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Open, Laparoscopy-assisted, Robotic-assisted Distal Gastrectomy for Gastric Cancer: Evidence from Randomized Clinical Trials. 开腹、腹腔镜辅助、机器人辅助胃癌远端切除术:来自随机临床试验的证据。
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17198
Toru Aoyama, Yukio Maezawa, Itaru Hashimoto

Gastric cancer (GC) is the fifth most common cancer and fourth leading cause of cancer-related deaths worldwide. Gastrectomy with lymphadenectomy is the standard treatment for both early and locally advanced GC. Laparoscopic surgery has been widely used for decades for the treatment of benign diseases, such as cholecystectomy and appendectomy. The use of laparoscopy-assisted distal gastrectomy (LADG) for the treatment of gastric cancer was first described by Kitano in 1994. Since then, the number of gastric cancer cases treated with LADG has gradually increased. Recently, robot-assisted gastrectomy (RDG) has also been introduced in the treatment of GC. To date, several randomized control trials (RCT) have been conducted to evaluate the safety, feasibility, and efficacy of LADG and RDG in comparison to open distal gastrectomy (ODG). However, the short- and long-term oncological outcomes of LADG and RDG remain controversial and have not been fully evaluated. To optimize GC treatment, especially gastrectomy with lymphadenectomy, it is necessary to understand the characteristics of each approach before gastric cancer treatment. This review summarizes the background, current status, and future perspectives of LADG and RDG in GC treatment using RCT data.

胃癌(GC)是全球第五大常见癌症,也是导致癌症相关死亡的第四大原因。胃切除加淋巴结切除术是治疗早期和局部晚期胃癌的标准方法。几十年来,腹腔镜手术已广泛用于良性疾病的治疗,如胆囊切除术和阑尾切除术。北野(Kitano)于 1994 年首次描述了腹腔镜辅助远端胃切除术(LADG)用于治疗胃癌。此后,使用 LADG 治疗胃癌的病例逐渐增多。最近,机器人辅助胃切除术(RDG)也被引入胃癌的治疗中。迄今为止,已有多项随机对照试验(RCT)评估了 LADG 和 RDG 与开腹远端胃切除术(ODG)相比的安全性、可行性和有效性。然而,LADG 和 RDG 的短期和长期肿瘤治疗效果仍存在争议,尚未得到全面评估。为了优化胃癌治疗,尤其是胃切除加淋巴结清扫术,有必要在胃癌治疗前了解每种方法的特点。本综述利用 RCT 数据总结了 LADG 和 RDG 治疗胃癌的背景、现状和未来展望。
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引用次数: 0
The Expression and Prognostic Value of Multiple Glucose Transporters in Cutaneous Melanoma. 多种葡萄糖转运体在皮肤黑色素瘤中的表达及其预后价值
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17199
Weijie Ma, Zhongze Li, Jiexi Wen, Shaofeng Yan

Background/aim: Over-expression of glucose transporters (GLUTs), membrane proteins that facilitate glucose transport, has been implicated in cutaneous melanomas. Our prior studies have demonstrated increased expression of GLUT1 and GLUT3 in melanomas and their association with poorer prognosis. This study aimed to investigate the expression of GLUT isoforms 4 and 8 in melanocytic lesions, examine the co-expression status of multiple GLUTs, and evaluate their prognostic significance.

Materials and methods: We analyzed 171 melanocytic lesions (97 primary melanomas, 19 metastatic melanomas, and 55 nevi) using a tissue microarray and immunohistochemistry using antibodies against GLUT4 and GLUT8. Membranous expression of GLUTs was scored using a semi-quantitative method. A combined GLUT total score was generated by summing scores from GLUT1, GLUT3, GLUT4, and GLUT8 (including data from previous studies).

