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The Prognostic Potential of Neurokinin 1 Receptor in Breast Cancer and Its Relationship with Ki-67 Index 神经激肽1受体对乳腺癌预后的影响及其与Ki-67指数的关系
IF 1.9 Q3 Medicine Pub Date : 2022-04-04 DOI: 10.1155/2022/4987912
M. Al-Keilani, Rana Elstaty, M. Alqudah
Background Neurokinin 1 receptor (NK1R) is a promising biomarker and therapeutic target in breast cancer. This study was aimed at investigating the expression level of NK1R in breast cancer tissues and its relationship with proliferation index as measured by Ki-67, clinicopathological characteristics of patients, and overall survival rate. Methods Immunohistochemical expression of NK1R and Ki-67 was measured in 164 paraffin-embedded breast cancer tissues of four molecular subtypes (42 HER2-enriched, 40 luminal A, 42 luminal B, and 40 triple negative). NK1R was scored semiquantitatively, while Ki-67 was obtained by the percentage of total number of tumor cells with nuclear staining. The optimal cutoff values for NK1R and Ki-67 were assessed by Cutoff Finder. Pearson's Chi-square (χ2) and Fisher's exact tests were used to compare the staining scores between groups. The Kaplan-Meier method with log-rank test was used for survival analysis. ANOVA and Student's t-test were used to compare group means. Results A total of 164 patients were included in the study which represented females with invasive ductal carcinoma. NK1R was expressed at high levels in about 34% of investigated cases. The mean Ki-67 level was about 27% and 41.5% of sample had high Ki-67 (expression level > 22%). NK1R expression levels were associated with higher tumor grade (p = 0.021) and high Ki-67 (p = 0.012). NK1R expression negatively impacted overall survival in grade II tumors (p = 0.027). Conclusion NK1R contributes to cellular proliferation and is associated with negative prognosis in breast cancer. These findings suggest the potential role of NK1R as a therapeutic target in breast cancer.
神经激肽1受体(Neurokinin 1 receptor, NK1R)是一种很有前景的乳腺癌生物标志物和治疗靶点。本研究旨在探讨NK1R在乳腺癌组织中的表达水平及其与Ki-67增殖指数、患者临床病理特征及总生存率的关系。方法164例乳腺癌石蜡包埋组织(her2富集型42例,A型40例,B型42例,三阴性40例)中NK1R和Ki-67的免疫组化表达。NK1R采用半定量评分法,Ki-67采用核染色肿瘤细胞总数的百分比法。采用cutoff Finder评估NK1R和Ki-67的最佳截断值。采用Pearson卡方检验(χ2)和Fisher精确检验比较各组间染色评分。生存分析采用Kaplan-Meier法和log-rank检验。采用方差分析和学生t检验比较各组均值。结果本研究共纳入164例浸润性导管癌女性患者。NK1R在约34%的调查病例中高水平表达。Ki-67平均水平约为27%,41.5%的样本Ki-67高表达(表达水平> 22%)。NK1R表达水平与较高的肿瘤分级(p = 0.021)和高Ki-67 (p = 0.012)相关。NK1R表达负向影响II级肿瘤的总生存率(p = 0.027)。结论NK1R参与乳腺癌细胞增殖并与不良预后相关。这些发现提示NK1R作为乳腺癌治疗靶点的潜在作用。
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引用次数: 4
Association of XRCC3, XRCC4, BAX, and BCL-2 Polymorphisms with the Risk of Breast Cancer. XRCC3、XRCC4、BAX和BCL-2多态性与乳腺癌风险的关系
IF 1.9 Q3 Medicine Pub Date : 2022-03-14 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5817841
Emre Ozoran, Fadime Didem Can Trabulus, Duygu Erhan, Bahadir Batar, Mehmet Guven

Background: Breast cancer is the most common malignancy in women. Genetic risk factors associated with breast cancer incidence have been identified.

Aims: This study is aimed at determining the association of XRCC3 Thr241Met (rs861539), XRCC4 G(-1394) T (rs6869366) DNA repair and BAX G(-248) A (rs4645878), and BCL2 C(-938) A (rs2279115) apoptotic gene polymorphisms with breast cancer.

Materials and methods: Genetic analysis was performed using peripheral blood samples. Gene polymorphisms were detected by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. 175 patients and 158 healthy controls were enrolled in the study.

Results: Breast cancer risk was 5.43 times more in individuals with AA genotype of Bax G(-248) A (rs4645878) (P = 0.002). The risk of metastasis was 11 times with this genotype. It was associated with 6 times more risk of having a tumor larger than 2 cm. The risk of breast cancer was 2.77 times more in individuals carrying the Met/Met genotype of XRCC3 Thr241Met (rs861539) (P = 0.009). The risk of having advanced clinical stage (stage III+IV) with the Met/Met genotype was 4 times more increased. No relationship with breast cancer was found with XRCC4 G(-1394) T (rs6869366) and BCL2 C(-938) A (rs2279115) gene polymorphisms.

