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Sunitinib Combined with Th1 Cytokines Potentiates Apoptosis in Human Breast Cancer Cells and Suppresses Tumor Growth in a Murine Model of HER-2pos Breast Cancer. 舒尼替尼联合Th1细胞因子增强人乳腺癌细胞凋亡并抑制HER-2pos乳腺癌小鼠模型的肿瘤生长
IF 1.9 Q3 Medicine Pub Date : 2021-04-14 eCollection Date: 2021-01-01 DOI: 10.1155/2021/8818393
Nirmala Ghimirey, Chase Steele, Brian J Czerniecki, Gary K Koski, Loral E Showalter

Although immune-based therapies have made remarkable inroads in cancer treatment, they usually must be combined with standard treatment modalities, including cytotoxic drugs, to achieve maximal clinical benefits. As immunotherapies are further advanced and refined, considerable efforts will be required to identify combination therapies that will maximize clinical responses while simultaneously decreasing the unpleasant and sometimes life-threatening side effects of standard therapy. Over the last two decades, evidence has emerged that Th1 cytokines can play a central role in protective antitumor immunity and that combinations of Th1 cytokines can induce senescence and apoptosis in cancer cells. To explore the possibility of combining targeted drugs with Th1-polarizing vaccines, we undertook a study to examine the impact of combining Th1 cytokines with the relatively broad-spectrum receptor tyrosine kinase antagonist, sunitinib. We found that when a panel of five phenotypically diverse human breast cancer cell lines was subjected to treatment with sunitinib plus recombinant Th1 cytokines IFN-γ and TNF-α, synergistic effects were observed across a number of parameters including different aspects of apoptotic cell death. Interestingly, sunitinib was found to have a profoundly suppressive effect of T cell's capacity to secrete IFN-γ, indicating that in vivo use of this drug may hinder robust Th1 responses. Nonetheless, this suppression was circumvented in a mouse model of HER-2pos breast disease by supplying recombinant interferon-gamma to achieve a combination therapy significantly more potent than either agent.

尽管免疫疗法在癌症治疗方面取得了显著进展,但它们通常必须与标准治疗方式(包括细胞毒性药物)联合使用,才能获得最大的临床效益。随着免疫疗法的进一步发展和完善,将需要付出相当大的努力来确定联合疗法,以最大限度地提高临床反应,同时减少标准疗法令人不快的、有时危及生命的副作用。在过去的二十年中,有证据表明Th1细胞因子可以在保护性抗肿瘤免疫中发挥核心作用,并且Th1细胞因子的组合可以诱导癌细胞衰老和凋亡。为了探索靶向药物与Th1极化疫苗联合使用的可能性,我们进行了一项研究,以检查Th1细胞因子与相对广谱受体酪氨酸激酶拮抗剂舒尼替尼联合使用的影响。我们发现,当一组五种表型不同的人类乳腺癌细胞系接受舒尼替尼加重组Th1细胞因子IFN-γ和TNF-α治疗时,在许多参数中观察到协同效应,包括凋亡细胞死亡的不同方面。有趣的是,舒尼替尼被发现对T细胞分泌IFN-γ的能力有深刻的抑制作用,这表明在体内使用这种药物可能会阻碍强大的Th1反应。然而,在HER-2pos乳腺疾病的小鼠模型中,通过提供重组干扰素- γ来实现比任何一种药物更有效的联合治疗,这种抑制被规避了。
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引用次数: 3
Corrigendum to "Breast Cancer Survival and Incidence: 10 Years Cancer Registry Data in the Northwest, Iran". “乳腺癌生存率和发病率:伊朗西北部10年癌症登记数据”的更正。
IF 1.9 Q3 Medicine Pub Date : 2021-02-20 eCollection Date: 2021-01-01 DOI: 10.1155/2021/2604819
Roya Dolatkhah, Mohammad Hossein Somi, Mohammad Asghari Jafarabadi, Mehrnaz Hosseinalifam, Sepideh Sepahi, Mina Belalzadeh, Marzieh Nezamdoust, Saeed Dastgiri

[This corrects the article DOI: 10.1155/2020/1963814.].