Results: A significant up-regulation of GLUT4 and GLUT8 expression was found in melanomas compared to nevi (p<0.0001 for both). Concurrent over-expression of multiple GLUTs was more prevalent in melanomas compared to nevi (p<0.0001), and it was also more frequent in metastatic melanomas compared to primary melanomas (p=0.047). Importantly, high total GLUT expression scores were significantly correlated with negative prognostic factors, such as ulceration and mitoses (p=0.03 and p=0.008 respectively). Additionally, Kaplan-Meier survival curves revealed that patients with elevated GLUT total score in their melanomas had a lower disease-specific survival (p=0.006). Furthermore, analysis of multiple GLUTs improved diagnostic sensitivity.

Conclusion: Similar to GLUT1 and GLUT3, melanoma exhibits up-regulation of GLUT 4 and GLUT8 compared to nevi. Evaluation of multiple GLUT isoforms improves diagnostic and prognostic values.

背景/目的:葡萄糖转运体(GLUTs)是一种促进葡萄糖转运的膜蛋白,它的过度表达与皮肤黑色素瘤有关。我们之前的研究表明,黑色素瘤中 GLUT1 和 GLUT3 的表达增加,且与较差的预后有关。本研究旨在调查黑色素细胞病变中GLUT同工酶4和8的表达,检查多种GLUT的共表达情况,并评估其预后意义:我们使用组织芯片和针对 GLUT4 和 GLUT8 的抗体进行免疫组化,分析了 171 例黑色素细胞病变(97 例原发性黑色素瘤、19 例转移性黑色素瘤和 55 例痣)。采用半定量法对 GLUT 的膜表达进行评分。将 GLUT1、GLUT3、GLUT4 和 GLUT8 的得分相加,得出综合的 GLUT 总分(包括之前研究的数据):结果:与痣相比,黑色素瘤中 GLUT4 和 GLUT8 的表达明显上调(p 结论:与 GLUT1 和 GLUT3 相似,黑色素瘤中 GLUT4 和 GLUT8 的表达也明显上调:与 GLUT1 和 GLUT3 相似,黑色素瘤中 GLUT4 和 GLUT8 的表达也比痣高。评估多种 GLUT 同工酶可提高诊断和预后价值。
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引用次数: 0
Prognostic Impact of Human Lymphocyte Antigen (HLA) Class I Expression in Patients With Breast Cancer. 乳腺癌患者人类淋巴细胞抗原 (HLA) I 类表达的预后影响
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17233
Motonobu Uchiyama, Hiroaki Shima, Goro Kutomi, Daisuke Kyuno, Asaka Wada, Yoko Kuga, Yasuaki Tamura, Yoshihiko Hirohashi, Toshihiko Torigoe, Ichiro Takemasa

Background/aim: Various biomarkers are utilized in the field of breast cancer. Human lymphocyte antigen (HLA) class I molecules have a critical role in cancer immune surveillance. Therefore, this study aimed to assess the HLA class I expression and analyze the correlation with clinicopathologic factors in breast cancer.

Patients and methods: We investigated the clinical pathology archives of 150 consecutive patients with breast cancer who underwent a curative operation at the Sapporo Medical University, Japan, from January 2012 to December 2014. Immunohistochemical staining was used to evaluate HLA class I expression and CD8-positive T cell infiltration. The Pearson χ2 test was used to assess HLA class I expression level and clinicopathological parameters. The Kaplan-Meier method was used to evaluate survival and the log-rank test to analyze the differences between survival curves.

Results: Patients with dull/negative HLA class I had significantly poor disease-free survival (DFS) compared with those with positive HLA class I (p=0.0073). Univariate analyses revealed that pT, pN, positive lymphatic invasion, and dull/negative HLA class I were significantly associated with DFS. Multivariate analyses revealed dull/negative HLA class I as an independent poor prognostic factor (hazard ratio=2.75, 95% confidence interval=1.30-5.80, p=0.008).

Conclusion: HLA class I expression level may have a very sensitive prognostic effect on patients with breast cancer.

