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Lee FSW, Chen YH, Tran ND, Lin CK, Pham LA. Association between Asbestos Exposure and the Incidence of Kidney Cancer: a Weight-of-Evidence Evaluation and Meta-analysis. Curr Environ Health Rep 2023; 10:394-409. [PMID: 37889448 DOI: 10.1007/s40572-023-00415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Occupational asbestos exposure has been extensively linked to various cancers, with ongoing debates regarding its association with kidney cancer. This study aims to investigate the correlation between occupational asbestos exposure and kidney cancer incidence. Additionally, potential influencing factors are analyzed to enhance the comprehension of the relationship between asbestos exposure and kidney cancer. RECENT FINDING While asbestos has established strong associations with malignant mesothelioma and lung cancer, its connection to other malignancies such as gastric, colorectal, and kidney cancers remains under scrutiny. The current study presents mixed opinions on the relationship between asbestos exposure and kidney cancer. Our analysis revealed a potential association between asbestos exposure and the incidence of kidney cancer. Notably, among different types of asbestos, exposure to amphibole appeared to be particularly linked to a higher incident risk of kidney cancer.
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Affiliation(s)
- Fu-Shiuan Whitney Lee
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yu-Han Chen
- Department of Internal Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA
| | - Ngoc Dang Tran
- Department of Environmental and Occupational Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Cheng-Kuan Lin
- School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
- University Medical Shing Mark Hospital, Bien Hoa, Dong Nai, Vietnam.
| | - Le An Pham
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Family Medicine, Hospital of University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
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Peng Z, Hu Y, Ren J, Yu N, Li Z, Xu Z. Circulating Th22 cells, as well as Th17 cells, are elevated in patients with renal cell carcinoma. Int J Med Sci 2021; 18:99-108. [PMID: 33390778 PMCID: PMC7738959 DOI: 10.7150/ijms.47384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
T-helper (Th) 22 cells serve an essential role in different types of tumors and autoimmune diseases. No research has been conducted to study the role of Th22 cells in the pathogenesis of renal cell carcinoma (RCC). We aimed to evaluate the prognostic value of circulating Th22, Th17, and Th1 cells in RCC patients. Thirty-two newly diagnosed RCC patients and thirty healthy controls were enlisted in the research. Their peripheral blood was collected, and the frequencies of circulating Th22, Th17, and Th1 cells were detected by flow cytometry. Plasma IL-22 concentrations were examined by an enzyme-linked immunosorbent assay (ELISA). Quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to identify the mRNA expression levels of aromatic hydrocarbon receptor (AHR) and RAR-associated orphan receptor C (RORC) in peripheral blood mononuclear cells (PBMC). Compared with the healthy control group, the frequency of circulating Th22 and Th17 cells and concentrations of plasma IL-22 were significantly increased in RCC patients. However, there was no significant difference in the frequency of Th1 cells. A positive correlation between Th22 cells and plasma IL-22 levels was found in RCC patients. Also, there was a significant positive correlation between Th22 and Th17 cells in RCC patients. An up-regulated expression of AHR and RORC transcription factors were also observed in RCC patients. As tumor stage and grade progressed, the frequencies of Th22 and Th17 cells and the level of plasma IL-22 significantly increased. Meanwhile, there was a positive correlation between Th22 and Th17 cells and RCC tumor stage or grade. Furthermore, patients with high Th22 or Th17 cells frequency displayed a decreased trend in survival rate. Our research indicated that the increased circulating Th22 and Th17 cells and plasma IL-22 may be involved in the pathogenesis of RCC and may be involved in the occurrence and development of tumors. Th22 cells, plasma IL-22, and Th17 cells may be promising new clinical biomarkers and may be used as cellular targets for RCC therapeutic intervention.
