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Establishment of artificial intelligence model for precise histological subtyping of lung adenocarcinoma and its application to quantitative and spatial analysis. 建立肺腺癌组织学精准亚型的人工智能模型,并将其应用于定量和空间分析。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae066
Eisuke Miura, Katsura Emoto, Tokiya Abe, Akinori Hashiguchi, Tomoyuki Hishida, Keisuke Asakura, Michiie Sakamoto

Background: The histological subtype of lung adenocarcinoma is a major prognostic factor. We developed a new artificial intelligence model to classify lung adenocarcinoma images into seven histological subtypes and adopted the model for whole-slide images to investigate the relationship between the distribution of histological subtypes and clinicopathological factors.

Methods: Using histological subtype images, which are typical for pathologists, we trained and validated an artificial intelligence model. Then, the model was applied to whole-slide images of resected lung adenocarcinoma specimens from 147 cases.

Result: The model achieved an accuracy of 99.7% in training sets and 90.4% in validation sets consisting of typical tiles of histological subtyping for pathologists. When the model was applied to whole-slide images, the predominant subtype according to the artificial intelligence model classification matched that determined by pathologists in 75.5% of cases. The predominant subtype and tumor grade (using the WHO fourth and fifth classifications) determined by the artificial intelligence model resulted in similar recurrence-free survival curves to those determined by pathologists. Furthermore, we stratified the recurrence-free survival curves for patients with different proportions of high-grade components (solid, micropapillary and cribriform) according to the physical distribution of the high-grade component. The results suggested that tumors with centrally located high-grade components had a higher malignant potential (P < 0.001 for 5-20% high-grade component).

Conclusion: The new artificial intelligence model for histological subtyping of lung adenocarcinoma achieved high accuracy, and subtype quantification and subtype distribution analyses could be achieved. Artificial intelligence model therefore has potential for clinical application for both quantification and spatial analysis.

背景:肺腺癌的组织学亚型是一个重要的预后因素。我们开发了一种新的人工智能模型,将肺腺癌图像分为七种组织学亚型,并将该模型用于全滑动图像,研究组织学亚型分布与临床病理因素之间的关系:方法:利用病理学家典型的组织学亚型图像,我们训练并验证了一个人工智能模型。然后,将该模型应用于 147 例切除的肺腺癌标本的全切片图像:结果:该模型在训练集中的准确率为 99.7%,在验证集中的准确率为 90.4%。当该模型应用于整张切片图像时,根据人工智能模型分类得出的主要亚型与病理学家确定的亚型相符的病例占 75.5%。人工智能模型确定的主要亚型和肿瘤分级(采用世界卫生组织第四和第五分级)与病理学家确定的无复发生存曲线相似。此外,我们还根据高级别成分的物理分布情况,对高级别成分(实性、微乳头状和楔形)比例不同的患者的无复发生存曲线进行了分层。结果表明,高级别成分位于中心位置的肿瘤具有更高的恶性潜能(P 结论):用于肺腺癌组织学亚型分析的新型人工智能模型具有较高的准确性,可实现亚型量化和亚型分布分析。因此,人工智能模型在量化和空间分析方面具有临床应用潜力。
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引用次数: 0
D-dimer cut-off value for predicting venous thromboembolism at the initial diagnosis in Japanese patients with advanced lung cancer. 日本晚期肺癌患者初诊时预测静脉血栓栓塞的D-二聚体临界值。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae064
Keita Kawakado, Yukari Tsubata, Takamasa Hotta, Masahiro Yamasaki, Nobuhisa Ishikawa, Takeshi Masuda, Tetsuya Kubota, Kunihiko Kobayashi, Takeshi Isobe

Objective: Cancer is a well-known risk factor for venous thromboembolism. The D-dimer level is used to predict venous thromboembolism; however, reports on an appropriate D-dimer cut-off value in Japanese patients with advanced lung cancer are lacking. Therefore, this study aimed to calculate the D-dimer cut-off value for venous thromboembolism at the time of lung cancer diagnosis.

Methods: The Rising-venous thromboembolism/NEJ037 study was a multicenter, prospective observational study. Patients with lung cancer who were contraindicated for radical resection or radiation were enrolled and followed up for 2 years. In the present study (jRCT no. 061180025), a receiver operating characteristic curve for D-dimer levels was created using the dataset of the Rising-venous thromboembolism/NEJ037 study.