[这更正了文章DOI: 10.1155/2020/1963814。]
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引用次数: 0
Clinicopathological and Molecular Characteristics of Pleomorphic Invasive Lobular Carcinoma. 多形性浸润性小叶癌的临床病理及分子特征。
IF 1.9 Q3 Medicine Pub Date : 2020-11-22 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8816824
Jennifer M Segar, Ritu Pandey, Kiah J Farr, Raymond Nagle, Lauren LeBeau, Victor J Gonzalez, Pavani Chalasani

Pleomorphic invasive lobular carcinoma (PILC) is a distinct morphological and biologically aggressive variant of invasive lobular carcinoma (ILC). We hypothesized that was due to de novo activation of PI3K/Akt/mTOR pathway in PILC resulting in higher proliferation rate and markers of cell cycle activation. We identified PILC and ILC tumors and tested for PI3K/Akt/mTOR pathway activation by immunohistochemistry (PTEN and pS6K1) and gene expression analysis (by Nanostring nCounter system). Proliferation index (Ki67) was elevated in 85% of PILCs compared to 20% of ILCs (p < 0.007). PTEN expression was high in all while pS6K1 was high in 8/9 PILCs compared to 3/9 ILCs (p < 0.007). Gene expression analysis shows that PILCs have overexpression of genes involved in cell cycle proliferation, cellular proliferation, DNA damage, and repair genes but no difference in PI3K/Akt/mTOR pathway genes. PILCs are a biologically distinct group of ILC, and clinicopathological characteristics suggest they would have a more clinically aggressive behavior. In addition, our results indicate that PI3k/Akt/mTOR pathway and cell cycle proliferation are activated in majority of these tumors. Further studies are needed to investigate these mechanisms as there are approved therapies available that may benefit PILCs.

多形性浸润性小叶癌(PILC)是浸润性小叶癌(ILC)的一种独特的形态和生物侵袭性变异。我们假设这是由于PILC中PI3K/Akt/mTOR通路的重新激活导致更高的增殖率和细胞周期激活标记物。我们鉴定了PILC和ILC肿瘤,并通过免疫组化(PTEN和pS6K1)和基因表达分析(Nanostring nCounter系统)检测了PI3K/Akt/mTOR通路的激活情况。增殖指数(Ki67)在85%的PILCs中升高,在20%的ILCs中升高(p < 0.007)。PTEN在所有PILCs中均高表达,而pS6K1在8/9 PILCs中表达高于3/9 ILCs (p < 0.007)。基因表达分析显示,PILCs中存在细胞周期增殖、细胞增殖、DNA损伤和修复相关基因的过表达,但PI3K/Akt/mTOR通路基因无差异。PILCs是一种生物学上独特的ILC,临床病理特征表明它们具有更强的临床侵袭性行为。此外,我们的研究结果表明,在大多数这些肿瘤中,PI3k/Akt/mTOR通路和细胞周期增殖被激活。需要进一步的研究来调查这些机制,因为已有批准的治疗方法可能对PILCs有益。
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引用次数: 3
Immunotherapeutic Approaches in Triple-Negative Breast Cancer: State of the Art and Future Perspectives. 癌症三阴性的免疫治疗方法:最新技术和未来展望。
IF 1.9 Q3 Medicine Pub Date : 2020-11-04 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8209173
Karima Oualla, Loay Kassem, Lamiae Nouiakh, Lamiae Amaadour, Zineb Benbrahim, Samia Arifi, Nawfel Mellas

Triple-negative breast cancer (TNBC) is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). It accounts for 15%-20% of all breast cancers and is associated with an aggressive evolution and poor outcomes with the majority of recurrences and deaths occurring in the first 5 years. Chemotherapy remains the mainstay of treatment in the absence of effective targets, but the good understanding of immune tumor microenvironment, the identification of immune-related targets, and the role of tumor-infiltrating lymphocytes (TILs) in TNBC has allowed to develop promising immunotherapeutic strategies for this unique subset of breast cancer. Recently, immunotherapy is being extensively explored in TNBC and clinical trials have shown promising results. In this article, we tried to explain the rationale and mechanisms of targeting the immune system in TNBC, to report the results from recent clinical trials that put immunotherapy as a new standard of care in TNBC in addition to ongoing trials and future directions in the next decade.

