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Risk factors for lymph node metastasis in women with FIGO 2018 IA cervical cancer with a horizontal spread of > 7 mm 患有 FIGO 2018 IA 宫颈癌且水平扩散范围大于 7 毫米的妇女发生淋巴结转移的风险因素。
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.ejca.2024.115063

Background

In the FIGO 2018 classification, women with cervical cancer and a depth of invasion ≤ 5 mm and a horizontal spread of > 7 mm in excisional biopsy with tumour-free margins, are now classified as stage IA instead of IB. This stage shift may reduce the likelihood of surgical lymph node staging. It is therefore crucial to estimate the risk and risk factors of lymph node metastasis (pN+) in this group.

Methods

Women diagnosed with cervical cancer between 2005 and 2022 were identified from nationwide population-based registries from the Netherlands, Denmark, and Sweden. Inclusion criteria were squamous cell carcinoma or adenocarcinoma, FIGO 2009 stage IB1, a depth of invasion ≤ 5 mm and horizontal spread of > 7–≤ 40 mm. All cases underwent radical hysterectomy or radical trachelectomy, and surgical lymph node staging. Logistic regression was used to identify risk factors of pN+.

Results

We included 992 women (pN+ 4.1 %; n = 41). Lymphovascular space invasion (LVSI) was a significant risk factor of pN+ (odds ratio 4.26, 95 % confidence interval 2.24–8.32). Accordingly, the risk of pN+ was ≥ 7.3 % in LVSI-positive tumours. The risk was lowest in LVSI-negative tumours with a size of > 7–≤ 20 mm (2.2 %), although this varied by depth of invasion and histological subtype (pN+ range 0.6–5.1 %).

Conclusion

Women with LVSI-positive FIGO 2018 IA cervical cancer and a horizontal spread > 7 mm, should undergo surgical lymph node staging. In LVSI-negative tumours, lymph node staging should not be routinely performed; tumour size, depth of invasion and histology should be considered.
背景:在 FIGO 2018 分级中,患有宫颈癌且在切除活检中浸润深度≤5 毫米、水平扩散>7 毫米且边缘无肿瘤的女性,现在被归类为 IA 期而非 IB 期。这种分期的转变可能会降低手术淋巴结分期的可能性。因此,估算该群体淋巴结转移(pN+)的风险和风险因素至关重要:方法:从荷兰、丹麦和瑞典的全国性人口登记中筛选出 2005 年至 2022 年期间确诊为宫颈癌的女性。纳入标准为:鳞状细胞癌或腺癌、FIGO 2009 IB1 期、浸润深度≤ 5 毫米且水平扩散 > 7-≤ 40 毫米。所有病例均接受了根治性子宫切除术或根治性气管切除术,并进行了手术淋巴结分期。采用逻辑回归确定pN+的风险因素:我们共纳入992名妇女(pN+ 4.1 %;n = 41)。淋巴管间隙侵犯(LVSI)是pN+的重要风险因素(几率比4.26,95%置信区间2.24-8.32)。因此,LVSI阳性肿瘤的pN+风险≥7.3%。LVSI阴性、大小> 7-≤ 20 mm的肿瘤的pN+风险最低(2.2%),但这一风险因浸润深度和组织学亚型而异(pN+范围为0.6-5.1%):结论:LVSI阳性的FIGO 2018 IA宫颈癌患者,水平扩散范围大于7毫米,应进行手术淋巴结分期。对于LVSI阴性的肿瘤,不应常规进行淋巴结分期;应考虑肿瘤大小、浸润深度和组织学。
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引用次数: 0
Short- and long-term immunosuppressive effects of melanoma influence the prognostic value of the sentinel lymph node status 黑色素瘤的短期和长期免疫抑制作用会影响前哨淋巴结状态的预后价值。
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1016/j.ejca.2024.115054

Background

Presence of micrometastases in the sentinel lymph node (SLN) is currently used to assess prognosis of melanoma patients. The immunoactivity within the SLN is known to be influenced by the primary tumor (PT), which may in turn impact the SLNs’ metastatic state.

Aim

We characterize the temporal dependence and underlying mechanisms of the immunological effects of the PT on the SLN.

Methods

The prognostic value of SLN state as a function of PT removal time was evaluated. To put the results into a functional context, selected PTs and corresponding SLNs were analyzed for gene and protein expression patterns.