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Affiliation(s)
- Zhiguo Peng
- Department of Urology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
| | - Yu Hu
- Department of Medical Oncology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
| | - Juchao Ren
- Department of Urology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
| | - Nengwang Yu
- Department of Urology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
| | - Zeyan Li
- Department of Urology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
| | - Zhonghua Xu
- Department of Urology, Qilu Hospital, Shandong University, 107 Wenhua West Road, Jinan 250012, PR China
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Michalek IM, Kinnunen TI, Kjaerheim K, Lynge E, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Smoking-adjusted risk of kidney cancer by occupation: a population-based cohort study of Nordic men. Acta Oncol 2020; 59:582-587. [PMID: 32009517 DOI: 10.1080/0284186x.2020.1714722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 01/08/2020] [Indexed: 12/28/2022]
Abstract
Background: Evidence suggests that among some occupational groups, there is an elevated risk of kidney cancer. This might, however, derive from a difference in smoking habits across occupational groups. The objective of this study was to determine smoking-adjusted occupational variation in the incidence of kidney cancer in Nordic males.Material and Methods: The source population for this study consisted of 7.4 million men from Denmark, Iceland, Finland, Norway, and Sweden. Data on occupation were obtained from national censuses conducted in the years 1960-1990. Data on cancer cases came from national cancer registries. A proxy for the occupation-specific smoking prevalence among all Nordic men was calculated based on the occupation-specific smoking prevalence and lung cancer incidence data for Finnish men. Smoking-adjusted standardized incidence ratio (SIRadj) with 95% confidence intervals (95%CI) were calculated for each occupational group.Results: The highest SIRadj estimates were observed in dentists (1.32, 95%CI 1.06-1.62), journalists (1.20, 95%CI 1.00-1.42), physicians (1.19, 95%CI 1.03-1.36), public safety workers (1.18, 95%CI 1.10-1.26), administrators (1.17, 95%CI 1.13-1.22), military personnel (1.16, 95%CI 1.05-1.28), and religious workers (1.17, 95%CI 1.09-1.26). The lowest SIRadj was observed among forestry workers (0.82, 95%CI 0.76-0.88).Conclusions: Tobacco smoking plays an important role in the occupational variation in the risk of kidney cancer. The smoking-adjusted incidence of kidney cancer was increased in dentists, physicians, journalists, administrators, and public safety workers.
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Affiliation(s)
- Irmina Maria Michalek
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Women-Mother-Child Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Tarja I Kinnunen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Denmark
| | - Jan Ivar Martinsen
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Pär Sparen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eero Pukkala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Peters CE, Parent MÉ, Harris SA, Kachuri L, Latifovic L, Bogaert L, Villeneuve PJ. Workplace exposure to asbestos and the risk of kidney cancer in Canadian men. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2018; 109:464-472. [PMID: 30225576 PMCID: PMC6182333 DOI: 10.17269/s41997-018-0095-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/30/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Previous studies considered the role of occupational causes in kidney cancer but were limited by small sample sizes and imprecise exposure assessment. This study examined the relationship between occupational exposure to asbestos and the risk of kidney cancer across a range of jobs in a large, population-based case-control study in Canada. METHODS Data were from the case-control component of the National Enhanced Cancer Surveillance System, a study conducted between 1994 and 1997 in eight Canadian provinces. Male kidney cancer cases, histologically confirmed, and controls completed questionnaires on socio-demographics, anthropometry, diet, smoking, secondhand smoke exposure, and physical activity. Occupational histories were also collected, including each job held for at least 1 year since the age of 18. Occupational hygienists, blinded to case status, assigned exposure to asbestos, considering intensity, frequency, and probability of exposure (each 3-point scales). Logistic regression was used to estimate the odds of kidney cancer in exposed participants (defined using three metrics) compared to those without asbestos exposure. RESULTS There were 712 cases and 2454 controls in these analyses. Ever-exposure to asbestos was associated with 20% increased odds of kidney cancer compared to unexposed workers (OR 1.2, 95% confidence interval 1.0-1.4 when including possibly exposed workers). A small increase in risk was observed with cumulative exposure, while increasing intensity of exposure was related to increased odds of kidney cancer. CONCLUSIONS This study found some evidence for an association between occupational exposure to asbestos and kidney cancer. Higher intensity of exposure to asbestos had the strongest relationship with kidney cancer risk.
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Affiliation(s)
- Cheryl E Peters
- Department of Health Sciences, Carleton University, 3rd Floor, Health Sciences Building, Ottawa, ON, K1S 5B6, Canada.
