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Wang D, Li P, Fei X, Che S, Li J, Xuan Y, Wang J, Han Y, Gu W, Wang Y. A combined diagnostic model based on circulating tumor cell in patients with solitary pulmonary nodules. J Gene Med 2023; 25:e3529. [PMID: 37194408 DOI: 10.1002/jgm.3529] [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: 04/04/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Although many prediction models in diagnosis of solitary pulmonary nodules (SPNs) have been developed, few are widely used in clinical practice. It is therefore imperative to identify novel biomarkers and prediction models supporting early diagnosis of SPNs. This study combined folate receptor-positive circulating tumor cells (FR+ CTC) with serum tumor biomarkers, patient demographics and clinical characteristics to develop a prediction model. METHODS A total of 898 patients with a solitary pulmonary nodule who received FR+ CTC detection were randomly assigned to a training set and a validation set in a 2:1 ratio. Multivariate logistic regression was used to establish a diagnostic model to differentiate malignant and benign nodules. The receiver operating curve (ROC) and the area under the curve (AUC) were calculated to assess the diagnostic efficiency of the model. RESULTS The positive rate of FR+ CTC between patients with non-small cell lung cancer (NSCLC) and benign lung disease was significantly different in both the training and the validation dataset (p < 0.001). The FR+ CTC level was significantly higher in the NSCLC group compared with that of the benign group (p < 0.001). FR+ CTC (odds ratio, OR, 95% confidence interval, CI: 1.13, 1.07-1.19, p < 0.0001), age (OR, 95% CI: 1.06, 1.01-1.12, p = 0.03) and sex (OR, 95% CI: 1.07, 1.01-1.13, p = 0.01) were independent risk factors of NSCLC in patients with a solitary pulmonary nodule. The area under the curve (AUC) of FR+ CTC in diagnosing NSCLC was 0.650 (95% CI, 0.587-0.713) in the training set and 0.700 (95% CI, 0.603-0.796) in the validation set, respectively. The AUC of the combined model was 0.725 (95% CI, 0.659-0.791) in the training set and 0.828 (95% CI, 0.754-0.902) in the validation set, respectively. CONCLUSIONS We confirmed the value of FR+ CTC in diagnosing SPNs and developed a prediction model based on FR+ CTC, demographic characteristics, and serum biomarkers for differential diagnosis of solitary pulmonary nodules.
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Affiliation(s)
- Dong Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Peng Li
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiang Fei
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuyu Che
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinlong Li
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yunpeng Xuan
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinglong Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yudong Han
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weiqing Gu
- Department of Oncology, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, China
| | - Yongjie Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Jiang B, Pan J, Qian YY, He C, Xia J, He SX, Sha WH, Feng ZJ, Wan J, Wang SS, Zhong L, Xu SC, Li XL, Huang XJ, Zou DW, Song DD, Zhang J, Ding WQ, Chen JY, Chu Y, Zhang HJ, Yu WF, Xu Y, He XQ, Tang JH, He L, Fan YH, Chen FL, Zhou YB, Zhang YY, Yu Y, Wang HH, Ge KK, Jin GH, Xiao YL, Fang J, Yan XM, Ye J, Yang CM, Li Z, Song Y, Wen MY, Zong Y, Han X, Wu LL, Ma JJ, Xie XP, Yu WH, You Y, Lu XH, Song YL, Ma XQ, Li SD, Zeng B, Gao YJ, Ma RJ, Ni XG, He CH, Liu YP, Wu JS, Liu J, Li AM, Chen BL, Cheng CS, Sun XM, Ge ZZ, Feng Y, Tang YJ, Li ZS, Linghu EQ, Liao Z. Clinical guideline on magnetically controlled capsule gastroscopy (2021 edition). J Dig Dis 2023; 24:70-84. [PMID: 37220999 DOI: 10.1111/1751-2980.13173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023]
Abstract
With the development and generalization of endoscopic technology and screening, clinical application of magnetically controlled capsule gastroscopy (MCCG) has been increasing. In recent years, various types of MCCG are used globally. Therefore, establishing relevant guidelines on MCCG is of great significance. The current guidelines containing 23 statements were established based on clinical evidence and expert opinions, mainly focus on aspects including definition and diagnostic accuracy, application population, technical optimization, inspection process, and quality control of MCCG. The level of evidence and strength of recommendations were evaluated. The guidelines are expected to guide the standardized application and scientific innovation of MCCG for the reference of clinicians.
