolizumab for metastatic disease (n = 1,344) with >1 EHR-documented visit from January 1, 2011, to March 31, 2016. Patients with a > 90-day gap between advanced disease diagnosis and first EHR structured data entry were excluded. RESULTS Estimated median overall survival (OS) was 8.0 months (95% confidence interval 7.4-9.0 months). Estimated median OS was 4.7 months (3.4-6.6) for patients with anaplastic lymphoma kinase rearrangement- and epidermal growth factor receptor mutation-positive tumors, and 8.6 months (7.7-10.6) for patients without such mutations. Age at PD-1 inhibitor initiation or line of therapy did not impact OS. CONCLUSION This analysis suggests OS in real-world patients may be shorter than in conventional clinical trial patient cohorts, potentially due to narrow trial eligibility criteria. The lack of difference in OS by line of therapy or age at immunotherapy initiation suggests sustained benefit of PD-1 inhibitors in multitreated patients with mNSCLC and that age is not a predictor of outcome. Further studies are underway in patients with comorbidities, organ dysfunction, and multiple prior therapies. IMPLICATIONS FOR PRACTICE This study evaluated data derived from electronic health records of patients with metastatic non-small cell lung cancer treated with programmed cell death protein 1 (PD-1) inhibitors in the year following regulatory approval. This real-world cohort had shorter overall survival (OS) indexed to PD-1 inhibitor initiation than reported in clinical trials. Late-line treatment did not influence OS, and patients aged >75 at immunotherapy initiation did not have worse outcomes than younger patients. As new therapies enter clinical practice, real-world data can complement clinical trial evidence providing information on generalizability and helping inform clinical treatment decisions.
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Affiliation(s)
- Sean Khozin
- U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kenneth R Carson
- Flatiron Health, New York, New York, USA
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Jizu Zhi
- U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Richard Pazdur
- U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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19
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Byeon KH, Ha YS, Choi SH, Kim BS, Kim HT, Yoo ES, Kwon TG, Lee JN, Kim TH. Predictive factors for adrenal metastasis in extra-adrenal malignancy patients with solitary adrenal mass. J Surg Oncol 2018; 118:1271-1276. [PMID: 30367684 DOI: 10.1002/jso.25272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/20/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES The adrenal gland is a frequent site for metastasis, and a solitary adrenal mass is often observed during staging workup or imaging follow-up in patients with extra-adrenal malignancy. To create an appropriate management plan, it is essential to distinguish between benign adrenal lesions and metastasis in patients with extra-adrenal cancer having solitary adrenal masses. Therefore, here we evaluated the predictive factors for adrenal metastasis in patients with extra-adrenal malignancy having solitary adrenal mass. MATERIALS AND METHODS From September 2003 to June 2016, we retrospectively reviewed patients with extra-adrenal malignancy having solitary adrenal mass on a cancer staging workup or follow-up study who subsequently underwent adrenalectomy at our institution. All patients underwent preoperative functional studies; those with positive results were excluded from this study. Characteristics of oncology patients with adrenal mass including age, sex, body mass index, smoking, mass location, mass size, hypertension, diabetes mellitus, precontrast Hounsfield unit (HU), and synchronous or metachronous adrenal mass based on the time of the extra-adrenal cancer diagnosis were analyzed. RESULTS Of the total 68 patients with extra-adrenal cancer having solitary adrenal mass, 22 had pathologically confirmed adrenal metastasis. Primary cancers consisted of hepatocellular cell carcinoma (n = 7), renal cell carcinoma (n = 7), lung cancer (n = 4), colon cancer (n = 3), and breast cancer (n = 1). On multivariate analysis, a higher precontrast HU (P = 0.001, odds ratio [OR] = 1.105, 95% confidence interval [CI] = 1.042-1.172), male sex ( P = 0.019, OR = 9.782, 95% CI = 1.462-65.461), and metachronous adrenal mass ( P = 0.007, OR = 11.090, 95% CI = 1.937-63.490) were observed as predictive factors for adrenal metastasis in patients with extra-adrenal cancer having solitary adrenal mass. The cut-off value of precontrast HU to distinguish between metastasis and benign lesions was 36.2 (sensitivity = 81.8%; specificity = 91.3%). CONCLUSION High precontrast HU (> 36), male sex, and metachronous adrenal mass are predictive factors for adrenal metastasis in patients with extra-adrenal malignancy having solitary adrenal mass.
