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Clinicopathologic Features and Digital Imaging Analysis of HER2 Protein in Breast Carcinomas With Different HER2 Fluorescence in Situ Hybridization Patterns. 具有不同 HER2 荧光原位杂交模式的乳腺癌中 HER2 蛋白的临床病理特征和数字成像分析
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-17 DOI: 10.1016/j.clbc.2024.10.004
Aidan C Li, Scott Hammond, Debra Crosby, Zaibo Li, Anil V Parwani

Background: HER2-targeted therapies have significantly improved outcomes for patients with HER2-positive breast cancer (BC), which represents 15% to 20% of all BC cases. HER2 status is assessed via immunohistochemistry (IHC) and/or in situ hybridization (ISH), dividing BCs into five groups (G1-G5).

Patients and methods: In a study of 2,702 primary BC cases, comprising 12.7% G1, 0.2% G2, 2.8% G3, 8.5% G4, and 75.9% G5, we analyzed clinicopathologic features and HER2 protein expression digitally for each ISH group.

Results: Notably, G5 cases had a higher proportion of lobular carcinoma (13.9%) compared to other groups. G3 cases showed the highest percentage of grade 3 tumors (56.9%), while G5 cases had the lowest (21.4%). Additionally, G5 cases had the highest rate of estrogen receptor (ER) positivity (84.6%), while G1-HC (high copy number) cases had the lowest (70.4%). Most G1-HC cases were HER2 IHC 3+ (76.1%), while most G5 cases were IHC 0/1+ (75.7%). IHC 2+ was most common in G1-LC (low copy number) and G3 cases (83.8% and 90.7%, respectively), with G4 cases predominantly IHC 2+ (56.3%) and IHC 1+ (30.1%). Discordant HER2 IHC and ISH results were observed in 12 cases (0.4%), including 7 G1-HC (2.3%), 4 G1-LC (10.8%), and 1 G5 case (0.1%). Digital quantification of HER2 IHC levels in all groups except G5 revealed that G1-HC tumors had the highest HER2 protein expression, followed by G3, with G4 showing the lowest.

Conclusion: These findings offer valuable insights into the clinicopathologic characteristics and future management for different HER2 ISH groups.

背景:HER2靶向疗法大大改善了HER2阳性乳腺癌(BC)患者的预后,HER2阳性乳腺癌患者占所有BC病例的15%至20%。HER2状态通过免疫组化(IHC)和/或原位杂交(ISH)进行评估,将乳腺癌分为五组(G1-G5):在对2702例原发性BC(包括12.7%的G1、0.2%的G2、2.8%的G3、8.5%的G4和75.9%的G5)进行的研究中,我们对每个ISH组的临床病理特征和HER2蛋白表达进行了数字化分析:值得注意的是,与其他组别相比,G5 病例的小叶癌比例更高(13.9%)。G3病例中3级肿瘤的比例最高(56.9%),而G5病例中3级肿瘤的比例最低(21.4%)。此外,G5 病例的雌激素受体(ER)阳性率最高(84.6%),而 G1-HC(高拷贝数)病例的雌激素受体阳性率最低(70.4%)。大多数 G1-HC 病例的 HER2 IHC 为 3+(76.1%),而大多数 G5 病例的 IHC 为 0/1+(75.7%)。IHC 2+ 在 G1-LC(低拷贝数)和 G3 病例中最为常见(分别为 83.8% 和 90.7%),G4 病例主要是 IHC 2+ (56.3%)和 IHC 1+ (30.1%)。有12例(0.4%)患者的HER2 IHC和ISH结果不一致,包括7例G1-HC(2.3%)、4例G1-LC(10.8%)和1例G5(0.1%)。对除G5以外所有组别的HER2 IHC水平进行数字量化后发现,G1-HC肿瘤的HER2蛋白表达量最高,其次是G3,G4最低:这些发现为不同 HER2 ISH 组的临床病理特征和未来管理提供了有价值的见解。
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引用次数: 0
USP4/CARM1 Axis Promotes the Malignant Transformation of Breast Cancer Cells by Upregulating SLC7A11 Expression. USP4/CARM1 轴通过上调 SLC7A11 的表达促进乳腺癌细胞的恶性转化
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-16 DOI: 10.1016/j.clbc.2024.10.001
Xin Li, Changjiao Yan, Jun Yun, Xin Xu, Hongliang Wei, Xiaolong Xu, Yike Li, Jun Yi

Background: Coactivator associated arginine methyltransferase 1 (CARM1) has been identified as a regulator of breast cancer (BC) progression, yet the underlying mechanisms remain elusive.

Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to assess the mRNA expression of CARM1 and solute carrier family 7 member 11 (SLC7A11). Western blotting was conducted to detect the protein expressions of CARM1, ubiquitin specific peptidase 4 (USP4), and SLC7A11. Cell viability, apoptosis, invasion, and migration were evaluated using CCK-8 assay, flow cytometry, transwell assay, and wound-healing assay, respectively. Fe2+ and GSH levels were determined by colorimetric assay. Fluorescence microscopy and flow cytometry were utilized to quantify reactive oxygen species (ROS) production. Co-immunoprecipitation (Co-IP) assay and cycloheximide (CHX) assay were performed to investigate the relationship between USP4 and CARM1. Xenograft mouse model assay was conducted to validate the effects of USP4 silencing and CARM1 overexpression on the malignant phenotypes of BC cells.