背景/目的:乳腺癌领域使用了多种生物标记物。人类淋巴细胞抗原(HLA)I类分子在癌症免疫监视中起着至关重要的作用。因此,本研究旨在评估 HLA I 类分子的表达,并分析其与乳腺癌临床病理因素的相关性:我们调查了 2012 年 1 月至 2014 年 12 月期间在日本札幌医科大学接受治愈性手术的 150 名连续乳腺癌患者的临床病理档案。免疫组化染色用于评估 HLA I 类表达和 CD8 阳性 T 细胞浸润。皮尔逊χ2检验用于评估HLA I类表达水平和临床病理参数。采用Kaplan-Meier法评估生存率,并用log-rank检验分析生存曲线之间的差异:结果:与HLA I级阳性患者相比,HLA I级阴性患者的无病生存率(DFS)明显较低(P=0.0073)。单变量分析显示,pT、pN、淋巴侵袭阳性和HLA I级阴性与无病生存期显著相关。多变量分析显示,HLA I级阴性/迟钝是一个独立的不良预后因素(危险比=2.75,95%置信区间=1.30-5.80,P=0.008):结论:HLA I类表达水平可能对乳腺癌患者的预后有非常敏感的影响。
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引用次数: 0
Impact of BMI and Body Composition on First-line Systemic Treatment for Unresectable Hepatocellular Carcinoma. 体重指数和身体成分对不可切除肝细胞癌一线系统治疗的影响
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17239
Takafumi Yamamoto, Takanori Ito, Kazuyuki Mizuno, Shinya Yokoyama, Kenta Yamamoto, Norihiro Imai, Yoji Ishizu, Takashi Honda, Hiroki Kawashima

Background/aim: The effects of body mass index (BMI) and body composition on the outcomes of systemic treatment for unresectable hepatocellular carcinoma (uHCC) remain unclear.

Patients and methods: In this retrospective study, patients with uHCC treated with lenvatinib (LEN) or atezolizumab+bevacizumab, were classified into high- (≥25 kg/m2) and low- (<25 kg/m2) BMI groups and evaluated for prognosis. Prognostic impact of body composition was also evaluated.

Results: Patients with a high BMI had lower skeletal mass index (SMI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI) compared to those in the low-BMI cohort. The baseline Child-Pugh scores and Barcelona Clinic Liver Cancer stages were comparable between the two cohorts. The overall survival (OS) was better in the high BMI group compared to the low BMI group (median, 913 vs. 484 days; p=0.008). SMI had a strong influence on OS. Additionally, low BMI, VATI, SATI, and visceral-to-subcutaneous fat ratio (VSR) in the LEN treatment group were associated with shorter progression-free survival (PFS).

Conclusion: Following systemic treatment for uHCC, patients with low BMI have a poor prognosis. Among anthropometric factors, low SMI is associated with poor OS. In the LEN treatment group, low VATI may impact PFS negatively.

背景/目的:体重指数(BMI)和身体成分对不可切除肝细胞癌(uHCC)系统治疗结果的影响仍不清楚:在这项回顾性研究中,来伐替尼(LEN)或阿特珠单抗+贝伐单抗治疗的uHCC患者被分为高(≥25 kg/m2)和低(2)BMI组,并对预后进行了评估。同时还评估了身体成分对预后的影响:结果:与低体重指数组相比,高体重指数组患者的骨骼质量指数(SMI)、皮下脂肪组织指数(SATI)和内脏脂肪组织指数(VATI)均较低。两组患者的基线 Child-Pugh 评分和巴塞罗那临床肝癌分期具有可比性。与低体重指数组相比,高体重指数组的总生存期(OS)更长(中位数为913天对484天;P=0.008)。SMI对OS有很大影响。此外,LEN治疗组的低BMI、VATI、SATI和内脏与皮下脂肪比(VSR)与较短的无进展生存期(PFS)相关:结论:在对uHCC进行全身治疗后,低体重指数患者的预后较差。结论:uHCC 患者接受全身治疗后,低体重指数患者的预后较差。在LEN治疗组中,低VATI可能会对PFS产生负面影响。
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引用次数: 0
Stereotactic Ablative Radiotherapy for Early-stage Lung Cancer in Patients With Left Ventricular Assist Device: A Case Series. 使用左心室辅助装置治疗早期肺癌的立体定向消融放疗:病例系列。
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17240
Kazuhiko Hayashi, Hiroshi Ishikawa, Kei Fujiwara, Masataka Nakai, Hitoshi Ono, Yasutoshi Fumimoto, Nobuyuki Tamaki, Shotaro Tatekawa, Takero Hirata, Toru Kimura, Haruhiko Hirata, Keisuke Tamari, Yoshito Takeda, Shinichi Shimizu, Yasushi Shintani, Kazuhiko Ogawa