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Affiliation(s)
- Bin Jiang
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- Department of Gastroenterology, The First Naval Hospital of Southern Theater Command, Zhanjiang, Guangdong Province, China
| | - Jun Pan
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yang Yang Qian
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chen He
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ji Xia
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- Department of Gastroenterology, The 926th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kaiyuan, Yunnan Province, China
| | - Shui Xiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wei Hong Sha
- Department of Gastroenterology, Guangdong Provincial Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Zhi Jie Feng
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Jun Wan
- Department of Gastroenterology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Sha Sha Wang
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Liang Zhong
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu Chang Xu
- Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai, China
| | - Xiu Ling Li
- Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - Xiao Jun Huang
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
| | - Duo Wu Zou
- Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dan Dan Song
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Zhang
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Qun Ding
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia Yu Chen
- Department of Gastroenterology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
| | - Ye Chu
- Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Jing Zhang
- Department of Digestive Endoscopy, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Wei Fang Yu
- Department of Gastroenterology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Yan Xu
- Department of Gastroenterology, Guangzhou Cadre Health Management Center, Guangzhou, Guangdong Province, China
| | - Xue Qiang He
- Department of Gastroenterology and Respiration, The 924th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Guilin, Guangxi Zhuang Autonomous Region, China
| | - Jian Hua Tang
- Department of Gastroenterology, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, China
| | - Ling He
- Department of Gastroenterology II, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, China
| | - Yi Hong Fan
- Department of Gastroenterology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, China
| | - Feng Lin Chen
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Yu Bao Zhou
- Department of Gastroenterology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yi Yang Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Yong Yu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hai Hong Wang
- Department of Gastroenterology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ku Ku Ge
- Department of Gastroenterology, Xi'an Children's Hospital, Xi'an, Shaanxi Province, China
| | - Guo Hua Jin
- Department of Gastroenterology, The First Bethune Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ying Lian Xiao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jun Fang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Xue Min Yan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Ye
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Chong Mei Yang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Yan Song
- Digestive Endoscopy Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
| | - Mao Yao Wen
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ye Zong
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao Han
- Department of Gastroenterology, General Hospital of the Northern Theater Command, Shenyang, Liaoning Province, China
| | - Lan Lan Wu
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Jing Ma
- Department of Gastroenterology, Jiangsu Provincial Hospital, Nanjing, Jiangsu Province, China
| | - Xiao Ping Xie
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wei Hua Yu
- Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Yu You
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Xiao Hong Lu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Yu Lin Song
- Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xue Qin Ma
- Department of Gastroenterology, Qinghai University Affiliated Hospital, Xining, Qinghai Province, China
| | - Shu Dan Li
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Bin Zeng
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Yun Jie Gao
- Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Jun Ma
- Department of Gastroenterology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
| | - Xiao Guang Ni
- Department of Digestive Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Hui He
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, Guangdong Province, China
| | - Yi Pin Liu
- Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong Province, China
| | - Jian Sheng Wu
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jing Liu
- Department of Gastroenterology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ai Min Li
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Bai Li Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Chun Sheng Cheng
- Department of Gastroenterology, Nanshan Hospital, Guangdong Medical University, Shenzhen, Guangdong Province, China
| | - Xiao Mei Sun
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang Province, China
| | - Zhi Zheng Ge
- Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Feng
- Editorial Office of Chinese Journal of Digestion, Shanghai, China
| | - Yong Jin Tang
- Editorial Office of Chinese Journal of Digestive Endoscopy, Nanjing, Jiangsu Province, China
| | - Zhao Shen Li
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - En Qiang Linghu
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhuan Liao
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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6