Results: The Rising-venous thromboembolism/NEJ037 study included a total of 1008 patients, of whom 976, whose D-dimer levels had been measured at the time of cancer diagnosis, were included in the present study. At the time of lung cancer diagnosis, 62 (6.3%) and 914 (93.7%) patients presented with and without venous thromboembolism, respectively. The D-dimer values ranged from 0.1 to 180.1 μg/ml and from 0.1 to 257.2 μg/ml in patients with and without venous thromboembolism, respectively. The receiver operating characteristic curve was discriminative with a cut-off value of 3.3 μg/ml and an area under the curve of 0.794 (sensitivity, 0.742; specificity, 0.782; 95% confidence interval, 0.725-0.863).

Conclusions: This is the first study to calculate the D-dimer cut-off value in Japanese patients with advanced lung cancer. Patients with D-dimer levels ≥3.3 μg/ml at the time of initial diagnosis may have coexisting venous thromboembolism.

目的:癌症是众所周知的静脉血栓栓塞风险因素。D-二聚体水平可用于预测静脉血栓栓塞;然而,有关日本晚期肺癌患者的适当 D-二聚体临界值的报告却缺乏。因此,本研究旨在计算肺癌诊断时静脉血栓栓塞的 D-二聚体临界值:Rising-venous thromboembolism/NEJ037 研究是一项多中心、前瞻性观察研究。有根治性切除术或放射治疗禁忌症的肺癌患者被纳入研究,并接受为期两年的随访。在本研究(jRCT 编号:061180025)中,利用 Rising-venous 血栓栓塞症/NEJ037 研究的数据集绘制了 D-二聚体水平的接收器操作特征曲线:Rising-静脉血栓栓塞症/NEJ037研究共纳入了1008名患者,其中976名患者在癌症诊断时测定了D-二聚体水平。在确诊肺癌时,分别有 62 名(6.3%)和 914 名(93.7%)患者出现和未出现静脉血栓栓塞。有静脉血栓栓塞和无静脉血栓栓塞患者的 D-二聚体值范围分别为 0.1 至 180.1 μg/ml 和 0.1 至 257.2 μg/ml。接收器操作特征曲线具有鉴别性,临界值为 3.3 μg/ml,曲线下面积为 0.794(灵敏度为 0.742;特异性为 0.782;95% 置信区间为 0.725-0.863):这是首个计算日本晚期肺癌患者D-二聚体临界值的研究。初步诊断时D-二聚体水平≥3.3 μg/ml的患者可能同时患有静脉血栓栓塞症。
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引用次数: 0
Sarcopenic obesity predicts short- and long-term outcomes after neoadjuvant chemotherapy and surgery for gastric cancer. 肉样肥胖可预测胃癌新辅助化疗和手术后的短期和长期预后。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae080
Chunning Duan, Mingru Wu, Xia Wen, Lvping Zhuang, Jianwei Sun

Background: Sarcopenic obesity (SO) affects outcomes in various malignancies. However, its clinical significance in patients undergoing neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (LAGC) remains unclear. This study investigated the impact of pre- and post-NAC SO on postoperative morbidity and survival.

Methods: Data from 207 patients with LAGC, who underwent NAC followed by radical gastrectomy between January 2010 and October 2019, were reviewed. Skeletal muscle mass and visceral fat area were measured pre- and post-NAC using computed tomography to define sarcopenia and obesity, the coexistence of which was defined as SO.

Results: Among the patients, 52 (25.1%) and 38 (18.4%) developed SO before and after NAC, respectively. Both pre- (34.6%) and post- (47.4%) NAC SO were associated with the highest postoperative morbidity rates; however, only post-NAC SO was an independent risk factor for postoperative morbidity [hazard ratio (HR) = 9.550, 95% confidence interval (CI) = 2.818-32.369; P < .001]. Pre-NAC SO was independently associated with poorer 3-year overall [46.2% vs. 61.3%; HR = 1.258 (95% CI = 1.023-1.547); P = .049] and recurrence-free [39.3% vs. 55.4%; HR 1.285 (95% CI 1.045-1.579); P = .017] survival.

Conclusions: Pre-NAC SO was an independent prognostic factor in patients with LAGC undergoing NAC; post-NAC SO independently predicted postoperative morbidity.

