The early-stage triple-negative breast cancer landscape derives a novel prognostic signature and therapeutic target

PURPOSE

Triple-negative breast cancer (TNBC) is a highly heterogeneous disease. Patients with early-stage TNBCs have distinct likelihood of distant recurrence. This study aimed to develop a prognostic signature of early-stage TNBC patients to improve risk stratification.

METHODS

Using RNA-sequencing data, we analyzed 189 pathologically confirmed pT1-2N0M0 TNBC patients and identified 21 mRNAs that were highly expressed in tumor and related to relapse-free survival. All-subset regression program was used for constructing a 7-mRNA signature in the training set (n = 159); the accuracy and prognostic value were then validated using an independent validation set (n = 158).

RESULTS

Here, we profiled the transcriptome data from 189 early-stage TNBC patients along with 50 paired normal tissues. Early-stage TNBCs mainly consisted of basal-like immune-suppressed subtype and had higher homologous recombination deficiency scores. We developed a prognostic signature including seven mRNAs (ACAN, KRT5, TMEM101, LCA5, RPP40, LAGE3, CDKL2). In both the training (n = 159) and validation set (n = 158), this signature could identify patients with relatively high recurrence risks and served as an independent prognostic factor. Time-dependent receiver operating curve showed that the signature had better prognostic value than traditional clinicopathological features in both sets. Functionally, we showed that TMEM101 promoted cell proliferation and migration in vitro, which represented a potential therapeutic target.

CONCLUSIONS

Our 7-mRNA signature could accurately predict recurrence risks of early-stage TNBCs. This model may facilitate personalized therapy decision-making for early-stage TNBCs individuals.

On-Site Fluorination for Enhancing Utilization of Lithium in a Lithium-Sulfur Full Battery

The rechargeability of the lithium anode in lithium-sulfur (Li-S) batteries is an issue for this type of battery. In this work, we demonstrate a Li-S full battery comprising a protected anode scaffold and a Li₂S cathode. The stabilized performance is attained by an on-site fluorination strategy, using BiF₃ for the interfacial coating of the anode. Unlike previously reported LiF protective coating derived from the vapor/solution depositions, BiF₃ nanocrystals would be lithiated on-site to the anode surface and server as the protective layer. The chemically inertial Li₃Bi alloy can provide additional ion-conductive paths and stitch the LiF to form a seamless protective layer, thereby suppressing the dendrite propagation and parasitic reactions effectively. With the designed anode structures and compositions, the high-loading full battery (8.05 mg cm^-2) can achieve an exceptional utilization of both sulfur (898 mAh g_S^-1) and lithium (1533 mAh g_Li^-1) over 200 cycles, marking a step toward cyclable Li metal batteries at a high capacity.

Lamin B1 deficiency promotes malignancy and predicts poor prognosis in gastric cancer

Gastric cancer (GC) is a kind of global malignancy. However, the expression pattern and clinical relevance of lamin B1 in GC remain to be elucidated. We endeavored to investigate how GC is influenced by lamin B1 and the related mechanisms. The lamin B1 expression in GC tissues from 71 patients was assessed by using immunohistochemistry (IHC). The expression of lamin B1 was connected with the clinical stage, depth of invasion, and poorer overall survival. Colony formation assays and methyl thiazolyl tetrazolium (MTT) were used to assess cell viability. The migration ability of GC cells was determined by cell scratch assay and Transwell invasion assay. Moreover, we used two cell lines of GC to explore the underlying mechanism of lamin B1 in boosting the GC cells proliferation and invasion in vitro by assessing the effects on related signal transduction pathways. Our data demonstrated that the expression level of lamin B1 was downregulated in GC tissues, and low expression level of lamin B1 was significantly correlated with higher clinical stage, depth of invasion, nodal stage, and poor prognosis. Moreover, in vitro experiments demonstrated that lamin B1 knockdown promoted, whereas lamin B1 overexpression inhibited, gastric cancer cell proliferation and migration. We also observed that lamin B1 knockdown could promote the activity of the PI3K/PTEN/Akt and MAPK/ERK pathway with a decrease in the p53/p21WAF1/CIP1 expression, whereas lamin B1 overexpression contributed to the opposite results. In conclusion, our studies indicate that lamin B1 deficiency is crucial in GC progression. Furthermore, the results elucidating the biological mechanisms of lamin B1 may potentially contribute to current GC treatment modalities.

Total laparoscopic segmental gastrectomy for gastrointestinal stromal tumors: A case report

BACKGROUND

Gastrointestinal stromal tumors are lesions that originate from digestive tract walls. Several laparoscopic techniques, including local resections, wedge resections and partial gastrectomies, have been used successfully. However, there are no reports on laparoscopic segmental gastrectomy for gastrointestinal stromal tumors.