Results: CARM1 and SLC7A11 expression was upregulated in BC tissues and cells when compared with normal breast tissues and cells. Silencing of CARM1 inhibited the malignant phenotypes of BC cells, including decreased cell viability, invasion, and migration and increased cell apoptosis, ferroptosis and oxidative stress. In addition, USP4 stabilized CARM1 protein expression through its deubiquitinating activity. Overexpression of CARM1 attenuated the effects of USP4 silencing in both MCF-7 and MDA-MB-231 cells. Furthermore, silencing of CARM1 reduced SLC7A11 expression, and SLC7A11 overexpression relieved the CARM1 silencing-induced effects. Further, overexpression of CARM1 counteracted the inhibitory effects of USP4 silencing on tumor growth in vivo.

Conclusion: Our study reveals a novel mechanism by which USP4-dependent CARM1 promotes the malignant growth of BC cells by interacting with SLC7A11. Targeting this axis may provide a potential therapeutic strategy for BC.

背景:与激活剂相关的精氨酸甲基转移酶 1(CARM1)已被确定为乳腺癌(BC)进展的调控因子,但其潜在机制仍不清楚:共激活因子相关精氨酸甲基转移酶1(CARM1)已被确定为乳腺癌(BC)进展的调控因子,但其潜在机制仍不明确:方法:采用定量实时聚合酶链反应(qRT-PCR)评估CARM1和溶质运载家族7成员11(SLC7A11)的mRNA表达。采用 Western 印迹法检测 CARM1、泛素特异性肽酶 4 (USP4) 和 SLC7A11 的蛋白表达。细胞活力、凋亡、侵袭和迁移分别采用 CCK-8 检测法、流式细胞仪、Transwell 检测法和伤口愈合检测法进行评估。Fe2+和GSH水平通过比色法测定。荧光显微镜和流式细胞术用于量化活性氧(ROS)的产生。进行了共免疫沉淀(Co-IP)测定和环己亚胺(CHX)测定,以研究USP4和CARM1之间的关系。 进行了异种移植小鼠模型试验,以验证USP4沉默和CARM1过表达对BC细胞恶性表型的影响:结果:与正常乳腺组织和细胞相比,CARM1和SLC7A11在BC组织和细胞中表达上调。沉默 CARM1 可抑制 BC 细胞的恶性表型,包括降低细胞活力、侵袭和迁移,增加细胞凋亡、铁变态反应和氧化应激。此外,USP4 通过其去泛素化活性稳定了 CARM1 蛋白的表达。在 MCF-7 和 MDA-MB-231 细胞中,过表达 CARM1 可减轻 USP4 沉默的影响。此外,沉默 CARM1 会降低 SLC7A11 的表达,而过表达 SLC7A11 则会缓解 CARM1 沉默引起的影响。此外,过表达 CARM1 抵消了 USP4 沉默对体内肿瘤生长的抑制作用:我们的研究揭示了一种新的机制,即依赖于 USP4 的 CARM1 通过与 SLC7A11 相互作用促进 BC 细胞的恶性生长。我们的研究揭示了一种新的机制,即依赖于 USP4 的 CARM1 通过与 SLC7A11 相互作用促进 BC 细胞的恶性生长。
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引用次数: 0
Disparities in Hereditary Genetic Testing in Patients with Triple Negative Breast Cancer. 三阴性乳腺癌患者遗传基因检测中的差异。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1016/j.clbc.2024.09.018
Shruti Gupta, Jade E Jones, Demetria Smith-Graziani

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that disproportionately affects younger females, non-Hispanic Black women, Hispanic women, and women with the BRCA1 gene mutation. Hereditary genetic testing is particularly important in this population to assess preventative and treatment strategies, however access to genetic testing is variable. A qualitative review was performed to evaluate barriers to genetic testing for patients with TNBC. Mutations common in breast cancer are reviewed along with updated guidelines on management strategies, including the ability to include PARP inhibitors as a treatment strategy. Barriers to genetic testing are multifactorial, with non-Hispanic Black women being tested less often than other groups. The disparity is even further represented by the limited number of non-Hispanic Black patients with TNBC who receive risk-reducing surgery or targeted systemic therapy. Eliminating barriers to genetic testing can allow us to support guideline-directed care for patients with TNBC at higher risk for genetic mutations.

三阴性乳腺癌(TNBC)是乳腺癌的一种侵袭性亚型,对年轻女性、非西班牙裔黑人女性、西班牙裔女性和 BRCA1 基因突变女性的影响尤为严重。遗传基因检测对这一人群评估预防和治疗策略尤为重要,但基因检测的可及性却不尽相同。我们进行了一项定性研究,以评估 TNBC 患者接受基因检测的障碍。研究回顾了乳腺癌中常见的基因突变以及最新的治疗策略指南,包括将 PARP 抑制剂作为治疗策略的能力。基因检测的障碍是多因素的,非西班牙裔黑人妇女接受检测的频率低于其他群体。非西班牙裔黑人 TNBC 患者中接受降低风险手术或系统性靶向治疗的人数有限,这进一步体现了这种差异。消除基因检测的障碍可以让我们为基因突变风险较高的 TNBC 患者提供指导性治疗。
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引用次数: 0
The Systemic Immune-Inflammation Index is a Predictor of Chemotherapy Sensitivity and Disease-Free Survival in Patients With Hormone Receptor-Positive Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer. 全身免疫炎症指数是激素受体阳性人类表皮生长因子受体 2 阴性乳腺癌患者化疗敏感性和无病生存期的预测因子
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.clbc.2024.09.016
Xuan Liu, Guoqing Yan, Jian Pang, Zhi Xiao, Haiqing Xie

Background: The relationship between the systemic immune-inflammation index (SII), chemotherapy sensitivity, and prognosis in HR+HER2- breast cancer (BC) has not been extensively studied.

