Journal of Buon最新文献

Coronavirus-related Severe Acute Respiratory Syndrome (SARS-CoV) in 2002/2003, Middle-East Respiratory Syndrome (MERS-Cov) in 2012/2013, and especially the current 2019/2020 Severe Acute Respiratory Syndrome-2 (SARS-CoV-2) tested the national health systems' endurance worldwide. In order to fight this emergency situation, a variety of pharmaceutical companies focused on the design and development of efficient vaccines that are considered necessary for providing a level of normalization in totally affected human social-economical activity worldwide. COVID-19 led to an increased uncertainty in the field of oncological patients' management disrupting the normal conditions of therapeutic and monitoring procedures. In the current article, we explored the impact of SARS-CoV-2 infection on oral carcinoma patients. We observed COVD-19 pandemic negatively affects the normality regarding early diagnosis and optimal management (surgical operation, post-operational follow up/monitoring) in HNSCC/OSCC patients. Understanding the involvement of SARS-CoV-2 in the progression of malignancies is the first critical step for targeting the virus by efficient monoclonal antibodies and vaccines.

Molecular biology of cancer cell is a domain of medical science that is rapidly growing in our days. Knowing the ways and paths that cancer cells follow is crucial to the prevention of cancer itself. Central role to these paths, concerning the cell cycle and the process of apoptosis, has the protein p53. The whole mechanism of the cell cycle is activated by the action of various mitogens, such as growth factors, hormones and cytokines. Carcinogenesis involves alterations of genes (proto-oncogenes and tumor suppressor genes), which encode proteins of the signal transduction. Many of the damages that lead to carcinogenesis may be due to the lack of repressive signals for cell division, but also to the absence of the sensitivity of cells to repressive signals. The cell has mechanisms of receiving apoptotic-antitumor signals and mechanisms of execution of these instructions. A percentage of cancers (4-8%) are etiologically linked to germ (stem) cells mutations and occur at an increased frequency in families (hereditary cancers). Substantial progress in understanding the mechanisms of carcinogenesis, filtration and metastasis of cancer has highlighted the key role of specific genes, primarily oncogenes and tumor suppressor genes.

Cancer-related lymphedema is the result of surgical operation or radiation therapy of the corresponding lymph nodes and is due to the obstruction of the lymphatic drainage in the affected area. In lymphedema the lymphatic stasis causes an inflammatory reaction that leads to the proliferation of adipose tissue and fibrosis, resulting in mild to severe permanent swelling of the affected part of the body. It is more often found in the upper extremities of women with breast cancer. It may, however, appear at one or more extremities and may include the corresponding quadrant of the trunk. It may also affect head and neck, breast, genitals and lower extremities, depending on the surgery the patient has undergone. It is often associated with obesity (BMI>40). Early diagnosis and treatment of lymphedema is related with better therapeutic outcome. Women with breast cancer confront more problems with lymphedema than with mastectomy. Its effect on patients' quality of life is relevant to changes in body image, self-esteem, feelings of weakness, fear and anxiety about disease progression, financial costs, and reduced limb function. More recent studies support the effectiveness of contemporary surgical techniques in lymphedema's treatment. In conservative management, CDT remains the treatment of choice and in combination with exercise, weight control programs and self-care training seems to significantly improve patients' quality of life.

Purpose: The aim of the present study is to evaluate the concordance between preoperative endometrial sampling histopathology performed by conventional dilatation and curettage (D&C) and final histopathological diagnosis after total hysterectomy concerning tumor grade and subtype in patients with endometrial cancer (EC).

Methods: In this comparative retrospective study, 203 women with endometrial cancer were included who underwent at first dilatation and curettage and then total hysterectomy. The preoperative histopathological report obtained by dilatation and curettage was compared with the final histopathology after total hysterectomy to assess the accuracy of endometrial sampling.

Results: Comparison of preoperative with postoperative histopathological results showed an overall 5.9% and 10.9% discordance regarding endometrial cancer histological subtype and grade, respectively. Six (4.9%) of the patients with preoperative grade 1 were grade 2 and 1 (0.8%) was found to be grade 3. Three (8.3%) of the patients with preoperative grade 2 were found to be grade 3 after hysterectomy. Discordance is higher for endometrioid endometrial cancer grade 2 (25%) compared with grade 1 (5.7%) and 3 (18.8%).

Conclusion: Patients should be informed and consent for the potential discrepancy between the pre and postoperative histopathological features of malignancy. This discrepancy may result in either under or overtreatment. Thus, it should be accounted for when counseling for a major operation.

Purpose: To evaluate the sexual functions of prostate cancer patients receiving radiotherapy (RT) with curative intent.

