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Clinical features and prognostic factors of breast cancer in young women: a retrospective single-center study. Arch Gynecol Obstet 2023; 307:957-968. [PMID: 35835921 DOI: 10.1007/s00404-022-06670-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/14/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE This research aims to characterize the differences in clinical features and prognostic factors between younger and older breast cancer (BC) patients in China. METHODS All patients who were recently diagnosed with BC between January 1, 2015 and December 31, 2016 at Shanxi Province Cancer Hospital were recruited. We collected the epidemiological and clinical data as well as the follow-up information. RESULTS Out of the 1968 BC patients who met the criteria for analysis, 227 (11.53%) were under 40 years of age with a median age of 34 years at diagnosis. All patients were classified into the age < 40, age 40-59, and age ≥ 60 groups. There were significant differences in the histology, tumor size, T stage, grade, and human epidermal growth factor receptor-2 (HER-2) levels among the three groups (all P < 0.05). The 5-year overall survival (OS) rates were 86.34%, 89.58%, and 84.84% for the age < 40, age 40-59, and age ≥ 60 groups, respectively. The TNM stage was the only predictor of clinical outcome in all BC patients. The prognostic value of intrinsic subtypes for OS was different among the three groups. CONCLUSION Our study helped identify an age-related prognostic indicator of adverse events in BC patients and showed that young women with BC exhibited more aggressive clinical and pathological features. Our findings may facilitate clinical management and therapeutic interventions in young BC patients, especially in young women with a history of exposure to risk factors and age < 40 years.
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Gao X, Luo W, He L, Yang L. Nomogram models for stratified prediction of axillary lymph node metastasis in breast cancer patients (cN0). Front Endocrinol (Lausanne) 2022; 13:967062. [PMID: 36111297 PMCID: PMC9468373 DOI: 10.3389/fendo.2022.967062] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine the predictors of axillary lymph node metastasis (ALNM), two nomogram models were constructed to accurately predict the status of axillary lymph nodes (ALNs), mainly high nodal tumour burden (HNTB, > 2 positive lymph nodes), low nodal tumour burden (LNTB, 1-2 positive lymph nodes) and negative ALNM (N0). Accordingly, more appropriate treatment strategies for breast cancer patients without clinical ALNM (cN0) could be selected. Methods From 2010 to 2015, a total of 6314 patients with invasive breast cancer (cN0) were diagnosed in the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and internal validation groups at a ratio of 3:1. As the external validation group, data from 503 breast cancer patients (cN0) who underwent axillary lymph node dissection (ALND) at the Second Affiliated Hospital of Chongqing Medical University between January 2011 and December 2020 were collected. The predictive factors determined by univariate and multivariate logistic regression analyses were used to construct the nomograms. Receiver operating characteristic (ROC) curves and calibration plots were used to assess the prediction models' discrimination and calibration. Results Univariate analysis and multivariate logistic regression analyses showed that tumour size, primary site, molecular subtype and grade were independent predictors of both ALNM and HNTB. Moreover, histologic type and age were independent predictors of ALNM and HNTB, respectively. Integrating these independent predictors, two nomograms were successfully developed to accurately predict the status of ALN. For nomogram 1 (prediction of ALNM), the areas under the receiver operating characteristic (ROC) curve in the training, internal validation and external validation groups were 0.715, 0.688 and 0.876, respectively. For nomogram 2 (prediction of HNTB), the areas under the ROC curve in the training, internal validation and external validation groups were 0.842, 0.823 and 0.862. The above results showed a satisfactory performance. Conclusion We established two nomogram models to predict the status of ALNs (N0, 1-2 positive ALNs or >2 positive ALNs) for breast cancer patients (cN0). They were well verified in further internal and external groups. The nomograms can help doctors make more accurate treatment plans, and avoid unnecessary surgical trauma.
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Affiliation(s)
- Xin Gao
- Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenpei Luo
- Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingyun He
- Scientific Research and Education Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Lu Yang
- Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Dai G, Yang Y, Liu S, Liu H. Hypoxic Breast Cancer Cell-Derived Exosomal SNHG1 Promotes Breast Cancer Growth and Angiogenesis via Regulating miR-216b-5p/JAK2 Axis. Cancer Manag Res 2022; 14:123-133. [PMID: 35027847 PMCID: PMC8751978 DOI: 10.2147/cmar.s327621] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/21/2021] [Indexed: 12/26/2022] Open
Abstract
Background Hypoxia is an important process that involved in the tumor microenvironment. In addition, hypoxic tumor cell-derived exosomes could promote tumor growth and angiogenesis. Thus, we aimed to investigate whether exosomes could regulate tumor development and progression under hypoxia in breast cancer. Methods The level of SNHG1 in hypoxic breast cancer cells and exosomes derived from hypoxic breast cancer cells was determined by real-time qPCR assay. Bioinformatics prediction and dual-luciferase reporter assays were used to determine the interaction between SNHG1, miR-216b-5p and JAK2. Results We found that comparing with exosomes derived from normoxia breast cancer cells, exosomes derived from hypoxic breast cancer cells could promote the proliferation, migration and angiogenesis of human umbilical vein endothelial cells (HUVECs). In addition, SNHG1 level was significantly upregulated in exosomes derived from hypoxic breast cancer cells. Moreover, exosome-mediated delivery of SNHG1 siRNA3 markedly reversed the effects of exosome-mediated delivery of SNHG1 on HUVECs. Mechanically, SNHG1 could increase the level of JAK2 by competitively binding to miR-216b-5p. Additionally, exosome-mediated delivery of SNHG1 was found to promote breast cancer growth in vivo. Conclusion Collectively, our study revealed that exosomal SNHG1 from hypoxic breast cancer cells could promote tumor angiogenesis and growth via regulating miR-216b-5p/JAK2 axis, suggesting that SNHG1 may serve as a potential therapeutic target for breast cancer.