Conclusion: Multicenter trials using subjects with genetic variations are needed to establish the relationship between breast cancer and single gene polymorphism.

背景:乳腺癌是女性最常见的恶性肿瘤。与乳腺癌发病率相关的遗传风险因素已经确定。目的:本研究旨在探讨XRCC3 Thr241Met (rs861539)、XRCC4 G(-1394) T (rs6869366) DNA修复和BAX G(-248) A (rs4645878)、BCL2 C(-938) A (rs2279115)凋亡基因多态性与乳腺癌的相关性。材料和方法:采用外周血标本进行遗传分析。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测基因多态性。175名患者和158名健康对照者参加了这项研究。结果:Bax G(-248) A (rs4645878) AA基因型个体患乳腺癌的风险高5.43倍(P = 0.002)。该基因型的转移风险为11倍。它与肿瘤大于2厘米的风险增加6倍有关。携带Met/Met基因型XRCC3 Thr241Met (rs861539)的个体患乳腺癌的风险是其2.77倍(P = 0.009)。具有Met/Met基因型的晚期临床阶段(III+IV期)的风险增加了4倍。XRCC4 G(-1394) T (rs6869366)和BCL2 C(-938) A (rs2279115)基因多态性与乳腺癌无相关性。结论:乳腺癌与单基因多态性之间的关系需要多中心试验来确定。
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引用次数: 1
Assessment of Suspected Breast Lesions in Early-Stage Triple-Negative Breast Cancer during Follow-Up after Breast-Conserving Surgery Using Multiparametric MRI 多参数MRI评价保乳术后早期三阴性乳腺癌疑似乳腺病变
IF 1.9 Q3 Medicine Pub Date : 2022-02-18 DOI: 10.1155/2022/4299920
L. Sad, Naglaa Lofty Dabees, Dareen Abd El-Aziz Mohamed, A. Tageldin, S. Younis
Background The local recurrence rate of triple-negative breast cancer (TNBC) can be as high as 12%.The standard treatment for early-stage TNBC is breast-conserving surgery (BCS), followed by postoperative radiotherapy with or without chemotherapy. However, detection of the local recurrence of the disease after radiotherapy is a major issue. Objective The aim of this study was at investigating the role of dynamic and functional magnetic resonance imaging (MRI) during follow-up after BCS and radiotherapy with/without chemotherapy to differentiate between locoregional recurrence and postoperative fibrosis. Patients and Methods. This prospective study was conducted at the oncology, radiology, and pathology departments, Tanta University. It involved 50 patients with early-stage TNBC who were treated with BCS, followed by radiotherapy with/without chemotherapy. The suspected lesions were evaluated during the follow-up period by sonomammography. All patients were subjected to MRI, including conventional sequences, diffusion-weighted imaging (DWI), and dynamic postcontrast study. Results Ten cases were confirmed as recurrent malignant lesions. After contrast administration, they all exhibited irregular T1 hypodense lesions of variable morphology with diffusion restriction and positive enhancement. Eight cases displayed a type III curve, while two showed a type II curve. Histopathological assessment was consistent with the MRI findings in all eight cases. The combination of the data produced by DWI-MRI and dynamic contrast-enhanced (DCE) MRI resulted in 100%sensitivity, 92.5% specificity, 90.9% positive predictive value, 100% negative predictive value, and 98% accuracy. Conclusion Combination of DWI-MRI and DCE-MRI could have high diagnostic value for evaluating postoperative changes in patients with TNBC after BCS, followed by radiotherapy with/without chemotherapy. Trial Registrations. No trial to be registered.
背景三阴性乳腺癌(TNBC)的局部复发率可高达12%。早期TNBC的标准治疗方法是保乳手术(BCS),然后是术后放疗加或不加化疗。然而,放射治疗后疾病局部复发的检测是一个主要问题。目的本研究的目的是探讨动态和功能性磁共振成像(MRI)在BCS和放疗伴/不伴化疗后随访中的作用,以区分局部复发和术后纤维化。患者和方法。本前瞻性研究在坦塔大学肿瘤科、放射科和病理科进行。该研究涉及50例早期TNBC患者,他们接受BCS治疗,随后进行放疗加/不加化疗。在随访期间通过超声x线摄影评估疑似病变。所有患者均接受MRI检查,包括常规序列、弥散加权成像(DWI)和动态对比后研究。结果10例确诊为复发性恶性病变。造影后均表现为不规则T1低密度病变,形态变化,扩散受限,阳性增强。8例显示III型曲线,2例显示II型曲线。所有8例患者的组织病理学检查结果与MRI一致。DWI-MRI与动态对比增强(DCE) MRI相结合,敏感性为100%,特异性为92.5%,阳性预测值为90.9%,阴性预测值为100%,准确率为98%。结论DWI-MRI与DCE-MRI联合应用对评价三阴癌患者BCS术后变化,再加/不加化疗放疗具有较高的诊断价值。试验注册。没有试验需要注册。