Methods: Fifty patients with low-risk prostate cancer who responded to the international index of erectile function (IIEF) questionnaire before and after RT were included in the study Results: Statistically significant decline was observed in sexual functions by the end of RT. While the average sexual desire scores of the patients before RT was 6.24, it decreased to 3.62 (p=0.001) after RT. The average of sexual satisfaction scores dropped from 8.94 to 4.6 (p=0.001), the average of erection function scores dropped from 20.14 to 11.76 (p=0.001), orgasmic function scores dropped from 9.6 to 3.9 (p=0.001) and the average of overall satisfaction scores dropped from 7.48 to 4.36 (p=0.001).

Conclusion: Sexual functions evaluated by the IIEF questionnaire decrease by the end of RT.

Purpose: The neutrophil-to-lymphocyte ratio (NLR) is an accessible marker from a routine blood test. This study explored the prognostic and predictive value of a change in NLR (c-NLR) after chemotherapy, baseline NLR (bNLR) and chemotherapy response, in metastatic gastric cancer (mGC) patients.

Methods: A total of 116 mGC patients treated between 2009 to 2019 at seven hospitals from Galician Research Group on Digestive Tumors (GITuD) were reviewed in a multicentre, ambispective and observational study. NLR was calculated and the optimal cut-off was defined as NLR=3.96 based on ROC method. NLR was determined at baseline and after two chemotherapy cycles in first line treatment. Change NLR was calculated as NLR after two chemotherapy cycles minus bNLR. The relation of bNLR and c-NLR to overall survival (OS) was evaluated by Kaplan-Meier method and compared by log-rank test. Dynamic Score (DScore) based on c-NLR and baseline NLR were correlated with OS and radiological response. Univariate, multivariate and chi-square analyses were performed.

Results: Median patient age was 68.7 years, and 66% were male. Univariate analysis showed OS correlation for bNLR ≥3.96 (5.97 vs 10.87 months, p=0.001), c-NLR increase (6.63 vs 10.34 months, p=0.021) and DScore (12.74 vs 7.68 vs 2.43 months, p<0.001). High DScore was associated with radiological progression after two cycles (x2=10.26, p=0.006). Multivariate analysis: bNLR ≥3.96 (HR=2.16, p=0.003) and c-NLR increase (HR= 2.36, p=0.003) were prognostic factors of poor OS.

Conclusion: High bNLR and increased NLR after chemotherapy were associated with worse outcome. Dynamic measurement of NLR provides information for stratifying patients to guide optimal treatment.

Purpose: To investigate the difference of clinicopathologic characteristics and prognosis between invasive papillary carcinoma (IPC) and invasive ductal carcinoma (IDC) in breast cancer patients, and to further confirm the influence of molecular subtype on prognosis of IPC.

Methods: A total of 158,132 eligible patients from 2010 to 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database, of which 348 patients were IPC and 157,784 patients were IDC. We assessed the clinicopathologic characteristics, molecular subtypes and prognostic value of IPC and compared them with those of IDC.

Results: IPC was more frequently presented with older age at diagnosis, less proportion of married and white race, lower grade, smaller tumor size, higher rates of negative nodal status, more AJCC stage I disease and HR+/Her2- breast cancer, and was less likely to be treated with mastectomy, chemotherapy, and radiation therapy than IDC (p<0.05). IPC had a better 5-year breast cancer-specific survival (BCSS) and overall survival (OS) rates than IDC. After adjusting confounding and matching the confounding factors, IPC patients were still associated with better BCSS. Regarding patients with specific subtypes, patients with IPC had more HR+/Her2- subtypes. In addition, HR+/Her2--IPC patients had a better BCSS than HR+/Her2--IDC patients, but OS was similar between the two groups. However, BCSS and OS did not differ in the two groups after matching the confounding factors. Subgroup analysis indicated that molecular subtype may be the main confounding factor in IPC prognosis.

Conclusions: IPC showed more favorable behavior than IDC, but prognosis was not as favorable as people once thought. The determination of the appropriate therapeutic regimen for IPC still needs to be made according to risk factors such as histological grade, pathological stage and molecular subtype.

Purpose: An early diagnosis is of great significance in improving the survival rate of patients. At present, the application values of different diagnostic methods in ovarian cancer are different, and the clinical diagnosis alone is not ideal. Therefore, this study explored the application value of Doppler ultrasound combined with CA125 and CA19.9 in the early diagnosis of epithelial ovarian cancer.

Methods: A total of 58 patients with ovarian diseases were divided into an observation group (epithelial ovarian cancer group, n=29) and a control group (benign ovarian tumour group, n=29). Doppler ultrasound results and serum CA125 and CA19.9 detection results of the two groups were collected to analyse and compare the application values of ultrasound and different kinds of tumour markers in the early diagnosis of epithelial ovarian cancer.

