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Contemporary views on the clinical, epidemiological and molecular genetic characteristics of melanoma of the skin and mucous membranes 关于皮肤和粘膜黑色素瘤的临床、流行病学和分子遗传学特征的当代观点
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-22-30
V. A. Bogdanova, L. V. Spirina, S. U. Chizhevskaya, I. V. Kovaleva, K. V. Nikulnikov
Melanoma of the skin and mucous membranes remains a global medical problem, which is associated with the increasing prevalence of this disease and the lack of adequate molecular genetic markers for its diagnosis and prognosis. The development of molecular approaches in the treatment of this type of tumor is associated with the identification of mutations, and with the development of immunotherapeutic and targeted drugs that can improve the effectiveness of treatment of patients with this pathology. However, the heterogeneity of the mechanisms of tumor development and the formation of resistance are a problem. It is worth noting the presence of many epigenetic mechanisms that are promising markers of the development, diagnosis and prognosis of the effectiveness of treatment of melanoma of the skin and mucous membranes. This review contains up-to-date information on the molecular mechanisms of the disease associated with the genetic characteristics of the tumor and biological factors of resistance to therapy. Of particular interest is the intersection of signaling pathways associated with melanocyte-inducing transcription factor (MITF), which is associated with transcription and growth factors, and is a target of epigenetic regulation using microRNAs and long non-coding RNAs.
皮肤和粘膜黑色素瘤仍然是一个全球性的医学问题,这与该疾病的发病率不断上升以及缺乏适当的分子遗传标记来诊断和预后有关。治疗此类肿瘤的分子方法的发展与突变的识别、免疫治疗药物和靶向药物的开发有关,这些药物可以提高此类病理患者的治疗效果。然而,肿瘤发生机制的异质性和抗药性的形成是一个问题。值得注意的是,有许多表观遗传学机制是皮肤和粘膜黑色素瘤的发展、诊断和预后治疗效果的有希望的标志物。这篇综述包含了与肿瘤遗传特征和抗药性生物因素相关的疾病分子机制的最新信息。尤其值得关注的是与黑色素细胞诱导转录因子(MITF)相关的信号通路的交叉,MITF 与转录和生长因子相关,是利用 microRNA 和长非编码 RNA 进行表观遗传调控的靶点。
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引用次数: 0
Decreasing the ability of HCT116 cells to escape from therapy induced senescence by increasing the duration of doxorubicin treatment 通过延长多柔比星的治疗时间,降低 HCT116 细胞摆脱治疗诱导的衰老的能力
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-90-98
N. Persiyantseva, S. Y. Vikhrova, M. S. Korotkova, D. B. Kazansky, V. V. Tatarsky, M. Zamkova
Contacts: Maria Anatolievna Zamkova zamkovam@gmail.com Introduction. Due to the toxicity of high doses of chemotherapy, low concentrations used in cancer treatment leads to the development of senescence phenotype in tumor cells, characterized by a block in the cell cycle progression and the absence of division; changes in the transcriptional and metabolic profile of cells. A negative consequence of this stage is acquisition of individual cells the ability to escape from senescence and return to re-proliferation.Aim. To estimate the effect of the duration of drug treatment of HCT116 tumor cells on their ability to escape from therapy induced senescence.Materials and methods. The senescence phenotype was confirmed by the analysis of β-galactosidase activity; cell cycle analysis; estimation of protein levels by western blotting. Colonies were stained with crystal violet dye.Results. In our study, we showed that the duration of HCT116 cells incubation with low-dose doxorubicin affects their ability to return to re-proliferation – increasing the treatment time using same drug dose reduces the process of colony formation. The duration of doxorubicin treatment does not affect the formation of the senescence phenotype, which was confirmed by analyzing different markers of this stage (changes in β-galactosidase activity, cell cycle analysis, assessment of p21 and γH2AX protein levels). However, there is a delay in the development of cellular response to DNA damage caused by doxorubicin in cells exposed to prolong treatment protocol (increase in β-galactosidase activity, formation of polyploid cells).Conclusion. The duration of doxorubicin treatment of HCT116 cancer cells affects long-term consequences, reducing the ability of senescent cells to escape this stage when the incubation time with the drug is extended.
联系人: Maria Anatolievna ZamkovaMaria Anatolievna Zamkova zamkovam@gmail.com 简介。由于高剂量化疗的毒性,低浓度化疗在癌症治疗中的使用导致肿瘤细胞衰老表型的形成,其特征是细胞周期进展受阻和不分裂;细胞的转录和代谢谱发生变化。这一阶段的一个消极后果是,单个细胞获得了摆脱衰老和重新增殖的能力。估计药物治疗 HCT116 肿瘤细胞的持续时间对其摆脱治疗诱导的衰老能力的影响。通过β-半乳糖苷酶活性分析、细胞周期分析、Western 印迹法评估蛋白质水平来确认衰老表型。用结晶紫染料对菌落进行染色。我们的研究表明,HCT116 细胞与低剂量多柔比星共培养的时间长短会影响其恢复再增殖的能力--在使用相同剂量药物的情况下,延长治疗时间会减少菌落形成的过程。多柔比星处理时间的长短不会影响衰老表型的形成,这一点已通过分析这一阶段的不同标记物(β-半乳糖苷酶活性变化、细胞周期分析、p21 和 γH2AX 蛋白水平评估)得到证实。然而,细胞对多柔比星造成的 DNA 损伤的反应(β-半乳糖苷酶活性增加、多倍体细胞的形成)的发展会出现延迟。对 HCT116 癌细胞进行多柔比星治疗的时间长短会影响长期后果,延长药物孵育时间会降低衰老细胞摆脱这一阶段的能力。
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引用次数: 0
Transcriptional, growth factors, components of the AKT/mTOR signaling pathway, receptors and ligands of programmed cell death expression in melanoma 黑色素瘤中程序性细胞死亡表达的转录、生长因子、AKT/mTOR 信号通路成分、受体和配体
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-46-54
K. V. Nikulnikov, V. A. Bogdanova, L. V. Spirina, S. U. Chizhevskaya, I. V. Kondakova, E. Choynzonov, V. I. Chernov