Patients and methods: Clinical data from 980 patients diagnosed with HR+HER2- BC between June 2012 and June 2016 were collected. Patients were divided into low- and high-SII groups according to median SII value. Differences among variables were assessed using the chi-squared test. The inverse probability of treatment weighting (IPTW) method was used to control bias. The associations between clinicopathological factors, baseline SII, and disease-free survival (DFS) were analyzed using Kaplan-Meier curves and Cox analyses.

Results: The median follow-up period was 37 months (5-77). 480 patients underwent neoadjuvant chemotherapy, and low baseline SII values were associated with higher pathological complete response (pCR) rates than those in the high SII group (16.4% vs. 9.2%; P = .019). Multivariate analyses revealed that larger tumor size, more lymph node involvement, high Ki-67 score, and high baseline SII were independent prognostic factors for worse outcomes in patients with HR+HER2- BC. The risk for metastasis/recurrence was higher in the high SII group compared with that in the low SII group (hazard ratio 2.07 [95% CI, 1.35-3.19]; P = .001). After IPTW, a similar result was obtained, in that a high SII value was significantly associated with worse DFS among patients with HR+HER2- BC.

Conclusion: A low baseline SII was associated with higher pCR rates after neoadjuvant chemotherapy and was an independent prognostic factor for better DFS outcomes in patients with HR+HER2- BC.

背景:HR+HER2-乳腺癌(BC)患者全身免疫炎症指数(SII)、化疗敏感性和预后之间的关系尚未得到广泛研究:尚未广泛研究HR+HER2-乳腺癌(BC)患者全身免疫炎症指数(SII)、化疗敏感性和预后之间的关系:收集2012年6月至2016年6月期间确诊为HR+HER2-BC的980名患者的临床数据。根据 SII 中位值将患者分为低 SII 组和高 SII 组。变量之间的差异采用卡方检验进行评估。采用逆概率治疗加权法(IPTW)控制偏倚。采用 Kaplan-Meier 曲线和 Cox 分析法分析了临床病理因素、基线 SII 和无病生存期(DFS)之间的关系:中位随访期为 37 个月(5-77 个月)。480名患者接受了新辅助化疗,与高SII组相比,低基线SII值与更高的病理完全反应率(pCR)相关(16.4% vs. 9.2%; P = .019)。多变量分析显示,肿瘤体积较大、淋巴结受累较多、Ki-67评分较高和基线SII较高是导致HR+HER2- BC患者预后较差的独立预后因素。与低SII组相比,高SII组的转移/复发风险更高(危险比2.07 [95% CI, 1.35-3.19];P = .001)。IPTW后也得出了类似的结果,即在HR+HER2- BC患者中,高SII值与较差的DFS显著相关:结论:低基线SII与新辅助化疗后较高的pCR率相关,并且是HR+HER2- BC患者较好DFS结果的独立预后因素。
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引用次数: 0
Effective Strategies for the Prevention and Mitigation of Phosphatidylinositol-3-Kinase Inhibitor-Associated Hyperglycemia: Optimizing Patient Care. 预防和缓解磷脂酰肌醇-3-激酶抑制剂相关高血糖症的有效策略:优化患者护理。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-28 DOI: 10.1016/j.clbc.2024.09.017
Heather N Moore, Marcus D Goncalves, Abigail M Johnston, Erica L Mayer, Hope S Rugo, William J Gradishar, Dylan M Zylla, Richard M Bergenstal

Hyperglycemia is a common adverse event (AE) associated with phosphatidylinositol-3-kinase inhibitors (PI3Kis) and considered an on-target effect. Presence of hyperglycemia is associated with poor outcomes in patients with cancer, and there is need for further refinement of hyperglycemia prevention and mitigation strategies in patients receiving PI3Kis. In this review, the authors highlight effective strategies for preventing PI3Ki-induced hyperglycemia before and during treatment as well as hyperglycemia management. Prior to initiating treatment with PI3Ki, identify baseline risk factors of patients at increased risk for developing hyperglycemia, which include older age, obesity, and glycosylated hemoglobin (HbA1c) 5.7%-6.4% (prediabetes or Type 2 diabetes). To prevent new-onset hyperglycemia, optimize blood glucose, and recommend a low-carbohydrate (60-130 g/day) diet along with regular exercise to all patients prior to initiating the PI3Ki. Prophylactic metformin may be considered in all patients starting a PI3Ki with HbA1c ≤6.4%. Although existing recommendations support monitoring fasting blood glucose (FBG) once weekly (twice-weekly for intermediate-risk, daily for high-risk patients) and HbA1c every 3 months upon initiation of PI3Ki, more frequent FBG monitoring may be considered for prompt detection of hyperglycemia. Experts also recommend considering postprandial glucose monitoring because it is an early indicator of glucose intolerance. If hyperglycemia develops, metformin (first-line) and/or sodium glucose co-transporter 2 inhibitors or thiazolidinediones (second-/third-line) are the preferred agents; consider early referral to an endocrinologist. In conclusion, hyperglycemia is a common but manageable AE associated with PI3Kis. Multidisciplinary approach to the prevention, monitoring, and management of hyperglycemia optimizes patient care and allows patients to maintain therapy on PI3Ki.