Results: The results of Doppler ultrasound showed that the resistance index of the blood flow in the observation group was lower than that in the control group, and the ultrasound score was higher than that in the control group (p<0.05). The levels of serum tumour markers CA125 and CA19.9 in the observation group were significantly higher than those in the control group (p<0.05). The results of the repeated measurement analysis of variance showed that there were significant differences in the ultrasound score, blood flow resistance index, and CA125 and CA19.9 levels in different stages of ovarian cancer (p<0.05). There was no difference in the ultrasonographic score between stage I and the partum stage, while the stages of menstruation and implantation showed a gradually increasing trend (p<0.05). The blood flow resistance index and CA125 and CA19.9 levels increased gradually with the stage (p<0.05). The sensitivity (93.1%), specificity (96.55%), positive predictive value (96.43%), negative predictive value (93.33%) and diagnosis rate (94.83%) of Doppler ultrasonography combined with CA125 and CA19.9 in the diagnosis of epithelial ovarian cancer were higher than those of the single indicator detection method or the two combined diagnostic detection methods.

Conclusion: Doppler ultrasound combined with CA125 and CA19.9 has high sensitivity, high specificity and high coincidence rate and can improve the early clinical diagnosis of epithelial ovarian cancer.

Purpose: The characteristics of pathogenic microbes are useful for understanding the microbe-driven tumorigenesis. There is a lack of studies on the lung microecology for lung cancer (LC) patients without any respiratory infection. In this work, we aimed to describe the profiles of pathogenic microbes in lung microenvironment of non-small cell lung cancer (NSCLC) patients using pathogen targeted sequencing and 16S rDNA sequencing.

Methods: A total of 22 NSCLC patients (13 adenocarcinomas and 9 squamous cell carcinomas) without any pulmonary infection were enrolled. Among them, we collected 15 pieces of tumor tissues, 5 pieces of peritumoral tissues, 6 blood serum samples, and 5 broncho-alveolar lavage fluid (BALF) samples. Pathogen targeted sequencingand16S rDNA sequencing was performed for microbial classification.

Results: The pathogen targeted sequencing results showed that 33, 14, 11, and 27 pathogenic microorganisms were detected in tumor tissues, peritumoral tissues, blood samples, and BALF, respectively. No common microorganisms were shared by four sample types. However, some common elements were shared by three sets: Streptococcus cristatus, Enterococcus, Staphylococcus haemolyticus, Corynebacterium pseudodiphtheria, Acinetobacter jungii, Haemophilus haemolyticus and Haemophilus parainfluenzae. Based on the 16S rDNA sequencing of two BALF samples, there were 104 OTUs found in one BALF sample and 127 OTUs in the other BALF sample; among them, there were 82 common ones, such as OTU1, OTU10, OTU101, OTU105, OTU106, and so on. Based on the above microbial classification and abundance, there might be enriched function in COG terms like COG1132, COG0438 and COG0745, and KEGG terms like K06147, K02029, and K09687.

Conclusion: This study emphasizes the role of the microbiome in LC patients without respiratory infection. These potential biomarkers of LC based on the taxonomic composition of pathogenic microorganisms might have clinical application.

Purpose: To explore the effect of erythropoietin-producing hepatocellular receptor A5 (EPHA5) on the stemness of non-small cell lung cancer cells and its molecular mechanism.

Methods: Highly-expressed EPHA5 in NCI-H460 and NCI-H1229 cells was silenced. After EPHA5 silencing, the positive expression level of cluster of differentiation 133 (CD133) in NCI-H460 and NCI-H1229 cells was detected by flow cytometry, and the expression levels of stemness markers sex determining region Y-box 2 (Sox2), Nanog, Kruppel-like factor 4 (KLF4) and octamer-binding transcription factor 4 (Oct4) in cells were detected by Western blotting.

Results: The expression level of EPHA5 in non-small cell lung cancer H460 and H1229 cells was higher than that in A549 and SPC-A1 cells. After EPHA5 silencing, the levels of CD133 and stemness markers Sox2, Nanog, KLF4 and Oct4 in H460 and H1229 cells all declined. CCK-8 assay showed that Wnt agonists at a concentration of 2.5 and 5 μm had little effect on the proliferative activity of H460 and H1229 cells. Western blotting revealed that Wnt agonists at a concentration of 5 μm could better enhance the expression of β-catenin. After treatment with Wnt agonists, the expression of CD133 in H460 and H1229 cells with EPHA5 silencing by siRNA3 was higher than that before treatment, and the expression levels of Sox2, Nanog, KLF4 and Oct4 in the above two cells were also increased compared with those before treatment. However, the levels of the above indexes were all lower after treatment with Wnt agonists than those before silencing.

Conclusion: Activating the Wnt signaling pathway can induce the increase in EPHA5 expression and enhance the stemness of non-small cell lung cancer cells.