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Pleural mesothelioma in situ : a comprehensive review. 原位胸膜间皮瘤:全面回顾。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-03-11 DOI: 10.1097/CEJ.0000000000000883
Federica Danuzzo, Federico Raveglia, Francesca Spinelli, Chiara Maria Sibilia, Enrico Cassina, Lidia Libretti, Emanuele Pirondini, Antonio Tuoro, Francesca Bono, Maria Emilia Paladino, Diego Cortinovis, Francesco Petrella

Pleural mesothelioma is a rare and aggressive cancer that affects the pleura. In recent years, there has been increasing interest and attention in detecting and diagnosing early-stage or precancerous forms of mesothelioma because of its severe prognosis and short life expectancy at the time of diagnosis. Mesothelioma in situ represents a clear opportunity to improve and innovate the diagnostic approach and the multimodality treatment of mesothelioma: the diagnosis of pleural mesothelioma at the 'in-situ phase' means early disease detection and thus paves the way to new possible curable strategies. Since 2021, when mesothelioma in situ was finally identified and described as a new histological entity, its diagnosis and management became a challenge and the subject of ongoing research; several aspects remain open and still outstanding as regards diagnostic techniques, time and probability of progression, need for and methods of follow up, aggressive and early surgery. This narrative review aims to provide a comprehensive overview of mesothelioma in situ covering its definition, risk factors, diagnostic criteria, and tricky aspects of early detection. It also highlights its clinical significance, new perspectives, and potential future indications in the context of pleural mesothelioma multidisciplinary management.

胸膜间皮瘤是一种影响胸膜的罕见侵袭性癌症。近年来,由于间皮瘤的严重预后和确诊时预期寿命短,人们对检测和诊断早期或癌前形式的间皮瘤越来越感兴趣和重视。原位间皮瘤为改进和创新间皮瘤的诊断方法和多模式治疗提供了一个明确的机会:在 "原位阶段 "诊断胸膜间皮瘤意味着疾病的早期发现,从而为新的可能治愈策略铺平了道路。自 2021 年原位间皮瘤最终被确定并描述为一种新的组织学实体以来,其诊断和管理就成为了一项挑战和正在进行的研究课题;在诊断技术、进展的时间和概率、随访的需要和方法、积极和早期手术等方面,仍有几个方面尚未解决。这篇叙述性综述旨在全面概述原位间皮瘤,包括其定义、风险因素、诊断标准和早期检测的棘手问题。它还强调了在胸膜间皮瘤多学科管理方面的临床意义、新观点和潜在的未来适应症。
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引用次数: 0
Evaluation of BUBR1, MCM2, and GMNN as oral cancer biomarkers. 评估作为口腔癌生物标记物的 BUBR1、MCM2 和 GMNN。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-31 DOI: 10.1097/CEJ.0000000000000932
Naíza M M Abrahim, Roberta B Cavalcante, Maria Inês de M C Pardini, Silvia H B Rabenhorst, Adriana Camargo Ferrasi

Oral cancer is a public health problem worldwide. Late diagnosis results in a low survival rate. However, this tumor can arise from oral precancerous lesions and identification of biomarkers in precursor lesions has the potential for early diagnosis, improving patient survival. In this context, proteins involved in the cell cycle control are potentially promising. This study aimed to evaluate the importance of immunohistochemical expression of BUBR1, MCM2, and GMNN as biomarkers of oral carcinogenesis considering different oral sites. Sixty-six samples of oral epithelial dysplasia (from 33 males and 33 females) and 63 samples of oral squamous cell carcinoma (from 44 males and 19 females) were subjected to immunohistochemistry to detect some human proteins. Ki67 expression was included as a marker of cell proliferation. Marker expression was quantified by manually counting at least 1000 cells, and the labeling index was used in all statistical analyses. GMNN, MCM2, BUBR1 (nuclear and cytoplasmic labeling), and Ki67 expression levels were higher in carcinomas than in dysplasia (P < 0.05). Cytoplasmic BUBR1 was a good marker of malignancy (AUC = 0.8525, P < 0.05), but Ki67 was not (AUC = 0.5943, P = 0.0713). GMNN, MCM2, BUBR1, and Ki67 had higher expression in carcinoma than in dysplasia, regardless of the site of the lesion. Cytoplasmic BUBR1 has the potential to be used as a marker of tumor progression.