癌症三阴性(TNBC)的特征是缺乏雌激素受体(ER)、孕酮受体(PR)和人表皮生长因子受体2(HER2)。它占所有乳腺癌的15%-20%,与侵袭性进化和不良后果有关,大多数复发和死亡发生在前5年。在缺乏有效靶点的情况下,化疗仍然是治疗的主要手段,但对免疫肿瘤微环境、免疫相关靶点的识别以及肿瘤浸润淋巴细胞(TIL)在TNBC中的作用的良好理解,使我们能够为这一独特的癌症亚群开发出有前景的免疫治疗策略。最近,免疫疗法在TNBC中得到了广泛的探索,临床试验显示出了有希望的结果。在这篇文章中,我们试图解释靶向TNBC免疫系统的原理和机制,并报告最近的临床试验的结果,这些试验将免疫疗法作为TNBC的一种新的护理标准,此外还有正在进行的试验和未来十年的方向。
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引用次数: 6
Male Breast Cancer in Togo: Imaging and Clinicopathological Findings. 多哥男性乳腺癌:影像学和临床病理结果。
IF 1.9 Q3 Medicine Pub Date : 2020-08-31 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3056067
Tchin Darre, Mazamaesso Tchaou, Toukilnan Djiwa, Panakinao Simgban, Ayi Kossi Amavi, Bidamin N'Timon, Abdoulatif Amadou, Mayi Bombonne, Bagassam Sama, Koffi Amégbor, Gado Napo-Koura

Background: Breast cancer in men is a rare condition, often diagnosed late. The purpose of this study was to describe its epidemiological, histopathological, and radiographic aspects in Togo.

Materials and methods: This was a descriptive retrospective study on cases of breast cancer in humans diagnosed histologically at the Laboratory of Anatomy Pathological and Imagery of the University Hospital in Lomé, over a period of 25 years (1995 to 2019). The parameters studied were epidemiological, anatomopathological, and imaging.

Results: Eighty-two (82) cases were diagnosed, an annual frequency of 3.28 cases. The mean age was 45 ± 2.5 years; the range was 27-63 years. The family history of 47 patients (57.32%) was known. Carcinomas represented the predominant histological group with predominantly nonspecific invasive carcinoma (87.5%). These cancers were diagnosed at late stages (75.71% grade II). They were mainly of luminal B profile (38.75%) and associated with mutations of the BRCA2 and BRCA1 genes in 14.63% of the cases. The lesions were classified ACR 5 in 61.5% (11/18). Two cases of breast angiosarcoma were diagnosed by the identification of CD31 markers and factor VIII in immunohistochemistry. Hormone therapy such as tamoxifen was prescribed in all luminal patients (43 patients). Radiotherapy was administered to 15 patients (18.3%), with acute toxicity in 20% of the cases. After a median follow-up of 36 months, the evolution was complete remission in 27 patients (32.93%).

Conclusion: Breast cancer in men is rare, often diagnosed late with a poor prognosis.

背景:男性乳腺癌是一种罕见的疾病,通常诊断较晚。本研究的目的是描述其在多哥的流行病学,组织病理学和放射学方面。材料和方法:这是一项描述性回顾性研究,研究对象是25年(1995年至2019年)期间在洛姆罗伊大学医院解剖病理和影像实验室进行组织学诊断的人类乳腺癌病例。研究的参数包括流行病学、解剖病理学和影像学。结果:确诊82例,年发病率3.28例。平均年龄45±2.5岁;年龄范围为27-63岁。有家族史的47例(57.32%)。癌是主要的组织学组,以非特异性浸润性癌为主(87.5%)。这些癌症在晚期被诊断出来(75.71%为II级),它们主要是luminal B谱(38.75%),14.63%的病例与BRCA2和BRCA1基因突变相关。61.5%(11/18)的病变被归为acr5级。通过免疫组织化学CD31标记物及因子VIII的检测,对2例乳腺血管肉瘤进行诊断。所有luminal患者(43例)均给予他莫昔芬等激素治疗。放射治疗15例(18.3%),其中20%有急性毒性。中位随访36个月后,27例患者(32.93%)完全缓解。结论:男性乳腺癌罕见,常诊断较晚,预后较差。
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引用次数: 3
A Systematic Review of the Prevalence and Diagnostic Workup of PIK3CA Mutations in HR+/HER2- Metastatic Breast Cancer. HR+/HER2-转移性乳腺癌中PIK3CA突变的患病率和诊断检查的系统综述
IF 1.9 Q3 Medicine Pub Date : 2020-06-20 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3759179
Elizabeth J Anderson, Lea E Mollon, Joni L Dean, Terri L Warholak, Ayal Aizer, Emma A Platt, Derek H Tang, Lisa E Davis