Introduction. Melanoma is the most dangerous neoplasm of the skin, characterized by a malignant and aggressive course. Transcriptional and growth factors, components of the AKT/mTOR signaling pathway, receptors and ligands of programmed cell death are involved in significant processes of oncogenesis.Aim. To study the expression of components of the AKT/mTOR (mTOR – mammalian target of rapamycin) signaling pathway, transcription and growth factors, expression of AMPK, LC3B, programmed cell death 1 (PD-1), programmed death-ligand 1 PD-L1 and programmed death-ligand 2 (PD-L2) in skin and mucosal tumor tissues.Materials and methods. The study included 21 patients with a verified diagnosis of melanoma of the skin of various localizations and mucous membranes of the nasal cavity T1a–4bN0M0 (I–IV stages) and 18 patients with basal cell carcinoma of the skin of various localizations T1–4N0M0 (I–VIA stages), aged 45 to 72 years old, who were treated in the department of head and neck tumors of the Cancer Research Institute, Tomsk National Research Medical Center. The presence of tumor ulceration was determined by microscopy and registration of the true absence of the epidermis over the tumor or due to traumatization of the epidermis. Expression of components of the AKT/mTOR signaling pathway, transcription and growth factors, expression of AMPK, LC3B, PD-1, PD-L1 and PD-L2 in the tumor tissue was determined by real-time polymerase chain reaction.Results. An increase in the expression of 70 S6 kinase and VHL was found in melanoma tissues compared to basal cell carcinoma. At the same time, the presence of signs of ulceration was associated with a low level of c-RAF, nuclear factor kappa B (NF-kB) p50 and hypoxia-inducible factor 1 (HIF-1) matrix RNA (mRNA) against the background of an increase in the expression of the hypoxia-inducible factor 2 (HIF-2) transcription factor. The study of the molecular features of neoplasms in relation to the tumor thickness according to Breslow revealed the contribution of transcription and growth factors, the intensity of intracellular signaling processes, modification of the microenvironment, autophagy and neoangiogenesis.Conclusion. The molecular and biological features of melanomas associated with invasive tumor growth have been identified. An increase in the expression of 70 S6 kinase and VHL are characteristic of a malignant skin tumor. The presence of signs of ulceration and tumor invasion were associated with a change in the transcriptional characteristics of factors with the induction of key markers, oncogenesis, which contributes to the formation of the invasive potential of the tumor.
简介黑色素瘤是最危险的皮肤肿瘤,具有恶性和侵袭性的特点。转录因子和生长因子、AKT/mTOR 信号通路成分、受体和程序性细胞死亡配体参与了肿瘤发生的重要过程。研究皮肤和粘膜肿瘤组织中 AKT/mTOR(mTOR--哺乳动物雷帕霉素靶标)信号通路成分、转录和生长因子、AMPK、LC3B、程序性细胞死亡 1(PD-1)、程序性死亡配体 1 PD-L1 和程序性死亡配体 2(PD-L2)的表达。研究对象包括在托木斯克国立研究医疗中心癌症研究所头颈部肿瘤科接受治疗的21名经确诊为不同部位皮肤和鼻腔粘膜黑色素瘤T1a-4bN0M0(I-IV期)患者和18名不同部位皮肤基底细胞癌T1-4N0M0(I-VIA期)患者,他们的年龄在45至72岁之间。肿瘤溃疡的存在是通过显微镜检查和登记肿瘤上表皮的真正缺失或表皮创伤而确定的。通过实时聚合酶链反应测定肿瘤组织中 AKT/mTOR 信号通路成分、转录因子和生长因子的表达,以及 AMPK、LC3B、PD-1、PD-L1 和 PD-L2 的表达。与基底细胞癌相比,黑色素瘤组织中 70 S6 激酶和 VHL 的表达增加。同时,在缺氧诱导因子 2(HIF-2)转录因子表达增加的背景下,溃疡迹象的存在与低水平的 c-RAF、核因子卡巴 B(NF-kB)p50 和缺氧诱导因子 1(HIF-1)基质 RNA(mRNA)有关。根据布雷斯洛理论对肿瘤分子特征与肿瘤厚度的关系进行的研究显示,转录因子和生长因子、细胞内信号转导过程的强度、微环境的改变、自噬和新血管生成都对肿瘤有影响。黑色素瘤的分子和生物学特征与肿瘤的侵袭性生长有关。70 S6 激酶和 VHL 的表达增加是恶性皮肤肿瘤的特征。溃疡和肿瘤侵袭迹象的出现与诱导关键标志物的因子转录特征的变化有关,肿瘤发生有助于肿瘤侵袭潜能的形成。
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引用次数: 0
Genetic factors of thrombosis FII G20210A, FV G1691A (Arg506Gln) in patients with thoracoabdominal malignant tumors 胸腹恶性肿瘤患者血栓形成的遗传因素 FII G20210A、FV G1691A (Arg506Gln)
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-105-112
A. A. Korolyova, S. Gerasimov, L. N. Lyubchenko
Introduction. Malignant tumor is one of the leading factors of venous and arterial thrombosis. But there is no data on the need for a genetic testing protocol of cancer patients for genetic predisposition thrombotic conditions, despite the fact that a number of polymorphisms of hemostasis genes are considered to be unconditionally proven factors of high cumulative thrombogenic risk, and proteins encoded by these genes are direct links in the cascades of pathological hypercoagulation in neoplastic processes.Aim. To identify groups of high genetic risk of thrombotic complications among patients with malignant thoracoabdominal tumors.Materials and methods. The study included 223 patients with malignant tumors of the lung, stomach, esophagus, operated in the Department of Thoracic Oncology of the N.N. Blokhin National Research Center of Oncology in 2018–2019. The study groups consisted of patients with myocardial infarction (n = 62), ischemic stroke (n = 24), venous thrombosis/ venous thromboembolic complications (n = 40), patients without cardiovascular diseases, but with a family history burdened by cardiovascular diseases (n = 33). The control group included 81 patients.Results. Among patients with malignant tumors of thoracoabdominal localization, a statistically significant difference was determined in the frequency of carriage of the heterozygous genotype FV 1691GA (Arg506Gln) in patients who had a myocardial infarction (χ2 = 4.0; p = 0.046), who had venous thrombosis (χ2 = 4.118; p = 0.043), in the group of patients with burdened with a family history (χ2 = 4.997; p = 0.026) in comparison with the control group. Statistically significant difference in the frequency of carriage of the heterozygous variant of the mutation in the FII G20210A gene relative to the control group, it was determined in the group of patients who had an acute cerebrovascular accident (χ2 = 6.881; p = 0.009) and among patients with a burdened history (χ2 = 7.563; p = 0.006).Conclusion. In order to assess the risk of development and prevention of thrombotic complications in the perioperative period in patients with malignant thoracoabdominal tumors, who have suffered myocardial infarction, ischemic stroke, venous thrombosis/venous thromboembolic complications, as well as patients without cardiovascular pathology, but with thrombotic conditions in relatives of the first degree, it is advisable to perform DNA diagnostics at the prehospital stage to identify of gene polymorphisms FII G20210A and FV G1691A (Arg506Gln).