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Affiliation(s)
- Kyeong-Hyeon Byeon
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yun-Sok Ha
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Seock Hwan Choi
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Eun Sang Yoo
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Gyun Kwon
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jun Nyung Lee
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae-Hwan Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
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20
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Garrido P, Viñolas N, Isla D, Provencio M, Majem M, Artal A, Carcereny E, Garcia Campelo R, Lianes P, De La Peñas R, Felip E. Lung cancer in Spanish women: The WORLD07 project. Eur J Cancer Care (Engl) 2018; 28:e12941. [DOI: 10.1111/ecc.12941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 07/07/2017] [Accepted: 08/24/2018] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | | | - Angel Artal
- Hospital Universitario Miguel Servet; Zaragoza Spain
| | - Enric Carcereny
- Hospital Universitari Germans Trias i Pujol; Barcelona Spain
| | | | - Pilar Lianes
- Consorci Sanitari del Maresme - Hospital de Mataró; Mataró, Barcelona Spain
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21
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Wang L, Cao Y, Ren M, Chen A, Cui J, Sun D, Gu W. Sex Differences in Hazard Ratio During Drug Treatment of Non-small-cell Lung Cancer in Major Clinical Trials: A Focused Data Review and Meta-analysis. Clin Ther 2017; 39:34-54. [PMID: 28069259 DOI: 10.1016/j.clinthera.2016.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/24/2016] [Accepted: 12/05/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE Understanding how sex impacts the efficacy of anticancer agents is a crucial step toward personalized and precision medicine. This review and meta-analysis evaluated sex differences in hazard ratios (HRs) of progression-free survival and overall survival in representative Phase III clinical trials of non-small-cell lung cancer (NSCLC). METHODS Data were extracted from 24 large-scale clinical trials that included 12,000 male and 7000 female patients. The data were examined for HR differences between subgroups by sex, smoking status, and age, and for potential sex-smoking status, sex-age, and sex-drug interactions, during cancer treatment. FINDINGS Summarized information revealed variations in the influences of sex, smoking status, and age on the efficacy of drugs used for the treatment of NSCLC. The male and female subgroups had different HR values. Smoking status, age, and the percentage of female patients in a treatment group had no influence on the sex HR. The sex difference was supported by a set of data collected from all journals. IMPLICATIONS The findings from this meta-analysis are important for assessing potential toxicity during drug treatment in both sexes. The outcomes measures of a drug in clinical application should be specified by subpopulation, such as males versus females, as a first step in personalized medicine.
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Affiliation(s)
- Lishi Wang
- Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China; Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Yanhong Cao
- National Center for Endemic Disease Control, Harbin Medical University, Harbin, People׳s Republic of China
| | - Mingji Ren
- Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China
| | - Amei Chen
- Department of Basic Medicine (Basic Medical Research), Inner Mongolia Medical University, Inner Mongolia, People׳s Republic of China
| | - Jinglin Cui
- Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee; Center of Integrative Research, The First Hospital of Qiqihaer City, Qiqihaer, People׳s Republic of China
| | - DiaJun Sun
- National Center for Endemic Disease Control, Harbin Medical University, Harbin, People׳s Republic of China
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, The University of Tennessee Health Science Center, Memphis, Tennessee; Research Service, Veterans Affairs Medical Center, Memphis, Tennessee.
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22
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Xiao D, Pan H, Li F, Wu K, Zhang X, He J. Analysis of ultra-deep targeted sequencing reveals mutation burden is associated with gender and clinical outcome in lung adenocarcinoma. Oncotarget 2016; 7:22857-64. [PMID: 27009843 PMCID: PMC5008406 DOI: 10.18632/oncotarget.8213] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/23/2016] [Indexed: 12/14/2022] Open
Abstract
Gender-associated difference in incidence and clinical outcomes of lung cancer have been established, but the biological mechanisms underlying these gender-associated differences are less studied. Recently we have characterized the genomic landscape of lung adenocarcinoma derived from Chinese population (Reference [1]). In this study we evaluated the clinical significance of mutation burden in lung adenocarcinoma and found that the male tumors harbored statistically greater burden of genetic alterations than female counterparts (Male median 3 (range 0-34) vs female median = 2 (0-24), male to female ratio = 1.636, 95% CI = 1.343-1.992) after adjustment of age at surgery, stage, smoking status. Kaplan-Meier survival analysis revealed that greater burden of genetic alterations was associated with worse overall survival. Moreover, multivariable analysis demonstrated mutation burden was an independent prognostic factor for the patients. Taken together, our analysis demonstrated gender disparity of mutation burden and their prognostic value in lung adenocarcinoma. This gender difference in mutation burden might provide an explanation for the distinct difference in the clinical outcomes between sexes in lung adenocarcinoma.