高血糖是与磷脂酰肌醇-3-激酶抑制剂(PI3Kis)相关的常见不良事件(AE),被认为是一种靶向效应。高血糖的出现与癌症患者的不良预后有关,因此需要进一步完善预防和缓解 PI3Kis 患者高血糖的策略。在本综述中,作者重点介绍了在治疗前和治疗期间预防 PI3Ki 诱导的高血糖的有效策略以及高血糖管理。在开始使用 PI3Ki 治疗之前,应确定患者发生高血糖风险增加的基线风险因素,包括年龄较大、肥胖和糖化血红蛋白 (HbA1c) 5.7%-6.4% (糖尿病前期或 2 型糖尿病)。为预防新发高血糖,优化血糖,建议所有患者在开始服用 PI3Ki 之前,采用低碳水化合物(60-130 克/天)饮食,同时定期锻炼。对于 HbA1c≤6.4% 开始服用 PI3Ki 的所有患者,可考虑使用预防性二甲双胍。尽管现有建议支持在开始使用 PI3Ki 后每周监测一次空腹血糖 (FBG)(中危患者每周两次,高危患者每天一次),每 3 个月监测一次 HbA1c,但为了及时发现高血糖,可考虑更频繁地监测 FBG。专家还建议考虑进行餐后血糖监测,因为餐后血糖是葡萄糖不耐受的早期指标。如果出现高血糖,二甲双胍(一线)和/或葡萄糖钠协同转运体 2 抑制剂或噻唑烷二酮类药物(二线/三线)是首选药物;考虑尽早转诊至内分泌科医生。总之,高血糖是与 PI3Kis 相关的一种常见但可控的 AE。采用多学科方法来预防、监测和管理高血糖可优化患者护理,并使患者能够维持 PI3Ki 治疗。
{"title":"Effective Strategies for the Prevention and Mitigation of Phosphatidylinositol-3-Kinase Inhibitor-Associated Hyperglycemia: Optimizing Patient Care.","authors":"Heather N Moore, Marcus D Goncalves, Abigail M Johnston, Erica L Mayer, Hope S Rugo, William J Gradishar, Dylan M Zylla, Richard M Bergenstal","doi":"10.1016/j.clbc.2024.09.017","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.09.017","url":null,"abstract":"<p><p>Hyperglycemia is a common adverse event (AE) associated with phosphatidylinositol-3-kinase inhibitors (PI3Kis) and considered an on-target effect. Presence of hyperglycemia is associated with poor outcomes in patients with cancer, and there is need for further refinement of hyperglycemia prevention and mitigation strategies in patients receiving PI3Kis. In this review, the authors highlight effective strategies for preventing PI3Ki-induced hyperglycemia before and during treatment as well as hyperglycemia management. Prior to initiating treatment with PI3Ki, identify baseline risk factors of patients at increased risk for developing hyperglycemia, which include older age, obesity, and glycosylated hemoglobin (HbA1c) 5.7%-6.4% (prediabetes or Type 2 diabetes). To prevent new-onset hyperglycemia, optimize blood glucose, and recommend a low-carbohydrate (60-130 g/day) diet along with regular exercise to all patients prior to initiating the PI3Ki. Prophylactic metformin may be considered in all patients starting a PI3Ki with HbA1c ≤6.4%. Although existing recommendations support monitoring fasting blood glucose (FBG) once weekly (twice-weekly for intermediate-risk, daily for high-risk patients) and HbA1c every 3 months upon initiation of PI3Ki, more frequent FBG monitoring may be considered for prompt detection of hyperglycemia. Experts also recommend considering postprandial glucose monitoring because it is an early indicator of glucose intolerance. If hyperglycemia develops, metformin (first-line) and/or sodium glucose co-transporter 2 inhibitors or thiazolidinediones (second-/third-line) are the preferred agents; consider early referral to an endocrinologist. In conclusion, hyperglycemia is a common but manageable AE associated with PI3Kis. Multidisciplinary approach to the prevention, monitoring, and management of hyperglycemia optimizes patient care and allows patients to maintain therapy on PI3Ki.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of [18F] FDG PET/CT and [18F]FDG PET/MRI in the Detection of Distant Metastases in Breast Cancer: A Meta-Analysis. 比较[18F] FDG PET/CT和[18F] FDG PET/MRI检测乳腺癌远处转移:元分析。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-28 DOI: 10.1016/j.clbc.2024.09.015
Fangqian Shen, Qi Liu, Yishuang Wang, Can Chen, Hu Ma

Purpose: This meta-analysis aims to assess and compare the diagnostic effectiveness of [18F] FDG PET/CT and [18F] FDG PET/MRI for distant metastases in breast cancer patients.

Methods: A comprehensive search of the PubMed and Embase databases was performed to identify relevant articles until September 22, 2023. Studies were eligible to be included if they assessed the diagnostic performance of [18F] FDG PET/CT and/or [18F] FDG PET/MRI in detecting distant metastases of breast cancer patients. The DerSimonian and Laird method was used to assess sensitivity and specificity, and then transformed through the Freeman-Tukey double arcsine transformation.