Background/aim: Radiotherapy-induced malfunction of pacemakers and cardiac defibrillators has been reported, and corresponding guidelines have been developed in various countries. Although several studies have reported the effects of radiotherapy in patients with implantable left ventricular assist device (LVAD), its safety remains unclear. Herein, we report three cases of stereotactic ablative radiotherapy (SABR) using CyberKnife for early-stage lung cancer in patients with implantable LVAD.

Case report: Three patients in their 50s or 60s, including two women and one man, who had LVADs due to dilated or ischemic cardiomyopathy and performance status of 0 or 1, were diagnosed with stage IA2 lung cancer (cT1bN0M0) by imaging only. All three patients were deemed inoperable due to cardiac comorbidity and underwent SABR at the Osaka University Hospital. The total radiation dose was 42-52 Gy, administered in four fractions. All treatment plans were designed to keep the LVAD dose below 2 Gy. In all patients, SABR was completed without acute adverse events or LVAD malfunction. During the follow-up period of 3-29 months, no disease progression or chronic adverse events were observed in any of the patients.

Conclusion: This case series indicated that SABR using CyberKnife is a safe treatment option for early-stage lung cancer in patients with LVAD by reducing the dose to the LVAD.

背景/目的:放疗诱发心脏起搏器和心脏除颤器故障的报道屡见不鲜,各国也制定了相应的指南。尽管有多项研究报道了放射治疗对植入式左心室辅助装置(LVAD)患者的影响,但其安全性仍不明确。在此,我们报告了三例使用 CyberKnife 进行立体定向消融放疗(SABR)治疗植入式左心室辅助器患者早期肺癌的病例:三位五六十岁的患者,包括两位女性和一位男性,因扩张型或缺血性心肌病而安装了左心室支架,表现状态为 0 或 1,仅通过影像学检查确诊为 IA2 期肺癌(cT1bN0M0)。这三位患者均因合并心脏病而无法手术,并在大阪大学医院接受了 SABR 治疗。总放射剂量为 42-52 Gy,分四次给药。所有治疗方案均将 LVAD 剂量控制在 2 Gy 以下。所有患者均完成了 SABR,未发生急性不良事件或 LVAD 故障。在3-29个月的随访期间,所有患者均未出现疾病进展或慢性不良反应:本系列病例表明,使用 CyberKnife 进行 SABR 是一种安全的治疗方法,可通过减少 LVAD 的剂量来治疗 LVAD 患者的早期肺癌。
{"title":"Stereotactic Ablative Radiotherapy for Early-stage Lung Cancer in Patients With Left Ventricular Assist Device: A Case Series.","authors":"Kazuhiko Hayashi, Hiroshi Ishikawa, Kei Fujiwara, Masataka Nakai, Hitoshi Ono, Yasutoshi Fumimoto, Nobuyuki Tamaki, Shotaro Tatekawa, Takero Hirata, Toru Kimura, Haruhiko Hirata, Keisuke Tamari, Yoshito Takeda, Shinichi Shimizu, Yasushi Shintani, Kazuhiko Ogawa","doi":"10.21873/anticanres.17240","DOIUrl":"https://doi.org/10.21873/anticanres.17240","url":null,"abstract":"<p><strong>Background/aim: </strong>Radiotherapy-induced malfunction of pacemakers and cardiac defibrillators has been reported, and corresponding guidelines have been developed in various countries. Although several studies have reported the effects of radiotherapy in patients with implantable left ventricular assist device (LVAD), its safety remains unclear. Herein, we report three cases of stereotactic ablative radiotherapy (SABR) using CyberKnife for early-stage lung cancer in patients with implantable LVAD.