背景:肉样肥胖(SO)会影响各种恶性肿瘤的治疗效果。然而,其对局部晚期胃癌(LAGC)新辅助化疗(NAC)患者的临床意义仍不明确。本研究调查了新辅助化疗前后SO对术后发病率和生存率的影响:研究回顾了 2010 年 1 月至 2019 年 10 月间接受 NAC 后进行根治性胃切除术的 207 例 LAGC 患者的数据。使用计算机断层扫描测量了NAC术前和术后的骨骼肌质量和内脏脂肪面积,以确定肌肉疏松症和肥胖症,并将两者同时存在定义为SO.Results:患者中分别有 52 人(25.1%)和 38 人(18.4%)在接受 NAC 之前和之后出现 SO。NAC术前(34.6%)和术后(47.4%)SO与最高的术后发病率相关;然而,只有NAC术后SO是术后发病率的独立风险因素[危险比(HR)= 9.550,95%置信区间(CI)= 2.818-32.369;P 结论:NAC术前SO是术后发病率的独立风险因素:在接受 NAC 手术的 LAGC 患者中,NAC 术前 SO 是一个独立的预后因素;NAC 术后 SO 可独立预测术后发病率。
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引用次数: 0
Franseen needle in endobronchial ultrasound-guided transbronchial needle aspiration: a phase II prospective study. 支气管内超声引导下经支气管针吸术中的 Franseen 针:II 期前瞻性研究。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae077
Kohei Shikano, Jun Ikari, Takahiro Nakajima, Masayuki Ota, Yuki Shiko, Akira Naito, Mitsuhiro Abe, Takeshi Kawasaki, Jun-Ichiro Ikeda, Yoshihito Ozawa, Takuji Suzuki

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been used to diagnose and stage lung cancer. Acquire™ Pulmonary and Expect™ Pulmonary dedicated EBUS-TBNA needles were introduced as the Franseen and Lancet needles, respectively. It is still unclear whether the Franseen or Lancet needles yield a higher quality specimen especially focusing on next-generation sequencing-based molecular testing.

Methods: A single-center, prospective study performed at the Chiba University Hospital randomly assigned patients to two groups: Group A, wherein the first and second EBUS-TBNA were performed using Lancet and Franseen needles, respectively, and Group B, wherein the first and second EBUS-TBNA were performed using Franseen and Lancet needles, respectively. Each specimen was compared and analyzed pathologically. The primary outcome was the histological tissue area except blood clot and the cellularity of each sample. We also examined the success rate of molecular testing.

Results: Twelve patients who underwent EBUS-TBNA between November 2022 and February 2023 were enrolled in this study. The tissue area of the specimens obtained by the Franseen and Lancet needles was 13.3 ± 6.4 mm2 and 10.6 ± 6.3 mm2, respectively (P = .355). The tumor cellularity in the specimens obtained using the Franseen and Lancet needles was 54.0 ± 30.3 and 46.2 ± 36.3%, respectively (P = .608). The success rate of molecular testing using the single-pass sample by Franseen needle was 85.7 and 57.1% by Lancet needle. No serious complications were reported.

Conclusions: The Franseen needle tended to show a greater amount of specimen with higher tumor cellularity than the Lancet needle which may contribute higher success rate of molecular testing. Further studies must be conducted to validate the results of this study.

Key findings: What is known and what is new?  What is the implication, and what should change now?