Results: 29 articles consisting of 3779 patients were finally included in this study. The overall sensitivity of [18F] FDG PET/CT in diagnosing distant metastases of breast cancer was 0.96 (95% CI: 0.93-0.98), and the overall specificity was 0.95 (95% CI: 0.92-0.97). The overall sensitivity of [18F] FDG PET/MRI was 1.00 (95% CI: 0.97-1.00), and the specificity was 0.97 (95% CI: 0.94-1.00). The results suggested that [18F] FDG PET/CT and [18F] FDG PET/MRI appears to have similar sensitivity (P = .16) and specificity (P = .30) in diagnosing distant metastases of breast cancer.

Conclusions: The results of our meta-analysis indicated that [18F] FDG PET/CT and [18F] FDG PET/MRI in diagnosing distant metastases of breast cancer appear to have similar sensitivity and specificity. Patients who have access to only one of these modalities will not have the accuracy of their staging compromised. In clinical practice, both of these imaging techniques have their respective strengths and limitations, and physicians should take these into account when making the most suitable choice for patients.

目的:本荟萃分析旨在评估和比较[18F] FDG PET/CT和[18F] FDG PET/MRI对乳腺癌患者远处转移的诊断效果:对PubMed和Embase数据库进行了全面检索,以确定截至2023年9月22日的相关文章。如果研究评估了[18F] FDG PET/CT和/或[18F] FDG PET/MRI在检测乳腺癌患者远处转移方面的诊断性能,则符合纳入条件。本研究采用 DerSimonian 和 Laird 方法评估灵敏度和特异性,然后通过 Freeman-Tukey 双弧线变换进行转换。18F] FDG PET/CT 诊断乳腺癌远处转移的总体敏感性为 0.96(95% CI:0.93-0.98),总体特异性为 0.95(95% CI:0.92-0.97)。18F] FDG PET/MRI 的总体敏感性为 1.00(95% CI:0.97-1.00),特异性为 0.97(95% CI:0.94-1.00)。结果表明,[18F] FDG PET/CT 和 [18F] FDG PET/MRI 在诊断乳腺癌远处转移方面具有相似的敏感性(P = .16)和特异性(P = .30):我们的荟萃分析结果表明,[18F] FDG PET/CT 和 [18F] FDG PET/MRI 在诊断乳腺癌远处转移方面具有相似的敏感性和特异性。患者如果只能使用其中一种方法,其分期的准确性也不会受到影响。在临床实践中,这两种成像技术都有各自的优势和局限性,医生在为患者做出最合适的选择时应将这些因素考虑在内。
{"title":"Comparison of [<sup>18</sup>F] FDG PET/CT and [<sup>18</sup>F]FDG PET/MRI in the Detection of Distant Metastases in Breast Cancer: A Meta-Analysis.","authors":"Fangqian Shen, Qi Liu, Yishuang Wang, Can Chen, Hu Ma","doi":"10.1016/j.clbc.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.09.015","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to assess and compare the diagnostic effectiveness of [<sup>18</sup>F] FDG PET/CT and [<sup>18</sup>F] FDG PET/MRI for distant metastases in breast cancer patients.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed and Embase databases was performed to identify relevant articles until September 22, 2023. Studies were eligible to be included if they assessed the diagnostic performance of [<sup>18</sup>F] FDG PET/CT and/or [<sup>18</sup>F] FDG PET/MRI in detecting distant metastases of breast cancer patients. The DerSimonian and Laird method was used to assess sensitivity and specificity, and then transformed through the Freeman-Tukey double arcsine transformation.</p><p><strong>Results: </strong>29 articles consisting of 3779 patients were finally included in this study. The overall sensitivity of [<sup>18</sup>F] FDG PET/CT in diagnosing distant metastases of breast cancer was 0.96 (95% CI: 0.93-0.98), and the overall specificity was 0.95 (95% CI: 0.92-0.97). The overall sensitivity of [<sup>18</sup>F] FDG PET/MRI was 1.00 (95% CI: 0.97-1.00), and the specificity was 0.97 (95% CI: 0.94-1.00). The results suggested that [<sup>18</sup>F] FDG PET/CT and [<sup>18</sup>F] FDG PET/MRI appears to have similar sensitivity (P = .16) and specificity (P = .30) in diagnosing distant metastases of breast cancer.</p><p><strong>Conclusions: </strong>The results of our meta-analysis indicated that [<sup>18</sup>F] FDG PET/CT and [<sup>18</sup>F] FDG PET/MRI in diagnosing distant metastases of breast cancer appear to have similar sensitivity and specificity. Patients who have access to only one of these modalities will not have the accuracy of their staging compromised. In clinical practice, both of these imaging techniques have their respective strengths and limitations, and physicians should take these into account when making the most suitable choice for patients.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maximizing Breast Cancer Detection Through Screening: A Comparative Analysis of Imaging-Based Approaches. 通过筛查最大限度地发现乳腺癌:基于成像方法的比较分析。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-26 DOI: 10.1016/j.clbc.2024.09.012
Matthew F Covington

Introduction/background: This study estimates the percentage of detectable breast cancers in the screening population that could be found with primary and supplemental screening, and provides cost estimates for population wide supplemental screening in the U.S.

Materials and methods: Published estimates on cancer detection rates of 2D mammography, tomosynthesis (DBT), whole breast ultrasound (US), molecular breast imaging (MBI), contrast-enhanced mammography (CEM), and MRI, the number of mammograms conducted in the United States in 2023, and the proportion of dense breast tissue, were utilized. The maximum number of detectable cancers was projected from incremental cancer detection rates of the most sensitive supplemental screening method. The proportion of cancers detectable for each modality was calculated. In 2023, Medicare reimbursement rates were used to estimate supplemental screening costs.