CASE SUMMARY

We present our analysis of 17 patients who were admitted to our hospital from January 2014 to December 2018. All tumors were located in the corpus and antrum of the stomach, close to the lesser curvature of the stomach. The tumors originated from the anterior wall in nine cases and from the posterior wall of the stomach in eight cases. Laparoscopic segmental gastrectomy and end-to-end anastomosis between the proximal and the distal residual stomach were used in all patients. The mean operative time was 112.4 min. The mean length of hospital stay was 4.6 d. Mean operative blood loss was 73.5 mL. There were no leaks, no postoperative bleeding nor need for reintervention. Mean postoperative follow-up was 35.4 mo. The Visick grading index showed fewer gastrointestinal symptoms 3 mo after surgery. Two patients (11.8%) had reflux esophagitis and gastritis.

CONCLUSION

Laparoscopic segmental gastrectomy may be a new function-preserving gastrectomy that is feasible for treatment of gastrointestinal stromal tumors that grow in the middle third of the stomach and on the lesser stomach curvature.

Rational design of spontaneous reactions for protecting porous lithium electrodes in lithium-sulfur batteries

A rechargeable lithium anode requires a porous structure for a high capacity, and a stable electrode/electrolyte interface against dendrite formation and polysulfide crossover when used in a lithium-sulfur battery. Here, we design two simple steps of spontaneous reactions for protecting porous lithium electrodes. First, a reaction between molten lithium and sulfur-impregnated carbon nanofiber forms a fibrous network with a lithium shell and a carbon core. Second, we coat the surface of this porous lithium electrode with a composite of lithium bismuth alloys and lithium fluoride through another spontaneous reaction between lithium and bismuth trifluoride, solvated with phosphorous pentasulfide, which also polymerizes with lithium sulfide residual in the electrode to form a solid electrolyte layer. This protected porous lithium electrode enables stable operation of a lithium-sulfur battery with a sulfur loading of 10.2 mg cm-2 at 6.0 mA cm-2 for 200 cycles.

Genomic and Transcriptomic Landscape of Triple-Negative Breast Cancers: Subtypes and Treatment Strategies

We comprehensively analyzed clinical, genomic, and transcriptomic data of a cohort of 465 primary triple-negative breast cancer (TNBC). PIK3CA mutations and copy-number gains of chromosome 22q11 were more frequent in our Chinese cohort than in The Cancer Genome Atlas. We classified TNBCs into four transcriptome-based subtypes: (1) luminal androgen receptor (LAR), (2) immunomodulatory, (3) basal-like immune-suppressed, and (4) mesenchymal-like. Putative therapeutic targets or biomarkers were identified among each subtype. Importantly, the LAR subtype showed more ERBB2 somatic mutations, infrequent mutational signature 3 and frequent CDKN2A loss. The comprehensive profile of TNBCs provided here will serve as a reference to further advance the understanding and precision treatment of TNBC.

The endogenous retrovirus-derived long noncoding RNA TROJAN promotes triple-negative breast cancer progression via ZMYND8 degradation

Human endogenous retroviruses (HERVs) play pivotal roles in the development of breast cancer. However, the detailed mechanisms of noncoding HERVs remain elusive. Here, our genome-wide transcriptome analysis of HERVs revealed that a primate long noncoding RNA, which we dubbed TROJAN, was highly expressed in human triple-negative breast cancer (TNBC). TROJAN promoted TNBC proliferation and invasion and indicated poor patient outcomes. We further confirmed that TROJAN could bind to ZMYND8, a metastasis-repressing factor, and increase its degradation through the ubiquitin-proteasome pathway by repelling ZNF592. TROJAN also epigenetically up-regulated metastasis-related genes in multiple cell lines. Correlations between TROJAN and ZMYND8 were subsequently confirmed in clinical samples. Furthermore, our study verified that antisense oligonucleotide therapy targeting TROJAN substantially suppressed TNBC progression in vivo. In conclusion, the long noncoding RNA TROJAN promotes TNBC progression and serves as a potential therapeutic target.

Effects of adjuvant chemotherapy in T1N0M0 triple-negative breast cancer

OBJECTIVES

Patients with T1N0M0 breast cancers are considered to have an excellent prognosis, even in triple-negative breast cancer (TNBC), which is often associated with diminished recurrence-free survival (RFS) and overall survival. Chemotherapy remains the only adjuvant treatment for TNBC, but evidence that adjuvant chemotherapy is beneficial for stage T1N0M0 TNBC patients is limited. In this study, we aimed to evaluate the effect of adjuvant chemotherapy and the benefit of taxanes in T1N0M0 TNBC patients.