- Institut Armand Frappier-Institut National de la Recherche Scientifique, Laval, QC, Canada.
| | - Marie-Élise Parent
- Institut Armand Frappier-Institut National de la Recherche Scientifique, Laval, QC, Canada
| | - Shelley A Harris
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Linda Kachuri
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lidija Latifovic
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Laura Bogaert
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, 3rd Floor, Health Sciences Building, Ottawa, ON, K1S 5B6, Canada
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Farioli A, Straif K, Brandi G, Curti S, Kjaerheim K, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Biasco G, Violante FS, Mattioli S, Pukkala E. Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case-control study in four Nordic countries. Occup Environ Med 2018; 75:191-198. [PMID: 29133597 PMCID: PMC5869450 DOI: 10.1136/oemed-2017-104603] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/01/2017] [Accepted: 09/28/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). METHODS We conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work. RESULTS We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC. CONCLUSIONS Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed.
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Affiliation(s)
- Andrea Farioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Kurt Straif
- International Agency for Research on Cancer, Lyon, France
| | - Giovanni Brandi
- Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
- ‘G. Prodi’ Interdepartmental Center for Cancer Research, University of Bologna, Bologna, Italy
| | - Stefania Curti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Jan Ivar Martinsen
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Pär Sparen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Guido Biasco
- Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
- ‘G. Prodi’ Interdepartmental Center for Cancer Research, University of Bologna, Bologna, Italy
| | | | - Stefano Mattioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Bianchi C, Bianchi T, Ramani L. Malignant Mesothelioma of the Pleuraand Other Malignancies in the Same Patient. TUMORI JOURNAL 2018; 93:19-22. [PMID: 17455866 DOI: 10.1177/030089160709300104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The co-existence of mesothelioma, mostly asbestos-related, and other primary malignancies has repeatedly been reported. The present study evaluated the frequency of such an occurrence. Methods In the period October 1979-June 2002, 215 cases of malignant pleural mesothelioma were diagnosed at the Hospital of Monfalcone, Italy. All the cases of the above series, examined at necropsy (169), were included in the study. Occupational histories had been obtained from the patients or from their relatives by personal or telephone interviews. In 132 cases, asbestos bodies were isolated after chemical digestion of lung samples. The thoracic cavities were examined for pleural plaques. Results Additional malignancies were observed in 32 cases (18.9%). Multiple tumors were synchronous in 22 cases, metachronous in 8 cases, and synchronous and metachronous in 2. Four different tumors were found in 2 cases, 3 malignancies were detected in 6 patients, and 2 malignancies in the remaining 24. The most frequent additional malignancies were prostate adenocarcinoma (7 cases), non-Hodgkin lymphoma or chronic lymphocytic leukaemia (5 cases), bladder carcinoma (4 cases), kidney carcinoma (4 cases), large bowel carcinoma (4 cases), and liver cell carcinoma (4 cases). All the patients had histories of exposure to asbestos, mostly in shipbuilding. Lung asbestos body burdens ranged between 60 and 230,000 per gram of dried tissue. Pleural plaques were found in 26 cases. Conclusions In contrast with other series of the literature, in the present cases the co-existence of mesothelioma and other malignancies appeared as a relatively frequent event. The lack of a control group does not allow definite conclusions about the meaning of the occurrence. However, the co-existence of certain tumors with asbestos-related mesothelioma suggests that mesothelioma and associated malignancies might share some etiologic factors (asbestos and others).
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Affiliation(s)
- Claudio Bianchi
- Center for the Study of Environmental Cancer, Italian League against Cancer, Monfalcone, Gorizia, Italy.
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Möhner M, Pohrt A, Gellissen J. Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis. Int Arch Occup Environ Health 2017; 90:555-574. [PMID: 28409224 PMCID: PMC5583269 DOI: 10.1007/s00420-017-1219-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 04/05/2017] [Indexed: 12/12/2022]
Abstract
Background While occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear. Objectives This review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed. Methods Cohort studies with silica exposure and case–control studies of renal disease were searched in PubMed until January 2015. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. A meta-analysis was performed to evaluate the association to silica exposure. Results A total of 23 cohort and four case–control studies were included in the analysis. The meta-analysis of cohort studies yielded elevated overall SMRs for renal disease. Some studies, however, included dose–response analyses, most of which did not show a positive trend. The approaches and results of the case–control studies were very heterogeneous. Conclusions While the studies of cohorts exposed to silica found elevated SMRs for renal disease, no clear evidence of a dose–response relationship emerged. The elevated risk may be attributed to diagnostic and methodological issues. In order to permit a reliable estimation of a possible causal link, exposed cohorts should be monitored for renal disease, as the information from mortality studies is hardly reliable in this field. Electronic supplementary material The online version of this article (doi:10.1007/s00420-017-1219-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthias Möhner
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany.