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Affiliation(s)
- Dakai Xiao
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Research Center for Translational Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease and State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Hui Pan
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Research Center for Translational Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Kui Wu
- BGI-Shenzhen, Shenzhen, China
| | - Xin Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease and State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease and State Key Laboratory of Respiratory Disease, Guangzhou, China
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23
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Green A, Hauge J, Iachina M, Jakobsen E. The mortality after surgery in primary lung cancer: results from the Danish Lung Cancer Registry. Eur J Cardiothorac Surg 2015; 49:589-94. [PMID: 25825264 DOI: 10.1093/ejcts/ezv107] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/19/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The study has been performed to investigate the mortality within the first year after resection in patients with primary lung cancer, together with associated prognostic factors including gender, age, tumour stage, comorbidity, alcohol abuse, type of surgery and post-surgical complications. METHODS All patients (n = 3363) from the nationwide Danish Lung Cancer Registry with first resection performed between 1 January 2007 and 31 December 2011 were analysed by Kaplan-Meier techniques and Cox-regression analysis concerning death within the first year after resection. Covariates included gender, age, comorbidity (Charlson comorbidity index), perioperative stage, type of resection, registered complications to surgery and alcohol abuse. RESULTS The cumulative deaths after 30 days, 90 days, 180 days and 360 days were 72 (2.1%), 154 (4.6%), 239 (7.1%) and 478 (14.2%), respectively. Low stage, female gender, young age, no comorbidity, no postoperative complications, no alcohol abuse and lobectomy as type of resection were favourable for survival. CONCLUSIONS Our results demonstrate that resection in primary lung cancer impacts mortality far beyond the initial 30 days after resection, which is conventionally considered a time window of relevance for the adverse outcome of surgery. Increased efforts should be made for optimizing the selection of patients suited for resection and for identifying patients at increased risk of death after resection. Furthermore, patients should be monitored more closely and more frequently, in particular those patients with high risk of death after resection.
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Affiliation(s)
- Anders Green
- Odense Patient data Explorative Network (OPEN), Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jacob Hauge
- The Danish Lung Cancer Registry, Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | - Maria Iachina
- Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Erik Jakobsen
- The Danish Lung Cancer Registry, Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
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24
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Gansmo LB, Knappskog S, Romundstad P, Hveem K, Vatten L, Lønning PE. Influence of
MDM2
SNP309 and SNP285 status on the risk of cancer in the breast, prostate, lung and colon. Int J Cancer 2014; 137:96-103. [DOI: 10.1002/ijc.29358] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 11/06/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Liv B. Gansmo
- Section of Oncology, Department of Clinical ScienceUniversity of BergenBergen Norway
- Department of OncologyHaukeland University HospitalBergen Norway
| | - Stian Knappskog
- Section of Oncology, Department of Clinical ScienceUniversity of BergenBergen Norway
- Department of OncologyHaukeland University HospitalBergen Norway
| | - Pål Romundstad
- Department of Public Health, Faculty of MedicineNorwegian University of Science and TechnologyTrondheim Norway
| | - Kristian Hveem
- Department of Public Health, Faculty of MedicineNorwegian University of Science and TechnologyTrondheim Norway
| | - Lars Vatten
- Department of Public Health, Faculty of MedicineNorwegian University of Science and TechnologyTrondheim Norway
| | - Per E. Lønning
- Section of Oncology, Department of Clinical ScienceUniversity of BergenBergen Norway
- Department of OncologyHaukeland University HospitalBergen Norway
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Abstract
Menopausal hormone therapy with estrogen plus progestin or estrogen alone (for women with prior hysterectomy) is still used by millions of women for climacteric symptom management throughout the world. Until 2002, hormone therapy influence on cancer risk and other chronic diseases was determined through observational study reports. Since then, results from the Women's Health Initiative randomized, placebo-controlled hormone therapy trials have substantially changed concepts regarding estrogen plus progestin and estrogen alone influence on the most common cancers in postmenopausal women. In these trials, estrogen plus progestin significantly increased breast cancer incidence and deaths from breast cancer, significantly increased deaths from lung cancer, significantly decreased endometrial cancer, and did not have a clinically significant influence on colorectal cancer. In contrast, estrogen alone use in women with prior hysterectomy significantly reduced breast cancer incidence and deaths from breast cancer without significant influence on colorectal cancer or lung cancer. These complex results are discussed in the context of known potential mediating mechanisms of action involved in interaction with steroid hormone receptors.
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Affiliation(s)
- Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States.
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26
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Tong BC, Kosinski AS, Burfeind WR, Onaitis MW, Berry MF, Harpole DH, D'Amico TA. Sex differences in early outcomes after lung cancer resection: analysis of the Society of Thoracic Surgeons General Thoracic Database. J Thorac Cardiovasc Surg 2014; 148:13-8. [PMID: 24726742 DOI: 10.1016/j.jtcvs.2014.03.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 02/25/2014] [Accepted: 03/11/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Women with lung cancer have superior long-term survival outcomes compared with men, independent of stage. The cause of this disparity is unknown. For patients undergoing lung cancer resection, these survival differences could be due, in part, to relatively better perioperative outcomes for women. This study was undertaken to determine differences in perioperative outcomes after lung cancer surgery on the basis of sex. METHODS The Society of Thoracic Surgeons' General Thoracic Database was queried for all patients undergoing resection of lung cancer between 2002 and 2010. Postoperative complications were analyzed with respect to sex. Univariable analysis was performed, followed by multivariable modeling to determine significant risk factors for postoperative morbidity and mortality. RESULTS A total of 34,188 patients (16,643 men and 17,545 women) were considered. Univariable analysis demonstrated statistically significant differences in postoperative complications favoring women in all categories of postoperative complications. Women also had lower in-hospital and 30-day mortality (odds ratio, 0.56; 95% confidence interval, 0.44-0.71; P < .001). Multivariable analysis demonstrated that several preoperative conditions independently predicted 30-day mortality: male sex, increasing age, lower diffusion capacity, renal insufficiency, preoperative radiation therapy, cancer stage, extent of resection, and thoracotomy as surgical approach. Coronary artery disease was an independent predictor of mortality in women but not in men. Thoracotomy as the surgical approach and preoperative radiation therapy were predictive of mortality for men but not for women. Postoperative prolonged air leak and empyema predicted mortality in men but not in women. CONCLUSIONS Women have lower postoperative morbidity and mortality after lung cancer surgery. Some risk factors are sex-specific with regard to mortality. Further study is warranted to determine the cause of these differences and to determine their effect on survival.