口腔癌是全世界的公共卫生问题。晚期诊断导致生存率低。然而,这种肿瘤可能源于口腔癌前病变,识别癌前病变中的生物标志物有可能实现早期诊断,提高患者的生存率。在这种情况下,参与细胞周期控制的蛋白质具有潜在的前景。本研究旨在评估 BUBR1、MCM2 和 GMNN 的免疫组化表达作为口腔癌发生生物标志物的重要性。研究人员对 66 份口腔上皮发育不良样本(33 名男性和 33 名女性)和 63 份口腔鳞状细胞癌样本(44 名男性和 19 名女性)进行了免疫组化,以检测一些人类蛋白质。Ki67 表达作为细胞增殖的标志物。标记物的表达通过人工计数至少 1000 个细胞进行量化,所有统计分析均使用标记指数。癌细胞中 GMNN、MCM2、BUBR1(细胞核和细胞质标记)和 Ki67 的表达水平高于发育不良细胞(P < 0.05)。细胞质 BUBR1 是恶性肿瘤的良好标记物(AUC = 0.8525,P < 0.05),但 Ki67 不是(AUC = 0.5943,P = 0.0713)。无论病变部位如何,GMNN、MCM2、BUBR1 和 Ki67 在癌中的表达均高于在发育不良中的表达。细胞质 BUBR1 有可能被用作肿瘤进展的标志物。
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引用次数: 0
Passive smoking and risk of head and neck cancer: a systematic review and meta-analysis. 被动吸烟与头颈部癌症风险:系统回顾与荟萃分析。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-30 DOI: 10.1097/CEJ.0000000000000930
Fei Xu, Nan Mu, Yang Song, Meili Ma

Studies on the association between passive smoking and head and neck cancer (HNC) are controversial. This meta-analysis aimed to explore this association. A systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases was conducted up to July 2024 to identify relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the DerSimonian-Laird random-effects model. Heterogeneity among studies was assessed, and the risk of bias was evaluated. A total of 1036 records were identified, of which 17 studies were included. Passive smoking was significantly associated with an increased risk of HNC overall (OR = 1.70, 95% CI: 1.27-2.28, P < 0.001). The association was particularly strong for oral cancer (OR = 1.85, 95% CI: 1.07-3.17, P = 0.026), oropharyngeal cancer (OR = 2.78, 95% CI: 1.29-5.98, P = 0.009), laryngeal cancer (OR = 1.60, 95% CI: 1.24-2.06, P < 0.001), and hypopharyngeal cancer (OR = 2.60, 95% CI: 1.45-4.66, P = 0.001). No significant association was observed for nasopharyngeal carcinoma (OR = 1.14, 95% CI: 0.78-1.66, P = 0.498). Geographically, the risk was elevated among both Asian and European populations. Passive smoking is associated with an increased risk of HNC, particularly for subtypes such as oral, oropharyngeal, laryngeal, and hypopharyngeal cancers. These findings underscore the importance of mitigating exposure to passive smoking as a public health measure.

关于被动吸烟与头颈癌(HNC)之间关系的研究存在争议。本荟萃分析旨在探讨这种关联。截至 2024 年 7 月,我们对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了系统检索,以确定相关研究。采用DerSimonian-Laird随机效应模型计算了汇总的几率比(ORs)和95%置信区间(CIs)。对研究之间的异质性进行了评估,并对偏倚风险进行了评估。共发现了 1036 条记录,其中纳入了 17 项研究。被动吸烟与HNC总体患病风险的增加有明显相关性(OR = 1.70,95% CI:1.27-2.28,P < 0.001)。口腔癌(OR = 1.85,95% CI:1.07-3.17,P = 0.026)、口咽癌(OR = 2.78,95% CI:1.29-5.98,P = 0.009)、喉癌(OR = 1.60,95% CI:1.24-2.06,P <0.001)和下咽癌(OR = 2.60,95% CI:1.45-4.66,P = 0.001)与被动吸烟的关系尤为密切。鼻咽癌(OR = 1.14,95% CI:0.78-1.66,P = 0.498)与此无明显关联。从地域上看,亚洲人和欧洲人患鼻咽癌的风险都较高。被动吸烟与罹患 HNC 的风险增加有关,尤其是口腔癌、口咽癌、喉癌和下咽癌等亚型。这些发现强调了减少被动吸烟作为一项公共卫生措施的重要性。
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引用次数: 0
Prevalence of BRCA1 and BRCA2 mutations in ovarian cancer patients from Yunnan Province in southwest China. 中国西南地区云南省卵巢癌患者中 BRCA1 和 BRCA2 基因突变的发生率。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-25 DOI: 10.1097/CEJ.0000000000000931
Yongmei Peng, Jiaqian Liao, Xian He, Yongchun Zhou, Lei Zhang, Yue Jia, Hongying Yang