| | - Anne Pohrt
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany
| | - Johannes Gellissen
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany
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Mariusdottir E, Ingimarsson JP, Jonsson E, Einarsson GV, Aspelund T, Gudnason V, Gudbjartsson T. Occupation as a risk factor for renal cell cancer: a nationwide, prospective epidemiological study. Scand J Urol 2016; 50:181-5. [DOI: 10.3109/21681805.2016.1151460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Matsumoto R, Shinohara N, C-Hatanaka K, Kuroda N, Tsuchiya K, Maruyama S, Abe T, Nonomura K. Concurrent occurrence of renal cell carcinoma with rhabdoid features in a married couple: a case report. BMC Res Notes 2015; 8:3. [PMID: 25588411 PMCID: PMC4302605 DOI: 10.1186/s13104-014-0957-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 12/23/2014] [Indexed: 11/29/2022] Open
Abstract
Background Renal cell carcinoma (RCC) with rhabdoid features is a rare histology and exhibits clinically aggressive behavior. We report a case of a married couple in whom RCC with rhabdoid features concurrently occurred. The rarity of this event suggests that environmental factors may contribute to the etiology of RCC with rhabdoid features. Case presentation A 76-year-old Japanese woman was diagnosed with a hypervascular mass in the right kidney and tumor thrombus extending into the right atrium by enhanced computed tomography (CT). She underwent radical nephrectomy and tumor thrombectomy following systemic therapy with the tyrosine kinase inhibitor sunitinib. The histological evaluation denoted clear cell RCC with rhabdoid features. The patient died of cancer 12 months postoperatively. A 76-year-old man, her husband, presented with gross hematuria 2 weeks after his wife had undergone surgery. He had a long history of asbestos exposure. An abdominal CT scan revealed a hypervascular mass in the right kidney and tumor thrombus extending into the inferior vena cava. He also underwent radical nephrectomy and tumor thrombectomy. The histological evaluation also showed clear cell RCC with rhabdoid features. Bone metastasis occurred 12 months postoperatively, but he died of an unrelated cause 18 months after surgery. Conclusion Concurrent occurrence of RCC with rhabdoid features may not to be coincidental. Although further studies are warranted, asbestos exposure may contribute to the etiology of clear cell RCC with rhabdoid features.
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Affiliation(s)
- Ryuji Matsumoto
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
| | - Kanako C-Hatanaka
- Department of Pathology, Hokkaido University Hospital, North-14, West-5, Sapporo, Japan.
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan.
| | - Kunihiko Tsuchiya
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
| | - Satoru Maruyama
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
| | - Takashige Abe
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
| | - Katsuya Nonomura
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Japan.
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Narayanan S, Patel PH, Fan A, Srinivas S. Epidemiology of Renal Cell Carcinoma. KIDNEY CANCER 2015. [DOI: 10.1007/978-3-319-17903-2_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Asbestos: a hidden player behind the cholangiocarcinoma increase? Findings from a case-control analysis. Cancer Causes Control 2013; 24:911-8. [PMID: 23408245 PMCID: PMC3631123 DOI: 10.1007/s10552-013-0167-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 02/04/2013] [Indexed: 12/16/2022]
Abstract
Purposes We conducted a case–control analysis to explore the association between occupational exposure to asbestos and cholangiocarcinoma (CC). Methods The study was based on historical data from 155 consecutive patients with CC [69 intrahepatic CC (ICC) and 86 extrahepatic CC (ECC)] referred to Sant’Orsola-Malpighi University Hospital between 2006 and 2010. The cases were individually matched by calendar period of birth, sex, and region of residence to historical hospital and population controls. Occupational exposure to asbestos was retrospectively assessed considering job titles obtained from work histories. Separate conditional logistic regression models were applied for ECC and ICC. Estimates were adjusted for smoking status and socioeconomic class. Results We matched 149 controls (median birth year: 1947; males: 56 %) to 41 cases of ICC (median birth year: 1946; males: 56 %) and 212 controls (median birth year: 1945; males: 48 %) to 59 cases of ECC (median birth year: 1945; males 51 %); 53 cases were not matched due to residence or birth year. We found an increased risk of ICC in workers exposed to asbestos (adjusted OR 4.81, 95 % CI 1.73–13.33); we also observed suggestive evidence that asbestos exposure might be associated with ECC (adjusted OR 2.09, 95 % CI 0.83–5.27). Sensitivity analysis restricted to patients from the Province of Bologna produced confirmatory figures. Conclusions Our findings suggest that ICC could be associated with asbestos exposure; a chronic inflammatory pathway is hypothesized. Exposure to asbestos could be one of the determinants of the progressive rise in the incidence of ICC during the last 30 years.
