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SARS-CoV-2 pathogenesis in the gastrointestinal tract mediated by Spike induced intestinal inflammation 由穗状病毒诱发的肠道炎症介导的 SARS-CoV-2 在胃肠道的致病机制
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-21 DOI: 10.1093/pcmedi/pbad034
Zhan-yu Li, Jian-zhong He, Yun Yin, Lei Tang, Ye Liu, Olivia Monteiro, Fa-min Zeng
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引用次数: 0
Precision medicine in inflammatory bowel disease 炎症性肠病的精准医疗
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-18 DOI: 10.1093/pcmedi/pbad033
Zhen Zeng, Mingshan Jiang, Xi Li, Jing Yuan, Hu Zhang
Inflammatory bowel disease (IBD) is an incurable disease characterized by remission-relapse cycles throughout its course. Both Crohn's disease (CD) and ulcerative colitis (UC), the two main forms of IBD, exhibit tendency to develop complications and substantial heterogeneity in terms of frequency and severity of relapse, thus posing great challenges to the clinical management for IBD. Current treatment strategies are effective in different ways in induction and maintenance therapies for IBD. Recent advances in studies of genetics, pharmacogenetics, proteomics and microbiome provide a strong driving force for identifying molecular markers of prognosis and treatment response, which should help clinicians manage IBD patients more effectively, and then, improve clinical outcomes and reduce treatment costs of patients. In this review, we summarize and discuss precision medicine in IBD, focusing on predictive markers of disease course and treatment response, and monitoring indices during therapeutic drug monitoring.
炎症性肠病(IBD)是一种不治之症,其特点是在整个病程中会出现缓解-复发循环。克罗恩病(CD)和溃疡性结肠炎(UC)是 IBD 的两种主要形式,这两种疾病都有并发症倾向,而且在复发频率和严重程度方面存在很大的异质性,因此给 IBD 的临床治疗带来了巨大挑战。目前的治疗策略对 IBD 的诱导治疗和维持治疗有不同的效果。遗传学、药物遗传学、蛋白质组学和微生物组研究的最新进展为确定预后和治疗反应的分子标记提供了强大的推动力,有助于临床医生更有效地管理 IBD 患者,进而改善临床疗效并降低患者的治疗费用。在这篇综述中,我们总结并讨论了 IBD 的精准医疗,重点是疾病过程和治疗反应的预测标志物以及治疗药物监测期间的监测指标。
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引用次数: 0
The significance of long non-coding RNAs in the pathogenesis, diagnosis and treatment of inflammatory bowel disease. 长非编码 RNA 在炎症性肠病的发病机制、诊断和治疗中的意义。
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-11 eCollection Date: 2023-12-01 DOI: 10.1093/pcmedi/pbad031
Fei Jiang, Min Wu, Rongpeng Li

Inflammatory bowel diseases (IBD) are a group of chronic relapsing gastrointestinal inflammatory diseases with significant global incidence. Although the pathomechanism of IBD has been extensively investigated, several aspects of its pathogenesis remain unclear. Long non-coding RNAs (lncRNAs) are transcripts with more than 200 nucleotides in length that have potential protein-coding functions. LncRNAs play important roles in biological processes such as epigenetic modification, transcriptional regulation and post-transcriptional regulation. In this review, we summarize recent advances in research on IBD-related lncRNAs from the perspective of the overall intestinal microenvironment, as well as their potential roles as immune regulators, diagnostic biomarkers and therapeutic targets or agents for IBD.