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Affiliation(s)
- Betty C Tong
- Section of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
| | - Andrzej S Kosinski
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC
| | | | - Mark W Onaitis
- Section of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Mark F Berry
- Section of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - David H Harpole
- Section of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Thomas A D'Amico
- Section of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
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Hsiao SH, Lin SE, Chou YT, Wang JL, Chung CL, Yu MC, Fang CL, Lee HL, Chiang LL, Liu HE, Wu CW. Histological subtype and smoking status, but not gender, are associated with epidermal growth factor receptor mutations in non-small-cell lung cancer. Mol Clin Oncol 2013; 2:252-258. [PMID: 24649342 DOI: 10.3892/mco.2013.232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 08/15/2013] [Indexed: 11/06/2022] Open
Abstract
Mutations in epidermal growth factor receptor (EGFR) commonly occur in non-small-cell lung cancer (NSCLC) patients characterized by female gender, never-smoker status and adenocarcinoma histology. The aim of this study was to determine whether gender is a confounding factor for EGFR mutations in NSCLC. To elucidate the confounding effect, Pearson's χ2 test and logistic regression models were used to correlate these characteristics with EGFR mutations in 426 NSCLC patients treated at our institutes. Of those 426 NSCLC patients, 47% were females, 57% were non-smokers and 84% had adenocarcinomas. The multivariate logistic regression analysis demonstrated that never-smoker status [odds ratio (OR)=3.49, 95% confidence interval (CI): 1.99-6.13; P<0.001)] and adenocarcinoma (OR=9.43, 95% CI 3.62-24.56; P<0.001) were associated with EGFR mutations; however, gender was not (OR=1.25, 95% CI: 0.73-2.15; P=0.416). Furthermore, gender was not associated with EGFR mutation subtypes (OR=1.19, 95% CI: 0.56-2.50; P=0.650). The frequency of EGFR mutations among females and males was not different in non-smokers (64.8 vs. 55.8%, P=0.204) or ever-smokers (27.8 vs. 24.2%, P=0.775). Therefore, if the assessment for EGFR mutation status was limited to non-smoking females with adenocarcinoma, up to 40% of the patients harboring EGFR mutations would be precluded from the benefit of EGFR inhibitor therapy. Our results indicated that gender is a confounding factor for EGFR mutations in NSCLC and suggested that gender may not be associated with tumorigenesis in NSCLC-harboring EGFR mutations.
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Affiliation(s)
- Shih-Hsin Hsiao
- Molecular Medicine Program, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan, R.O.C. ; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Sey-En Lin
- Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Yu-Ting Chou
- Institute of Biomedical Science, Academia Sinica, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Jinn-Li Wang
- Department of Pediatrics, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C. ; Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C. ; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Ming-Chih Yu
- Division of Pulmonary Medicine, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Chia-Lang Fang
- Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Hsin-Lun Lee
- Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Ling-Ling Chiang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - H Eugene Liu
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C. ; Division of Hematology and Oncology, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Cheng-Wen Wu
- Molecular Medicine Program, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan, R.O.C. ; Institute of Biomedical Science, Academia Sinica, Taipei Medical University, Taipei, Taiwan, R.O.C
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Wang D, Sun SQ, Yu YH, Wu WZ, Yang SL, Tan JM. Suppression of SCIN inhibits human prostate cancer cell proliferation and induces G0/G1 phase arrest. Int J Oncol 2013; 44:161-6. [PMID: 24212916 DOI: 10.3892/ijo.2013.2170] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/08/2013] [Indexed: 11/05/2022] Open
Abstract
SCIN is a calcium regulated actin severing and capping protein. Its homologue in zebrafish is found to be related with cell death. In the present study, we found that SCIN is highly expressed in human prostate cancer specimens. However, the functions of SCIN in human prostate carcinoma cells are largely unknown. To address the function of SCIN in prostate carcinoma cells, we used lentivirus-mediated RNAi to knock down SCIN expression in PC3 cells, a prostate carcinoma cell line. We found that in vitro silencing of SCIN could inhibit the proliferation and colony formation ability of PC3 cells. Furthermore, cell cycle analysis showed that reduced SCIN expression lead to G0/G1 cell cycle arrest through the regulation of cell cycle-related genes, such as p21Waf1/Cip1, cyclin-dependent kinase inhibitor 2A (CDKN2A, p16Ink4A) and cyclin A2. These results suggest that SCIN plays an important role in the proliferation of prostate cancer cells and lentivirus-mediated inhibition of SCIN expression may be a potential therapeutic method for the treatment of prostate cancer.