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Bellocco R, Pasquali E, Rota M, Bagnardi V, Tramacere I, Scotti L, Pelucchi C, Boffetta P, Corrao G, La Vecchia C. Alcohol drinking and risk of renal cell carcinoma: results of a meta-analysis. Ann Oncol 2012; 23:2235-2244. [PMID: 22398178 DOI: 10.1093/annonc/mds022] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The role of alcohol consumption in relation with renal cell carcinoma is still unclear; a few studies have reported a beneficial effect of moderate levels of alcohol consumption, whereas it remains still under debate whether there is a dose-response association. MATERIALS AND METHODS Twenty observational studies (4 cohort, 1 pooled and 15 case-control) reporting results on at least three levels of alcohol consumption were selected through a combined search with PubMed and EMBASE of articles published before November 2010. Overall relative risks (RRs) and 95% confidence intervals (CIs) were estimated using random-effects models, and both second-order fractional polynomials and random effect meta-regression models were implemented for the study of dose-risk relation. RESULTS The estimated RRs were 0.85 (95% CI: 0.80-0.92) for any alcohol drinking, 0.90 (95% CI: 0.83-0.97) for light drinking (0.01-12.49 g/day), 0.79 (95% CI: 0.71-0.88) for moderate drinking (12.5-49.9 g/day) and 0.89 (95% CI: 0.58-1.39) for heavy drinking (≥50 g/day), respectively. CONCLUSION Our meta-analysis supports the hypothesis of a negative effect of moderate alcohol consumption on the risk of renal cell cancer.
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Affiliation(s)
- R Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Statistics, University of Milano-Bicocca, Milan.
| | - E Pasquali
- Department of Statistics, University of Milano-Bicocca, Milan
| | - M Rota
- Department of Statistics, University of Milano-Bicocca, Milan; Department of Clinical Medicine and Prevention, Centre of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza
| | - V Bagnardi
- Department of Statistics, University of Milano-Bicocca, Milan; Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan
| | - I Tramacere
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - L Scotti
- Department of Statistics, University of Milano-Bicocca, Milan
| | - C Pelucchi
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - P Boffetta
- International Prevention Research Institute, Lyon, France; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - G Corrao
- Department of Statistics, University of Milano-Bicocca, Milan
| | - C La Vecchia
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
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14
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Karami S, Colt JS, Schwartz K, Davis FG, Ruterbusch JJ, Munuo SS, Wacholder S, Stewart PA, Graubard BI, Rothman N, Chow WH, Purdue MP. A case-control study of occupation/industry and renal cell carcinoma risk. BMC Cancer 2012; 12:344. [PMID: 22873580 PMCID: PMC3502582 DOI: 10.1186/1471-2407-12-344] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 07/09/2012] [Indexed: 01/22/2023] Open
Abstract
Background The role of occupation in the etiology of renal cell carcinoma (RCC) is unclear. Here, we investigated associations between employment in specific occupations and industries and RCC, and its most common histologic subtype, clear cell RCC (ccRCC). Methods Between 2002 and 2007, a population-based case–control study of Caucasians and African Americans (1,217 cases; 1,235 controls) was conducted within the Detroit and Chicago metropolitan areas to investigate risk factors for RCC. As part of this study, occupational histories were ascertained through in-person interviews. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating occupation and industry to RCC risk using adjusted unconditional logistic regression models. Results Employment in the agricultural crop production industry for five years or more was associated with RCC (OR = 3.3 [95% CI = 1.0-11.5]) and ccRCC in particular (OR = 6.3 [95% CI = 1.7-23.3], P for trend with duration of employment = 0.0050). Similarly, RCC risk was elevated for employment of five years or longer in non-managerial agricultural and related occupations (ORRCC = 2.1 [95% CI = 1.0-4.5]; ORccRCC = 3.1 [95% CI = 1.4-6.8]). Employment in the dry-cleaning industry was also associated with elevated risk (ORRCC = 2.0 [95% CI = 0.9-4.4], P for trend = 0.093; ORccRCC = 3.0 [95% CI = 1.2-7.4], P for trend = 0.031). Suggestive elevated associations were observed for police/public safety workers, health care workers and technicians, and employment in the electronics, auto repair, and cleaning/janitorial services industries; protective associations were suggested for many white-collar jobs including computer science and administrative occupations as well employment in the business, legislative, and education industries. Conclusions Our findings provide support for an elevated risk of RCC in the agricultural and dry-cleaning industries and suggest that these associations may be stronger for the ccRCC subtype. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Sara Karami
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 6120 Executive Boulevard, MSC 7242, Bethesda, MD 20892-7242, USA.