Carriers with germline breast cancer 1/2 gene mutations (BRCAm) are likely to develop ovarian cancer (OC). Therefore, identifying these mutations may enable individualized therapy for OC and preventive measures to reduce OC risk in BRCAm carrier families. Thus, we investigated the prevalence of BRCAm in OC patients from Yunnan Province in Southwest China. In total, 674 unselected OC patients were enrolled and tested for BRCAm via next-generation sequencing. Data on clinicopathological characteristics and personal/family history of cancer were collected. The prevalence rates of pathogenic/likely pathogenic BRCAm were 26.6% overall, 20.8% among BRCA1m carriers, 5.5% among BRCA2m carriers, and 0.3% among carriers of both BRCA1m and BRCA2m. The most common pathogenic mutation in the BRCA1 gene was c.5114T>C (n = 9). The number of BRCAm carriers was significantly greater among patients with serous cancer, a personal tumor history, a family history of hereditary breast and ovarian cancer (HBOC)-related tumors, and bilateral tumors. The most common pathogenic mutation in this cohort was c.5114T>C (n = 9) in BRCA1. The prevalence and spectrum of BRCAm in OC patients from Yunnan Province are different from those in other groups. BRCA status testing is advised for all OC patients, particularly those with a family history of HBOC.

乳腺癌 1/2基因(BRCAm)种系突变携带者很可能会罹患卵巢癌(OC)。因此,确定这些基因突变可用于卵巢癌的个体化治疗,并采取预防措施降低 BRCAm 携带者家族的卵巢癌风险。因此,我们调查了中国西南部云南省卵巢癌患者中 BRCAm 的患病率。我们共招募了 674 名未入选的 OC 患者,并通过新一代测序对他们进行了 BRCAm 检测。研究人员收集了临床病理特征和个人/家族癌症病史数据。总的致病性/可能致病性 BRCAm 患病率为 26.6%,BRCA1m 携带者为 20.8%,BRCA2m 携带者为 5.5%,BRCA1m 和 BRCA2m 携带者均为 0.3%。BRCA1 基因中最常见的致病突变是 c.5114T>C(n = 9)。在患有浆液性癌、个人肿瘤史、遗传性乳腺癌和卵巢癌(HBOC)相关肿瘤家族史以及双侧肿瘤的患者中,BRCAm 携带者的数量明显较多。该队列中最常见的致病突变是 BRCA1 中的 c.5114T>C(n = 9)。云南省 OC 患者的 BRCAm 患病率和谱系与其他群体不同。建议所有卵巢癌患者,尤其是有HBOC家族史的患者进行BRCA状态检测。
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引用次数: 0
Germline testing of Iranian families suspected of Lynch syndrome: molecular characterization and current surveillance of families with pathogenic variants in MSH2, MSH6, and PMS2. 对疑似林奇综合征的伊朗家庭进行基因检测:对 MSH2、MSH6 和 PMS2 中存在致病变异的家庭进行分子特征描述和当前监测。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-22 DOI: 10.1097/CEJ.0000000000000916
Mohammad Sina, Shiva Zarinfam, Silvia Clara Giliani, Pietro Luigi Poliani, Keivan Majidzadeh-A

Lynch syndrome accounts for 3-5% of all colorectal and endometrial cancer cases, and suboptimal management of Lynch syndrome in the Middle East resulted in the underdiagnosis of mutation carriers. Probands from 24 unrelated Iranian families with a history of cancer(s) suggestive of Lynch syndrome underwent microsatellite instability analysis or immunohistochemistry, multigene panel testing, copy number variation detection, or multiplex ligation-dependent probe amplification. Pathogenic variants were identified in five patients (21%), including three in MSH2, one in MSH6, and one in PMS2. Microsatellite instability analysis showed the lengths of the CAT25 marker in tumor and normal samples were 149 and 148 bp, respectively. Among 21 family members with Lynch syndrome in the MSH2 gene, identified from the three families who previously underwent cascade screening, colorectal and endometrial cancers were the most frequent. While 66% of patients had insurance that included coverage for mutation carrier screening, only one insurance provider extended coverage for next-generation sequencing. Special attention to probands and telematic management of at-risk relatives to organize blood sample collection at their convenience enhanced cascade testing 20-fold per proband. In conclusion, the age of onset and segregation analysis indicated that PMS1 may not be a cancer susceptibility gene, and the tumor spectrum in MSH2 pathogenic carriers is similar to Western countries. Collecting blood samples at patients' convenience is a possible strategy to reduce the cost of identifying Lynch syndrome through cascade testing. The genetic analysis of patients for inherited cancers would optimize the current management of Lynch syndrome in Iran by omitting noncarriers from surveillance programs.