简介恶性肿瘤是静脉和动脉血栓形成的主要因素之一。尽管许多止血基因的多态性被认为是无条件证明的累积性血栓形成高风险因素,而且这些基因编码的蛋白质是肿瘤过程中病理高凝状态级联的直接环节,但目前还没有数据表明有必要对癌症患者进行血栓形成遗传易感性基因检测。确定胸腹恶性肿瘤患者中血栓并发症遗传风险高的人群。研究对象包括2018-2019年在N.N. Blokhin国家肿瘤学研究中心胸部肿瘤科手术的223例肺、胃、食管恶性肿瘤患者。研究组包括心肌梗死患者(n = 62)、缺血性中风患者(n = 24)、静脉血栓/静脉血栓栓塞并发症患者(n = 40)、无心血管疾病但有心血管疾病家族史的患者(n = 33)。对照组包括81名患者。在胸腹局部恶性肿瘤患者中,心肌梗死患者携带杂合基因型 FV 1691GA (Arg506Gln)的频率差异有统计学意义(χ2 = 4.0;p = 0.046)、静脉血栓患者(χ2 = 4.118;p = 0.043)、有家族史负担的患者组(χ2 = 4.997;p = 0.026)中的杂合子基因型 FV 1691GA(Arg506Gln)与对照组相比有显著差异。与对照组相比,发生过急性脑血管意外的患者组(χ2 = 6.881; p = 0.009)和有家族病史的患者组(χ2 = 7.563; p = 0.006)携带 FII G20210A 基因突变杂合变体的频率有统计学意义的差异。为了评估曾患心肌梗死、缺血性脑卒中、静脉血栓/静脉血栓栓塞并发症的胸腹部恶性肿瘤患者在围手术期发生血栓并发症的风险和预防措施,需要对胸腹部恶性肿瘤患者和无心血管并发症的患者在围手术期发生血栓并发症的风险和预防措施进行评估、以及无心血管病变但一级亲属中有血栓形成情况的患者,建议在入院前进行 DNA 诊断,以确定 FII G20210A 和 FV G1691A (Arg506Gln) 基因多态性。
{"title":"Genetic factors of thrombosis FII G20210A, FV G1691A (Arg506Gln) in patients with thoracoabdominal malignant tumors","authors":"A. A. Korolyova, S. Gerasimov, L. N. Lyubchenko","doi":"10.17650/2313-805x-2024-11-1-105-112","DOIUrl":"https://doi.org/10.17650/2313-805x-2024-11-1-105-112","url":null,"abstract":"Introduction. Malignant tumor is one of the leading factors of venous and arterial thrombosis. But there is no data on the need for a genetic testing protocol of cancer patients for genetic predisposition thrombotic conditions, despite the fact that a number of polymorphisms of hemostasis genes are considered to be unconditionally proven factors of high cumulative thrombogenic risk, and proteins encoded by these genes are direct links in the cascades of pathological hypercoagulation in neoplastic processes.Aim. To identify groups of high genetic risk of thrombotic complications among patients with malignant thoracoabdominal tumors.Materials and methods. The study included 223 patients with malignant tumors of the lung, stomach, esophagus, operated in the Department of Thoracic Oncology of the N.N. Blokhin National Research Center of Oncology in 2018–2019. The study groups consisted of patients with myocardial infarction (n = 62), ischemic stroke (n = 24), venous thrombosis/ venous thromboembolic complications (n = 40), patients without cardiovascular diseases, but with a family history burdened by cardiovascular diseases (n = 33). The control group included 81 patients.Results. Among patients with malignant tumors of thoracoabdominal localization, a statistically significant difference was determined in the frequency of carriage of the heterozygous genotype FV 1691GA (Arg506Gln) in patients who had a myocardial infarction (χ2 = 4.0; p = 0.046), who had venous thrombosis (χ2 = 4.118; p = 0.043), in the group of patients with burdened with a family history (χ2 = 4.997; p = 0.026) in comparison with the control group. Statistically significant difference in the frequency of carriage of the heterozygous variant of the mutation in the FII G20210A gene relative to the control group, it was determined in the group of patients who had an acute cerebrovascular accident (χ2 = 6.881; p = 0.009) and among patients with a burdened history (χ2 = 7.563; p = 0.006).Conclusion. In order to assess the risk of development and prevention of thrombotic complications in the perioperative period in patients with malignant thoracoabdominal tumors, who have suffered myocardial infarction, ischemic stroke, venous thrombosis/venous thromboembolic complications, as well as patients without cardiovascular pathology, but with thrombotic conditions in relatives of the first degree, it is advisable to perform DNA diagnostics at the prehospital stage to identify of gene polymorphisms FII G20210A and FV G1691A (Arg506Gln).","PeriodicalId":505368,"journal":{"name":"Advances in Molecular Oncology","volume":"50 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of miRNAs miR-125a-5p, -27a-5p, -193a-5p, -135b-5p, -451a, -495-3p and -136-5p in parental ovarian cancer cells and secreted extracellular vesicles 亲代卵巢癌细胞和分泌的细胞外囊泡中的 miRNAs miR-125a-5p、-27a-5p、-193a-5p、-135b-5p、-451a、-495-3p 和 -136-5p 分析
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-113-123
G. Skryabin, A. A. Beliaeva, A. D. Enikeev, D. Bagrov, A. M. Keremet, А. V. Komelkov, D. S. Elkin, D. M. Sylantieva, E. Tchevkina