PIK3CA mutation frequency varies among breast cancer (BC) subtypes. Recent evidence suggests combination therapy with the PI3K inhibitor (PI3Ki) alpelisib and endocrine therapy (ET) improves response rates and progression-free survival (PFS) in PIK3CA-mutant, hormone receptor positive (HR+) BC versus ET alone; thus, better understanding the clinical and epidemiologic elements of these mutations is warranted. This systematic review characterizes the PIK3CA mutation epidemiology, type of testing approaches (e.g., liquid or tissue tumor biopsy), and stability/concordance (e.g., consistency in results by liquid versus solid tumor sample, by the same method over time) in patients with HR+/HER2- advanced (locally unresectable) or metastatic disease (HR+/HER2- mBC) and explores performance (e.g., pairwise concordance, sensitivity, specificity, or predictive value) of respective mutation findings. A comprehensive search of PubMed/MEDLINE, EMBASE, Cochrane Central, and select conference abstracts (i.e., AACR, ASCO, SABCS, ECCO, and ESMO conferences between 2014 and 2017) identified 39 studies of patients with HR+, HER2- mBC. The median prevalence of PIK3CA mutation was 36% (range: 13.3% to 61.5%); identified testing approaches more commonly used tissue over liquid biopsies and primarily utilized next-generation sequencing (NGS), polymerase chain reaction (PCR), or Sanger sequencing. There was concordance and stability between tissues (range: 70.4% to 94%) based on limited data. Given the clinical benefit of the PI3Ki alpelisib in patients with PIK3CA mutant HR+/HER2- mBC, determination of tumor PIK3CA mutation status is of importance in managing patients with HR+/HER2- mBC. Prevalence of this mutation and utility of test methodologies likely warrants PIK3CA mutation testing in all patients with this breast cancer subtype via definitive assessment of PIK3CA mutational status.

PIK3CA突变频率在乳腺癌(BC)亚型中有所不同。最近的证据表明,PI3K抑制剂(PI3Ki) alpelisib和内分泌治疗(ET)联合治疗可提高pik3ca突变,激素受体阳性(HR+) BC的缓解率和无进展生存期(PFS)。因此,更好地了解这些突变的临床和流行病学因素是必要的。本系统综述描述了HR+/HER2晚期(局部不可切除)或转移性疾病(HR+/HER2- mBC)患者的PIK3CA突变流行病学、检测方法类型(例如,液体或组织肿瘤活检)和稳定性/一致性(例如,液体和实体肿瘤样本结果的一致性),并探讨了各自突变发现的表现(例如,两两一致性、敏感性、特异性或预测值)。综合检索PubMed/MEDLINE、EMBASE、Cochrane Central和精选会议摘要(即2014年至2017年间的AACR、ASCO、SABCS、ECCO和ESMO会议),确定了39项HR+、HER2- mBC患者的研究。PIK3CA突变的中位患病率为36%(范围:13.3% ~ 61.5%);确定了比液体活检更常用的组织检测方法,主要使用新一代测序(NGS)、聚合酶链反应(PCR)或桑格测序。基于有限的数据,组织间存在一致性和稳定性(范围:70.4%至94%)。鉴于PI3Ki alpelisib在PIK3CA突变HR+/HER2- mBC患者中的临床益处,确定肿瘤PIK3CA突变状态对于HR+/HER2- mBC患者的管理具有重要意义。这种突变的普遍性和检测方法的实用性可能需要通过对PIK3CA突变状态的明确评估,对所有患有这种乳腺癌亚型的患者进行PIK3CA突变检测。
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引用次数: 31
Breast Cancer Survival and Incidence: 10 Years Cancer Registry Data in the Northwest, Iran. 乳腺癌生存率和发病率:伊朗西北部10年癌症登记数据
IF 1.9 Q3 Medicine Pub Date : 2020-05-01 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1963814
Roya Dolatkhah, Mohammad Hossein Somi, Mohammad Asghari Jafarabadi, Mehrnaz Hosseinalifam, Sepideh Sepahi, Mina Belalzadeh, Marzieh Nezamdoust, Saeed Dastgiri

Methods: Data were obtained from East Azerbaijan cancer registry database for the 10-year period between 2007 and 2016. Survival analysis was performed to calculate the breast cancer-specific survival proportions and mortality rates. Joinpoint trend analysis was performed to estimate the incidence trend of the cancer.