背景:支气管内超声引导下经支气管针吸术(EBUS-TBNA)已被用于肺癌的诊断和分期。Acquire™ Pulmonary 和 Expect™ Pulmonary 专用 EBUS-TBNA 针分别作为 Franseen 针和 Lancet 针问世。目前还不清楚 Franseen 针和 Lancet 针是否能产生更高质量的标本,尤其是基于下一代测序的分子检测:在千叶大学医院进行的一项单中心前瞻性研究将患者随机分为两组:A组分别使用Lancet针和Franseen针进行第一次和第二次EBUS-TBNA检查,B组分别使用Franseen针和Lancet针进行第一次和第二次EBUS-TBNA检查。对每个标本进行比较和病理分析。主要结果是每个样本的组织学组织面积(血块除外)和细胞度。我们还检查了分子检测的成功率:本研究共纳入了 2022 年 11 月至 2023 年 2 月期间接受 EBUS-TBNA 治疗的 12 例患者。弗兰森针和柳叶刀针获得的标本组织面积分别为(13.3 ± 6.4)平方毫米和(10.6 ± 6.3)平方毫米(P = .355)。使用弗朗森针和柳叶刀针获得的标本的肿瘤细胞度分别为 54.0 ± 30.3% 和 46.2 ± 36.3%(P = .608)。使用 Franseen 针进行单次样本分子检测的成功率为 85.7%,使用 Lancet 针的成功率为 57.1%。无严重并发症报告:与柳叶刀针相比,Franseen针往往能显示出更多肿瘤细胞度更高的标本,这可能有助于提高分子检测的成功率。必须开展进一步研究来验证本研究的结果:哪些是已知的,哪些是新的? 有什么影响,现在应该做些什么改变?
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引用次数: 0
Elranatamab in Japanese patients with relapsed/refractory multiple myeloma: results from MagnetisMM-2 and MagnetisMM-3. 艾拉他单抗在日本复发/难治性多发性骨髓瘤患者中的应用:MagnetisMM-2 和 MagnetisMM-3 的结果。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae068
Shinsuke Iida, Satoshi Ito, Hisayuki Yokoyama, Tadao Ishida, Yuya Nagai, Hiroshi Handa, Shigeki Ito, Yoichi Kamei, Masatoshi Nakamura, Kenshi Suzuki

Background: Despite advances, most patients with multiple myeloma (MM) experience relapse and repeat multiple treatment lines, highlighting an unmet need for patients with relapsed or refractory MM (RRMM). Bispecific antibodies are a new option, but their efficacy and safety in Japanese patients are unknown.

Methods: This was an analysis of Japanese patients receiving elranatamab monotherapy in MagnetisMM-2 (NCT04798586) and MagnetisMM-3 (NCT04649359). Both studies evaluated a priming dose regimen of elranatamab followed by weekly subcutaneous doses, in patients with disease progression while receiving or who were intolerant to ≥3 prior therapies (≥1 proteasome inhibitor, ≥1 immunomodulatory drug and ≥1 anti-CD38 monoclonal antibody). The primary endpoints were dose limiting toxicities (DLTs) in MagnetisMM-2 and confirmed objective response rate (ORR) in MagnetisMM-3. In both, key secondary endpoints included safety, tolerability, duration of response, time to response, progression-free survival and overall survival.

Results: In MagnetisMM-2 (N = 4) and MagnetisMM-3 (n = 12), median ages were 68.5 and 66.5 years, respectively. No DLTs were observed in MagnetisMM-2. ORRs were 50.0% (95% CI, 6.8-93.2) and 58.3% (95% CI, 27.7-84.8) in MagnetisMM-2 and MagnetisMM-3, respectively. All patients experienced treatment-emergent adverse events in MagnetisMM-2 (grade 3/4: 75.0%) and MagnetisMM-3 (grade 3/4: 100%); cytokine release syndrome occurred in 100% (grade 3/4: 25.0%) and 58.3% (no grade 3/4) of patients, respectively. Neither study reported immune effector cell-associated neurotoxicity syndrome.

Conclusions: No new safety signals were observed, and ORRs were similar to that of the overall MagnetisMM-3 trial population, supporting further studies of elranatamab in Japanese patients with RRMM. ClinicalTrials.gov identifier: NCT04798586 (MagnetisMM-2), NCT04649359 (MagnetisMM-3).