Introduction. The identification of markers for liquid diagnostics of ovarian cancer is one of the most urgent tasks of gynecologic oncology. Currently, extracellular vesicles (EVs) are of great interest as a source of oncomarkers, including miRNA markers. We have previously shown that the levels of miR-125a-5p, -27a-5p, -193a-5p and 135b-5p are significantly elevated and miR-451a, -495-3p and -136-5p are significantly decreased in the EVs from uterine aspirates of ovarian cancer patients.Aim. Analysis of miR-125a-5p, -27a-5p, -193a-5p, 135b-5p, 451a, 495-3p and -136-5p levels in ovarian cancer cell cultures and secreted EVs.Material and methods. Cultivation of ovarian cancer cell lines: OVCAR-3, OVCAR-4, OVCAR-8 and SKOV3; EVs isolation from conditioned medium by ultracentrifugation; EVs validation by nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), western blot analysis of exosomal markers; isolation of miRNAs from cells and EVs; analysis of miRNAs by Stem-Loop – reverse transcription-quantitative polymerase chain reaction.Results. In all cell lines studied, the expression of miR-125a-5p, -27a-5p, -193a-5p and -135b-5p significantly exceeds the expression of -451a, -495-3p and -136-5p. All ovarian cancer cell lines are featured by a “cells >EVs” ratio for highly expressed miRNAs and “EVs >cells” ratio for poorly expressed miRNAs.Conclusion. The results of the study support the relation between the differential expression of studied miRNAs and the pathogenesis of ovarian cancer and confirm the high diagnostic potential of these molecules.
导言。鉴定卵巢癌液体诊断标记物是妇科肿瘤学最紧迫的任务之一。目前,细胞外囊泡(EVs)作为包括 miRNA 标记在内的 oncomarkers 的来源备受关注。我们曾研究发现,卵巢癌患者子宫穿刺抽出物的EVs中,miR-125a-5p、-27a-5p、-193a-5p和135b-5p水平明显升高,miR-451a、-495-3p和-136-5p水平明显下降。分析卵巢癌细胞培养物和分泌的 EVs 中 miR-125a-5p、-27a-5p、-193a-5p、135b-5p、451a、495-3p 和 -136-5p 的水平。卵巢癌细胞系的培养:OVCAR-3、OVCAR-4、OVCAR-8 和 SKOV3;通过超速离心从条件培养基中分离 EVs;通过纳米粒子追踪分析(NTA)、透射电子显微镜(TEM)、外泌体标记物的 Western 印迹分析验证 EVs;从细胞和 EVs 中分离 miRNA;通过 Stem-Loop - 反转录-定量聚合酶链反应分析 miRNA。在研究的所有细胞系中,miR-125a-5p、-27a-5p、-193a-5p和-135b-5p的表达量明显高于-451a、-495-3p和-136-5p。所有卵巢癌细胞系的特点是,高表达 miRNAs 的比例为 "细胞>EVs",低表达 miRNAs 的比例为 "EVs>细胞"。研究结果支持所研究的 miRNAs 的差异表达与卵巢癌发病机制之间的关系,并证实这些分子具有很高的诊断潜力。
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引用次数: 0
Immune-phenotyping and transcriptomic profiling of blood monocytes from patients with breast cancer under neoadjuvant chemotherapy 对接受新辅助化疗的乳腺癌患者血液单核细胞进行免疫分型和转录组特征分析
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-79-89
M. Patysheva, M. Stakheyeva, E. S. Grigoryeva, P. Iamshchikov, I. V. Larionova, А. A. Budnickya, N. Tarabanovskaya, N. Cherdyntseva, J. Kzhyshkowska
Introduction. Chemotherapy is a common treatment for breast cancer. Chemotherapeutic drugs effect blood monocytes, which are major contributors to cancer pathogenesis. However, to date, pro-tumor or anti-tumor programming by chemotherapy of monocytes is controversial.Aim. To characterize changes in phenotypic and transcriptomic profiles of monocytes of breast cancer patients before and after chemotherapeutic treatment.Materials and methods. In a cohort of 50 breast cancer patients, monocyte populations were identified based on their expression of CD14, CD16, CD163, and HLA-DR evaluated by flow cytometry before and after neoadjuvant chemotherapy. Bulk RNA sequencing was adopted to explore the transcriptomic profile of CD14+ monocytes before and after treatment. After treatment, we observed an increase in the activity of signaling pathways related to lipid metabolism and intracellular transport of vesicles from the endoplasmic reticulum, against the background of a decreased response to exposure to interferon γ and interferon α, and foreign molecules (exogenous nucleic acids, viruses and bacteria).Results. In breast cancer patients, neoadjuvant chemotherapy decreased in CD14+16+HLA-DR+ monocytes. Under cytostatic treatment, increased gene expression of MGLL, NR4A2, UCK1, YOD1, ABCA2, PAPSS2, ATP10 (log2FoldChange ≥0.8; false discovery rate (FDR) ≤0.01) and decreased gene expression of KPNA2, ERCC4, JAGN1, RUBCNL, SMYD4, B3GALT4 (log2FoldChange ≥0.8; FDR ≤0.01) were observed in monocytes of patients. Using discriminant analysis, the relative numbers of CD14+16–, CD14+16+, CD14-16+, CD14+16-HLA-DR+, CD14+16+HLA-DR+ and CD14–16+HLA-DR+ monocytes in the blood were found to be valuable in predicting response to neoadjuvant chemotherapy.Conclusion. Thus, association of blood monocytes with chemotherapeutic treatment in breast cancer was revealed.