Results: A total number of 4989 patients were recorded with primary diagnosis of breast cancer. Of them, we collected follow-up data for 1335 (1309 female and 26 male). The 10-year crude mortality rate was 3.34 (per 100,000). The one-, two-, three-, five-, and ten-year breast cancer-specific survival proportions were 0.92 (95% CI 0.91-0.93), 0.88 (95% CI 0.86-0.90), 0.84 (95% CI 0.83-0.86), 0.77 (95% CI 0.74-0.80), and 0.65 (95% CI 0.60-0.70), respectively. Over the study period, the age-standardized incidence rates increased from 21.68 to 36.99 (per 100,000) with an annual percentage change of 5.5 percent. Older individuals and males patients had significantly worse survival, and patients with high-grade tumors had significantly higher risk of mortality.

Conclusion: A relatively better survival for breast cancer in East Azerbaijan, Iran, was observed compared to the overall breast cancer-specific survival proportions and mortality rates in the country. However, it is still poor compared to the developed countries indicating that inappropriate treatment modalities might have played a role on this.

方法:数据来自2007年至2016年东阿塞拜疆癌症登记数据库。进行生存分析,计算乳腺癌特异性生存率和死亡率。采用联合点趋势分析估计肿瘤的发病趋势。结果:本组共4989例初诊乳腺癌患者。其中,我们收集了1335例(女性1309例,男性26例)的随访资料。10年粗死亡率为3.34(每10万人)。1年、2年、3年、5年和10年乳腺癌特异性生存率分别为0.92 (95% CI 0.91-0.93)、0.88 (95% CI 0.86-0.90)、0.84 (95% CI 0.83-0.86)、0.77 (95% CI 0.74-0.80)和0.65 (95% CI 0.60-0.70)。在研究期间,年龄标准化发病率从21.68上升到36.99(每10万人),年增长率为5.5%。老年人和男性患者的生存率明显较差,恶性肿瘤患者的死亡率明显较高。结论:与该国总体乳腺癌特异性生存率和死亡率相比,观察到伊朗东阿塞拜疆的乳腺癌生存率相对较高。然而,与发达国家相比,它仍然很差,这表明不适当的治疗方式可能在这方面发挥了作用。
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引用次数: 28
Association between Lymph Node Status and Expression Levels of Androgen Receptor, miR-185, miR-205, and miR-21 in Breast Cancer Subtypes. 乳腺癌亚型中淋巴结状态与雄激素受体miR-185、miR-205和miR-21表达水平的关系
IF 1.9 Q3 Medicine Pub Date : 2020-04-23 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3259393
Tatiana S Kalinina, Vladislav V Kononchuk, Alisa K Yakovleva, Efim Y Alekseenok, Sergey V Sidorov, Lyudmila F Gulyaeva

Breast cancer is the most commonly diagnosed cancer among women. Difficulties in treating breast cancer are associated with the occurrence of metastases at early stages of disease, leading to its further progression. Recent studies have shown that changes in androgen receptor (AR) and microRNAs' expressions are associated with mammary gland carcinogenesis, in particular, with the formation of metastases. Thus, to identify novel metastatic markers, we evaluated the expression levels of AR; miR-185 and miR-205, both of which have been confirmed to target AR; and miR-21, transcription of which is regulated by AR, in breast cancer samples (n = 89). Here, we show that the molecular subtypes of breast cancer differ in the expression profiles of AR and AR-associated microRNAs. In addition, the expression of AR and these microRNAs may depend on the expression of PR, ER, and HER2 receptors. Our results show that the possibility of using AR and microRNAs as markers depends on the tumor subtype: a decrease in AR expression may be the marker for the presence of lymph node metastases in patients with HER2-positive subtypes of breast cancer, and disturbance of miR-205, miR-185, and miR-21 expressions may be the marker in patients with a luminal B HER2-positive subtype. Cases with metastases in this type of breast cancer are characterized by a higher level of miR-205 and a lower level of miR-185 and miR-21 in tumor tissues compared to nonmetastatic cases. A decrease in the miR-185 level is also associated with lymph node metastasis in luminal B HER2-negative breast cancer. Thus, the expression levels of AR, miR-185, miR-205, and miR-21 can serve as markers to predict cancer spread to the lymph node in luminal B- and HER2-positive subtypes of breast cancer.