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Affiliation(s)
- Gaosai Dai
- Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Yupeng Yang
- Department of Thyroid and Breast Surgery, Jinan Zhangqiu District Hospital of TCM, Jinan, Shandong, 250200, People’s Republic of China
| | - Shuhao Liu
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Huantao Liu
- Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Correspondence: Huantao Liu Department of Breast Surgery, Qilu Hospital of Shandong University, Wenhuaxi Road 107, Jinan, Shandong, 250012, People’s Republic of China Email
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Liu X, He S, Yao X, Hu T. Development and Validation of Prognostic Nomograms for Elderly Patients with Osteosarcoma. Int J Gen Med 2021; 14:5581-5591. [PMID: 34548809 PMCID: PMC8449646 DOI: 10.2147/ijgm.s331623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background The aim of the current study was to construct prognostic nomograms for individual risk prediction in elderly patients with osteosarcoma. Methods Data for 816 elderly patients (≥40 years old) with osteosarcoma between 2004 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database were randomly assigned to training (N=573) and internal validation (N=243) sets. The essential clinical predictors were identified based on least absolute shrinkage and selection operator (Lasso) Cox regression. Nomograms were constructed to predict the 1-, 3-, and 5-year cancer-specific survival (CSS) and overall survival (OS). Results Our LASSO regression analyses of the training set yielded five clinicopathological features (age, chemotherapy, surgery, AJCC stage, and summary stage) in the training cohort for the prognosis of elderly patients with osteosarcoma, while grade was only associated with OS and M stage was only associated with CSS. Construction of nomograms based on these predictors was performed to evaluate the prognosis of elderly patients with osteosarcoma. The C-index, calibration and decision curve analysis also showed the satisfactory performance of these nomograms for prognosis prediction. Conclusion The constructed nomograms are helpful tools for exactly predicting the prognosis of elderly patients with osteosarcoma, which could enable patients to be more accurately managed in clinical practice.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Orthopedic Surgery, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Shaoya He
- Department of Gastroenterology, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Xi Yao
- Department of Orthopedic Surgery, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Tianyang Hu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Radmilović Varga L, Dedić Plavetić N, Podolski P, Mijatović D, Kulić A, Vrbanec D. PROGNOSTIC VALUE OF TOPOISOMERASE 2-ALPHA AND B-MYB IN EARLY BREAST CANCER TREATED WITH ADJUVANT CHEMOTHERAPY. Acta Clin Croat 2021; 60:16-24. [PMID: 34588717 PMCID: PMC8305358 DOI: 10.20471/acc.2021.60.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 02/12/2021] [Indexed: 11/24/2022] Open
Abstract
Breast cancer is the most common malignancy in females. Despite its well-established prognostic factors, our prognostic ability at an individual patient level remains limited. In this study, the immunohistochemical expression of B-Myb and DNA topoisomerase 2-alpha (Topo2a) was analyzed in primary tumors to identify patients with a higher risk of disease recurrence after adjuvant chemotherapy for early invasive breast cancer. We analyzed a cohort of 215 early invasive breast cancer patients having undergone surgery from 2002 to 2003 at the Zagreb University Hospital Centre, including 153 patients treated with adjuvant chemotherapy. All of them were followed-up prospectively for at least ten years according to routine institutional practice. Statistically significant correlations were found between B-Myb and Topo2a expression levels and particular well-established prognostic factors. B-Myb expression was lower in estrogen receptor (ER)-positive tumors (p=0.0773), whereas larger tumors and those with positive lymphovascular invasion displayed a statistically significantly higher B-Myb expression (p=0.0409 and p=0.0196). Higher tumor grade indicated higher Topo2a values (p=0.0102 and p=0.0069). The subgroup with the expression of both proteins above the median value had an almost statistically significantly (p=0.0613) inferior prognosis compared to the rest of the cohort. Study results showed the B-Myb and Topo2a expression to have a prognostic value in breast cancer patients after adjuvant chemotherapy, which should be additionally explored in future studies in a larger patient cohort.
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Affiliation(s)
| | - Natalija Dedić Plavetić
- 1Department of Pulmonology, Varaždin General Hospital, Klenovnik, Croatia; 2Department of Oncology, Division of Medical Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Pathophysiology, Zagreb University Hospital Centre, Zagreb, Croatia; 6Juraj Dobrila University of Pula, Pula, Croatia
| | - Paula Podolski
- 1Department of Pulmonology, Varaždin General Hospital, Klenovnik, Croatia; 2Department of Oncology, Division of Medical Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Pathophysiology, Zagreb University Hospital Centre, Zagreb, Croatia; 6Juraj Dobrila University of Pula, Pula, Croatia
| | - Davor Mijatović
- 1Department of Pulmonology, Varaždin General Hospital, Klenovnik, Croatia; 2Department of Oncology, Division of Medical Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Pathophysiology, Zagreb University Hospital Centre, Zagreb, Croatia; 6Juraj Dobrila University of Pula, Pula, Croatia
| | - Ana Kulić
- 1Department of Pulmonology, Varaždin General Hospital, Klenovnik, Croatia; 2Department of Oncology, Division of Medical Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Pathophysiology, Zagreb University Hospital Centre, Zagreb, Croatia; 6Juraj Dobrila University of Pula, Pula, Croatia
| | - Damir Vrbanec
- 1Department of Pulmonology, Varaždin General Hospital, Klenovnik, Croatia; 2Department of Oncology, Division of Medical Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Pathophysiology, Zagreb University Hospital Centre, Zagreb, Croatia; 6Juraj Dobrila University of Pula, Pula, Croatia
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