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15
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Navai N, Wood CG. Environmental and modifiable risk factors in renal cell carcinoma. Urol Oncol 2012; 30:220-4. [PMID: 22385993 DOI: 10.1016/j.urolonc.2011.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Prevention of disease requires a firm understanding of the relevant environmental and modifiable risk factors. We present a comprehensive review of these factors in renal cell carcinoma. MATERIALS AND METHODS A literature search of the PubMed database was performed to identify clinical studies examining the relationship between environmental and modifiable factors in the development of renal cell carcinoma (terms utilized: kidney cancer; renal cell carcinoma; risk factors; environment; obesity; hypertension; trichloroethylene). An emphasis was placed on more recent studies. RESULTS Case control and large cohort studies have examined the relationship of numerous environmental and modifiable factors and the risk of renal cell carcinoma. Of particular note are dose-dependent increases in smokers, the obese, and hypertensive patients. CONCLUSIONS Environmental and modifiable risk factors contribute significantly to the risk of sporadic renal cell carcinoma. Emphasis should be placed on smoking cessation and hypertension control. Emerging evidence would suggest that dietary intake and quality impact renal cell carcinoma risk.
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Affiliation(s)
- Neema Navai
- Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77054, USA.
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16
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Song DY, Song S, Song Y, Lee JE. Alcohol intake and renal cell cancer risk: a meta-analysis. Br J Cancer 2012; 106:1881-90. [PMID: 22516951 PMCID: PMC3364130 DOI: 10.1038/bjc.2012.136] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 03/13/2012] [Accepted: 03/18/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND An inverse association between alcoholic beverage intake and risk of renal cell cancer has been suggested in recent studies. METHODS We examined the association between alcoholic beverages and renal cell cancer risk in a meta-analysis. We identified relevant studies by searching the database of PubMed, EMBASE, and MEDLINE published through August 2011. We combined the study-specific relative risks (RRs) using a random-effects model. RESULTS A total of 20 case-control studies, 3 cohort studies, and 1 pooled analysis of cohort studies were included in the meta-analysis. We observed that alcoholic beverage intake was associated with a lower risk of renal cell cancer in combined analysis of case-control and cohort studies; for total alcoholic beverage intake, combined RRs (95% confidence intervals) comparing top with bottom categories were 0.76 (0.68-0.85) in case-control studies, and 0.71 (0.63-0.78) in cohort studies (P for difference by study design=0.02). The inverse associations were observed for both men and women and for each specific type alcoholic beverage (beer, wine, and liquor). Also, we found that one drink per day of alcoholic beverage conferred the reduction in renal cell cancer risk, but further drinking above that level did not add benefit. CONCLUSION The findings from our meta-analysis support the hypothesis that alcoholic beverage intake is inversely associated with a lower risk of renal cell cancer, with moderate consumption conferring the protection and higher consumption conferring no additional benefits.
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Affiliation(s)
- D Y Song
- Department of Food and Nutrition, Sookmyung Women’s University, 52 Hyochangwon-gil, Yongsan-gu, Seoul 140-742, Republic of Korea
| | - S Song
- Department of Food and Nutrition, Seoul National University, Seoul 151-742, Republic of Korea
| | - Y Song
- School of Human Ecology, Catholic University, Gyeongi-do 420-743, Republic of Korea
| | - J E Lee
- Department of Food and Nutrition, Sookmyung Women’s University, 52 Hyochangwon-gil, Yongsan-gu, Seoul 140-742, Republic of Korea
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17
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Patel PH, Srinivas S. Epidemiology of Renal Cell Carcinoma. KIDNEY CANCER 2012. [DOI: 10.1007/978-3-642-21858-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Abstract
Renal cell cancer (RCC) is increasingly diagnosed at an early stage in many countries, which likely contributes to the recent leveling of RCC mortality in the United States and many European countries. However, over all stages nearly 50% of the patients die within 5 years after diagnosis. Smoking and obesity may account for approximately 40% of all incidental cases in high-risk countries. Besides obesity, rising prevalence of hypertension may play a growing role. Several other occupational and lifestyle factors may also affect the risk of RCC. Genetic variations may be an important factor in the differing incidence among populations.