炎症性肠病(IBD)是一组慢性复发性胃肠道炎症性疾病,在全球发病率很高。虽然 IBD 的病理机制已被广泛研究,但其发病机制的几个方面仍不清楚。长非编码 RNA(lncRNA)是长度超过 200 个核苷酸的转录本,具有潜在的蛋白质编码功能。LncRNA 在表观遗传修饰、转录调控和转录后调控等生物过程中发挥着重要作用。在这篇综述中,我们从整体肠道微环境的角度总结了与 IBD 相关的 lncRNA 的最新研究进展,以及它们作为免疫调节剂、诊断生物标志物和 IBD 治疗靶标或药物的潜在作用。
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引用次数: 0
PBS: a prospective longitudinal multi-omics bariatric surgery cohort PBS:前瞻性纵向多组学减肥手术队列
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 DOI: 10.1093/pcmedi/pbad032
Y. Jiao, Jiaming Xue, Shuai Chen, Wei Sun, Xiangqing Kong, Lianmin Chen, Liming Tang
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引用次数: 0
Prealbumin as a prognostic indicator for hospital readmission of ulcerative colitis patients 前白蛋白作为溃疡性结肠炎患者再入院的预后指标
4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-11-10 DOI: 10.1093/pcmedi/pbad026
Chao Ye, Anmin Wang, Wei Li, Wenyuan Li, Qi shen, Zhangfei Wang, Li Xie, Qiuxia Jiang, Kaiguang Zhang, Shu Zhu
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引用次数: 0
Loss of chromosome 9p21 is associated with a poor prognosis in adenosquamous carcinoma of the pancreas 染色体9p21缺失与胰腺腺鳞癌预后不良相关
4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-11-07 DOI: 10.1093/pcmedi/pbad030
Yina Jiang, YinYing Wu, Liwen Zhang, Yan Wang, Guiping Xu, Yuan Deng, Liang Han, Enxiao Li, Qingyong Ma, Mian Xu, Zheng Wu, Zheng Wang
Abstract Adenosquamous carcinoma of the pancreas (ASCP) is a rare histological subtype of pancreatic cancer with a poor prognosis and a high metastasis rate. However, little is known about its genomic landscape and prognostic biomarkers. Forty-eight ASCP specimens and 98 pancreatic ductal adenocarcinoma (PDAC) tumours pecimens were sequenced to explore the genomic landscape and prognostic biomarkers. The homozygous deletion of the 9p21.3 region (including CDKN2A, CDKN2B, and MTAP) (9p21 loss) occurred in both ASCP and PDAC, and a higher frequency of 9p21 loss was observed in ASCP (12.5% vs. 2.0%, p = 0.022). Notably, 9p21 loss was significantly associated with poor disease-free survival (DFS) in ASCP patients (mDFS = 4.17 vs. 7.33 months, HR = 3.70, p = 0.009). The most common gene alterations in patients with ASCP were KRAS (96%), TP53 (81%), CDKN2A (42%), SMAD4 (21%), CDKN2B (13%), and FAT3 (13%). The mutation rates of ACVR2A (6.25% vs. 0), FANCA (6.25% vs. 0), RBM10 (6.25% vs. 0), and SPTA1 (8.33% vs. 1.02%) were significantly higher in ASCP than in PDAC. In conclusion, we have comprehensively described the genomic landscape of the largest cohort of ASCP patients to date and highlight that 9p21 loss may be a promising prognostic biomarker for ASCP, which provides a molecular basis for prognosis prediction and new therapeutic strategies for ASCP.
摘要胰腺腺鳞癌(Adenosquamous carcinoma of pancreatic, ASCP)是一种少见的胰腺组织学亚型,预后差,转移率高。然而,对其基因组景观和预后生物标志物知之甚少。对48例ASCP标本和98例胰腺导管腺癌(PDAC)肿瘤标本进行测序,以探索基因组景观和预后生物标志物。9p21.3区域(包括CDKN2A、CDKN2B和MTAP)的纯合缺失(9p21缺失)在ASCP和PDAC中均有发生,且ASCP中9p21缺失的频率更高(12.5% vs. 2.0%, p = 0.022)。值得注意的是,9p21缺失与ASCP患者较差的无病生存期(DFS)显著相关(mDFS = 4.17 vs. 7.33个月,HR = 3.70, p = 0.009)。ASCP患者中最常见的基因改变是KRAS(96%)、TP53(81%)、CDKN2A(42%)、SMAD4(21%)、CDKN2B(13%)和FAT3(13%)。ACVR2A (6.25% vs. 0)、FANCA (6.25% vs. 0)、RBM10 (6.25% vs. 0)和SPTA1 (8.33% vs. 1.02%)在ASCP患者中的突变率显著高于PDAC患者。总之,我们全面描述了迄今为止最大的ASCP患者队列的基因组景观,并强调9p21缺失可能是ASCP的一个有希望的预后生物标志物,为ASCP的预后预测和新的治疗策略提供了分子基础。