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引用次数: 0
Pharmacological Properties to Pharmacological Insight of Sesamin in Breast Cancer Treatment: A Literature-Based Review Study 芝麻素在乳腺癌治疗中的药理作用:基于文献的综述研究
IF 1.9 Q3 Medicine Pub Date : 2022-02-17 DOI: 10.1155/2022/2599689
M. Sohel, Md. Nurul Islam, Md. Arju Hossain, Tayeba Sultana, A. Dutta, M. Rahman, Suraiya Aktar, Khairul Islam, Abdullah Al Mamun
The use of dietary phytochemical rather than conventional therapies to treat numerous cancers is now a well-known approach in medical science. Easily available and less toxic dietary phytochemicals present in plants should be introduced in the list of phytochemical-based treatment areas. Sesamin, a natural phytochemical, may be a promising chemopreventive agent aiming to manage breast cancer. In this study, we discussed the pharmacological properties of sesamin that determine its therapeutics opportunity to be used in breast cancer treatment and other diseases. Sesamin is available in medicinal plants, especially in Sesamum indicum, and is easily metabolized by the liver. To better understand the antibreast cancer consequence of sesamin, we postulate some putative pathways related to the antibreast cancer mechanism: (1) regulation of estrogen receptor (ER-α and ER-β) activities, (2) suppressing programmed death-ligand 1 (PD-L1) overexpression, (3) growth factor receptor inhibition, and (4) some tyrosine kinase pathways. Targeting these pathways, sesamin can modulate cell proliferation, cell cycle arrest, cell growth and viability, metastasis, angiogenesis, apoptosis, and oncogene inactivation in various in vitro and animal models. Although the actual tumor intrinsic signaling mechanism targeted by sesamin in cancer treatment is still unknown, this review summarized that this phytoestrogen suppressed NF-κB, STAT, MAPK, and PIK/AKT signaling pathways and activated some tumor suppressor protein in numerous breast cancer models. Cotreatment with γ-tocotrienol, conventional drugs, and several drug carriers systems increased the anticancer potentiality of sesamin. Furthermore, sesamin exhibited promising pharmacokinetics properties with less toxicity in the bodies. Overall, the shreds of evidence highlight that sesamin can be a potent candidate to design drugs against breast cancer. So, like other phytochemicals, sesamin can be consumed for better therapeutic advantages due to having the ability to target a plethora of molecular pathways until clinically trialed standard drugs are not available in pharma markets.
使用膳食植物化学疗法而不是传统疗法来治疗多种癌症,现在是医学上一种众所周知的方法。植物中存在的容易获得且毒性较低的膳食植物化学物质应列入基于植物化学物质的处理领域清单。芝麻素是一种天然的植物化学物质,可能是一种很有前途的化学预防剂,旨在控制乳腺癌。在这项研究中,我们讨论了芝麻素的药理学特性,这些特性决定了它在乳腺癌治疗和其他疾病中的治疗机会。芝麻素存在于药用植物中,尤其是芝麻,很容易被肝脏代谢。为了更好地了解芝麻素的抗乳腺癌作用,我们假设了一些与抗乳腺癌机制相关的可能途径:(1)调节雌激素受体(ER-α和ER-β)活性,(2)抑制程序性死亡配体1 (PD-L1)过表达,(3)生长因子受体抑制,(4)一些酪氨酸激酶途径。针对这些途径,芝麻素可以在各种体外和动物模型中调节细胞增殖、细胞周期阻滞、细胞生长和活力、转移、血管生成、凋亡和癌基因失活。虽然芝麻素在肿瘤治疗中的实际肿瘤内在信号机制尚不清楚,但本综述总结了该植物雌激素在多种乳腺癌模型中抑制NF-κB、STAT、MAPK和PIK/AKT信号通路并激活一些肿瘤抑制蛋白。与γ-生育三烯醇、常规药物和几种药物载体系统共处理增加了芝麻素的抗癌潜力。此外,芝麻素具有良好的药代动力学特性,在体内毒性较小。总的来说,零星的证据强调芝麻素可以成为设计抗乳腺癌药物的有力候选者。因此,像其他植物化学物质一样,芝麻素可以获得更好的治疗优势,因为它有能力针对大量的分子途径,直到临床试验的标准药物无法在制药市场上获得。
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引用次数: 7
Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon. 乳腺癌分子亚型和Ki67表达作为新辅助化疗后病理完全缓解的预测价值的临床意义:来自黎巴嫩三级保健中心的经验
IF 1.9 Q3 Medicine Pub Date : 2022-02-12 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1218128
Ali Atoui, Maroun Bou Zerdan, Ahmad El Mahmoud, Nathalie Chamseddine, Lina Hamad, Hazem I Assi