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Affiliation(s)
- Eunyoung Cho
- Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA.
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19
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Thakur A, Jain SK. Kidney Cancer: Current Progress in Treatment. World J Oncol 2011; 2:158-165. [PMID: 29147242 PMCID: PMC5649653 DOI: 10.4021/wjon345w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2011] [Indexed: 02/01/2023] Open
Abstract
Kidney cancer accounts for approximately 2% of all cancers worldwide, with renal cell carcinoma being the most widespread form. Worldwide, the occurrence and mortality rates are rising by 2–3% per decade. Cigarette smoking, obesity, acquired cystic kidney disease and inherited vulnerability are identified risk issues for kidney cancer. Immunotherapy confers a small but significant overall survival benefit in metastatic renal cell carcinoma but only for the minority of patients, i.e. the 20% with good predictive characteristics. Current developments in the molecular biology of renal cell carcinoma have recognized multiple pathways related with the progress of this cancer. Several strategies have been explored targeting these trails, with major clinical benefits shown in early studies. New agents including the small molecule targeted inhibitors like sunitinib, sorafenib and temsirolimus, and the monoclonal antibody bevacizumab have shown anti-tumour activity in randomised clinical trials and have become the standard of care for most patients.
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Affiliation(s)
- Ankita Thakur
- Faculty of Pharmacy, Adina Institute of Pharmaceutical Sciences, Sagar, M.P. - 470002, India
| | - Sunil K Jain
- Faculty of Pharmacy, Adina Institute of Pharmaceutical Sciences, Sagar, M.P. - 470002, India
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20
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Cheng G, Xie L. Alcohol intake and risk of renal cell carcinoma: a meta-analysis of published case-control studies. Arch Med Sci 2011; 7:648-57. [PMID: 22291801 PMCID: PMC3258765 DOI: 10.5114/aoms.2011.24135] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 11/10/2010] [Accepted: 12/24/2010] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION While some studies have indicated that alcohol intake is associated with a decreased risk of renal cell carcinoma, others have not. We conducted a meta-analysis of case-control studies to provide a quantitative assessment of the association between alcohol intake and the risk of renal cell carcinoma. MATERIAL AND METHODS We identified studies by a literature search of PubMed and review of references of relevant articles. Both the fixed and random-effects models were used to obtain the summary risk estimates associated with the highest versus the lowest consumption categories depending on the heterogeneity of effects among studies. Dose-response meta-analysis was performed for studies reporting categorical risk estimates for a series of exposure levels. RESULTS Fifteen studies were included in this meta-analysis. An inverse association between alcohol consumption and renal cell carcinoma was observed in both the overall alcohol intake group (OR 0.67, 95% CI 0.62-0.73) and subgroups stratified by sex, study design, geographical region, specific beverages and alcohol assessment. The dose-response meta-analysis showed that an increase in alcohol consumption of 12 g of ethanol per day was associated with a 5% statistically significant decreased risk of renal cell cancer. CONCLUSIONS High alcohol consumption exhibits a preventive effect for renal cell carcinoma in a dose-response manner. Further efforts should be made to clarify the underlying biological mechanisms.
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Affiliation(s)
- Guang Cheng
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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21
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Moore LE, Wilson RT, Campleman SL. Lifestyle Factors, Exposures, Genetic Susceptibility, and Renal Cell Cancer Risk: A Review. Cancer Invest 2009; 23:240-55. [PMID: 15945510 DOI: 10.1081/cnv-200055962] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Malignant kidney tumors account for approximately 2% of all new primary cancer cases diagnosed in the United States, with an estimated 30,000 cases occurring annually. Although a variety of agents, chemical and biological, have been implicated as causal agents in the development of renal cell carcinoma (RCC), the etiology remains enigmatic. The strongest association has been developed between cigarette smoking and renal cancer however consistent, positive associations between RCC and obesity, diabetes, and hypertension have also been reported. In addition, more recent investigations of familial kidney cancer syndromes indicate that a strong genetic component contributes to RCC development. Several genes have been identified through investigation of familial kidney cancer syndromes. This review article describes recent trends in RCC incidence and the currently identifiable etiological causes that account for approximately half of the RCC cases diagnoses. The remainder of this review then focuses on additional risk factors that have thus far not been well examined but may be helpful in explaining the increasing incidence trends and the geographic or racial variation observed nationally and worldwide.