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Affiliation(s)
- Dong Wang
- Department of Urology, Fuzhou General Hospital, Fuzhou 350025, P.R. China
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Zhai R, Yu X, Wei Y, Su L, Christiani DC. Smoking and smoking cessation in relation to the development of co-existing non-small cell lung cancer with chronic obstructive pulmonary disease. Int J Cancer 2013; 134:961-70. [PMID: 23921845 DOI: 10.1002/ijc.28414] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/05/2013] [Accepted: 07/09/2013] [Indexed: 12/25/2022]
Abstract
Previous studies have identified a mixed-phenotype of non-small cell lung cancer (NSCLC) with co-existing chronic obstructive pulmonary disease (COPD). Although NSCLC and COPD share a common risk factor in smoking, whether and how smoking may contribute to the coexistence of NSCLC with COPD (NSCLC-COPD) is unclear. Our study suggests that cigarette smoking is the major risk factor for the development of NSCLC-COPD, especially in females and among patients with squamous cell carcinoma subtype.
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Affiliation(s)
- Rihong Zhai
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
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Scaglia NC, Chatkin JM, Pinto JA, Tsukazan MTR, Wagner MB, Saldanha AF. Role of gender in the survival of surgical patients with nonsmall cell lung cancer. Ann Thorac Med 2013; 8:142-7. [PMID: 23922608 PMCID: PMC3731855 DOI: 10.4103/1817-1737.114297] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 03/10/2013] [Indexed: 11/04/2022] Open
Abstract
PURPOSE There are reports of greater survival rates in nonsmall cell lung cancer (NSCLC) patients of female gender. The objective of this study was to evaluate the role of gender in survival of NSCLC patients treated surgically with curative intent (stage I/II). METHODS In a retrospective cohort design, we screened 498 NSCLC patients submitted to thoracotomies at the hospital Sγo Lucas, in Porto Alegre, Brazil from 1990 to 2009. After exclusion of patients that did not fit to all the inclusion criteria, we analyzed survival rates of 385 subjects. Survival was analyzed using the Kaplan-Meier method. The Cox regression model was used to evaluate potential confounding factors. RESULTS Survival rates at 5 and 10 years were 65.3% and 49.5% for women and 46.5% and 33.2% for men, respectively (P = 0.006). Considering only stage I patients, the survival rates at 5 and 10 years were 76.2% and 55.1% for women and 50.7% and 35.4% for men, respectively (P = 0.011). No significant differences in survival rates were found among stage II patients. CONCLUSIONS Our results show female gender as a possible protective factor for better survival of stage I NSCLC patients, but not among stage II patients. This study adds data to the knowledge that combined both genders survival rates for NSCLC is not an adequate prognosis.
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Affiliation(s)
- Nóris C Scaglia
- Department of Respiratory Diseases, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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31
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Age-specific effect of gender on upper tract urothelial carcinoma outcomes. Med Oncol 2013; 30:640. [PMID: 23780658 DOI: 10.1007/s12032-013-0640-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The research is to evaluate the age-specific differential effects of gender on outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Between August 1998 and October 2010, we retrospectively reviewed the data from 285 (67.7%) men and 136 (32.3%) women treated with RNU for UTUC at our two institutions. Kaplan-Meier survival estimates the age-specific effect of gender on cancer-specific survival (CSS). Cox proportional hazards regression analyses were used to address the effect of gender on CSS. No significant sex-related differences were found in age and diagnosis, clinicopathologic features, and treatment (all P values >0.05). Women had a 18.7% increased risk of death from UTUC than men (hazard ratio [HR] 1.187; 95% confidence interval [95% CI] 1.017-1.893; P = 0.021). The survival disadvantage was only present in patients aged 59 years and older (P < 0.001). Conversely, the survival advantage for women was found in women aged 42 to 58 years (P = 0.011) and in the age group <42 years (P = 0.019). On multivariable Cox regression analyses that adjusted for the effects of clinicopathologic features, the female gender was associated with decreased CSS (P = 0.036). In conclusion, the impact of gender on UTUC outcomes after RNU is age-specific. Females who aged 59 years and older experienced worse outcomes than their male counterparts, while women in the age group <42 years and 42-58 years have better outcomes than men. Further research is needed to elucidate the molecular mechanisms underlying the age-specific differential effect of gender on UTUC outcomes.