林奇综合征占所有结直肠癌和子宫内膜癌病例的 3-5%,而中东地区对林奇综合征的管理不够完善,导致突变携带者诊断不足。来自 24 个无血缘关系、有林奇综合征癌症病史的伊朗家庭的患者接受了微卫星不稳定性分析或免疫组化、多基因面板检测、拷贝数变异检测或多重结扎依赖性探针扩增。在五名患者(21%)中发现了致病变体,包括 MSH2 中的三个变体、MSH6 中的一个变体和 PMS2 中的一个变体。微卫星不稳定性分析表明,肿瘤和正常样本中 CAT25 标记的长度分别为 149 和 148 bp。从之前接受级联筛查的三个家庭中发现的 21 名 MSH2 基因林奇综合征家族成员中,结直肠癌和子宫内膜癌的发病率最高。虽然 66% 的患者拥有包括突变携带者筛查在内的保险,但只有一家保险提供商为下一代测序提供了保险。对原发患者的特别关注以及对高危亲属的远程管理,使他们在方便的时候组织血样采集,使每位原发患者的级联检测率提高了 20 倍。总之,发病年龄和分离分析表明,PMS1 可能不是癌症易感基因,MSH2 致病携带者的肿瘤谱与西方国家相似。在患者方便的时候采集血液样本是通过级联检测降低林奇综合征鉴定成本的一种可行策略。通过对患者进行遗传性癌症基因分析,可以将非携带者排除在监测计划之外,从而优化伊朗目前对林奇综合征的管理。
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引用次数: 0
Association between different patterns of obesity and the short-term outcomes of gastric cancer surgery. 不同肥胖模式与胃癌手术短期疗效之间的关系。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-18 DOI: 10.1097/CEJ.0000000000000926
Guoqing Shi, Tianyu Gao, Peng Du, Jiwu Guo, Yan Dong, Jie Mao

Previous studies have shown that general and central obesity are each linked to adverse outcomes in gastrointestinal cancers. However, their combined effect on gastrointestinal cancers surgery outcomes were less understood. This study aims to integrate both general and central obesity to examine the outcomes of gastric cancer surgery in different obesity patterns. We retrospectively analyzed 248 patients who underwent gastric cancer surgery between 2021 and 2023 in a single institute. The Inbody720 body composition analyzer measured body composition. We evaluated the relationship between obesity patterns - combining BMI with central obesity measures (waist circumference, waist-to-hip ratio, visceral fat area) - and postoperative complications and 30-day readmission. Central-only obesity were more likely to induce fistula (P = 0.025), while non-obesity was more likely to develop postoperative abdominal effusion (P = 0.049) and bleeding (P = 0.042). Central-only obesity was significantly associated with severe postoperative complications after adjustment for hypertension, diabetes, abdominal surgery history, preoperative albumin levels, age, sex, and surgical types. This remains significant even after adjusting for muscle mass. However, we did not find the same results for significant complications. Regarding 30-day readmission, there are no differences between different patterns of obesity. Central-only obesity is an independent risk factor for severe postoperative complications in gastric cancer, while a high BMI appears to be associated with a lower risk compared to non-obese patients, but not significant postoperative complications. The likelihood of readmission within 30 days post-surgery may not be related to the patient's pattern of obesity.