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引用次数: 0
A pairwise radiomics algorithm - lesion pair relation estimation (PRE) model for distinguishing multiple primary lung cancer (MPLC) from intrapulmonary metastasis (IPM) 两两放射组学算法-病变对关系估计(PRE)模型鉴别多发性原发性肺癌(MPLC)与肺内转移(IPM)
4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-10-30 DOI: 10.1093/pcmedi/pbad029
Ting-Fei Chen, Lei Yang, Hai-Bin Chen, Zhi-Guo Zhou, Zhen-Tian Wu, Hong-He Luo, Qiong Li, Ying Zhu
Abstract Background Distinguishing multiple primary lung cancer (MPLC) from intrapulmonary metastasis (IPM) is critical for their disparate treatment strategy and prognosis. This study aimed to establish a non-invasive model to make the differentiation pre-operatively. Methods We retrospectively studied 168 patients with multiple lung cancers (307 pairs of lesions) including 118 cases for modeling and internal validation, and 50 cases for independent external validation. Radiomic features on computed tomography (CT) were extracted to calculate the absolute deviation of paired lesions. Features were then selected by correlation coefficients and random forest classifier five-fold cross-validation, based on which the lesion pair relation estimation (PRE) model was developed. A major voting strategy was used to decide diagnosis for cases with multiple pairs of lesions. Cases from another institute were included as the external validation set for the PRE model to compete with two experienced clinicians. Results Seven radiomic features were selected for the PRE model construction. With major voting strategy, the mean area under receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity of the training vs. internal validation vs. external validation cohort to distinguish MPLC were 0.983 vs. 0.844 vs. 0.793, 0.942 vs. 0.846 vs. 0.760, 0.905 vs. 0.728 vs. 0.727, and 0.962 vs. 0.910 vs. 0.769, respectively. AUCs of the two clinicians were 0.619 and 0.580. Conclusions The CT radiomic feature-based lesion PRE model is potentially an accurate diagnostic tool for the differentiation of MPLC and IPM, which could help with clinical decision making.
背景区分多发原发性肺癌(MPLC)和肺内转移(IPM)对于其不同的治疗策略和预后至关重要。本研究旨在建立无创模型进行术前鉴别。方法回顾性研究168例多发性肺癌患者(307对病变),其中118例进行建模和内部验证,50例进行独立外部验证。提取计算机断层扫描(CT)上的放射学特征来计算成对病变的绝对偏差。然后通过相关系数和随机森林分类器五重交叉验证选择特征,在此基础上建立病变对关系估计(PRE)模型。一个主要的投票策略被用来决定多对病变病例的诊断。来自另一个研究所的病例被纳入PRE模型的外部验证集,与两位经验丰富的临床医生竞争。结果选取7个放射学特征进行PRE模型构建。在主要投票策略下,训练组、内部验证组和外部验证组区分MPLC的平均受试者工作特征曲线下面积(AUC)、准确度、灵敏度和特异性分别为0.983、0.844、0.793、0.942、0.846、0.760、0.905、0.728、0.727、0.962、0.910、0.769。两名临床医生的auc分别为0.619和0.580。结论基于CT放射学特征的病变PRE模型可作为MPLC与IPM鉴别的准确诊断工具,有助于临床决策。
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引用次数: 0
Investigating the gut microbiota's influence on psoriasis and psoriatic arthritis risk: a Mendelian randomization analysis. 研究肠道微生物群对银屑病和银屑病关节炎风险的影响:孟德尔随机分析。
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-09-15 eCollection Date: 2023-09-01 DOI: 10.1093/pcmedi/pbad023
Nianzhou Yu, Jiayi Wang, Yuancheng Liu, Yeye Guo