简介化疗是治疗乳腺癌的常用方法。化疗药物会影响血液中的单核细胞,而单核细胞是癌症发病的主要因素。然而,迄今为止,化疗对单核细胞的促癌或抗癌作用仍存在争议。目的:描述化疗前后乳腺癌患者单核细胞表型和转录组特征的变化。在 50 例乳腺癌患者中,根据新辅助化疗前后流式细胞术评估的 CD14、CD16、CD163 和 HLA-DR 的表达情况确定单核细胞群。我们采用大容量 RNA 测序技术来研究 CD14+ 单核细胞在治疗前后的转录组学特征。治疗后,我们观察到与脂质代谢和细胞内内质网囊泡运输有关的信号通路的活性增加,而对干扰素γ、干扰素α和外来分子(外源核酸、病毒和细菌)的反应降低。在乳腺癌患者中,新辅助化疗减少了 CD14+16+HLA-DR+ 单核细胞。在细胞抑制剂治疗下,MGLL、NR4A2、UCK1、YOD1、ABCA2、PAPSS2、ATP10 的基因表达增加(log2FoldChange ≥0.8;假发现率(FDR)≤0.01),患者单核细胞中 KPNA2、ERCC4、JAGN1、RUBCNL、SMYD4、B3GALT4 基因表达减少(log2FoldChange ≥0.8;FDR ≤0.01)。通过判别分析,发现血液中 CD14+16-、CD14+16+、CD14-16+、CD14+16-HLA-DR+、CD14+16+HLA-DR+ 和 CD14-16+HLA-DR+ 单核细胞的相对数量对预测新辅助化疗反应有价值。因此,血液中的单核细胞与乳腺癌化疗的关系是显而易见的。
{"title":"Immune-phenotyping and transcriptomic profiling of blood monocytes from patients with breast cancer under neoadjuvant chemotherapy","authors":"M. Patysheva, M. Stakheyeva, E. S. Grigoryeva, P. Iamshchikov, I. V. Larionova, А. A. Budnickya, N. Tarabanovskaya, N. Cherdyntseva, J. Kzhyshkowska","doi":"10.17650/2313-805x-2024-11-1-79-89","DOIUrl":"https://doi.org/10.17650/2313-805x-2024-11-1-79-89","url":null,"abstract":"Introduction. Chemotherapy is a common treatment for breast cancer. Chemotherapeutic drugs effect blood monocytes, which are major contributors to cancer pathogenesis. However, to date, pro-tumor or anti-tumor programming by chemotherapy of monocytes is controversial.Aim. To characterize changes in phenotypic and transcriptomic profiles of monocytes of breast cancer patients before and after chemotherapeutic treatment.Materials and methods. In a cohort of 50 breast cancer patients, monocyte populations were identified based on their expression of CD14, CD16, CD163, and HLA-DR evaluated by flow cytometry before and after neoadjuvant chemotherapy. Bulk RNA sequencing was adopted to explore the transcriptomic profile of CD14+ monocytes before and after treatment. After treatment, we observed an increase in the activity of signaling pathways related to lipid metabolism and intracellular transport of vesicles from the endoplasmic reticulum, against the background of a decreased response to exposure to interferon γ and interferon α, and foreign molecules (exogenous nucleic acids, viruses and bacteria).Results. In breast cancer patients, neoadjuvant chemotherapy decreased in CD14+16+HLA-DR+ monocytes. Under cytostatic treatment, increased gene expression of MGLL, NR4A2, UCK1, YOD1, ABCA2, PAPSS2, ATP10 (log2FoldChange ≥0.8; false discovery rate (FDR) ≤0.01) and decreased gene expression of KPNA2, ERCC4, JAGN1, RUBCNL, SMYD4, B3GALT4 (log2FoldChange ≥0.8; FDR ≤0.01) were observed in monocytes of patients. Using discriminant analysis, the relative numbers of CD14+16–, CD14+16+, CD14-16+, CD14+16-HLA-DR+, CD14+16+HLA-DR+ and CD14–16+HLA-DR+ monocytes in the blood were found to be valuable in predicting response to neoadjuvant chemotherapy.Conclusion. Thus, association of blood monocytes with chemotherapeutic treatment in breast cancer was revealed.","PeriodicalId":505368,"journal":{"name":"Advances in Molecular Oncology","volume":"27 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of ABC-transporters in homeostasis, cancer pathogenesis and therapy ABC 转运体在体内平衡、癌症发病机制和治疗中的作用
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-8-21
S. Boichuk, T. V. Ivoilova
ABC transporters (ATP Binding Cassette (ABC) transporters) are proteins, which play a dual role in the substances transport across the membrane. On the one hand, they transport nutrients and other molecules inside the cell to supply the necessary nutrients, on the other hand, these proteins excrete some endogenous and exogenous substrates from the cell to maintain their homeostasis in the body and prevent from effects of aggressive environment. ABC transporters play a role in the pathogenesis of various metabolic disorders. In addition, a large amount of evidence has been accumulated about the participation of these proteins in oncogenesis because of their involvement into initiation, progression, invasion and metastasis of tumors, as well as development of multidrug resistance phenotype. Currently, these proteins are attractive therapeutic targets, influence on which can significantly increase the effectiveness of anticancer therapy and improve the prognosis of patients with oncological diseases, including recurrent, metastatic and inoperable forms.The review provides information on drugs that affect the functional activity of ABC transporters and the mechanisms of their action, and also presents the results of clinical trials of these inhibitors.