</p><p><strong>Case report: </strong>Three patients in their 50s or 60s, including two women and one man, who had LVADs due to dilated or ischemic cardiomyopathy and performance status of 0 or 1, were diagnosed with stage IA2 lung cancer (cT1bN0M0) by imaging only. All three patients were deemed inoperable due to cardiac comorbidity and underwent SABR at the Osaka University Hospital. The total radiation dose was 42-52 Gy, administered in four fractions. All treatment plans were designed to keep the LVAD dose below 2 Gy. In all patients, SABR was completed without acute adverse events or LVAD malfunction. During the follow-up period of 3-29 months, no disease progression or chronic adverse events were observed in any of the patients.</p><p><strong>Conclusion: </strong>This case series indicated that SABR using CyberKnife is a safe treatment option for early-stage lung cancer in patients with LVAD by reducing the dose to the LVAD.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel Diclofenac-NO Donor With High Affinity for Human Serum Albumin Induces Endoplasmic Reticulum Stress-mediated Cell Death in Human Pancreatic Cancer Cells. 对人血清白蛋白具有高亲和力的新型双氯芬酸-NO 给体诱导内质网应激介导的人胰腺癌细胞死亡。
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17204
Koji Nishi, Ryo Kanda, Kaho Takasaki, Ayano Tamori, Yoshifumi Arimura, Shuhei Imoto, Hirotaka Murase, Kenji Tsukigawa, Masaki Otagiri, Keishi Yamasaki

Background/aim: Nitric oxide (NO) has various physiological activities. In this study, diclofenac (DF) which has a high affinity for human serum albumin (HSA) was nitrosylated to a novel NO donor (NDF). The cytotoxic effects and the mechanism of NDF were investigated.

Materials and methods: Binding experiments of NDF to HSA were performed by the ultrafiltration method. NO was measured by the Griess method. The number of dead cells were measured using annexin V. Apoptosis and endoplasmic reticulum stress were evaluated by western blotting.

Results: NDF competitively inhibits the binding of DF to HSA, suggesting that NDF and DF have equivalent binding characteristics. NDF rapidly released NOx after being dissolved. At 200 μM, NDF induced cell death in human pancreatic cancer cells. Western blotting showed that NDF promoted the cleavage of PARP, caspase-3, and caspase-7. Inhibitors of caspase-1 and caspase-9 significantly suppressed NDF-induced cell death, as did a non-specific caspase inhibitor (Z-VAD). In addition, NDF significantly increased the expression of the endoplasmic reticulum stress marker, CHOP.

Conclusion: NDF induces apoptotic cell death by causing endoplasmic reticulum stress. The findings of this study suggest that NDF may become a promising compound for the treatment of pancreatic cancer.