背景:尽管取得了进展,但大多数多发性骨髓瘤(MM)患者仍会复发并重复多种治疗方案,这凸显了复发或难治性MM(RRMM)患者的需求尚未得到满足。双特异性抗体是一种新的选择,但其在日本患者中的疗效和安全性尚不清楚:这是对在MagnetisMM-2(NCT04798586)和MagnetisMM-3(NCT04649359)中接受艾拉那单抗单药治疗的日本患者进行的分析。这两项研究都评估了艾拉那单抗的起始剂量方案,随后是每周皮下注射剂量,用于在接受或不耐受≥3种既往疗法(≥1种蛋白酶体抑制剂、≥1种免疫调节药物和≥1种抗CD38单克隆抗体)的同时疾病进展的患者。主要终点是MagnetisMM-2的剂量限制性毒性(DLT)和MagnetisMM-3的确诊客观反应率(ORR)。这两项研究的主要次要终点包括安全性、耐受性、反应持续时间、反应时间、无进展生存期和总生存期:MagnetisMM-2(4例)和MagnetisMM-3(12例)的中位年龄分别为68.5岁和66.5岁。MagnetisMM-2中未观察到DLT。MagnetisMM-2和MagnetisMM-3的ORR分别为50.0%(95% CI,6.8-93.2)和58.3%(95% CI,27.7-84.8)。在MagnetisMM-2(3/4级:75.0%)和MagnetisMM-3(3/4级:100%)中,所有患者都出现了治疗突发不良事件;分别有100%(3/4级:25.0%)和58.3%(无3/4级)的患者出现细胞因子释放综合征。两项研究均未报告免疫效应细胞相关神经毒性综合征:结论:未观察到新的安全性信号,ORR与MagnetisMM-3试验总体人群相似,支持在日本RRMM患者中进一步研究艾拉那单抗。ClinicalTrials.gov identifier:NCT04798586(MagnetisMM-2)、NCT04649359(MagnetisMM-3)。
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引用次数: 0
Analysis of PIK3CA mutations in the primary and recurrent tumors of hormone receptor positive/human epidermal growth factor receptor 2 negative breast cancer. 激素受体阳性/人类表皮生长因子受体 2 阴性乳腺癌原发性和复发性肿瘤中 PIK3CA 基因突变的分析。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae072
Yue Wang, Xin Li, Shuang Zhang, Li Liang, Ling Xu, Yinhua Liu, Ting Li

Objective: Our aim was to compare the PIK3CA mutation status in matched primary and recurrent tumors of hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer (BC) to gain insight into the optimization of patient selection and detection time for PIK3CA-targeted therapy.

Methods: The data were from 3035 patients with BC diagnosed at the Breast Disease Center, Peking University First Hospital, between January 2008 and December 2017. Matched primary and recurrent samples were profiled using amplification-refractory mutation system-polymerase chain reaction covering 11 mutational hotspots in PIK3CA.

Results: PIK3CA mutations were detected in 54.3% primary tumors and 48.6% corresponding recurrences. PIK3CA mutation was detected in 37.5% cases in the locoregional recurrent group and 40.0% of distant metastasis, without a statistical difference. Besides, PIK3CA mutations were concordant in 88.6% of the matched pairs. For patients treated with neoadjuvant chemotherapy, 100% concordance was observed. However, PIK3CA mutation was neither correlated with clinicopathological features nor associated with clinical outcomes.

Conclusions: Mutations in PIK3CA in HR+/HER2- BC generally progressed to recurrent tumors. The high concordance rate of PIK3CA mutation status between primary tumors and corresponding recurrences suggests that the detection of primary tumors could be a substitute approach when recurrent samples are not easily obtainable.

目的我们的目的是比较激素受体阳性/人表皮生长因子受体2阴性(HR+/HER2-)乳腺癌(BC)配对原发肿瘤和复发肿瘤的PIK3CA突变状态,以深入了解PIK3CA靶向治疗的患者选择和检测时间的优化:数据来自2008年1月至2017年12月在北京大学第一医院乳腺病中心确诊的3035例BC患者。采用扩增-难治性突变系统聚合酶链反应对匹配的原发和复发样本进行了分析,涵盖了PIK3CA的11个突变热点:结果:54.3%的原发肿瘤和48.6%的复发肿瘤检测到PIK3CA突变。局部复发组中有37.5%的病例检测到PIK3CA突变,远处转移组中有40.0%的病例检测到PIK3CA突变,两者无统计学差异。此外,88.6%的配对患者的PIK3CA突变是一致的。在接受新辅助化疗的患者中,一致性达到100%。然而,PIK3CA突变既与临床病理特征无关,也与临床结果无关:结论:在HR+/HER2- BC中,PIK3CA突变通常会发展为复发性肿瘤。原发肿瘤和相应复发肿瘤的PIK3CA突变状态的高一致性表明,在不易获得复发样本时,检测原发肿瘤可作为一种替代方法。
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引用次数: 0
Projection of the number of new laryngeal cancer cases in the world. 全球新增喉癌病例数量预测。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae121
Kumiko Saika, Tomohiro Matsuda
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引用次数: 0
Neoadjuvant therapy increases the risk of metabolic disorders and osteosarcopenia in patients with early breast cancer. 新辅助治疗会增加早期乳腺癌患者出现代谢紊乱和骨质疏松症的风险。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae070
Yan Zhang, Hua Kang, Jing Zhao, Yajun Wang, Wei Cai, Xiaoli Zhang, Kaifu Li, Ye Zhao

Background: The purpose of this study is to evaluate the effects of neoadjuvant therapy on glucose and lipid metabolism, bone mineral density (BMD) and muscle, and to explore the relationship between metabolic disorders and changes in body composition, so as to provide better health management strategies for breast cancer survivors.