Introduction: Breast cancer is considered nowadays the most prevalent cancer worldwide. The molecular era has successfully divided breast cancer into subtypes based on the various hormonal receptors. These molecular subtypes play a major role in determining the neoadjuvant chemotherapy to be administered. It was noted that the use of neoadjuvant chemotherapy was associated with higher achievement of pathological complete response. The aim of the study was to determine the predictive role of breast cancer subtypes in the efficacy and prognosis of neoadjuvant chemotherapy regimens.

Methods: Combining dose dense anthracycline-based, regular dose anthracycline-based, and nonanthracycline-based chemotherapy, we observed data from 87 patients with breast cancer who received surgery after administration of neoadjuvant chemotherapy at our institution between January 2015 and July 2018. The patients were classified into luminal A, luminal B, HER2 overexpression, and triple negative breast cancer as well as low Ki67 (≤14%) and high Ki67 (>14%) expression groups using immunohistochemistry. Pathologic complete response was the only neoadjuvant chemotherapy outcome parameter. To evaluate variables associated with pathologic complete response, we used univariate analyses followed by multivariate logistic regression.

Results: 87 patients with breast cancer were classified into different subtypes according to the 12th St. Gallen International Breast Cancer Conference. The response rate to neoadjuvant chemotherapy was significantly different (p = 0.046) between the subgroups. There were significant correlations between pathological complete response (pCR) and ER status (p < 0.0001), HER2 (p = 0.013), molecular subtypes (p = 0.018), T stage (p = 0.024), N stage before chemotherapy (p = 0.04), and type of chemotherapy (p = 0.029). Luminal B type patients had the lowest pCR, followed by luminal A type patients.

Conclusion: Evaluating molecular subtype's significance in breast cancer prognosis warrants additional studies in our region with extensive data about patient-specific neoadjuvant chemotherapy regimens. Our study was able to reproduce results complementary to those present in the literature in other outcomes.

乳腺癌被认为是当今世界上最普遍的癌症。分子时代已经根据不同的激素受体成功地将乳腺癌分为不同的亚型。这些分子亚型在决定新辅助化疗中起主要作用。值得注意的是,新辅助化疗的使用与更高的病理完全缓解相关。该研究的目的是确定乳腺癌亚型在新辅助化疗方案的疗效和预后中的预测作用。方法:结合剂量密集蒽环类、常规剂量蒽环类和非蒽环类化疗,观察2015年1月至2018年7月在我院接受新辅助化疗后接受手术的87例乳腺癌患者的数据。采用免疫组化方法将患者分为luminal A、luminal B、HER2过表达、三阴性乳腺癌以及Ki67低表达组(≤14%)和高表达组(>14%)。病理完全缓解是唯一的新辅助化疗结果参数。为了评估与病理完全缓解相关的变量,我们使用单变量分析,然后是多变量逻辑回归。结果:根据第12届圣加仑国际乳腺癌会议,87例乳腺癌患者被分为不同的亚型。亚组间新辅助化疗有效率差异有统计学意义(p = 0.046)。病理完全缓解(pCR)与ER状态(p < 0.0001)、HER2 (p = 0.013)、分子亚型(p = 0.018)、T分期(p = 0.024)、化疗前N分期(p = 0.04)、化疗方式(p = 0.029)均有显著相关性。Luminal B型患者pCR最低,其次是Luminal A型患者。结论:评估分子亚型在乳腺癌预后中的意义,需要在我们地区进行更多的研究,并提供关于患者特异性新辅助化疗方案的大量数据。我们的研究能够再现与文献中其他结果相补充的结果。
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引用次数: 2
Prognostic Implications of MALAT1 and BACH1 Expression and Their Correlation with CTCs and Mo-MDSCs in Triple Negative Breast Cancer and Surgical Management Options. 三阴性乳腺癌患者MALAT1和BACH1表达的预后意义及其与ctc和Mo-MDSCs的相关性及手术治疗方案
IF 1.9 Q3 Medicine Pub Date : 2022-01-19 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8096764
Samah Said Elbasateeny, Mahmoud Abdou Yassin, Mohamed Mahmoud Mokhtar, Adel Mohamed Ismail, Huda Fathy Ebian, Samia Hussein, Sherin Attia Shazly, Mai Mohammed Abdelwabab

Background: Triple negative breast cancer (TNBC) is a biologically separate entity of breast cancer that cannot get benefits from targeted or endocrine therapy.

Objective: To assess the expression of MALAT1 and BACH1, as well as monocyte-myeloid-derived suppressor cell (Mo-MDSC) levels and circulating tumor cell (CTC) count in TNBC to correlate these markers with the clinic-pathological criteria of TNCB patients and to evaluate their roles as predictive markers for selection of the patients that can be operated by oncoplastic conserving breast surgery.

Methods: Eighty-eight TNBC were managed by modified doughnut breast oncoplastic surgery in early stages and by modified radical mastectomy for patients with late stages unsuitable for breast-conserving. All were examined for MALAT1 and BACH1 expression by immunohistochemistry and RT-PCR as well as Mo-MDSC levels and CTCs.