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Affiliation(s)
- Lee E Moore
- Occupational Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA.
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22
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Abstract
We analyzed renal cell cancer incidence patterns in the United States and reviewed recent epidemiologic evidence with regard to environmental and host genetic determinants of renal cell cancer risk. Renal cell cancer incidence rates continued to rise among all racial/ethnic groups in the United States, across all age groups, and for all tumor sizes, with the most rapid increases for localized stage disease and small tumors. Recent cohort studies confirmed the association of smoking, excess body weight, and hypertension with an elevated risk of renal cell cancer, and suggested that these factors can be modified to reduce the risk. There is increasing evidence for an inverse association between renal cell cancer risk and physical activity and moderate intake of alcohol. Occupational exposure to trichloroethylene has been positively associated with renal cell cancer risk in several recent studies, but its link with somatic mutations of the von Hippel-Lindau gene has not been confirmed. Studies of genetic polymorphisms in relation to renal cell cancer risk have produced mixed results, but genome-wide association studies with larger sample size and a more comprehensive approach are underway. Few epidemiologic studies have evaluated risk factors by subtypes of renal cell cancer defined by somatic mutations and other tumor markers.
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23
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Schouten LJ, van Dijk BA, Oosterwijk E, van Engeland M, Hulsbergen-van de Kaa CA, Kiemeney LA, Goldbohm RA, Kester A, de Vogel S, Schalken JA, van den Brandt PA. Alcohol Consumption and Mutations or Promoter Hypermethylation of the von Hippel-Lindau Gene in Renal Cell Carcinoma. Cancer Epidemiol Biomarkers Prev 2008; 17:3543-50. [DOI: 10.1158/1055-9965.epi-08-0321] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Pelucchi C, Galeone C, Montella M, Polesel J, Crispo A, Talamini R, Negri E, Ramazzotti V, Grimaldi M, Franceschi S, La Vecchia C. Alcohol consumption and renal cell cancer risk in two Italian case–control studies. Ann Oncol 2008; 19:1003-8. [DOI: 10.1093/annonc/mdm590] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ji J, Granström C, Hemminki K. Occupational risk factors for kidney cancer: a cohort study in Sweden. World J Urol 2005; 23:271-8. [PMID: 16133557 DOI: 10.1007/s00345-005-0007-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2005] [Accepted: 05/16/2005] [Indexed: 10/25/2022] Open
Abstract
Although many studies have examined the associations between occupational exposures and kidney cancer, the evidence is not consistent. To examine the risk of occupational exposures on kidney cancer, we carried out a follow-up study on the economically active Swedish population, based on the latest update of the Swedish Family-Cancer Database. We calculated standardized incidence ratios (SIR) and 95% confidence intervals (CIs) for different occupational groups, adjusted for age, period, and socioeconomic status. The reference group was all the economically active population. An increased risk of renal parenchymal cancer was observed for miners and quarry workers, drivers, sales agents, transport workers, and public safety and protection workers among men, and launderers and dry cleaners among women. Significantly increased SIRs of renal pelvical cancer were also observed for the food manufacture workers among men, and journalists and shoe and leather industry workers among women. Male forestry workers, smelters, and metal foundry workers had increased risk for unspecified kidney cancer. Although smoking may explain some of these results, exposure to gasoline, diesel, their exposure products, some metal and chemicals in shoe and leather works, and dry-cleaning products may be associated with kidney cancer.
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Affiliation(s)
- Jianguang Ji
- Department of Bioscience at Novum, Karolinska Institute, Huddinge, Sweden.
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26
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Richard S, Carrette MN, Béroud C, Ferlicot S, Imbernon E, Iwatsubo Y, Egloff H, Sordet D, Salé JM. High incidence of renal tumours in vitamins A and E synthesis workers: a new cause of occupational cancer? Int J Cancer 2004; 108:942-4. [PMID: 14712501 DOI: 10.1002/ijc.11637] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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