Results: Out of 469,437 detectable cancers, 2D mammography could detect 190,531 (41%), leaving 278,906 undetected. Adding supplemental screening could detect a combined 220,165 cancers (47%) with DBT, 237,596 (51%) with US, 331,727 (71%) with MBI, 377,049 (80%) with CEM and 469,437 (100%) with MRI. The imaging cost in US dollars to provide supplemental screening to all individuals with dense breasts in 2023 was $933M for tomosynthesis, $1.84B for US, $3.87B for CEM, $4.16B for MBI, and $6.36B for MRI.

Conclusion: The study highlights potential benefits from supplemental breast cancer screening, suggesting the combination of mammography and breast MRI offers the most effective detection method though at the highest imaging cost. These findings provide valuable insights to guide future research and inform decision-making in supplemental breast cancer screening strategies.

简介/背景:本研究估算了通过初筛和补充筛查可发现的乳腺癌在筛查人群中所占的比例,并提供了美国全民补充筛查的成本估算:利用已公布的二维乳腺X光摄影、断层扫描(DBT)、全乳超声波(US)、分子乳腺成像(MBI)、对比增强乳腺X光摄影(CEM)和核磁共振成像的癌症检出率估算值、2023年美国进行乳腺X光摄影的数量以及致密乳腺组织的比例。根据最敏感的补充筛查方法的增量癌症检出率,推算出可检出癌症的最大数量。计算出每种方式可检测到的癌症比例。2023 年,医疗保险报销率用于估算补充筛查成本:在 469,437 例可检测出的癌症中,二维乳腺 X 光检查可检测出 190,531 例(41%),还有 278,906 例未检测出。增加补充筛查后,DBT 共可检测出 220,165 例癌症(47%),US 共可检测出 237,596 例癌症(51%),MBI 共可检测出 331,727 例癌症(71%),CEM 共可检测出 377,049 例癌症(80%),MRI 共可检测出 469,437 例癌症(100%)。2023 年为所有致密乳房患者提供补充筛查的成像成本(以美元计)为:断层合成 9.33 亿美元、US 18.4 亿美元、CEM 38.7 亿美元、MBI 41.6 亿美元、MRI 63.6 亿美元:该研究强调了补充性乳腺癌筛查的潜在益处,表明乳腺 X 线照相术和乳腺核磁共振成像的结合提供了最有效的检测方法,但成像成本最高。这些发现为指导未来的研究提供了宝贵的见解,并为辅助乳腺癌筛查策略的决策提供了依据。
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引用次数: 0
RBM15 Drives Breast Cancer Cell Progression and Immune Escape via m6A-Dependent Stabilization of KPNA2 mRNA. RBM15 通过 m6A 依赖性稳定 KPNA2 mRNA 推动乳腺癌细胞进展和免疫逃逸。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-26 DOI: 10.1016/j.clbc.2024.09.006
Hu Wang, Yu Cao, Li Zhang, Qian Zhao, Shuangjian Li, Dan Li

Background: Breast cancer is the most frequently diagnosed cancer among women worldwide with high morbidity and mortality. Previous studies have indicated that RNA-binding motif protein-15 (RBM15), an N6-methyladenosine (m6A) writer, is implicated in the growth of breast cancer cells. Herein, we aimed to explore the function and detailed mechanism of RBM15 in breast cancer.

Methods: In this research, UALCAN databases were applied to analyze the expression of RBM15 or Karyopherin-2 alpha (KPNA2) in BRCA. RBM15 and KPNA2 mRNA levels were determined using real-time quantitative polymerase chain reaction (RT-qPCR) assay. RBM15, KPNA2, and Programmed cell death ligand 1 (PD-L1) protein levels were measured using western blot. Cell proliferation, migration, and invasion were assessed using 5-ethynyl-2'-deoxyuridine (EdU) and Transwell assays. The biological role of RBM15 on breast cancer tumor growth was verified using the xenograft tumor model in vivo. Effects of breast cancer cells on the proliferation and apoptosis of CD8+ T cells were analyzed using flow cytometry. Interaction between RBM15 and KPNA2 was validated using methylated RNA immunoprecipitation (MeRIP) and dual-luciferase reporter assays.

Results: RBM15 and KPNA2 were highly expressed in breast cancer tissues and cell lines. Furthermore, RBM15 silencing might suppress breast cancer cell proliferation, migration, invasion, and lymphocyte immunity in vitro, as well as block tumor growth in vivo. At the molecular level, RBM15 might improve the stability and expression of KPNA2 mRNA via m6A methylation.

Conclusion: RBM15 might contribute to the malignant progression and immune escape of breast cancer cells partly by modulating the stability of KPNA2 mRNA, providing a promising therapeutic target for breast cancer.