MATERIAL AND METHODS

A cohort of 354 consecutive patients with newly diagnosed T1N0M0 TNBC between January 2008 and December 2015 were included from the Fudan University Shanghai Cancer Center. Univariate and multivariate survival analyses were performed to compare patients treated with adjuvant chemotherapy with/without taxane addition.

RESULTS

Median follow-up was 45 months. Chemotherapy was used in 92.4% of patients. The 5-year estimated RFS rates of patients with and without adjuvant chemotherapy were 94.5% and 83.6%, respectively. In multivariate analysis, adjuvant chemotherapy and a lack of lymphovascular invasion were associated with a significant benefit for RFS. A significant RFS benefit from adjuvant chemotherapy was observed in T1c (hazard ratio, HR = 0.24, 95% CI [0.08-0.76], P = 0.014) but not in T1b (HR = 0.32, 95% CI [0.03-3.18], P = 0.330) subgroups. Addition of taxane to an anthracycline-based regimen was not significantly associated with improved RFS in T1N0M0 TNBC patients.

CONCLUSION

Adjuvant chemotherapy improves recurrence-free survival in T1c TNBC patients but not in T1b. Anthracycline-based taxane-free regimens might be sufficient to achieve RFS benefits in T1N0M0 TNBC patients.

[Primary thyroid paraganglioma: a case report]

Primary thyroid paraganglioma (PTPG) is rare,we report a case of 55 years old women with PTPG, which describes the clinical features, diagnosis and treatment. A possible diagnosis, treatment and follow-up strategy was proposed by reviewing relevant reports. It aims to improve the cognitive of PTPG and standardize its treatment.

A case of Diphyllobothrium latum infection in Dalian and a brief review of diphyllobothriasis in China

Diphyllobothrium latum infection in human is not common in China and only 15 cases have been reported since 1927. We document a case of Diphyllobothrium latum infection caused by the ingestion of raw fish in a 23-year-old woman in Dalian (Liaoning Province), and diphyllobothriasis latum in China is briefly reviewed. The patient experienced abdominal discomfort for about 6 months with a history of discharging proglottids in the feces. The morphologic characteristic of the gravid proglottids and eggs were identified as that of Diphyllobothrium latum. The patient was treated with pumpkin seed powder (100g) and betel nut(100g) on an empty stomach. The majority of reported human cases occurred due to the ingestion of raw or uncooked fish, such as pikes, burbots, trouts, perch and salmons. The patient is the first case reported in Dalian (Lianning Province).

SRAP analysis of DNA base sequence changes in lotus mutants induced by Fe⁺ implantation

Ion implantation, a new biophysically mutagenic technique, has shown great potential for crop breeding. To reveal the mutation effect of low-energy ion implantation on Baiyangdian red lotus, sequence-related amplified polymorphism markers were used to amplify and detect the DNA sequence differences in mutants induced by Fe(+) ion implantation. A total of 121 primer combinations were tested in 6 mutants and a control. Seven primer combinations (me1 + em3, me1 + em14, me9 + em3, me8 + em2, me6 + em1, me11 + em5, and me6 + em5) generated clear bands with high polymorphism and good repeatability. The results showed that among 15,317 bases cloned, 146 bases in 6 mutants were different from those of the wild type, showing a variation frequency of 0.95%. The types of base changes included deletion, insertion, transversion, and transition. Adenine was more sensitive to the irradiation than were the other bases. The results suggested that mutational "hotspots" probably exists in lotus and are induced by low-energy ion implantation.

Inoculation of phosphate solubilizing bacteria for the improvement of lead accumulation by Brassica juncea

Two phosphate-solubilizing bacterial strains were isolated and identified as Acinetobacter calcoaceticus YC-5a and Enterobacter agglomerans KMC-7 based on the 16S rRNA gene sequence analysis. A. calcoaceticus YC-5a is less well known as a phosphate-solubilizing plant-associated bacterium. The plant growth-promoting properties of the phosphate-solubilizing bacteria (PSB) were characterized in vitro, including their phosphate-solubilizing activities and their capabilities for producing indole-3-acetic acid and siderophores. A pot experiment was conducted to elucidate the effects of inoculating both strains on the growth and Pb uptake of Brassica juncea grown in different concentrations of Pb-contaminated soils. Inoculation with both PSB not only stimulated the growth of B. juncea, but it also influenced the accumulation of Pb in the shoots and roots of the host plant. The present study demonstrates that PSB are a valuable microbial resource that can be exploited to improve the efficiency of phytoextraction.