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Yu HA, Arcila ME, Rekhtman N, Sima CS, Zakowski MF, Pao W, Kris MG, Miller VA, Ladanyi M, Riely GJ. Analysis of tumor specimens at the time of acquired resistance to EGFR-TKI therapy in 155 patients with EGFR-mutant lung cancers. Clin Cancer Res 2013; 19:2240-7. [PMID: 23470965 DOI: 10.1158/1078-0432.ccr-12-2246] [Citation(s) in RCA: 1896] [Impact Index Per Article: 172.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE All patients with EGF receptor (EGFR)-mutant lung cancers eventually develop acquired resistance to EGFR tyrosine kinase inhibitors (TKI). Smaller series have identified various mechanisms of resistance, but systematic evaluation of a large number of patients to definitively establish the frequency of various mechanisms has not been conducted. EXPERIMENTAL DESIGN Patients with lung adenocarcinomas and acquired resistance to erlotinib or gefitinib enrolled onto a prospective biopsy protocol and underwent a rebiopsy after the development of acquired resistance. Histology was reviewed. Samples underwent genotyping for mutations in EGFR, AKT1, BRAF, ERBB2, KRAS, MEK1, NRAS and PIK3CA, and FISH for MET and HER2. RESULTS Adequate tumor samples for molecular analysis were obtained in 155 patients. Ninety-eight had second-site EGFR T790M mutations [63%; 95% confidence interval (CI), 55%-70%] and four had small cell transformation (3%, 95% CI, 0%-6%). MET amplification was seen in 4 of 75 (5%; 95% CI, 1%-13%). HER2 amplification was seen in 3 of 24 (13%; 95% CI, 3%-32%). We did not detect any acquired mutations in PIK3CA, AKT1, BRAF, ERBB2, KRAS, MEK1, or NRAS (0 of 88, 0%; 95% CI, 0%-4%). Overlap among mechanisms of acquired resistance was seen in 4%. CONCLUSIONS This is the largest series reporting mechanisms of acquired resistance to EGFR-TKI therapy. We identified EGFR T790M as the most common mechanism of acquired resistance, whereas MET amplification, HER2 amplification, and small cell histologic transformation occur less frequently. More comprehensive methods to characterize molecular alterations in this setting are needed to improve our understanding of acquired resistance to EGFR-TKIs.
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Affiliation(s)
- Helena A Yu
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA
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Rampersaud EN, Klatte T, Bass G, Patard JJ, Bensaleh K, Böhm M, Allhoff EP, Cindolo L, De La Taille A, Mejean A, Soulie M, Bellec L, Christophe Bernhard J, Pfister C, Colombel M, Belldegrun AS, Pantuck AJ, George D. The effect of gender and age on kidney cancer survival: younger age is an independent prognostic factor in women with renal cell carcinoma. Urol Oncol 2013; 32:30.e9-13. [PMID: 23422777 DOI: 10.1016/j.urolonc.2012.10.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 09/19/2012] [Accepted: 10/25/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Gender-specific differences in incidence of renal cell carcinoma (RCC) and its outcome have previously been reported. We used age as a surrogate to test whether this might be hormone-related in a large international RCC cohort. METHODS AND MATERIALS This study included patients treated by nephrectomy at 10 international academic centers. Clinicopathologic features were assessed using chi-square and the Student t-tests. Kaplan-Meier survival estimates and Cox proportional hazards models addressed the effect of gender and age on disease-specific survival. RESULTS Of the 5,654 patients, 3,777 (67%) were men and 1,877 (33%) were women. Generally, women presented at lower T stages (P<0.001), had fewer metastases (P<0.001), and had lower-grade tumors (P<0.001). Women more frequently had clear-cell (87% vs. 82%) and less frequently had papillary RCC (7% vs. 12%) than men (P<0.001). Women had a 19% reduced risk of death from RCC than men (hazard ratio 0.81, 95% confidence interval 0.73-0.90, P<0.001). The survival advantage for women was present to the greatest degree in the age group<42 years (P = 0.0136) and in women aged 42 to 58 years (P<0.001), but was not apparent in patients aged 59 years and older (P = 0.248). Age was an independent predictor of disease-specific survival in women (hazard ratio 1.011, 95% confidence interval 1.004-1.019, P = 0.004), but not in men. CONCLUSIONS As a group, women present with less advanced tumors, leading to a 19% reduced risk of RCC-specific death compared with men. This survival difference is present only in patients aged<59 years. Because this gender-based survival difference is not related to pathologic features, the role of hormonal effects on the development and progression of RCC needs to be investigated.