以往的研究表明,全身性肥胖和中心性肥胖都与胃肠道癌症的不良预后有关。然而,人们对它们对胃肠癌手术结果的综合影响了解较少。本研究旨在综合全身性肥胖和中心性肥胖,研究不同肥胖模式下的胃癌手术效果。我们回顾性分析了 2021 年至 2023 年期间在一家研究所接受胃癌手术的 248 名患者。Inbody720 身体成分分析仪测量了身体成分。我们评估了肥胖模式(结合体重指数和中心性肥胖测量值(腰围、腰臀比、内脏脂肪面积))与术后并发症和30天再入院之间的关系。单纯中心性肥胖更容易诱发瘘管(P = 0.025),而非肥胖则更容易出现术后腹腔积液(P = 0.049)和出血(P = 0.042)。在对高血压、糖尿病、腹部手术史、术前白蛋白水平、年龄、性别和手术类型进行调整后,纯中心性肥胖与严重的术后并发症显著相关。即使对肌肉质量进行调整后,这种关系仍然很明显。但是,我们在重大并发症方面没有发现相同的结果。关于 30 天再入院,不同肥胖模式之间没有差异。单纯中心性肥胖是胃癌术后严重并发症的独立风险因素,而与非肥胖患者相比,高体重指数似乎与较低的风险有关,但与重大术后并发症无关。术后30天内再次入院的可能性可能与患者的肥胖模式无关。
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引用次数: 0
The impact of different dietary flavonoids on the risk of coronary heart disease in cancer patients and that on the prognosis of patients with cancer and coronary heart disease. 不同膳食类黄酮对癌症患者冠心病风险的影响,以及对癌症和冠心病患者预后的影响。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-09 DOI: 10.1097/CEJ.0000000000000928
Jingjing Zhu, Tao Xu, Xu Cao, Di Pan, Zhiyuan Yao, Yuqi Li, Hongmei Wang, Zhengxiang Han

The purpose of this study is to explore the risk of coronary heart disease (CHD) in cancer patients who consume different flavonoids, and the impact of flavonoids on the prognosis of cancer patients with CHD. We extracted dietary flavonoids data on 1454 patients diagnosed with cancer from the National Health and Nutrition Examination Survey and Food and Nutrient Database for Dietary Studies. Logistic regression analysis was used to explore the relationship between the intake of flavonoids and the risk of CHD. Cox proportional hazard model was used to explore the impact of flavonoids intake on prognosis in 148 patients with cancer and CHD. Malvidin intake increased the risk of CHD by 1% [odds ratio (OR) = 1.01, 95% confidence interval (CI): 1.00-1.02, P < 0.05] in cancer patients, while epicatechin and isorhamnetin reduced the risk of CHD by 3% (OR = 0.97, 95% CI: 0.94-1.00, P < 0.05) and 15% (OR = 0.85, 95% CI: 0.72-1.00, P < 0.05), respectively. Adjusted by age, sex, and race, malvidin intake increased the risk of CHD in cancer patients by 1% (OR = 1.01, 95% CI: 1.00-1.02, P < 0.05), isorhamnetin decreased the risk by 15% (OR = 0.85, 95% CI: 0.72-1.00, P < 0.05), and epicatechin showed no effect on the risk of CHD ( P > 0.05). No flavonoids had impact on the prognosis of patients with cancer and CHD ( P > 0.05). For patients with cancer, consuming malvidin increases the risk of CHD, while isorhamnetin reduces the risk. Consuming flavonoids has no impact on the prognosis of patients with cancer and CHD.

本研究旨在探讨摄入不同类黄酮的癌症患者罹患冠心病(CHD)的风险,以及类黄酮对罹患冠心病的癌症患者预后的影响。我们从美国国家健康与营养调查和膳食研究食物与营养素数据库中提取了1454名确诊癌症患者的类黄酮膳食数据。采用逻辑回归分析探讨类黄酮摄入量与冠心病风险之间的关系。采用Cox比例危险模型探讨了类黄酮摄入量对148名癌症和心脏病患者预后的影响。摄入麦饭石黄酮会使癌症患者罹患冠心病的风险增加1%[几率比(OR)=1.01,95%置信区间(CI):1.00-1.02,P < 0.05],而表儿茶素和异鼠李素则会使罹患冠心病的风险分别降低3%(OR = 0.97,95% CI:0.94-1.00,P < 0.05)和15%(OR = 0.85,95% CI:0.72-1.00,P < 0.05)。经年龄、性别和种族调整后,摄入麦饭石黄酮会使癌症患者罹患冠心病的风险增加1%(OR = 1.01,95% CI:1.00-1.02,P < 0.05),异鼠李素会使罹患冠心病的风险降低15%(OR = 0.85,95% CI:0.72-1.00,P < 0.05),而表儿茶素对罹患冠心病的风险没有影响(P > 0.05)。没有一种类黄酮对癌症和心脏病患者的预后有影响(P > 0.05)。对于癌症患者来说,摄入麦饭石黄酮会增加患心脏病的风险,而摄入异鼠李素则会降低患心脏病的风险。食用类黄酮对癌症和心脏病患者的预后没有影响。
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引用次数: 0
A time-dependent bidirectional association between folate and lung cancer deaths among a national cohort. 国家队列中叶酸与肺癌死亡之间的时间依赖性双向关联
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-08 DOI: 10.1097/CEJ.0000000000000927
Blessing E Odion, Logan Cowan, Lili Yu, Jian Zhang