Methods: The clinical data of 43 patients with breast cancer who received neoadjuvant therapy in Xuanwu Hospital from January 2020 to June 2021 were analyzed retrospectively. The biochemical results, including albumin, blood glucose, triglyceride and cholesterol, were collected before neoadjuvant therapy and before surgery. The pectoral muscle area, pectoral muscle density and cancellous bone mineral density of the 12th thoracic vertebra were also measured by chest CT.

Results: After neoadjuvant therapy, fasting blood glucose, triglyceride and cholesterol were significantly increased, albumin was decreased. At the same time, pectoral muscle area, pectoral muscle density and T12 BMD were decreased. After treatment, BMD was positively correlated with pectoral muscle area, R2 = 0.319, P = 0.037, and BMD was also positively correlated with pectoral muscle density, R2 = 0.329, P = 0.031. Multivariate analysis showed that BMD and pectoral muscle density were correlated with menstrual status, and pectoral muscle area was correlated with body mass index before treatment, none of which was related to glucose and lipid metabolism.

Conclusion: Neoadjuvant therapy can cause glucose and lipid metabolism disorder, BMD decrease and muscle reduction. BMD was positively correlated with muscle area and density after treatment, suggesting that patients had an increased chance of developing osteosarcopenia.

研究背景本研究旨在评估新辅助治疗对糖、脂代谢、骨矿物质密度(BMD)和肌肉的影响,探讨代谢紊乱与身体成分变化之间的关系,从而为乳腺癌幸存者提供更好的健康管理策略:方法:回顾性分析2020年1月至2021年6月在宣武医院接受新辅助治疗的43例乳腺癌患者的临床资料。收集新辅助治疗前和手术前的生化指标,包括白蛋白、血糖、甘油三酯和胆固醇。胸部 CT 还测量了胸肌面积、胸肌密度和第 12 胸椎松质骨矿物质密度:结果:新辅助治疗后,空腹血糖、甘油三酯和胆固醇明显升高,白蛋白下降。同时,胸肌面积、胸肌密度和 T12 BMD 均下降。治疗后,BMD 与胸肌面积呈正相关,R2 = 0.319,P = 0.037;BMD 与胸肌密度也呈正相关,R2 = 0.329,P = 0.031。多变量分析表明,BMD和胸肌密度与月经状况相关,胸肌面积与治疗前体重指数相关,但均与糖脂代谢无关:结论:新辅助治疗可导致糖脂代谢紊乱、BMD下降和肌肉减少。结论:新辅助治疗会导致糖脂代谢紊乱、BMD 下降和肌肉减少,而治疗后 BMD 与肌肉面积和密度呈正相关,表明患者患骨肉疏松症的几率增加。
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引用次数: 0
A nomogram to predict the pathological complete response in patients with breast cancer based on the TILs-US score. 根据 TILs-US 评分预测乳腺癌患者病理完全反应的提名图。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae076
Hideo Shigematsu, Kayo Fukui, Akiko Kanou, Mutsumi Fujimoto, Kanako Suzuki, Haruka Ikejiri, Ai Amioka, Emiko Hiraoka, Shinsuke Sasada, Akiko Emi, Koji Arihiro, Morihito Okada

Background: The tumor-infiltrating lymphocytes-ultrasonography score is a calculation system for predicting lymphocyte-predominant breast cancers in surgical specimens. A nomogram based on the tumor-infiltrating lymphocytes-ultrasonography score was developed to predict the pathological complete response in breast cancer treated with neoadjuvant chemotherapy.

Methods: A retrospective evaluation was conducted on 118 patients with breast cancer treated with neoadjuvant chemotherapy at Hiroshima University Hospital. Tumor-infiltrating lymphocytes-ultrasonography scores ≥4 were classified as high. A nomogram was developed using a stepwise logistic regression model for pathological complete response (ypT0 ypN0), based on the smallest Akaike information criterion. The predictive ability and clinical usefulness of the nomogram were also evaluated.