ABC转运体(ATP结合盒(ABC)转运体)是一种蛋白质,在物质跨膜转运中扮演着双重角色。一方面,它们在细胞内转运营养物质和其他分子,以提供必要的营养物质;另一方面,这些蛋白质将一些内源性和外源性底物排出细胞,以维持体内平衡,防止受到侵袭性环境的影响。ABC 转运体在各种代谢紊乱的发病机制中扮演着重要角色。此外,已有大量证据表明,这些蛋白参与了肿瘤的发生、发展、侵袭和转移,以及多药耐药表型的形成。目前,这些蛋白是极具吸引力的治疗靶点,对它们施加影响可以显著提高抗癌治疗的效果,改善肿瘤疾病(包括复发性、转移性和无法手术的肿瘤)患者的预后。本综述提供了有关影响 ABC 转运体功能活性的药物及其作用机制的信息,还介绍了这些抑制剂的临床试验结果。
{"title":"The role of ABC-transporters in homeostasis, cancer pathogenesis and therapy","authors":"S. Boichuk, T. V. Ivoilova","doi":"10.17650/2313-805x-2024-11-1-8-21","DOIUrl":"https://doi.org/10.17650/2313-805x-2024-11-1-8-21","url":null,"abstract":"ABC transporters (ATP Binding Cassette (ABC) transporters) are proteins, which play a dual role in the substances transport across the membrane. On the one hand, they transport nutrients and other molecules inside the cell to supply the necessary nutrients, on the other hand, these proteins excrete some endogenous and exogenous substrates from the cell to maintain their homeostasis in the body and prevent from effects of aggressive environment. ABC transporters play a role in the pathogenesis of various metabolic disorders. In addition, a large amount of evidence has been accumulated about the participation of these proteins in oncogenesis because of their involvement into initiation, progression, invasion and metastasis of tumors, as well as development of multidrug resistance phenotype. Currently, these proteins are attractive therapeutic targets, influence on which can significantly increase the effectiveness of anticancer therapy and improve the prognosis of patients with oncological diseases, including recurrent, metastatic and inoperable forms.The review provides information on drugs that affect the functional activity of ABC transporters and the mechanisms of their action, and also presents the results of clinical trials of these inhibitors.","PeriodicalId":505368,"journal":{"name":"Advances in Molecular Oncology","volume":"37 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140740025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of circulating neutrophils in the progression of kidney cancer 循环中性粒细胞在肾癌进展中的作用
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-99-104
I. R. Magdieva, T. Abakumova, D. Dolgova, O. Y. Gorshkov, T. P. Gening
Introduction. Currently, the question of the role of neutrophils in the progression of kidney cancer remains relevant. Neutrophils are capable of exhibiting protumor properties through the secretion of cytokines, chemokines, and growth factors, which is determined by the expression of genes for these molecules. And the functional heterogeneity of neutrophils is characterized by differences in gene expression patterns.Aim. To assess the role of circulating neutrophils in the progression of kidney cancer.Materials and methods. In circulating neutrophils of patients with verified clear cell kidney cancer at stages I–III according to Tumor, Nodus and Metastasis (TNM) (n = 88) before surgical treatment and conditionally healthy donors (control group) (n = 20), the expression of NGAL genes was determined using quantitative reverse transcription polymerase chain reaction, MMP-13 and VEGF-A.Results. There was an increase in NGAL gene expression in circulating neutrophils (p = 0.05) at the initial stage and a decrease in it at advanced stages of kidney cancer (p = 0.03). High expression of the MMP-13 gene by circulating neutrophils was detected at all stages of kidney cancer relative to control values (at stage I p = 0.005; at stage II p = 0.003; at stage III p = 0.0008). A significant direct correlation was observed between the expression of the NGAL and MMP-13 genes in neutrophils at stage I kidney cancer (r = 0.696; p = 0.003). In the group of patients with kidney cancer, a direct correlation was found between the expression of the NGAL and VEGF-A genes (r = 0.322; p = 0.049). A multivariable Cox regression model for disease-free survival revealed the predictive value of VEGF-A and NGAL genes expression in circulating neutrophils. With an increase in the expression of the VEGF-A and NGAL genes in neutrophils by 1 unit, the risk of metastases increases by 0.80 (0.65–0.99; p = 0.043) and 1.42 (1.01–2.00; p = 0.046) times, respectively. The Kaplan–Meier analysis of disease-free survival in patients with kidney cancer showed the influence of NGAL expression in circulating neutrophils on progression-free time. In the group of patients with high NGAL expression, the median follow-up was 31.7 months, and in the group with low NGAL expression – more than 36 months (log-rank-test; p = 0.017).Conclusion. Thus, the data obtained suggest that circulating neutrophils play a leading role in the progression of kidney cancer. The level of expression of NGAL in circulating neutrophils can be used to predict the relapse-free period in patients with kidney cancer.