Results: MALAT1 and BACH1 expressions are correlated with the larger size, lymph node, distance metastasis, and TNM staging (p < 0.05). CTCs ≥ 5 and high MO-MDSCs were significantly more in TNBC with MALAT1 and BACH1 overexpression. The survival study proved that DFS for patients with both positive expression of MALAT1 and BACH1 was shorter than that of one positive expression, and both negative expression p ≤ 0.001, CTCs ≥ 5, and high Mo-MDSCs are associated with poor outcomes. No significant difference between modified round block and modified radical mastectomy techniques as regards recurrence. However, all postoperative management outcomes were significantly better in patients operated by oncoplastic conserving breast surgery.

Conclusion: BACH1 and MALAT1 expressions are significantly upregulated in TNBC. They are correlated with CTCs and Mo-MDCs, and all are associated with poor outcomes. Not all TNBC patients have a bad prognosis, patients negative for one of MALAT1 and BACH1 or both, have a slightly good prognosis, and so can be managed by breast oncoplastic conserving surgery.

背景:三阴性乳腺癌(TNBC)是一种生物学上独立的乳腺癌,不能从靶向或内分泌治疗中获益。目的:评估TNBC中MALAT1和BACH1的表达以及单核细胞-髓源性抑制细胞(Mo-MDSC)水平和循环肿瘤细胞(CTC)计数,以将这些标志物与TNCB患者的临床病理标准联系起来,并评估其作为选择可行保乳手术患者的预测标志物的作用。方法:88例TNBC患者,早期采用改良甜甜圈乳房肿瘤成形术,晚期不适合保乳者行改良乳房根治术。采用免疫组化、RT-PCR检测各组MALAT1、BACH1表达、Mo-MDSC水平及ctc水平。结果:MALAT1、BACH1表达与肿瘤大小、淋巴结、远处转移及TNM分期相关(p < 0.05)。CTCs≥5和高MO-MDSCs在MALAT1和BACH1过表达的TNBC中显著增加。生存研究证实MALAT1和BACH1同时阳性表达的患者的DFS均短于一个阳性表达的患者,且阴性表达p≤0.001、ctc≥5、Mo-MDSCs高均与预后不良相关。改良圆块术与改良根治术在复发率方面无显著差异。然而,所有的术后管理结果都明显好于行保乳手术的患者。结论:BACH1和MALAT1在TNBC中表达显著上调。它们与ctc和Mo-MDCs相关,并且都与不良预后相关。并非所有的TNBC患者预后不良,MALAT1和BACH1阴性或两者均阴性的患者预后稍好,因此可以通过乳房肿瘤整形保留手术进行治疗。
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引用次数: 7
Knowledge, Attitude, and Practice (KAP) toward Cervical Cancer Screening among Adama Science and Technology University Female Students, Ethiopia. 埃塞俄比亚Adama科技大学女生宫颈癌筛查的知识、态度和实践(KAP)
IF 1.9 Q3 Medicine Pub Date : 2022-01-13 eCollection Date: 2022-01-01 DOI: 10.1155/2022/2490327
Almaz Tadesse, Mesfin Tafa Segni, Hailu Fekadu Demissie

Background: Cervical cancer is a complication of Human Papillomavirus (HPV) infection is the second most common cancer in women worldwide. Eighty percent of the cases occur in low-resource countries. According to the 2009 World Health Organization report, the age-adjusted incidence rate of cervical cancer in Ethiopia was 35.9 per 100,000 patients with 7619 annual number of new cases and 60-81 deaths every year. The study is aimed at assessing the level of knowledge, attitude, and practice concerning cervical cancer among female students at Adama Science and Technology University. Methodology. An institutional based cross-sectional study was conducted among 667Adama Science and Technology University female students. A simple random sampling method was used to select the respondents. Structured self-administered questionnaire was used for data collection.

Results: About 404 (60.6%) of the participants heard about cervical cancer, 478 (71.7%) had positive attitude towards cervical cancer screening, and only 15 (2.2%) participants were screened for cervical cancer. Lack of information about cervical cancer was the most reported reason for not attending to cervical cancer screening. Conclusion and Recommendation. The study showed that there was low knowledge on cervical cancer and screening for premalignant lesion among women. There is a need to promote and encourage women to early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.

背景:宫颈癌是人类乳头瘤病毒(HPV)感染的并发症,是世界范围内女性第二大常见癌症。80%的病例发生在资源匮乏的国家。根据世界卫生组织2009年的报告,埃塞俄比亚经年龄调整的宫颈癌发病率为每10万名患者35.9例,每年有7619例新病例,60-81例死亡。这项研究的目的是评估阿道玛科技大学女学生对宫颈癌的知识、态度和行为水平。方法。本研究对安道麦科技大学6667名女大学生进行了基于机构的横断面调查。采用简单的随机抽样方法选择调查对象。采用结构化自我管理问卷进行数据收集。结果:约404人(60.6%)听说过宫颈癌,478人(71.7%)对宫颈癌筛查持积极态度,仅有15人(2.2%)接受过宫颈癌筛查。缺乏有关子宫颈癌的资料是不参加子宫颈癌普查的最主要原因。结论和建议。该研究表明,女性对宫颈癌和癌前病变筛查的认识较低。有必要通过告知妇女对子宫颈癌的易感性,促进和鼓励她们在癌前阶段进行早期子宫颈癌筛查。
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引用次数: 5
Indeterminate (B3) Breast Lesions and the Ongoing Role of Diagnostic Open Biopsy. 不确定(B3)乳腺病变和开放性活检诊断的持续作用。
IF 1.9 Q3 Medicine Pub Date : 2021-12-27 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5555458
Elizabeth Tan, Asiri Arachchi, Michael Cheng, Darren Lockie