Background: Numerous investigations have revealed the interplay between gut microbiota (GM) and psoriasis (Ps) and psoriatic arthritis (PsA). However, the causal relationship between them remains unknown.

Methods: We curated a collection of genetic variants (P < 1 × 10-5) associated with GM (n = 18 340) derived from the MiBioGen study. To explore the intricate relationship between GM and Ps as well as PsA, we harnessed the comprehensive resources of the FinnGen database, encompassing a vast cohort of individuals, including 4510 Ps cases and 212 242 controls and 1637 PsA cases and 212 242 controls. Mendelian randomization (MR) was used, including an inverse variance weighting method, followed by a sensitivity analysis to verify the robustness of the results.

Results: For Ps, some bacterial taxa, including Lactococcus, Ruminiclostridium 5, and Eubacterium fissicatena, were identified as risk factors; but Odoribacter demonstrated a protective effect against Ps. In the case of PsA, Lactococcus, Verrucomicrobiales, Akkermansia, Coprococcus 1, and Verrucomicrobiaceae were identified as risk factors; Odoribacter and Rikenellaceae exhibited a protective effect against the development of PsA.

Conclusion: Our study establishes a causal link between the GM and Ps and PsA. These findings provide insights into the underlying mechanisms and suggest potential therapeutic targets.

背景:大量研究揭示了肠道微生物群(GM)与银屑病(Ps)和银屑病关节炎(PsA)之间的相互作用。然而,它们之间的因果关系尚不清楚。方法:我们收集了来自MiBioGen研究的与GM相关的遗传变异(P -5) (n = 18 340)。为了探索GM、Ps和PsA之间的复杂关系,我们利用了FinnGen数据库的综合资源,其中包括大量个体,包括4510例Ps病例和212 242例对照,以及1637例PsA病例和212 242例对照。采用孟德尔随机化(MR),包括方差逆加权法,然后进行敏感性分析以验证结果的稳健性。结果:乳球菌、5型反刍芽胞杆菌和裂裂真杆菌是Ps的危险因素;在PsA病例中,乳球菌(Lactococcus)、Verrucomicrobiales、Akkermansia、Coprococcus 1和Verrucomicrobiaceae被确定为危险因素;气味杆菌和里氏菌科对PsA的发生具有保护作用。结论:我们的研究建立了GM与Ps和PsA之间的因果关系。这些发现提供了对潜在机制的见解,并提出了潜在的治疗靶点。
{"title":"Investigating the gut microbiota's influence on psoriasis and psoriatic arthritis risk: a Mendelian randomization analysis.","authors":"Nianzhou Yu, Jiayi Wang, Yuancheng Liu, Yeye Guo","doi":"10.1093/pcmedi/pbad023","DOIUrl":"https://doi.org/10.1093/pcmedi/pbad023","url":null,"abstract":"<p><strong>Background: </strong>Numerous investigations have revealed the interplay between gut microbiota (GM) and psoriasis (Ps) and psoriatic arthritis (PsA). However, the causal relationship between them remains unknown.</p><p><strong>Methods: </strong>We curated a collection of genetic variants (<i>P</i> < 1 × 10<sup>-5</sup>) associated with GM (<i>n</i> = 18 340) derived from the MiBioGen study. To explore the intricate relationship between GM and Ps as well as PsA, we harnessed the comprehensive resources of the FinnGen database, encompassing a vast cohort of individuals, including 4510 Ps cases and 212 242 controls and 1637 PsA cases and 212 242 controls. Mendelian randomization (MR) was used, including an inverse variance weighting method, followed by a sensitivity analysis to verify the robustness of the results.</p><p><strong>Results: </strong>For Ps, some bacterial taxa, including <i>Lactococcus, Ruminiclostridium 5</i>, and <i>Eubacterium fissicatena</i>, were identified as risk factors; but <i>Odoribacter</i> demonstrated a protective effect against Ps. In the case of PsA, <i>Lactococcus, Verrucomicrobiales, Akkermansia, Coprococcus 1</i>, and <i>Verrucomicrobiaceae</i> were identified as risk factors; <i>Odoribacter</i> and <i>Rikenellaceae</i> exhibited a protective effect against the development of PsA.</p><p><strong>Conclusion: </strong>Our study establishes a causal link between the GM and Ps and PsA. These findings provide insights into the underlying mechanisms and suggest potential therapeutic targets.</p>","PeriodicalId":33608,"journal":{"name":"Precision Clinical Medicine","volume":"6 3","pages":"pbad023"},"PeriodicalIF":5.3,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463075","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: 1
Impact of apolipoprotein A1 on tumor immune microenvironment, clinical prognosis and genomic landscape in hepatocellular carcinoma. 载脂蛋白A1对肝细胞癌肿瘤免疫微环境、临床预后和基因组景观的影响
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-09-02 eCollection Date: 2023-09-01 DOI: 10.1093/pcmedi/pbad021
Ying Wang, Shipeng Chen, Xiao Xiao, Fan Yang, Jinhan Wang, Hui Zong, Yuzhen Gao, Chenjun Huang, Xuewen Xu, Meng Fang, Xiaoyan Zhang, Chunfang Gao

Background: Current knowledge on apolipoprotein A1 (APOA1) in hepatocellular carcinoma (HCC) is fragmented and even contradictory. Multi-dimensional analyses are required to comprehensively elucidate its value and underlying mechanism.