导言。目前,嗜中性粒细胞在肾癌进展过程中的作用这一问题仍具有现实意义。中性粒细胞能够通过分泌细胞因子、趋化因子和生长因子表现出原发性肿瘤特性,而这是由这些分子的基因表达决定的。而中性粒细胞功能异质性的特点是基因表达模式的差异。评估循环中性粒细胞在肾癌进展中的作用。采用定量反转录聚合酶链反应检测手术治疗前根据肿瘤、转移和转移(TNM)分期确诊为 I-III 期透明细胞肾癌患者(88 人)和条件健康供体(对照组)(20 人)循环中性粒细胞中 NGAL 基因、MMP-13 和 VEGF-A 的表达。循环中性粒细胞的 NGAL 基因表达在肾癌初期有所增加(p = 0.05),而在晚期则有所减少(p = 0.03)。与对照值相比,循环中性粒细胞的 MMP-13 基因在肾癌各期均有高表达(I 期 p = 0.005;II 期 p = 0.003;III 期 p = 0.0008)。肾癌 I 期中性粒细胞中 NGAL 和 MMP-13 基因的表达之间存在明显的直接相关性(r = 0.696;p = 0.003)。在肾癌患者组中,NGAL 和 VEGF-A 基因的表达之间存在直接相关性(r = 0.322;p = 0.049)。无病生存率的多变量 Cox 回归模型显示了循环中性粒细胞中 VEGF-A 和 NGAL 基因表达的预测价值。中性粒细胞中的 VEGF-A 和 NGAL 基因表达量每增加 1 个单位,转移风险就会分别增加 0.80 (0.65-0.99; p = 0.043) 倍和 1.42 (1.01-2.00; p = 0.046) 倍。肾癌患者无病生存期的卡普兰-梅耶分析显示,循环中性粒细胞中的NGAL表达对无进展时间有影响。NGAL高表达组患者的中位随访时间为31.7个月,NGAL低表达组患者的中位随访时间超过36个月(log-rank检验;P = 0.017)。因此,获得的数据表明,循环中性粒细胞在肾癌的进展中起着主导作用。循环中性粒细胞中 NGAL 的表达水平可用于预测肾癌患者的无复发期。
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引用次数: 0
The use of T-cells with chimeric antigen receptor (CAR-T) in combination with chemotherapy and radiotherapy for the treatment of solid tumors 使用带有嵌合抗原受体(CAR-T)的 T 细胞与化疗和放疗相结合治疗实体瘤
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-31-45
M. Khaliulin, R. Safin, M. A. Kunst, E. Bulatov
The introduction of chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of hematological diseases, particularly in combating blood cancer. The success of this cell therapy approach has led to the development of approximately seven commercial CAR-T based drugs. However, the application of CAR-T therapy for solid tumors has proven to be less effective due to challenges such as the varied antigens in solid tumors, an immunosuppressive tumor environment, limited immune cell infiltration, reduced CAR-T cell activity and toxicity issues. To solve these problems, scientists are making efforts to improve and improve the methods of treatment of solid tumors. Chemotherapy is the standard treatment for a large number of malignant neoplasms. It is also used before starting cell therapy for lymphodepletion and better engraftment of injected CAR-T cells. It has been shown that chemotherapy can reduce the immunosuppressive effect of the tumor microenvironment, destroy the stroma, and promote better infiltration of the tumor by CAR-T cells, improving their survival, persistence, cytotoxicity, and influencing the metabolism of immune cells inside the tumor. The effectiveness of combining chemotherapy and CAR-T cell therapy relies on various factors such as tumor type, dosage, treatment schedule, CAR-T cell composition, and individual biological traits. Similarly, radiation therapy can enhance tumor cell vulnerability to specific treatments while also supporting tumor cell survival.In this review, we discuss the use of CAR-T therapy to combat solid tumors, regarding the challenges of treating solid tumors, ways to overcome them, and also touch upon the possibility of using combination treatments to improve the effectiveness of cell therapy.
嵌合抗原受体(CAR)T 细胞疗法的引入彻底改变了血液病的治疗,尤其是在抗击血癌方面。这种细胞疗法的成功开发了大约七种基于 CAR-T 的商业药物。然而,由于实体瘤抗原多样、免疫抑制肿瘤环境、免疫细胞浸润有限、CAR-T 细胞活性降低和毒性问题等挑战,CAR-T 疗法在实体瘤中的应用被证明效果不佳。为了解决这些问题,科学家们正在努力改进和完善治疗实体瘤的方法。化疗是治疗大量恶性肿瘤的标准方法。在开始细胞疗法之前,化疗还可用于淋巴清除和更好地接种注射的 CAR-T 细胞。有研究表明,化疗可以降低肿瘤微环境的免疫抑制作用,破坏基质,促进CAR-T细胞更好地浸润肿瘤,提高CAR-T细胞的存活率、持久性和细胞毒性,并影响肿瘤内免疫细胞的代谢。化疗与 CAR-T 细胞疗法相结合的效果取决于多种因素,如肿瘤类型、剂量、治疗时间、CAR-T 细胞组成和个体生物学特征。在这篇综述中,我们将讨论利用 CAR-T 疗法对抗实体瘤的问题,探讨治疗实体瘤所面临的挑战、克服这些挑战的方法,并探讨利用联合疗法提高细胞疗法疗效的可能性。
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引用次数: 0
Dynamics of miRNA expression in urine extracellular vesicles of prostate cancer patients after radical prostatectomy 前列腺癌根治术后患者尿液细胞外囊泡中 miRNA 表达的动态变化
Pub Date : 2024-04-05 DOI: 10.17650/2313-805x-2024-11-1-55-78
E. V. Shutko, O. Bryzgunova, I. A. Ostal’cev, S. V. Pak, S. E. Krasi’nikov, P. P. Laktionov, M. Konoshenko
Introduction. It is known that the treatment of oncological diseases including prostate cancer (PCa) causes changes in the expression of oncogenic and oncosuppressive miRNAs. The analysis of miRNA expression dynamics can be used to predict the course of the disease and its response to therapy. However, the effect of PCa therapy on the expression of extracellular miRNAs is just beginning to be investigated.Aim. To study the expression dynamics of 14 miRNAs (miR-19b, -22-3p, -30e, -31, -92a, -125b, -144, -200b, -205, -222, -375, -378a, -425, -660) in urine extracellular vesicles of PCa patients after radical prostatectomy and to reveal prognostic miRNA ratios.Materials and methods. Urine samples of 18 donors and 18 PCa patients, obtained before radical prostatectomy, 1 week and 3 months after surgery, were examined. Extracellular vesicles were isolated by aggregation-precipitation protocol; extracellular vesicles miRNAs were isolated using fiberglass sorbents and octane acid. Data on threshold detection cycles of 14 miRNAs were obtained using reverse transcription – loop polymerase chain reaction (TaqMan).Results. It was found that prostatectomy causes a significant change in the relative expression of 44 miRNA ratios in the urine of PCa patients. Four groups of miRNA ratios can be distinguished: 1) miRNA ratios, which expression level significantly differed between donors and PCa patients before surgery and significantly changed in PCa patients 3 months after prostatectomy in the direction of the level of donors (6 pairs); 2) miRNA ratios, which expression did not significantly differ between donors and PCa patients before surgery, but significantly differed from the baseline in PCa patients and donors 3 months after prostatectomy (5 pairs); 3) miRNA ratios, based on expression ratios of which PCa patients can be divided into two or three significantly different subgroups 3 months after prostatectomy (19 pairs); 4) miRNA ratios that did not significantly change their expression after prostatectomy (30 pairs).Conclusion. Prostatectomy causes a significant change in the level of expression of miRNA in urine. 6 pairs of miRNAs, the relative expression of which after surgery significantly changed towards that of healthy donors and 19 pairs of miRNAs, according to the level of relative expression of which patients with prostate cancer were divided into two significantly different subgroups 3 months after prostatectomy, were identified based on the analysis of the dynamics of miRNA expression after prostatectomy.