Introduction: Due to their uncertain malignant potential, indeterminate breast lesions on core needle biopsy (CNB) require diagnostic open biopsy (DOB). This study evaluated DOB results given largely benign pathology. Lesions included are atypical papilloma, atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and radial scar/complex sclerosing lesions (RS/CSL). Methodology. A retrospective audit from 2010 to 2017 analysed patients with a screen-detected suspicious lesion and indeterminate (B3) CNB diagnosis. Primary outcome was the malignancy upgrade rate, with secondary evaluation of patient factors predictive of malignancy including age, symptoms, mammogram characteristics, lesion size, biopsy method, and past and family history.

Results: 152 patients (median age 57 years) were included, with atypical papillomas being the largest subgroup (44.7%). On DOB histology, 99.34% were benign, resulting in a 0.66% malignancy upgrade rate. Patient characteristic analysis identified 86.84% of B3 lesions were in patients greater than 50 years old. 90.13% were asymptomatic, whilst 98.68% and 72.37% had a negative past and family history. Majority 46.71% of lesions had the mammogram characteristic of being a mass. However, with 57.89% of the lesion imaging size less than 4 mm, a corresponding 60.5% of core needle biopsies were performed stereotactically. The small malignant subgroup limited predictive factor evaluation.

Conclusion: Albeit a low 0.66% malignancy upgrade rate in B3 lesions, no statistically significant patient predictive factors were identified. Until predictive factors and further assessment of vacuum-assisted excision (VAE) techniques evolve, DOB remains the standard of care.

导读:由于不确定的恶性潜能,核心穿刺活检(CNB)的不确定乳腺病变需要诊断性开放活检(DOB)。本研究评估了DOB结果,主要是良性病理。病变包括不典型乳头状瘤、不典型导管增生(ADH)、不典型小叶增生(ALH)和放射状疤痕/复杂硬化病变(RS/CSL)。方法。2010年至2017年的回顾性审计分析了筛查发现的可疑病变和不确定(B3) CNB诊断的患者。主要预后指标为恶性肿瘤升级率,对预测恶性肿瘤的患者因素进行二次评估,包括年龄、症状、乳房x光片特征、病变大小、活检方法、既往史和家族史。结果:纳入152例患者(中位年龄57岁),非典型乳头状瘤是最大的亚组(44.7%)。在DOB组织学上,99.34%为良性,恶性升级率0.66%。患者特征分析发现86.84%的B3病变发生在年龄大于50岁的患者中。无症状者占90.13%,既往史和家族史阴性者占98.68%和72.37%。46.71%的病变具有肿块特征。然而,由于57.89%的病变成像尺寸小于4 mm,相应的60.5%的核心针活检是立体定向进行的。小的恶性亚组限制了预测因素的评估。结论:虽然B3病变的恶性升级率为0.66%,但没有发现具有统计学意义的患者预测因素。直到预测因素和进一步评估真空辅助切除(VAE)技术的发展,DOB仍然是标准的护理。
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引用次数: 1
Survival Outcomes among Human Epidermal Growth Factor Receptor 2- (HER2-) Positive Breast Cancer Patients at Kenyatta National Hospital. 肯雅塔国立医院人表皮生长因子受体 2-(HER2-)阳性乳腺癌患者的生存结果。
IF 1.9 Q3 Medicine Pub Date : 2021-12-15 eCollection Date: 2021-01-01 DOI: 10.1155/2021/3115727
Gloria Tuwei, Amsalu Degu

Introduction: HER2-positive breast cancer is associated with poor outcomes and higher mortality rates than other breast cancer subtypes. The advent of trastuzumab has significantly changed the natural history of HER2-positive breast cancer. However, it is not an affordable treatment option in sub-Saharan African countries. Because of the expense, most patients in our setting do not receive trastuzumab for the optimal control of their disease. Additionally, there is a lack of comprehensive data about the survival outcomes of HER2-positive breast cancer patients in our setting. The present study was aimed at determining the survival outcomes among HER2-positive breast cancer patients at the Oncology Department of Kenyatta National Hospital.

Methods: A hospital-based retrospective cohort design was used to evaluate the survival outcomes among patients with HER2-positive breast cancer treated from 1st January 2015 to 31st December 2019 at Kenyatta National Hospital. A total of 50 eligible HER2-positive breast cancer patients were included in the study. In the predesigned data abstraction tool, data were collected by reviewing the medical records of the patients. The data were entered and analyzed using the Statistical Package for the Social Sciences version 27 software. The mean survival time was estimated using Kaplan-Meier survival analysis.