Results: Among 118 patients, 34 (28.8%) achieved a pathological complete response, and 52 (44.1%) exhibited high tumor-infiltrating lymphocytes-ultrasonography. In multivariate logistic regression analysis, high tumor-infiltrating lymphocytes-ultrasonography (odds ratio, 6.01; P < 0.001), clinical complete response (odds ratio, 4.83; P = 0.004) and hormone receptor (odds ratio, 3.48; P = 0.038) were independent predictors of pathological complete response. A nomogram based on tumor-infiltrating lymphocytes-ultrasonography score, clinical complete response, hormone receptor and clinical N status was developed. The nomogram showed an area under the curve of 0.831 and a bias-corrected area under the curve of 0.809. The calibration plot showed a good fit between the expected and actual pathological complete response values. Decision curve analysis also showed the clinical utility of the nomogram for predicting pathological complete responses.

Conclusions: A nomogram based on the tumor-infiltrating lymphocytes-ultrasonography score exhibited a favorable predictive ability for pathological complete response in patients with breast cancer, which can be useful in predicting the residual disease status after neoadjuvant chemotherapy.

背景:肿瘤浸润淋巴细胞超声评分是预测手术标本中以淋巴细胞为主的乳腺癌的计算系统。研究人员根据肿瘤浸润淋巴细胞超声造影评分制定了一个提名图,用于预测接受新辅助化疗的乳腺癌患者的病理完全反应:广岛大学医院对接受新辅助化疗的118例乳腺癌患者进行了回顾性评估。肿瘤浸润淋巴细胞超声评分≥4分为高分。根据最小阿凯克信息准则,利用逐步逻辑回归模型为病理完全反应(ypT0 ypN0)制定了一个提名图。此外,还评估了提名图的预测能力和临床实用性:在 118 例患者中,34 例(28.8%)获得了病理完全反应,52 例(44.1%)表现为肿瘤浸润淋巴细胞高。在多变量逻辑回归分析中,高肿瘤浸润淋巴细胞超声检查(几率比为 6.01;P基于肿瘤浸润淋巴细胞-超声评分的提名图对乳腺癌患者的病理完全反应具有良好的预测能力,可用于预测新辅助化疗后的残留疾病状况。
{"title":"A nomogram to predict the pathological complete response in patients with breast cancer based on the TILs-US score.","authors":"Hideo Shigematsu, Kayo Fukui, Akiko Kanou, Mutsumi Fujimoto, Kanako Suzuki, Haruka Ikejiri, Ai Amioka, Emiko Hiraoka, Shinsuke Sasada, Akiko Emi, Koji Arihiro, Morihito Okada","doi":"10.1093/jjco/hyae076","DOIUrl":"10.1093/jjco/hyae076","url":null,"abstract":"<p><strong>Background: </strong>The tumor-infiltrating lymphocytes-ultrasonography score is a calculation system for predicting lymphocyte-predominant breast cancers in surgical specimens. A nomogram based on the tumor-infiltrating lymphocytes-ultrasonography score was developed to predict the pathological complete response in breast cancer treated with neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>A retrospective evaluation was conducted on 118 patients with breast cancer treated with neoadjuvant chemotherapy at Hiroshima University Hospital. Tumor-infiltrating lymphocytes-ultrasonography scores ≥4 were classified as high. A nomogram was developed using a stepwise logistic regression model for pathological complete response (ypT0 ypN0), based on the smallest Akaike information criterion. The predictive ability and clinical usefulness of the nomogram were also evaluated.</p><p><strong>Results: </strong>Among 118 patients, 34 (28.8%) achieved a pathological complete response, and 52 (44.1%) exhibited high tumor-infiltrating lymphocytes-ultrasonography. In multivariate logistic regression analysis, high tumor-infiltrating lymphocytes-ultrasonography (odds ratio, 6.01; P < 0.001), clinical complete response (odds ratio, 4.83; P = 0.004) and hormone receptor (odds ratio, 3.48; P = 0.038) were independent predictors of pathological complete response. A nomogram based on tumor-infiltrating lymphocytes-ultrasonography score, clinical complete response, hormone receptor and clinical N status was developed. The nomogram showed an area under the curve of 0.831 and a bias-corrected area under the curve of 0.809. The calibration plot showed a good fit between the expected and actual pathological complete response values. Decision curve analysis also showed the clinical utility of the nomogram for predicting pathological complete responses.</p><p><strong>Conclusions: </strong>A nomogram based on the tumor-infiltrating lymphocytes-ultrasonography score exhibited a favorable predictive ability for pathological complete response in patients with breast cancer, which can be useful in predicting the residual disease status after neoadjuvant chemotherapy.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The correlation between immune-related adverse events and efficacy of immune checkpoint inhibitors. 免疫相关不良事件与免疫检查点抑制剂疗效之间的相关性。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae067
Taito Fukushima, Satoshi Kobayashi, Makoto Ueno