简介众所周知,包括前列腺癌(PCa)在内的肿瘤疾病的治疗会导致致癌和抑癌 miRNA 的表达发生变化。对 miRNA 表达动态的分析可用于预测疾病的进程及其对治疗的反应。然而,关于PCa治疗对细胞外miRNA表达的影响的研究才刚刚开始。研究根治性前列腺切除术后 PCa 患者尿液细胞外囊泡中 14 个 miRNA(miR-19b、-22-3p、-30e、-31、-92a、-125b、-144、-200b、-205、-222、-375、-378a、-425、-660)的表达动态,并揭示预后 miRNA 比率。研究人员检测了 18 名供体和 18 名 PCa 患者在前列腺癌根治术前、术后 1 周和 3 个月的尿液样本。采用聚集-沉淀方案分离细胞外囊泡;使用玻璃纤维吸附剂和辛烷酸分离细胞外囊泡 miRNA。利用反转录-环聚合酶链反应(TaqMan)获得了 14 种 miRNA 的阈值检测周期数据。结果发现,前列腺切除术会导致 PCa 患者尿液中 44 个 miRNA 比率的相对表达发生显著变化。可将 miRNA 比率分为四组:1)miRNA 比值,供体和 PCa 患者在手术前的表达水平有显著差异,前列腺切除术后 3 个月 PCa 患者的表达水平与供体的表达水平呈显著变化(6 对);2)miRNA 比值,供体和 PCa 患者在手术前的表达水平无显著差异,但前列腺切除术后 3 个月 PCa 患者和供体的表达水平与基线有显著差异(5 对);3)miRNA 比率,根据其表达比率,PCa 患者在前列腺切除术后 3 个月可分为两到三个明显不同的亚组(19 对);4)miRNA 比率,其表达在前列腺切除术后无明显变化(30 对)。结论前列腺切除术会导致尿液中 miRNA 的表达水平发生显著变化。根据对前列腺切除术后 miRNA 表达动态的分析,确定了 6 对 miRNA,其相对表达量在手术后与健康供体相比有明显变化;以及 19 对 miRNA,根据其相对表达量的高低,前列腺癌患者在前列腺切除术后 3 个月被分为两个明显不同的亚组。
{"title":"Dynamics of miRNA expression in urine extracellular vesicles of prostate cancer patients after radical prostatectomy","authors":"E. V. Shutko, O. Bryzgunova, I. A. Ostal’cev, S. V. Pak, S. E. Krasi’nikov, P. P. Laktionov, M. Konoshenko","doi":"10.17650/2313-805x-2024-11-1-55-78","DOIUrl":"https://doi.org/10.17650/2313-805x-2024-11-1-55-78","url":null,"abstract":"Introduction. It is known that the treatment of oncological diseases including prostate cancer (PCa) causes changes in the expression of oncogenic and oncosuppressive miRNAs. The analysis of miRNA expression dynamics can be used to predict the course of the disease and its response to therapy. However, the effect of PCa therapy on the expression of extracellular miRNAs is just beginning to be investigated.Aim. To study the expression dynamics of 14 miRNAs (miR-19b, -22-3p, -30e, -31, -92a, -125b, -144, -200b, -205, -222, -375, -378a, -425, -660) in urine extracellular vesicles of PCa patients after radical prostatectomy and to reveal prognostic miRNA ratios.Materials and methods. Urine samples of 18 donors and 18 PCa patients, obtained before radical prostatectomy, 1 week and 3 months after surgery, were examined. Extracellular vesicles were isolated by aggregation-precipitation protocol; extracellular vesicles miRNAs were isolated using fiberglass sorbents and octane acid. Data on threshold detection cycles of 14 miRNAs were obtained using reverse transcription – loop polymerase chain reaction (TaqMan).Results. It was found that prostatectomy causes a significant change in the relative expression of 44 miRNA ratios in the urine of PCa patients. Four groups of miRNA ratios can be distinguished: 1) miRNA ratios, which expression level significantly differed between donors and PCa patients before surgery and significantly changed in PCa patients 3 months after prostatectomy in the direction of the level of donors (6 pairs); 2) miRNA ratios, which expression did not significantly differ between donors and PCa patients before surgery, but significantly differed from the baseline in PCa patients and donors 3 months after prostatectomy (5 pairs); 3) miRNA ratios, based on expression ratios of which PCa patients can be divided into two or three significantly different subgroups 3 months after prostatectomy (19 pairs); 4) miRNA ratios that did not significantly change their expression after prostatectomy (30 pairs).Conclusion. Prostatectomy causes a significant change in the level of expression of miRNA in urine. 6 pairs of miRNAs, the relative expression of which after surgery significantly changed towards that of healthy donors and 19 pairs of miRNAs, according to the level of relative expression of which patients with prostate cancer were divided into two significantly different subgroups 3 months after prostatectomy, were identified based on the analysis of the dynamics of miRNA expression after prostatectomy.","PeriodicalId":505368,"journal":{"name":"Advances in Molecular Oncology","volume":"60 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Advances in Molecular Oncology
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