乳腺癌是女性中最常见的癌症。治疗乳腺癌的困难与疾病早期发生转移有关,导致其进一步发展。近年来的研究表明,雄激素受体(AR)和microrna表达的变化与乳腺癌的发生,特别是转移的形成有关。因此,为了鉴定新的转移标志物,我们评估了AR的表达水平;miR-185和miR-205,它们都已被证实靶向AR;和miR-21,其转录受AR调节,在乳腺癌样本中(n = 89)。在这里,我们发现乳腺癌的分子亚型在AR和AR相关的microrna的表达谱上存在差异。此外,AR和这些microrna的表达可能依赖于PR、ER和HER2受体的表达。我们的研究结果表明,使用AR和microrna作为标志物的可能性取决于肿瘤亚型:AR表达降低可能是her2阳性乳腺癌亚型患者存在淋巴结转移的标志,miR-205, miR-185和miR-21表达紊乱可能是管腔B her2阳性亚型患者的标志。与非转移病例相比,这类乳腺癌转移病例的特点是肿瘤组织中miR-205水平较高,miR-185和miR-21水平较低。miR-185水平的降低也与管腔B her2阴性乳腺癌的淋巴结转移有关。因此,AR、miR-185、miR-205和miR-21的表达水平可以作为乳腺癌腔内B-和her2阳性亚型中预测肿瘤向淋巴结转移的标志物。
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引用次数: 10
Female Breast Cancer Patients, Mastectomy-Related Quality of Life: Experience from Ethiopia. 女性乳腺癌患者,乳房切除术相关的生活质量:来自埃塞俄比亚的经验。
IF 1.9 Q3 Medicine Pub Date : 2020-04-09 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8460374
Engida Abebe, Kassaw Demilie, Befekadu Lemmu, Kirubel Abebe

Background: Mastectomy is the most common form of treatment for a developing-nation woman diagnosed with breast cancer. This can have huge effect on a women's quality of life.

Objective: To assess mastectomy-related quality of life in female breast cancer patients.

Materials and methods: A facility-based cross-sectional descriptive study was conducted from February 1st to July 30th, 2018. A pretested structured data collection format was used to interview patients. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Breast Cancer-Specific (EORTC QLQ-BR23) were used to evaluate quality of life, functional capacity, and symptom scales. Data was analyzed with SPSS version 23.

Results: The mean age of the 86 patients was 43.2 years (SD ± 11.4) and ranged from 25 to 70 years. 54.7% (47) of patient's mastectomy was done on the right side. Based on EORTC QLQ-C30 global health status/QOL scale, the mean score was 48.3. On the evaluation of EORTC QLQ-BR23, future perspective about their health was low with a mean of 40.3 and their sexual functioning and enjoyment were significantly affected with mean scores of 85.3 and 71.2, respectively. Symptom scales were low with mean from 19.1 to 24.5. Majority (49, 57%) of respondents do not want to have breast reconstruction after mastectomy.

Conclusion: Our breast cancer patients who underwent mastectomy performed poor in terms of quality of life as compared to international findings which demands attention in incorporating psychosocial aspects in the treatment plan.

背景:乳房切除术是发展中国家诊断为乳腺癌的妇女最常见的治疗形式。这对女性的生活质量有很大的影响。目的:评价女性乳腺癌患者行乳房切除术后的生活质量。材料和方法:于2018年2月1日至7月30日进行基于设施的横断面描述性研究。采用预先测试的结构化数据收集格式对患者进行访谈。采用欧洲癌症研究与治疗组织生活质量问卷- core 30 (EORTC QLQ-C30)和乳腺癌特异性问卷(EORTC QLQ-BR23)评估生活质量、功能能力和症状量表。数据分析采用SPSS version 23。结果:86例患者平均年龄43.2岁(SD±11.4),年龄25 ~ 70岁。54.7%(47)的患者右侧乳房切除术。根据EORTC QLQ-C30全球健康状态/生活质量量表,平均得分为48.3分。在EORTC QLQ-BR23评价中,女性对健康的未来展望较低,平均得分为40.3分,对性功能和性享受的影响显著,平均得分分别为85.3分和71.2分。症状量表较低,平均值为19.1 ~ 24.5。大多数受访者(49.57%)不希望在乳房切除术后进行乳房重建。结论:与国际研究结果相比,我国接受乳房切除术的乳腺癌患者的生活质量较差,这需要在治疗计划中纳入心理社会方面的关注。
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引用次数: 8
Clinicopathological and Prognostic Characteristics of Malaysian Triple Negative Breast Cancer Patients Undergoing TAC Chemotherapy Regimen. 马来西亚三阴性乳腺癌患者TAC化疗方案的临床病理和预后特点。
IF 1.9 Q3 Medicine Pub Date : 2020-04-01 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8424365
Ahmad Aizat Abdul Aziz, Md Salzihan Md Salleh, Ravindran Ankathil