Methods: We collected 49 RNA-seq datasets, 40 cell line types data and 70 scRNA pan-cancer datasets public available, including 17 HCC datasets (1754 tumor samples), and enrolled 73 pairs of HCC tissue and 516 blood samples independently from our clinics. APOA1 impacting on the HCC tumor microenvironment (TME) was analyzed using intensive data mining. Methylation sequencing, flow cytometry, quantitative PCR, western blot, immunohistochemistry and clinical chemistry assays were conducted for wet experimental investigation.

Results: The APOA1 ontology fingerprint indicated that it played various crucial biological roles in HCC, primarily involved in cholesterol efflux. Consistent findings at histology, serology, and clinical follow-up revealed that high APOA1 was a good prognosis indicator of HCC. Hypermethylation in the APOA1 promoter region was found in clinical samples which is in accordance with the reduction of APOA1 in HCC. The cell cycle, DNA replication, mismatch repair pathways, and tumor cell proliferation were less observed in the HCC APOA1high subgroup. The favorable immunoregulatory abilities of APOA1 showed interesting findings: a positive correlation between APOA1 and anti-tumor immune cells (NK, CD8+ T cells) and a negative association with immune cells exerting immunosuppressive effects, including M2 macrophages.

Conclusion: This is an integrative multidimensional exploration of APOA1 using bioinformatics and experiments. Both the prognostic value and anti-tumor effects based on APOA1 panoramic exploration in the HCC TME demonstrate a new potential clinical target for HCC assessment and intervention in the future.

背景:目前关于载脂蛋白A1 (APOA1)在肝细胞癌(HCC)中的作用的认识是碎片化的,甚至是相互矛盾的。要全面阐明其价值和作用机制,需要多维度分析。方法:我们收集了49个RNA-seq数据集,40个细胞系类型数据集和70个scRNA泛癌症数据集,包括17个HCC数据集(1754个肿瘤样本),并独立从我们的诊所收集了73对HCC组织和516个血液样本。APOA1对HCC肿瘤微环境(TME)的影响采用密集的数据挖掘分析。采用甲基化测序、流式细胞术、定量PCR、western blot、免疫组织化学、临床化学等方法进行湿法实验研究。结果:APOA1本体论指纹图谱显示其在HCC中发挥多种重要的生物学作用,主要参与胆固醇外排。组织学、血清学和临床随访的一致结果表明,高APOA1是HCC的良好预后指标。在临床样本中发现APOA1启动子区域的高甲基化,这与HCC中APOA1的减少一致。细胞周期、DNA复制、错配修复途径和肿瘤细胞增殖在HCC apoa1高亚组中较少观察到。APOA1良好的免疫调节能力显示出有趣的发现:APOA1与抗肿瘤免疫细胞(NK、CD8+ T细胞)呈正相关,与具有免疫抑制作用的免疫细胞(包括M2巨噬细胞)负相关。结论:利用生物信息学和实验手段对APOA1进行了多维度的综合探索。基于APOA1全景探查在HCC TME中的预后价值和抗肿瘤作用,为未来HCC评估和干预提供了新的潜在临床靶点。
{"title":"Impact of apolipoprotein A1 on tumor immune microenvironment, clinical prognosis and genomic landscape in hepatocellular carcinoma.","authors":"Ying Wang, Shipeng Chen, Xiao Xiao, Fan Yang, Jinhan Wang, Hui Zong, Yuzhen Gao, Chenjun Huang, Xuewen Xu, Meng Fang, Xiaoyan Zhang, Chunfang Gao","doi":"10.1093/pcmedi/pbad021","DOIUrl":"https://doi.org/10.1093/pcmedi/pbad021","url":null,"abstract":"<p><strong>Background: </strong>Current knowledge on apolipoprotein A1 (APOA1) in hepatocellular carcinoma (HCC) is fragmented and even contradictory. Multi-dimensional analyses are required to comprehensively elucidate its value and underlying mechanism.</p><p><strong>Methods: </strong>We collected 49 RNA-seq datasets, 40 cell line types data and 70 scRNA pan-cancer datasets public available, including 17 HCC datasets (1754 tumor samples), and enrolled 73 pairs of HCC tissue and 516 blood samples independently from our clinics. APOA1 impacting on the HCC tumor microenvironment (TME) was analyzed using intensive data mining. Methylation sequencing, flow cytometry, quantitative PCR, western blot, immunohistochemistry and clinical chemistry assays were conducted for wet experimental investigation.</p><p><strong>Results: </strong>The APOA1 ontology fingerprint indicated that it played various crucial biological roles in HCC, primarily involved in cholesterol efflux. Consistent findings at histology, serology, and clinical follow-up revealed that high APOA1 was a good prognosis indicator of HCC. Hypermethylation in the APOA1 promoter region was found in clinical samples which is in accordance with the reduction of APOA1 in HCC. The cell cycle, DNA replication, mismatch repair pathways, and tumor cell proliferation were less observed in the HCC APOA1<sup>high</sup> subgroup. The favorable immunoregulatory abilities of APOA1 showed interesting findings: a positive correlation between APOA1 and anti-tumor immune cells (NK, CD8<sup>+</sup> T cells) and a negative association with immune cells exerting immunosuppressive effects, including M2 macrophages.</p><p><strong>Conclusion: </strong>This is an integrative multidimensional exploration of APOA1 using bioinformatics and experiments. Both the prognostic value and anti-tumor effects based on APOA1 panoramic exploration in the HCC TME demonstrate a new potential clinical target for HCC assessment and intervention in the future.</p>","PeriodicalId":33608,"journal":{"name":"Precision Clinical Medicine","volume":"6 3","pages":"pbad021"},"PeriodicalIF":5.3,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463074","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
Advances in diagnosis and prediction for aggression of pure solid T1 lung cancer. 纯实体T1型肺癌侵袭性诊断与预测研究进展。
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-08-17 eCollection Date: 2023-09-01 DOI: 10.1093/pcmedi/pbad020
Junhao Mu, Jing Huang, Min Ao, Weiyi Li, Li Jiang, Li Yang