Results

In a cohort of 202 patients with known distant metastasis and similar PT prognostic characteristics, SLNs removed before or within one week after the PT (IM-SLN) had a higher incidence of micrometastases than those removed at least one week after the PT (DEL-SLN).
The immunoactivity in IM-SLN was found to be lower than in DEL-SLN. Specifically, in IM-SLNs, T helper 17 / regulatory T-cells were predominant, whereas in DEL-SLNs, cytotoxic γδT-cells were more frequent. The higher immune activity in DEL-SLNs was probably facilitated by CD209+ antigen-presenting cells. Indeed, in PT with high TGFβ expression CD209+ cells appear to be trapped and no increased immunoactivity was observed in DEL-SLN.

Conclusions

Presence of micrometastases in DEL-SLNs have a higher negative prognostic value as in IM-SLNs since they indicate not only a melanoma’s propensity to metastasize, but possibly also its capacity to escape immune responses.
背景:前哨淋巴结(SLN)是否存在微转移目前被用于评估黑色素瘤患者的预后。目的:我们研究了原发肿瘤(PT)对前哨淋巴结(SLN)免疫学影响的时间依赖性和内在机制:方法:我们评估了SLN状态作为PT切除时间函数的预后价值。为了将结果置于功能背景下,对选定的PT和相应的SLN进行了基因和蛋白质表达模式分析:结果:在202例已知有远处转移且PT预后特征相似的患者队列中,PT切除前或切除后一周内切除的SLN(IM-SLN)比PT切除后至少一周内切除的SLN(DEL-SLN)有更高的微转移发生率。研究发现,IM-SLN 的免疫活性低于 DEL-SLN。具体来说,在IM-SLN中,T辅助细胞17/调节性T细胞占主导地位,而在DEL-SLN中,细胞毒性γδT细胞更为常见。DEL-SLNs中较高的免疫活性可能是由CD209+抗原递呈细胞促成的。事实上,在TGFβ高表达的PT中,CD209+细胞似乎被困住了,在DEL-SLN中没有观察到免疫活性增加:结论:DEL-SLN 中存在微转移灶与 IM-SLN 中存在微转移灶相比,具有更高的负面预后价值,因为微转移灶不仅表明黑色素瘤具有转移倾向,还可能表明黑色素瘤具有逃避免疫反应的能力。
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引用次数: 0
Response to the Letter re: Real-world outcomes of Italian patients with advanced non-squamous lung cancer treated with first-line pembrolizumab plus platinum-pemetrexed 对 "关于意大利晚期非鳞状肺癌患者接受彭博利珠单抗加铂类-培美曲塞一线治疗的实际效果 "一文的回复。
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1016/j.ejca.2024.115057
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引用次数: 0
A-270 Tinea in Cutaneous Lymphoma Patients A-270 皮肤淋巴瘤患者的癣病
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114413
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引用次数: 0
A-136 Effects of Mogamulizumab on CD39, CD73 and CD38 ectonucleotidases expression in T-cells of Sézary syndrome patients A-136 莫干单抗对塞扎里综合征患者 T 细胞中 CD39、CD73 和 CD38 外核苷酸酶表达的影响
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114348
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引用次数: 0
A-222 Flow cytometry of skin biopsies in CTCL patients during Mogamulizumab treatment A-222 Mogamulizumab 治疗期间 CTCL 患者皮肤活检的流式细胞术
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114350
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引用次数: 0
A-132 Navigating Modern Challenges in Early Mycosis Fungoides: A Case Report of a Peculiar Association and an Unusual Clinical Presentation A-132 应对早期真菌病的现代挑战:奇特的关联和不寻常临床表现的病例报告
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114361
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引用次数: 0
A-287 Spatial atlas of noncommunicable inflammatory skin disease and cutaneous T cell lymphoma A-287 非传染性炎症性皮肤病和皮肤 T 细胞淋巴瘤空间图集
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114366
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引用次数: 0
A-261 The impact of atopic dermatitis preceding cutaneous T-cell lymphoma and its effect on clinical outcomes: a retrospective review at a single tertiary referral center A-261 皮肤T细胞淋巴瘤前特应性皮炎的影响及其对临床结果的影响:对一家三级转诊中心的回顾性研究
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114412
{"title":"A-261 The impact of atopic dermatitis preceding cutaneous T-cell lymphoma and its effect on clinical outcomes: a retrospective review at a single tertiary referral center","authors":"","doi":"10.1016/j.ejca.2024.114412","DOIUrl":"10.1016/j.ejca.2024.114412","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142415896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
A-285 MHC-I Upregulation Safeguards Neoplastic T Cells in the Skin Against NK Cell-mediated Eradication in Mycosis Fungoides A-285 MHC-I 上调可保护皮肤中的肿瘤性 T 细胞免受 NK 细胞介导的真菌病根除作用的影响
IF 7.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ejca.2024.114356
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引用次数: 0
期刊
European Journal of Cancer
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