Results: The mean age was 45.44 ± 12.218 years, with a majority (80%) of the patients being below 60 years. Most patients (64%) had advanced-stage disease. The median follow-up time for patients with curative stages of breast cancer was 41 months, while the median follow-up time for those with the advanced incurable disease was 8.5 months. The 4-year survival rate was 62.5% for those curable-stage HER2-positive breast cancer compared to 5.6% for those with metastatic disease at presentation.

Conclusion: The 4-year survival rate for both early-stage and advanced-stage HER2-positive breast cancer in our setting is suboptimal when compared to existing outcome data from health care systems where trastuzumab is more widely available.

导言与其他乳腺癌亚型相比,HER2 阳性乳腺癌的预后较差,死亡率较高。曲妥珠单抗的出现极大地改变了 HER2 阳性乳腺癌的自然病史。然而,在撒哈拉以南非洲国家,这并不是一种负担得起的治疗方案。由于费用昂贵,在我们的环境中,大多数患者都没有接受曲妥珠单抗治疗以达到最佳的疾病控制效果。此外,我们还缺乏有关 HER2 阳性乳腺癌患者生存结果的全面数据。本研究旨在确定肯雅塔国立医院肿瘤科HER2阳性乳腺癌患者的生存结果:方法:采用基于医院的回顾性队列设计,评估2015年1月1日至2019年12月31日期间在肯雅塔国立医院接受治疗的HER2阳性乳腺癌患者的生存结果。研究共纳入了50名符合条件的HER2阳性乳腺癌患者。研究人员使用预先设计的数据抽取工具,通过查看患者的病历收集数据。数据使用社会科学统计软件包 27 版进行输入和分析。采用卡普兰-梅尔生存分析法估算平均生存时间:平均年龄为 45.44 ± 12.218 岁,大多数患者(80%)年龄在 60 岁以下。大多数患者(64%)为晚期患者。治愈期乳腺癌患者的中位随访时间为 41 个月,而晚期无法治愈者的中位随访时间为 8.5 个月。HER2阳性乳腺癌治愈期患者的4年生存率为62.5%,而转移性疾病患者的4年生存率仅为5.6%:结论:与曲妥珠单抗更广泛应用的医疗保健系统的现有结果数据相比,我国早期和晚期HER2阳性乳腺癌的4年生存率都不理想。
{"title":"Survival Outcomes among Human Epidermal Growth Factor Receptor 2- (HER2-) Positive Breast Cancer Patients at Kenyatta National Hospital.","authors":"Gloria Tuwei, Amsalu Degu","doi":"10.1155/2021/3115727","DOIUrl":"10.1155/2021/3115727","url":null,"abstract":"<p><strong>Introduction: </strong>HER2-positive breast cancer is associated with poor outcomes and higher mortality rates than other breast cancer subtypes. The advent of trastuzumab has significantly changed the natural history of HER2-positive breast cancer. However, it is not an affordable treatment option in sub-Saharan African countries. Because of the expense, most patients in our setting do not receive trastuzumab for the optimal control of their disease. Additionally, there is a lack of comprehensive data about the survival outcomes of HER2-positive breast cancer patients in our setting. The present study was aimed at determining the survival outcomes among HER2-positive breast cancer patients at the Oncology Department of Kenyatta National Hospital.</p><p><strong>Methods: </strong>A hospital-based retrospective cohort design was used to evaluate the survival outcomes among patients with HER2-positive breast cancer treated from 1<sup>st</sup> January 2015 to 31<sup>st</sup> December 2019 at Kenyatta National Hospital. A total of 50 eligible HER2-positive breast cancer patients were included in the study. In the predesigned data abstraction tool, data were collected by reviewing the medical records of the patients. The data were entered and analyzed using the Statistical Package for the Social Sciences version 27 software. The mean survival time was estimated using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>The mean age was 45.44 ± 12.218 years, with a majority (80%) of the patients being below 60 years. Most patients (64%) had advanced-stage disease. The median follow-up time for patients with curative stages of breast cancer was 41 months, while the median follow-up time for those with the advanced incurable disease was 8.5 months. The 4-year survival rate was 62.5% for those curable-stage HER2-positive breast cancer compared to 5.6% for those with metastatic disease at presentation.</p><p><strong>Conclusion: </strong>The 4-year survival rate for both early-stage and advanced-stage HER2-positive breast cancer in our setting is suboptimal when compared to existing outcome data from health care systems where trastuzumab is more widely available.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CD44 Variant Exon 6 Isoform Expression as a Potential Predictor of Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type. CD44变异外显子6异构体表达作为无特殊类型浸润性乳腺癌淋巴结转移的潜在预测因子
IF 1.9 Q3 Medicine Pub Date : 2021-12-10 eCollection Date: 2021-01-01 DOI: 10.1155/2021/1586367
Primariadewi Rustamadji, Elvan Wiyarta, Kristina A Bethania

Background: Invasive breast carcinoma of no special type (IBC-NST) is the most widespread invasive carcinoma subtype causing primarily regional metastases of the lymphatic node (LNM). The capacity of CD44 variant exon 6 (CD44v6) expression as an LNM predictor biomarker in IBC-NST was explored.