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Affiliation(s)
- Edward N Rampersaud
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA; Division of Hematology/Oncology, Duke University Medical Center, NC
| | - Tobias Klatte
- Department of Urology, Medical University of Vienna, Austria
| | - Geoffrey Bass
- Division of Hematology/Oncology, Duke University Medical Center, NC
| | - Jean-Jacques Patard
- Department of Urology, Bicêtre Hospital, Paris XI University, Kremlin Bicêtre, France
| | - Karim Bensaleh
- Department of Urology, Rennes University Hospital, Rennes, France
| | - Malte Böhm
- Department of Urology, University of Magdeburg, Germany
| | | | - Luca Cindolo
- Department of Urology, S. Pio da Pietrelcina Hospital, Vasto, Italy
| | | | - Arnaud Mejean
- Department of Urology, European Georges Pompidou Hospital, Paris, France
| | - Michel Soulie
- Department of Urology, University of Toulouse, France
| | | | | | | | - Marc Colombel
- Department of Urology, Lyon University, Lyon, France
| | - Arie S Belldegrun
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA
| | - Allan J Pantuck
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA.
| | - Daniel George
- Division of Hematology/Oncology, Duke University Medical Center, NC
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Abstract
There are clear gender-dependent differences in response rates and the probability of side effects in patients treated with chemotherapy. Sex-biased expression levels of metabolic enzymes and transporters in liver and kidney leading to different pharmacokinetics have been described for most common anti-cancer drugs. In women, half-life is often longer, which is associated with improved survival, but also increased toxicity.Some chemotherapy protocols lead to a better response rate in women without increasing toxicity (e.g., cisplatin and irinotecan), while others only increase toxicity, but do not improve response rates in women (e.g., 5-fluorouracil). The increased toxicity often correlates with different pharmacokinetics, but women also show a higher sensitivity to some agents with shorter half-life (e.g., steroids). Organ-specific toxicities like cardiac toxicity after doxorubicin treatment or neurotoxicity associated with ifosfamide are more severe in women due to gender-specific changes in gene expression. Novel therapies like tyrosine kinase inhibitors or monoclonal antibodies show very complex, but clinical significant differences depending on gender. Antibodies often have a longer half-life in women, which is associated with an improved response to therapy.Side effects appear to be highly dependent on different tissue properties, as women have a higher incidence of oral mucositis, but lower rates of gut toxicity. Nausea and vomiting is a greater problem in females during therapy due to the lower activity of anti-emetic drugs. Nausea and vomiting pose a bigger challenge in female patients, as anti-emetic drugs seem to be less effective.
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Affiliation(s)
- Oliver Schmetzer
- Max-Delbrück-Centrum for Molecular Medicine Molecular Immunotherapy, Berlin, Germany.
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Svensson G, Ewers SB, Ohlsson O, Olsson H. Prognostic factors in lung cancer in a defined geographical area over two decades with a special emphasis on gender. CLINICAL RESPIRATORY JOURNAL 2012; 7:91-100. [DOI: 10.1111/j.1752-699x.2012.00289.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Blumenstein I, Herrmann E, Filmann N, Zosel C, Tacke W, Bock H, Dignass A, Hartmann F, Zeuzem S, Stein J, Schröder O. Female patients suffering from inflammatory bowel diseases are treated less frequently with immunosuppressive medication and have a higher disease activity: a subgroup analysis of a large multi-centre, prospective, internet-based study. J Crohns Colitis 2011; 5:203-10. [PMID: 21575882 DOI: 10.1016/j.crohns.2010.12.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/18/2010] [Accepted: 12/21/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND The introduction of immunosuppressants and biologic agents has led to active debate and research about optimal therapeutic strategies considering risk factors and predictors of clinical outcome in inflammatory bowel disease (IBD). Data about gender-specific treatment differences and risk factors is lacking for IBD. The aim of the present study was to evaluate gender-related differences in the treatment of a distinct IBD patient population treated in the Rhein-Main region, Germany. METHODS Data about past medical history, disease status and medical treatment of 986 outpatients treated in ten gastroenterological practices and three hospitals were collected from November 1st 2005-July 31st 2007 and analyzed with regard to gender-related differences in therapy and disease management. RESULTS With the exception of an extended disease duration in women, no significant gender-related differences in demographic and clinical characteristics were observed. Men showed a significantly higher remission rate than women (p=0.025), while women received significantly less immunosuppressive medication compared to men (p=0.011). In addition, treatment with immunosuppressants was not different in women with child-bearing potential compared to menopausal women. CONCLUSION Our investigation demonstrates for the first time gender-specific differences in the therapeutic management in a large cohort of IBD patients.