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Ge Y, Yan H, Shi X, Wu Z, Wang Y, Zhang Z, Luo Q, Liu W, Liang L, Peng L, Hu J. Study on dietary intake, risk assessment, and molecular toxicity mechanism of benzo[α]pyrene in college students in China Bashu area. Food Sci Nutr 2022; 10:4155-4167. [PMID: 36514765 PMCID: PMC9731532 DOI: 10.1002/fsn3.3007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 12/16/2022] Open
Abstract
As an extremely strong polycyclic aromatic hydrocarbon carcinogen, benzo[α]pyrene (BaP) is often produced during food processing at high temperatures. Recently, food safety, as well as toxicity mechanism and risk assessment of BaP, has received extensive attention. We first constructed the database of BaP pollution concentration in Chinese daily food with over 104 data items; collected dietary intake data using online survey; then assessed dietary exposure risk; and finally revealed the possible toxicity mechanism through four comparative molecular dynamics (MD) simulations. The statistical results showed that the concentration of BaP in olive oil was the highest, followed by that in fried meat products. The margins of exposure and incremental lifetime cancer risk both indicated that the dietary exposure to BaP of the participants was generally safe, but there were still some people with certain carcinogenic risks. Specifically, the health risk of the core district population was higher than that of the noncore district in Bashu area, and the female postgraduate group was higher than the male group with bachelor degree or below. From MD trajectories, BaP binding does not affect the global motion of individual nucleic acid sequences, but local weak noncovalent interactions changed greatly; it also weakens molecular interactions of nucleic acid with Bacillus stearothermophilus DNA polymerase I large fragment (BF), and significantly changes the cavity structure of recognition interface. This work not only reveals the possible toxicity mechanism of BaP, but also provides theoretical guidance for the subsequent optimization of food safety standards and reference of rational diet.
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Affiliation(s)
- Yutong Ge
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Hailian Yan
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Xiaodong Shi
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Zhixiang Wu
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Yueteng Wang
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Zelan Zhang
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Qing Luo
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Wei Liu
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Li Liang
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Lianxin Peng
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
| | - Jianping Hu
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Pharmacy, Sichuan Industrial Institute of AntibioticsChengdu UniversityChengduChina
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8
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Wang C, Gu K, Wang F, Cai H, Zheng W, Bao P, Shu XO. Nut consumption in association with overall mortality and recurrence/disease-specific mortality among long-term breast cancer survivors. Int J Cancer 2022; 150:572-579. [PMID: 34668194 PMCID: PMC8678210 DOI: 10.1002/ijc.33824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/11/2022]
Abstract
High nut consumption is associated with reduced total and certain cause-specific mortality in general populations. However, its association with cancer outcomes among long-term breast cancer survivors remains unknown. We examined the associations of nut consumption (including peanuts and tree nuts), assessed at 5-year postdiagnosis, with overall survival (OS) and disease-free survival (DFS) among 3449 long-term breast cancer survivors from the Shanghai Breast Cancer Survival Study, applying Cox regression analysis. During a median follow-up of 8.27 years post dietary assessment, there were 374 deaths, including 252 breast cancer deaths. Among 3274 survivors without previous recurrence at the dietary assessment, 209 developed breast cancer-specific events, that is, recurrence, metastasis or breast cancer mortality. At 5-year post dietary assessment (ie, 10-year postdiagnosis), regular nut consumers had higher OS (93.7% vs 89.0%) and DFS (94.1% vs 86.2%) rates. After multivariable adjustment, nut consumption was positively associated with OS (Ptrend = .022) and DFS (Ptrend = .003) following a dose-response pattern, with hazard ratios (95% confidence interval) of 0.72 (0.52-1.05) for OS and 0.48 (0.31-0.73) for DFS, for participants with greater than median nut intake compared with nonconsumers. The associations did not vary by nut type. Stratified analyses showed that the associations were more evident among participants with a higher total energy intake for OS (Pinteraction = .02) and among participants with early stage (I-II) breast cancers for DFS (Pinteraction = .04). The nut-DFS associations were not modified by estrogen receptor/progesterone receptor status or other known prognostic factors. In conclusion, nut consumption was associated with better survival, particularly DFS, among long-term breast cancer survivors.
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Affiliation(s)
- Cong Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kai Gu
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control, and Prevention, Shanghai, People’s Republic of China
| | - Fei Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Breast Surgery, the Second Hospital of Shandong University, Jinan, Shandong, People’s Republic of China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pingping Bao
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control, and Prevention, Shanghai, People’s Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
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