Methods: We conducted a cross-sectional research with 48 paraffin blocks containing IBC-NST primary tumors that were divided into two groups by LNM. The assessment has been carried out in terms of age, tumor size, tumor grade, lymphovascular invasion (LVI), and CD44v6 expression. The expression of CD44v6 was analyzed on the grounds of immunohistochemical (IHC) staining, while other data were taken from archives. Statistical analysis is carried out by univariate, multivariate, and AUROC.

Results: CD44v6 exhibits a dominant expression in IBC-NST tumor cells. Univariate analysis revealed a significant association between CD44v6 and LNM status (p = 0.001). Multiple logistic regression results showed that CD44v6 expression and LVI were significantly associated with LNM with OR 10.7 (95% CI: 2.43 to 47.08) and 6.22 (95% CI: 1.4 to 27.88), respectively. CD44v6 expression was able to discriminate against LNM with AUROC 0.863 ± 0.053 (95% CI: 0.759 to 0.967) at the H-score cut-off 133.889 (75% sensitivity and 83.3% specificity).

Conclusion: CD44v6 expression and LVI are potential predictors of LNM in IBC-NST. The H-score cut-off of the CD44v6 expression can also be used as a threshold for classification in further investigation.

背景:无特殊类型浸润性乳腺癌(IBC-NST)是最广泛的浸润性癌亚型,主要引起淋巴结(LNM)的区域转移。探讨CD44变异外显子6 (CD44v6)表达作为IBC-NST的LNM预测生物标志物的能力。方法:对48例含IBC-NST原发肿瘤的石蜡块进行横断面研究,经LNM分为两组。根据年龄、肿瘤大小、肿瘤分级、淋巴血管侵袭(LVI)和CD44v6表达进行评估。CD44v6的表达采用免疫组化(IHC)染色,其他数据来源于档案资料。采用单变量、多变量和AUROC进行统计分析。结果:CD44v6在IBC-NST肿瘤细胞中显性表达。单因素分析显示CD44v6与LNM状态之间存在显著相关性(p = 0.001)。多元logistic回归结果显示,CD44v6表达和LVI与LNM显著相关,OR分别为10.7 (95% CI: 2.43 ~ 47.08)和6.22 (95% CI: 1.4 ~ 27.88)。CD44v6表达能够区分LNM, AUROC为0.863±0.053 (95% CI: 0.759 ~ 0.967), h评分截止值为133.889(75%敏感性和83.3%特异性)。结论:CD44v6表达和LVI是IBC-NST发生LNM的潜在预测因子。CD44v6表达的H-score截止值也可作为进一步研究的分类阈值。
{"title":"CD44 Variant Exon 6 Isoform Expression as a Potential Predictor of Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type.","authors":"Primariadewi Rustamadji,&nbsp;Elvan Wiyarta,&nbsp;Kristina A Bethania","doi":"10.1155/2021/1586367","DOIUrl":"https://doi.org/10.1155/2021/1586367","url":null,"abstract":"<p><strong>Background: </strong>Invasive breast carcinoma of no special type (IBC-NST) is the most widespread invasive carcinoma subtype causing primarily regional metastases of the lymphatic node (LNM). The capacity of CD44 variant exon 6 (CD44v6) expression as an LNM predictor biomarker in IBC-NST was explored.</p><p><strong>Methods: </strong>We conducted a cross-sectional research with 48 paraffin blocks containing IBC-NST primary tumors that were divided into two groups by LNM. The assessment has been carried out in terms of age, tumor size, tumor grade, lymphovascular invasion (LVI), and CD44v6 expression. The expression of CD44v6 was analyzed on the grounds of immunohistochemical (IHC) staining, while other data were taken from archives. Statistical analysis is carried out by univariate, multivariate, and AUROC.</p><p><strong>Results: </strong>CD44v6 exhibits a dominant expression in IBC-NST tumor cells. Univariate analysis revealed a significant association between CD44v6 and LNM status (<i>p</i> = 0.001). Multiple logistic regression results showed that CD44v6 expression and LVI were significantly associated with LNM with OR 10.7 (95% CI: 2.43 to 47.08) and 6.22 (95% CI: 1.4 to 27.88), respectively. CD44v6 expression was able to discriminate against LNM with AUROC 0.863 ± 0.053 (95% CI: 0.759 to 0.967) at the H-score cut-off 133.889 (75% sensitivity and 83.3% specificity).</p><p><strong>Conclusion: </strong>CD44v6 expression and LVI are potential predictors of LNM in IBC-NST. The H-score cut-off of the CD44v6 expression can also be used as a threshold for classification in further investigation.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39739991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
期刊
International Journal of Breast Cancer
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