The relationship between folate and the risk of cancer remains undetermined partially due to the dynamic changes in folate intakes at the population level caused by folic acid fortification implemented in the USA and other countries. To control for the interference from fortification, we assessed the relationship between folate and lung cancer death (LCD) risk among a national cohort established years before folic acid fortification. We followed up 14 528 adults aged 19 years or older who participated in the National Health and Nutrition Examination Survey (1988-1994) on average for 14 years. LCD's hazard ratios were estimated by the folate levels using Cox regressions. After 192 973 person-years (py) of follow-up, 233 LCDs were recorded. The LCD rates were 1.20/1000 py, 1.14/1000 py, and 1.38/1000 py for adults with low (1st quarter), moderate (2nd and 3rd quarter), and high (4th quarter) serum folate. In the first 10 years of follow-up, the adjusted hazard ratio was 2.87 (1.30-6.37) for adults with moderate, and 1.56 (0.58-4.23) for adults with high serum folate, compared to adults with low serum folate. For adults who survived longer than 10 years of follow-up, the hazard ratios were 0.45 (0.24-0.86) and 0.37 (0.16-0.87) respectively. No association was observed between LCD risk and red blood cell folate level. With minimized interference from folic acid fortification, we detected a time-dependent bidirectional association that supports the dual effects of folate on the carcinogenesis of lung cancer.

叶酸与癌症风险之间的关系仍未确定,部分原因是由于美国和其他国家实施的叶酸强化导致人群中叶酸摄入量的动态变化。为了控制强化的干扰,我们评估了叶酸与肺癌死亡(LCD)风险之间的关系,在叶酸强化前几年建立的国家队列中。我们对参加1988-1994年全国健康与营养调查的14 528名年龄在19岁及以上的成年人进行了平均14年的随访。LCD的风险比通过叶酸水平使用Cox回归估计。经过192 973人年(py)的随访,记录了233例lcd。血清叶酸低(第1季度)、中(第2和第3季度)和高(第4季度)成人的LCD率分别为1.20/1000 py、1.14/1000 py和1.38/1000 py。在前10年的随访中,与血清叶酸含量低的成年人相比,血清叶酸含量中等的成年人调整后的风险比为2.87(1.30-6.37),血清叶酸含量高的成年人调整后的风险比为1.56(0.58-4.23)。对于存活时间超过10年的成年人,风险比分别为0.45(0.24-0.86)和0.37(0.16-0.87)。没有观察到LCD风险与红细胞叶酸水平之间的关联。在叶酸强化的干扰最小化的情况下,我们发现了一种时间依赖性的双向关联,支持叶酸对肺癌致癌的双重作用。
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引用次数: 0
Establishment of prognostic model for invasive ductal carcinoma with distant metastasis within the triple-negative breast cancer: a SEER population-based study. 三阴性乳腺癌浸润性导管癌伴远处转移预后模型的建立:一项基于SEER人群的研究。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1097/CEJ.0000000000000925
Minghao Yang, Chunxi Wang, Lu Ouyang, Haowen Zhang, Junlong Lin

Triple-negative breast cancer (TNBC) is a complex and diverse group of malignancies. Invasive ductal carcinoma (IDC) is the predominant pathological subtype and is closely linked to the ominous potential for distant metastasis, a pivotal factor that significantly influences patient outcomes. In light of these considerations, the present study was conceived with the objective of developing a nomogram model. This model was designed to predict the prognosis observed in IDC with distant metastasis in TNBC. This was a retrospective study based on the SEER database. Data of 9739 IDC-TNBC patients diagnosed from 2010 to 2020 were included in our study. Independent risk factors were screened by univariate and multivariate Cox regression analyses successively, which were used to develop a nomogram model predicting for prognosis. Cox multivariable analysis showed statistical significance in bone metastasis, liver metastasis, surgery, and chemotherapy. Incorporating statistically significant variables, as well as clinically significant age, lung metastasis, and brain metastasis into the construction of the prediction model, the C-indexes of the training group and validation group were 0.702 (0.663-0.741) and 0.667 (0.600-0.734), respectively, while the calibration curves were all close to the ideal 45° reference line, and decision curve analysis curves show excellent net benefit in the predictive model. The prognostic prediction model developed in this study demonstrated enhanced predictive accuracy, enabling a more precise evaluation of mortality risks associated with IDC with distant metastasis in TNBC.