背景:乳腺癌是全球妇女中最常见的癌症,发病率和死亡率都很高。以往的研究表明,RNA 结合基序蛋白-15(RBM15)是一种 N6-甲基腺苷(m6A)的写入因子,与乳腺癌细胞的生长有关。在此,我们旨在探索 RBM15 在乳腺癌中的功能和详细机制:本研究应用 UALCAN 数据库分析 RBM15 或 Karyopherin-2 alpha(KPNA2)在 BRCA 中的表达。采用实时定量聚合酶链反应(RT-qPCR)测定 RBM15 和 KPNA2 mRNA 水平。采用免疫印迹法测定 RBM15、KPNA2 和程序性细胞死亡配体 1 (PD-L1) 蛋白水平。细胞增殖、迁移和侵袭采用 5- 乙炔基-2'-脱氧尿苷(EdU)和 Transwell 试验进行评估。使用体内异种移植肿瘤模型验证了 RBM15 对乳腺癌肿瘤生长的生物学作用。流式细胞术分析了乳腺癌细胞对 CD8+ T 细胞增殖和凋亡的影响。使用甲基化 RNA 免疫沉淀(MeRIP)和双荧光素酶报告实验验证了 RBM15 和 KPNA2 之间的相互作用:结果:RBM15和KPNA2在乳腺癌组织和细胞系中高表达。此外,沉默 RBM15 可在体外抑制乳腺癌细胞的增殖、迁移、侵袭和淋巴细胞免疫,并在体内阻断肿瘤生长。在分子水平上,RBM15可能通过m6A甲基化改善KPNA2 mRNA的稳定性和表达:结论:RBM15可能部分通过调节KPNA2 mRNA的稳定性来促进乳腺癌细胞的恶性进展和免疫逃逸,为乳腺癌提供了一个有前景的治疗靶点。
{"title":"RBM15 Drives Breast Cancer Cell Progression and Immune Escape via m6A-Dependent Stabilization of KPNA2 mRNA.","authors":"Hu Wang, Yu Cao, Li Zhang, Qian Zhao, Shuangjian Li, Dan Li","doi":"10.1016/j.clbc.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.09.006","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most frequently diagnosed cancer among women worldwide with high morbidity and mortality. Previous studies have indicated that RNA-binding motif protein-15 (RBM15), an N6-methyladenosine (m6A) writer, is implicated in the growth of breast cancer cells. Herein, we aimed to explore the function and detailed mechanism of RBM15 in breast cancer.</p><p><strong>Methods: </strong>In this research, UALCAN databases were applied to analyze the expression of RBM15 or Karyopherin-2 alpha (KPNA2) in BRCA. RBM15 and KPNA2 mRNA levels were determined using real-time quantitative polymerase chain reaction (RT-qPCR) assay. RBM15, KPNA2, and Programmed cell death ligand 1 (PD-L1) protein levels were measured using western blot. Cell proliferation, migration, and invasion were assessed using 5-ethynyl-2'-deoxyuridine (EdU) and Transwell assays. The biological role of RBM15 on breast cancer tumor growth was verified using the xenograft tumor model in vivo. Effects of breast cancer cells on the proliferation and apoptosis of CD8<sup>+</sup> T cells were analyzed using flow cytometry. Interaction between RBM15 and KPNA2 was validated using methylated RNA immunoprecipitation (MeRIP) and dual-luciferase reporter assays.</p><p><strong>Results: </strong>RBM15 and KPNA2 were highly expressed in breast cancer tissues and cell lines. Furthermore, RBM15 silencing might suppress breast cancer cell proliferation, migration, invasion, and lymphocyte immunity in vitro, as well as block tumor growth in vivo. At the molecular level, RBM15 might improve the stability and expression of KPNA2 mRNA via m6A methylation.</p><p><strong>Conclusion: </strong>RBM15 might contribute to the malignant progression and immune escape of breast cancer cells partly by modulating the stability of KPNA2 mRNA, providing a promising therapeutic target for breast cancer.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction of Microinvasion in Breast Ductal Carcinoma in Situ Using Conventional Ultrasound Combined with Contrast-Enhanced Ultrasound Features: A Two-Center Study. 使用传统超声结合对比度增强超声特征预测乳腺原位导管癌的微小浸润:一项双中心研究
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-25 DOI: 10.1016/j.clbc.2024.09.014
Tingting Wu, Jing Chen, Sihui Shao, Yu Du, Fang Li, Hui Liu, Liping Sun, Xuehong Diao, Rong Wu

Background: To develop and validate a model based on conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) features to preoperatively predict microinvasion in breast ductal carcinoma in situ (DCIS).

Patients and methods: Data from 163 patients with DCIS who underwent CUS and CEUS from the internal hospital was retrospectively collected and randomly apportioned into training and internal validation sets in a ratio of 7:3. External validation set included 56 patients with DCIS from the external hospital. Univariate and multivariate logistic regression analysis were performed to determine the independent risk factors associated with microinvasion. These factors were used to develop predictive models. The performance was evaluated through calibration, discrimination, and clinical utility.

Results: Multivariate analysis indicated that centripetal enhancement direction (odds ratio [OR], 13.268; 95% confidence interval [CI], 3.687-47.746) and enhancement range enlarged on CEUS (OR, 4.876; 95% CI, 1.470-16.181), lesion size of ≥20 mm (OR, 3.265; 95% CI, 1.230-8.669) and calcification detected on CUS (OR, 5.174; 95% CI, 1.903-14.066) were independent risk factors associated with microinvasion. The nomogram incorporated the CUS and CEUS features achieved favorable discrimination (AUCs of 0.850, 0.848, and 0.879 for the training, internal and external validation datasets), with good calibration. The nomogram outperformed the CUS model and CEUS model (all P < .05). Decision curve analysis confirmed that the predictive nomogram was clinically useful.