A growing number of early-stage lung cancers presenting as malignant pulmonary nodules have been diagnosed because of the increased adoption of low-dose spiral computed tomography. But pure solid T1 lung cancer with ≤3 cm in the greatest dimension is not always at an early stage, despite its small size. This type of cancer can be highly aggressive and is associated with pathological involvement, metastasis, postoperative relapse, and even death. However, it is easily misdiagnosed or delay diagnosed in clinics and thus poses a serious threat to human health. The percentage of nodal or extrathoracic metastases has been reported to be >20% in T1 lung cancer. As such, understanding and identifying the aggressive characteristics of pure solid T1 lung cancer is crucial for prevention, diagnosis, and therapeutic strategies, and beneficial to improving the prognosis. With the widespread of lung cancer screening, these highly invasive pure solid T1 lung cancer will become the main advanced lung cancer in future. However, there is limited information regarding precision medicine on how to identify these "early-stage" aggressive lung cancers. To provide clinicians with new insights into early recognition and intervention of the highly invasive pure solid T1 lung cancer, this review summarizes its clinical characteristics, imaging, pathology, gene alterations, immune microenvironment, multi-omics, and current techniques for diagnosis and prediction.

越来越多的早期肺癌表现为恶性肺结节已被诊断,因为越来越多的采用低剂量螺旋计算机断层扫描。但最大尺寸≤3cm的纯实体T1肺癌虽然体积小,但并不总是处于早期。这种类型的癌症具有很强的侵袭性,与病理累及、转移、术后复发甚至死亡有关。但在临床上极易误诊或延误诊断,对人体健康构成严重威胁。据报道,T1期肺癌的淋巴结或胸外转移率>20%。因此,了解和识别纯实体T1型肺癌的侵袭性特征对预防、诊断和治疗策略至关重要,有利于改善预后。随着肺癌筛查的广泛开展,这些高侵袭性纯实体T1型肺癌将成为未来晚期肺癌的主要类型。然而,关于如何识别这些“早期”侵袭性肺癌的精准医学信息有限。本文综述了高侵袭性纯实体T1肺癌的临床特点、影像学、病理、基因改变、免疫微环境、多组学以及目前的诊断和预测技术,为临床医生提供早期识别和干预提供新的见解。
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引用次数: 0
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Precision Clinical Medicine
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