A promising approach of reject water treatment using a tidal flow constructed wetland system employing alum sludge as main substrate

This study examined a novel reuse of alum sludge, an inescapable by-product of drinking water treatment process when aluminium salt is added as a coagulant, as the main medium in a laboratory-scale multi-stage constructed wetland (CW) system for reject water treatment. Such reject water is a main concern in municipal wastewater treatment plant (MWWTP) for increasing the organic and nutrient loading. A 'tidal flow' strategy was employed to enhance the wetland aeration to stimulate organic matters (OM) and ammoniacal-nitrogen (N) oxidation while the 'step feed' operation was adopted to supply the necessary amount of carbon source for denitrification. The results reveal that alum sludge acting as P adsorbent can secure the P removal. Meanwhile, high removals of N and OM can also be obtained due to the active bacteria growth on the alum sludge surface. The results show that average removal efficiencies of 65.4 +/- 12.3% for chemical oxygen demand (COD), 67.8 +/- 9.2% for five-day biochemical oxygen demand (BOD5), 33.6 +/- 17.0% for N and 99.5 +/- 0.49% for P can be achieved over a period of 190 days. This indicates that novel reuse of alum sludge as medium in CW system can provide a promising approach for reject water treatment. Therefore, it will significantly reduce the amount of pollutant feedback through reject water recycling in a MWWTP.

Towards the development of a novel construction solid waste (CSW) based constructed wetland system for tertiary treatment of secondary sewage effluents

This study was conducted to examine the possibility of using construction solid waste (CSW), an inevitable by-product of the construction and demolition process, as the main substrate in a laboratory scale multi-stage constructed wetland system (CWs) to improve phosphorus (P) removal from secondary sewage effluent. A tidal-flow operation strategy was employed to enhance the wetland aeration. This will stimulate aerobic biological processes and benefit the organic pollutants decomposition and nitrification process for ammoniacal-nitrogen (NH(+)(4)-N) removal. The results showed that the average P concentration in the secondary sewage effluent was reduced from 1.90 mg-P/L to 0.04 mg-P/L. CSW presents excellent P removal performance. The average NH(+)(4)-N concentration was reduced from 9.94 mg-N/L to 1.0 mg-N/L through nitrification in the system. The concentration of resultant nitrite and nitrate in the effluent of the CSW based CWs ranged from 0.1 to 2.4 mg-N/L and 0.01 to 0.8 mg-N/L, respectively. The outcome of this study has shown that CSW can be successfully used to act as main substrate in CWs. The application of CSW based CWs on improving N and P removals from secondary sewage effluent presents a win-win scenario. Such the reuse of CSW will benefit both the CSW disposal and nutrient control from wastewater. More significantly, such the application can transfer the CSW from a 'waste' to 'useful' material and can ease the pressure of construction waste solid management. Meanwhile, the final effluent from the CSW-based CWs can be used as non-potable water source in landscape irrigation, agriculture and industrial process.

[Treatment for severe rectal prolapse by laparoscopic rectopexy]

OBJECTIVE

To evaluate the clinical practice of laparoscopic rectopexy in the treatment of severe rectal prolapse.

METHODS

From March 1998 to February 2007, 4 cases of complete rectal prolapse, including 1 male and 3 female,ranged 21-82 years old, were treated by laparoscopic rectopexy. In one case, the posterior wall of rectum was freed and elevated, and pre-rectal introcession was closed by silk suture, then the posterior wall was suspended and fixed on sacral promontory fascia, finally the sigmoid colon was fixed by sutures on the fascia of left psoas major. In other three cases, insertion of mesh was performed. Rectum was freed and elevated to the level of levalor ani. A sheet of T-shape polypropylene mesh was placed posterior to the rectum, whose lower margin was at the level of levator ani and wrapped around the rectum covering except the anterior wall. The free margin of the mesh was sutured on the muscular layer of rectum, then the mesh was put posterior to the rectum and fixed on the sacral promontory fascia by clipping to repair hernia. After that, the pelvic peritoneum was closed, and finally the sigmoid colon was fixed by sutures on the fascia of left psoas major.

RESULTS

Four operation procedures were completed successfully. There was no conversion operation. The time was consumed 92.5 (80-100) min, and the bleeding amount was 6.5 (5-10) ml. No post-operative complications were found. Urine incontinence and encopresis were relieved. No recurrence and constipation was found after 2 months to 3 years follow up postoperatively.

CONCLUSION

Laparoscopic rectopexy is a safe, workable and effective procedure, which can reduce operative trauma and shorten hospitalization time.