Conclusion: The nomogram based on CUS and CEUS features showed promising predictive value for the preoperative identification of microinvasion in patients with DCIS.

背景:目的:开发并验证一种基于常规超声(CUS)和对比增强超声(CEUS)特征的模型,用于术前预测乳腺导管原位癌(DCIS)的微小病灶:回顾性收集内部医院163名接受CUS和CEUS检查的DCIS患者的数据,并按7:3的比例随机分为训练集和内部验证集。外部验证集包括外部医院的 56 例 DCIS 患者。通过单变量和多变量逻辑回归分析,确定与微小浸润相关的独立风险因素。这些因素被用于开发预测模型。通过校准、区分度和临床实用性对模型的性能进行了评估:多变量分析表明,CEUS 上向心性增强方向(几率比 [OR],13.268;95% 置信区间 [CI],3.687-47.746)和增强范围扩大(OR,4.876;95% CI,1.470-16.181)、病灶大小≥20 毫米(OR,3.265;95% CI,1.230-8.669)和 CUS 上检测到的钙化(OR,5.174;95% CI,1.903-14.066)是与微小病灶相关的独立危险因素。包含 CUS 和 CEUS 特征的提名图具有良好的区分度(训练、内部和外部验证数据集的 AUC 分别为 0.850、0.848 和 0.879)和校准性。提名图的表现优于 CUS 模型和 CEUS 模型(所有 P < .05)。决策曲线分析证实,预测提名图在临床上是有用的:基于CUS和CEUS特征的提名图对术前识别DCIS患者的微小病灶具有很好的预测价值。
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引用次数: 0
Trends and Regional Differences for Fertility Preservation Procedures in Women With Breast Cancer. 乳腺癌妇女生育力保存程序的趋势和地区差异。
IF 2.9 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-23 DOI: 10.1016/j.clbc.2024.09.011
Volkan Turan, Giuliano Bedoschi, Dong-Yun Lee, Caio Parente Barbosa, Renato de Oliveira, Koray Gorkem Sacinti, Murat Sonmezer, Matteo Lambertini, Claudia Massarotti, Amelia Schaub, Erica Wang, Sonia Gayete-Lafuente, Cheryl Dunlop, Richard A Anderson, Heejung Bang, Kutluk H Oktay

Introduction: Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation (FP) referral. Embryo, oocyte, or ovarian tissue cryopreservation are established FP modalities in women with breast cancer but there are few data on their uptake over time. In this study our aim was to determine the regional time trends and utility differences for fertility preservation methods of reproductive tissue cryopreservation.

Methods: This multicenter study included 1623 women diagnosed with breast cancer from 7 tertiary centers in 6 countries (Brazil, Italy, Scotland, South Korea, Turkey, USA). Participant centers provided the details of FP cryopreservation approaches broken down annually from 2012 to 2021. Women with newly diagnosed breast cancer, aged 18-45 years who were referred for FP at participating centers and had normal ovarian function at the time were included.

Results: We found a mean increase of 7% per year (P = .002, adjusting for centers) in the number of women referred for FP. Of those who were referred (n = 1623), a mean 38.7% underwent FP (n = 629), with a range of 12% in South Korea) to 95% in Brazil. The number of women undergoing ovarian stimulation for FP continually increased until 2021, with oocyte cryopreservation being the most common procedure throughout the study period (P = .014 for time trend). The proportion of random start ovarian stimulation cycles increased each year from 58.3% in 2012 to 86.8% in 2021, (P = .005 for time trend, and P = .04 for 2012 vs. 2021).

Conclusions: The utility of FP has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence FP practices. The findings of our study could have value for policy making in FP care for young women with breast cancer at the local, regional, or global level.

导言:乳腺癌是育龄妇女最常见的恶性肿瘤,化疗方案会损害生育能力,因此经常需要转诊进行生育力保存(FP)。胚胎、卵母细胞或卵巢组织冷冻保存是治疗乳腺癌妇女的成熟生育力保存方式,但有关其长期使用情况的数据却很少。在这项研究中,我们的目的是确定生殖组织冷冻的生育力保存方法的地区时间趋势和效用差异:这项多中心研究纳入了来自 6 个国家(巴西、意大利、苏格兰、韩国、土耳其和美国)7 个三级医疗中心的 1623 名确诊为乳腺癌的女性。参与研究的中心提供了从 2012 年到 2021 年每年的 FP 冷冻方法的详细信息。研究对象包括新诊断为乳腺癌的女性,年龄在18-45岁之间,在参与中心接受FP治疗,且当时卵巢功能正常:我们发现,转诊接受 FP 治疗的女性人数平均每年增加 7%(P = .002,根据中心进行调整)。在转诊的妇女中(n = 1623),平均有 38.7% 接受了 FP(n = 629),范围从韩国的 12% 到巴西的 95%。直到 2021 年,接受卵巢刺激进行 FP 的女性人数持续增加,在整个研究期间,卵母细胞冷冻保存是最常见的程序(时间趋势 P = .014)。随机启动卵巢刺激周期的比例逐年增加,从2012年的58.3%增至2021年的86.8%(时间趋势的P = .005,2012年与2021年的P = .04):结论:过去十年来,FP对年轻乳腺癌女性患者的实用性稳步提高,但地区差异对FP的使用有很大影响。我们的研究结果对制定地方、地区或全球层面的年轻女性乳腺癌患者 FP 护理政策具有重要价值。
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引用次数: 0
期刊
Clinical breast cancer
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