Immune checkpoint inhibitors have revolutionized cancer treatment by targeting the cytotoxic T lymphocyte antigen-4 and programmed death-1/ligand-1. Although immune checkpoint inhibitors show promising therapeutic efficacy, they often cause immune-related adverse events. Immune-related adverse events differ from the side effects of conventional chemotherapy and require vigilant monitoring. These events predominantly affect organs, such as the colon, liver, lungs, pituitary gland, thyroid and skin, with rare cases affecting the heart, nervous system and other tissues. As immune-related adverse events result from immune activation, indicating the reinvigoration of exhausted immune cells that attack both tumors and normal tissues, it is theoretically possible that immune-related adverse events may signal a better response to immune checkpoint inhibitor therapy. Recent retrospective studies have explored the link between immune-related adverse event development and clinical efficacy; however, the predictive value of immune-related adverse events in the immune checkpoint inhibitor response remains unclear. Additionally, studies have focused on immune-related adverse events, timing of onset and immunosuppressive treatments. This review focuses on pivotal studies of the association between immune-related adverse events and outcomes in patients treated with immune checkpoint inhibitors.

免疫检查点抑制剂以细胞毒性 T 淋巴细胞抗原-4 和程序性死亡-1/配体-1 为靶点,彻底改变了癌症治疗。尽管免疫检查点抑制剂显示出良好的疗效,但它们往往会引起免疫相关不良反应。免疫相关不良事件不同于传统化疗的副作用,需要警惕监测。这些事件主要影响结肠、肝脏、肺、垂体、甲状腺和皮肤等器官,少数情况下会影响心脏、神经系统和其他组织。由于免疫相关不良事件是免疫激活的结果,表明攻击肿瘤和正常组织的免疫细胞衰竭后重新焕发活力,因此从理论上讲,免疫相关不良事件可能预示着对免疫检查点抑制剂疗法的更好反应。最近的回顾性研究探讨了免疫相关不良事件的发生与临床疗效之间的联系;然而,免疫相关不良事件在免疫检查点抑制剂反应中的预测价值仍不明确。此外,研究的重点还包括免疫相关不良事件、发病时间和免疫抑制治疗。本综述重点关注免疫相关不良事件与接受免疫检查点抑制剂治疗的患者的预后之间关系的关键性研究。
{"title":"The correlation between immune-related adverse events and efficacy of immune checkpoint inhibitors.","authors":"Taito Fukushima, Satoshi Kobayashi, Makoto Ueno","doi":"10.1093/jjco/hyae067","DOIUrl":"10.1093/jjco/hyae067","url":null,"abstract":"<p><p>Immune checkpoint inhibitors have revolutionized cancer treatment by targeting the cytotoxic T lymphocyte antigen-4 and programmed death-1/ligand-1. Although immune checkpoint inhibitors show promising therapeutic efficacy, they often cause immune-related adverse events. Immune-related adverse events differ from the side effects of conventional chemotherapy and require vigilant monitoring. These events predominantly affect organs, such as the colon, liver, lungs, pituitary gland, thyroid and skin, with rare cases affecting the heart, nervous system and other tissues. As immune-related adverse events result from immune activation, indicating the reinvigoration of exhausted immune cells that attack both tumors and normal tissues, it is theoretically possible that immune-related adverse events may signal a better response to immune checkpoint inhibitor therapy. Recent retrospective studies have explored the link between immune-related adverse event development and clinical efficacy; however, the predictive value of immune-related adverse events in the immune checkpoint inhibitor response remains unclear. Additionally, studies have focused on immune-related adverse events, timing of onset and immunosuppressive treatments. This review focuses on pivotal studies of the association between immune-related adverse events and outcomes in patients treated with immune checkpoint inhibitors.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Japanese journal of clinical oncology
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