三阴性乳腺癌(TNBC)是一种复杂而多样的恶性肿瘤。浸润性导管癌(Invasive ductal carcinoma, IDC)是主要的病理亚型,与远处转移的潜在危险密切相关,是显著影响患者预后的关键因素。鉴于这些考虑,本研究的目的是建立一个nomogram模型。该模型旨在预测三阴癌伴远处转移的IDC患者的预后。这是一个基于SEER数据库的回顾性研究。我们的研究纳入了2010年至2020年诊断的9739例IDC-TNBC患者的数据。分别通过单因素和多因素Cox回归分析筛选独立危险因素,建立预测预后的nomogram模型。Cox多变量分析显示骨转移、肝转移、手术和化疗均有统计学意义。在构建预测模型时,将具有统计学意义的变量以及具有临床意义的年龄、肺转移、脑转移纳入预测模型,训练组和验证组的c指数分别为0.702(0.663-0.741)和0.667(0.600-0.734),校正曲线均接近理想的45°参考线,决策曲线分析曲线在预测模型中显示出极好的净效益。本研究中建立的预后预测模型显示出更高的预测准确性,能够更精确地评估与IDC合并TNBC远处转移相关的死亡风险。
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引用次数: 0
The effects of the ketogenic diet on cancer treatment: a narrative review. 生酮饮食对癌症治疗的影响:叙述性综述。
IF 2.1 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-20 DOI: 10.1097/CEJ.0000000000000918
Qingxuan Deng, Ruyue Lv, Tangbin Zou

Despite significant advances in therapy, cancer remains the top cause of death in parts of the globe. For many types of cancer, the typical treatment is a combination of surgery, chemotherapy, and radiotherapy. However, this conventional treatment is not successful on its own. As a consequence, innovative approaches that improve treatment efficacy are urgently needed. The ketogenic diet is a high-fat, moderate protein, and low-carbohydrate diet that appears to sensitize most cancers to conventional therapies by exploiting cancer cells' altered metabolism, making it an effective adjuvant cancer treatment alternative. This diet could decrease glucose metabolism while enhancing lipid metabolism, interfering with the Warburg effect, and inhibiting tumor cell proliferation. The anticancer impact of ketogenic diet has been established in numerous animal trials and clinical investigations on a wide range of tumor types, including glioblastoma, pancreatic cancer, head and neck cancer, breast cancer, invasive rectal cancer, ovarian cancer, and endometrial cancer. In this review, we discussed the various types of ketogenic diets, the mechanism of action for ketogenic diet as a cancer therapy, and the data gathered from continuing preclinical and clinical studies, intending to establish a solid theoretical foundation for future research.

尽管在治疗方面取得了重大进展,但在全球部分地区,癌症仍然是导致死亡的首要原因。对于许多类型的癌症,典型的治疗方法是手术、化疗和放疗相结合。然而,这种传统疗法本身并不成功。因此,迫切需要创新的方法来提高治疗效果。生酮饮食是一种高脂肪、适量蛋白质和低碳水化合物饮食,通过利用癌细胞新陈代谢的改变,似乎能使大多数癌症对传统疗法敏感,因此是一种有效的癌症辅助治疗方法。这种饮食可以降低葡萄糖代谢,同时增强脂质代谢,干扰沃伯格效应,抑制肿瘤细胞增殖。生酮饮食的抗癌作用已在大量动物试验和临床研究中得到证实,研究对象包括胶质母细胞瘤、胰腺癌、头颈癌、乳腺癌、浸润性直肠癌、卵巢癌和子宫内膜癌等多种肿瘤类型。在这篇综述中,我们讨论了各种类型的生酮饮食、生酮饮食作为癌症疗法的作用机制,以及从持续的临床前和临床研究中收集到的数据,旨在为今后的研究奠定坚实的理论基础。
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引用次数: 0
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European Journal of Cancer Prevention
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