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Affiliation(s)
- I Blumenstein
- First Department of Internal Medicine, Division of Gastroenterology, Goethe-University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany
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Ramalingam SS, Owonikoko TK, Khuri FR. Lung cancer: New biological insights and recent therapeutic advances. CA Cancer J Clin 2011; 61:91-112. [PMID: 21303969 DOI: 10.3322/caac.20102] [Citation(s) in RCA: 344] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Approximately 1.6 million new cases of lung cancer are diagnosed each year throughout the world. In many countries, the mortality related to lung cancer continues to rise. The outcomes for patients with all stages of lung cancer have improved in recent years. The use of systemic therapy in conjunction with local therapy has led to improved cure rates in both resectable and unresectable patient groups. For patients with advanced stage disease, modest but real improvements in overall survival and quality of life have been achieved with systemic chemotherapy. A major focus of research has been the development of molecularly targeted agents and the identification of biomarkers for patient selection. Patients with non-small cell lung cancer with mutations in the epidermal growth factor receptor (EGFR) tyrosine kinase domain achieve response rates of greater than 70% and superior progression-free survival when treated with an EGFR tyrosine kinase inhibitor compared with standard chemotherapy. This has now emerged as the preferred therapeutic approach for the subset of patients with a mutation in exons 19 or 21 of the EGFR. Another promising targeted approach involves the use of an anaplastic lymphoma kinase (ALK) inhibitor in patients with a translocation involving the echinoderm microtubule-associated protein-like 4 (EML4) and -ALK genes. Finally, a paradigm shift in favor of maintenance therapy for patients with advanced stage disease has gained strength from recent data. All of these advances have been made possible by developing a greater understanding of the biology, the discovery of novel anticancer agents, and improved supportive care measures. This article reviews the major strides made in the treatment of lung cancer in the recent past.
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Affiliation(s)
- Suresh S Ramalingam
- Department of Hematology and Medical Oncology and The Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Wang H, Zhang D, Wu W, Zhang J, Guo D, Wang Q, Jing T, Xu C, Bian X, Yang K. Overexpression and gender-specific differences of SRC-3 (SRC-3/AIB1) immunoreactivity in human non-small cell lung cancer: an in vivo study. J Histochem Cytochem 2010; 58:1121-7. [PMID: 20852035 DOI: 10.1369/jhc.2010.956979] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Steroid receptor coactivator-3 (SRC-3) has been reported to be overexpressed in the development and progression of many tumor types. SRC-3 has been detected in several lung cancer cell lines, but its expression and clinical significance in non-small cell lung cancer (NSCLC) remain unclear. In this study, 48 NSCLC tissues were collected and tissue microarrays were performed. The expression of SRC-3 was examined using nickel-intensified IHC. The results showed that of these 48 cases, 18 (37.5%) exhibited high levels of SRC-3 immunoreactivity, 23 (47.9%) exhibited moderate levels of SRC-3 immunoreactivity, and 7 (14.6%) were negative; thus, the total frequency of SRC-3 overexpression was 85.4% (41/48). This SRC-3 overexpression frequency was similar to the overexpression frequency observed for squamous cell carcinoma and adenocarcinoma (82.1% vs 90%) and for metastasis and non-metastasis patients (84.6% vs 85.7%). Data analysis demonstrated a significantly higher overexpression frequency in male patients compared with that in female patients (88.6% vs 76.9%). However, female patients tended to have higher expression levels of SRC-3, as measured by immunoreactivity, than male patients. These results demonstrate a high frequency of SRC-3 overexpression in NSCLC with a gender difference, suggesting that there is a specific role for SRC-3 in the pathogenesis of NSCLC.
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Affiliation(s)
- Haidong Wang
- Department of Thoracic Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
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Paggi MG, Vona R, Abbruzzese C, Malorni W. Gender-related disparities in non-small cell lung cancer. Cancer Lett 2010; 298:1-8. [PMID: 20826048 DOI: 10.1016/j.canlet.2010.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 08/10/2010] [Accepted: 08/13/2010] [Indexed: 02/08/2023]
Abstract
Epidemiological studies clearly outline some disparities in cancer onset, progression as well as prognosis and therapeutic response between sexes. In particular, in lung cancer, the leading cause of cancer death, at least in Western countries, a gender disparity appears now to emerge, especially for non-small cell lung cancer (NSCLC). Such a disparity is apparently due to a variety of mechanisms, ranging from genetic and epigenetic differences to gender-specific lifestyle as well as to behavioral causes and, clearly, to sex hormones activity. Here we briefly recapitulate gender differences in terms of risk factors, histopathological features and pathogenetic mechanisms in NSCLC, and hypothesize that a gender-oriented pharmacology could beneficially impact on innovative therapeutic strategies.
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Affiliation(s)
- Marco G Paggi
- Department of Development of Therapeutic Programs, National Cancer Institute "Regina Elena", Via Elio Chianesi 53, 00144 Rome, Italy
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40
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Ito H, Matsuo K, Tanaka H, Koestler DC, Ombao H, Fulton J, Shibata A, Fujita M, Sugiyama H, Soda M, Sobue T, Mor V. Nonfilter and filter cigarette consumption and the incidence of lung cancer by histological type in Japan and the United States: Analysis of 30-year data from population-based cancer registries. Int J Cancer 2010; 128:1918-28. [DOI: 10.1002/ijc.25531] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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