背景/目的:一氧化氮(NO)具有多种生理活性。本研究将与人血清白蛋白(HSA)具有高亲和力的双氯芬酸(DF)亚硝基化为一种新型的一氧化氮供体(NDF)。材料与方法:采用超滤法进行 NDF 与 HSA 的结合实验。NO用Griess法测定。用 Western 印迹法评估细胞凋亡和内质网应激:结果:NDF能竞争性地抑制DF与HSA的结合,这表明NDF和DF具有同等的结合特性。NDF 溶解后会迅速释放氮氧化物。在 200 μM 的浓度下,NDF 能诱导人胰腺癌细胞死亡。Western 印迹显示,NDF 能促进 PARP、caspase-3 和 caspase-7 的裂解。caspase-1和caspase-9抑制剂以及非特异性caspase抑制剂(Z-VAD)都能显著抑制NDF诱导的细胞死亡。此外,NDF 还能明显增加内质网应激标志物 CHOP 的表达:结论:NDF 通过引起内质网应激诱导细胞凋亡。本研究的结果表明,NDF可能成为一种治疗胰腺癌的前景广阔的化合物。
{"title":"Novel Diclofenac-NO Donor With High Affinity for Human Serum Albumin Induces Endoplasmic Reticulum Stress-mediated Cell Death in Human Pancreatic Cancer Cells.","authors":"Koji Nishi, Ryo Kanda, Kaho Takasaki, Ayano Tamori, Yoshifumi Arimura, Shuhei Imoto, Hirotaka Murase, Kenji Tsukigawa, Masaki Otagiri, Keishi Yamasaki","doi":"10.21873/anticanres.17204","DOIUrl":"https://doi.org/10.21873/anticanres.17204","url":null,"abstract":"<p><strong>Background/aim: </strong>Nitric oxide (NO) has various physiological activities. In this study, diclofenac (DF) which has a high affinity for human serum albumin (HSA) was nitrosylated to a novel NO donor (NDF). The cytotoxic effects and the mechanism of NDF were investigated.</p><p><strong>Materials and methods: </strong>Binding experiments of NDF to HSA were performed by the ultrafiltration method. NO was measured by the Griess method. The number of dead cells were measured using annexin V. Apoptosis and endoplasmic reticulum stress were evaluated by western blotting.</p><p><strong>Results: </strong>NDF competitively inhibits the binding of DF to HSA, suggesting that NDF and DF have equivalent binding characteristics. NDF rapidly released NOx after being dissolved. At 200 μM, NDF induced cell death in human pancreatic cancer cells. Western blotting showed that NDF promoted the cleavage of PARP, caspase-3, and caspase-7. Inhibitors of caspase-1 and caspase-9 significantly suppressed NDF-induced cell death, as did a non-specific caspase inhibitor (Z-VAD). In addition, NDF significantly increased the expression of the endoplasmic reticulum stress marker, CHOP.</p><p><strong>Conclusion: </strong>NDF induces apoptotic cell death by causing endoplasmic reticulum stress. The findings of this study suggest that NDF may become a promising compound for the treatment of pancreatic cancer.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
NSC-38270 Exhibits Anti-invasive and Pro-apoptotic Effects on Hepatocellular Carcinoma Huh7 Cells. NSC-38270 对肝细胞癌 Huh7 细胞具有抗侵袭和促凋亡作用
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17212
Jihye Seo, Minseo Park, Sayeon Cho

Background/aim: Hepatocellular carcinoma (HCC) is a main type of liver cancer with high metastatic potential, and its incidence is steadily increasing worldwide. However, the development of new drugs for the treatment of HCC is still insufficient. This study aimed to determine the anticancer effect of NSC-38270, a natural product, on HCC.

Materials and methods: After treating HCC Huh7 cells with NSC-38270, cell growth, wound healing, migration, and invasion assays were conducted. We investigated the effects of NSC-38270 on Twist1, a crucial epithelial-mesenchymal transition (EMT)-related transcription factor. In addition, apoptosis, histone H2A.X activation, and cell morphology assays were performed in Huh7 and immortalized normal liver cells following treatment with NSC-38270.

Results: NSC-38270 reduced the migration and invasion ability of Huh7 cells, accompanied by a decrease in Twist1. Furthermore, NSC-38270 induced apoptosis in Huh7 cells, whereas apoptosis was not observed in immortalized normal liver cells (THLE-2 cells and Chang liver cells).

Conclusion: NSC-38270 exhibited significant inhibitory effects on the migration and invasion of Huh7 cells by repressing Twist1. Importantly, it induced cancer cell-specific apoptotic effects. These findings suggest that NSC-38270 holds promising potential as a therapeutic candidate for cancer treatment.