Triple negative breast cancer (TNBC) is associated with aggressive tumour phenotype and early tumour relapse following diagnosis. Generally, clinicopathological features such as tumour size, patient's age at diagnosis, tumour histology subtypes, grade and stage, involvement of lymph nodes, and menopausal status are commonly used for predicting disease progression, prospects of recurrence, and treatment response. Prognostic value of clinicopathological features on Malaysian TNBC patients is limited. Thus, this study is aimed at investigating the association of clinicopathological features on disease-free survival (DFS) and overall survival (OS) of Malaysian TNBC patients undergoing TAC chemotherapy. Seventy-six (76) immunohistochemistry-confirmed TNBC patients were recruited. The clinicopathological features of TNBC patients were collected and recorded. Kaplan-Meier and log-rank followed by a Cox proportional hazard regression model were performed to evaluate the TNBC patients' survival. Out of 76 TNBC patients, 25 were chemoresistant and 51 were chemoresponders to the TAC chemotherapy regimen. The overall 5-year cumulative DFS and OS of TNBC patients were 63.5% and 76.3%, respectively. Multivariate Cox analysis demonstrated that medullary and metaplastic histology subtypes and positive axillary lymph node metastasis were significant prognostic factors associated with relapse with adjusted HR: 5.76, 95% CI: 2.35, 14.08 and adjusted HR: 3.55, 95% CI: 1.44, 8.74, respectively. Moreover, TNBC patients with medullary and metaplastic histology subtypes and positive axillary lymph node metastases had a higher risk to death than patients who had infiltrating ductal carcinoma and negative axillary lymph node metastasis (adjusted HR: 8.30, 95% CI: 2.38, 28.96 and adjusted HR: 6.12, 95% CI: 1.32, 28.42, respectively). Our results demonstrate the potential use of medullary and metaplastic histology subtype and positive axillary lymph node metastasis as a potential biomarker in predicting relapse and survival of the TNBC patients. This warrants further studies on intensification of chemotherapy and also identification and development of targeted therapy to reduce relapses and improve survival of TNBC patients.

三阴性乳腺癌(TNBC)与侵袭性肿瘤表型和诊断后早期肿瘤复发相关。通常,临床病理特征,如肿瘤大小、患者诊断时的年龄、肿瘤组织学亚型、分级和分期、淋巴结的累及程度和绝经状态,通常用于预测疾病进展、复发前景和治疗反应。临床病理特征对马来西亚TNBC患者的预后价值有限。因此,本研究旨在探讨马来西亚TNBC患者接受TAC化疗的临床病理特征与无病生存期(DFS)和总生存期(OS)的关系。招募了76例经免疫组织化学证实的TNBC患者。收集并记录TNBC患者的临床病理特征。采用Kaplan-Meier、log-rank及Cox比例风险回归模型评价TNBC患者的生存率。76例TNBC患者中,25例化疗耐药,51例化疗对TAC化疗方案有反应。TNBC患者总体5年累计DFS和OS分别为63.5%和76.3%。多因素Cox分析显示,髓质和化脓性组织学亚型以及腋窝淋巴结阳性转移是与复发相关的重要预后因素,调整后危险度分别为5.76,95% CI为2.35,14.08,调整后危险度为3.55,95% CI为1.44,8.74。此外,髓质和化生组织学亚型、腋窝淋巴结转移阳性的TNBC患者的死亡风险高于浸润性导管癌、腋窝淋巴结转移阴性的患者(调整后的HR分别为8.30,95% CI为2.38、28.96,调整后的HR为6.12,95% CI为1.32、28.42)。我们的研究结果表明,髓质和化生组织学亚型和腋窝淋巴结阳性转移可能作为预测TNBC患者复发和生存的潜在生物标志物。这需要进一步研究强化化疗,并确定和开发靶向治疗,以减少复发和提高TNBC患者的生存。
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引用次数: 7
期刊
International Journal of Breast Cancer
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