背景/目的:肝细胞癌(HCC)是肝癌的一种主要类型,具有高度转移性,其发病率在全球范围内稳步上升。然而,治疗 HCC 的新药开发仍然不足。本研究旨在确定天然产物 NSC-38270 对 HCC 的抗癌作用:用 NSC-38270 处理 HCC Huh7 细胞后,进行了细胞生长、伤口愈合、迁移和侵袭试验。我们研究了 NSC-38270 对 Twist1 的影响,Twist1 是一种关键的上皮-间质转化(EMT)相关转录因子。此外,在使用 NSC-38270 处理 Huh7 和永生化正常肝细胞后,还进行了细胞凋亡、组蛋白 H2A.X 活化和细胞形态学检测:结果:NSC-38270降低了Huh7细胞的迁移和侵袭能力,同时降低了Twist1。此外,NSC-38270 还诱导 Huh7 细胞凋亡,而在永生化正常肝细胞(THLE-2 细胞和 Chang 肝细胞)中未观察到凋亡:结论:NSC-38270通过抑制Twist1对Huh7细胞的迁移和侵袭有明显的抑制作用。重要的是,它还能诱导癌细胞特异性凋亡。这些研究结果表明,NSC-38270 具有作为癌症治疗候选药物的潜力。
{"title":"NSC-38270 Exhibits Anti-invasive and Pro-apoptotic Effects on Hepatocellular Carcinoma Huh7 Cells.","authors":"Jihye Seo, Minseo Park, Sayeon Cho","doi":"10.21873/anticanres.17212","DOIUrl":"https://doi.org/10.21873/anticanres.17212","url":null,"abstract":"<p><strong>Background/aim: </strong>Hepatocellular carcinoma (HCC) is a main type of liver cancer with high metastatic potential, and its incidence is steadily increasing worldwide. However, the development of new drugs for the treatment of HCC is still insufficient. This study aimed to determine the anticancer effect of NSC-38270, a natural product, on HCC.</p><p><strong>Materials and methods: </strong>After treating HCC Huh7 cells with NSC-38270, cell growth, wound healing, migration, and invasion assays were conducted. We investigated the effects of NSC-38270 on Twist1, a crucial epithelial-mesenchymal transition (EMT)-related transcription factor. In addition, apoptosis, histone H2A.X activation, and cell morphology assays were performed in Huh7 and immortalized normal liver cells following treatment with NSC-38270.</p><p><strong>Results: </strong>NSC-38270 reduced the migration and invasion ability of Huh7 cells, accompanied by a decrease in Twist1. Furthermore, NSC-38270 induced apoptosis in Huh7 cells, whereas apoptosis was not observed in immortalized normal liver cells (THLE-2 cells and Chang liver cells).</p><p><strong>Conclusion: </strong>NSC-38270 exhibited significant inhibitory effects on the migration and invasion of Huh7 cells by repressing Twist1. Importantly, it induced cancer cell-specific apoptotic effects. These findings suggest that NSC-38270 holds promising potential as a therapeutic candidate for cancer treatment.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In Silico Study of Simultaneous Integrated Boost Carbon-Ion Radiotherapy for Locally Advanced Pancreatic Cancer. 针对局部晚期胰腺癌的同步综合碳-离子放射治疗的硅学研究
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17208
Taku Nakaji, Makoto Shinoto, Shigeru Yamada, Taku Inaniwa

Background/aim: Carbon-ion radiotherapy (CiRT) has been used for the treatment of locally advanced pancreatic cancer (LAPC) with uniform dose plan. The aim of the present study is to investigate the effectiveness of a simultaneous integrated boost (SIB) technique with scanned CiRT against LAPC.

Materials and methods: Data of 21 patients with LAPC were used to compare two treatment planning approaches: a conventional uniform dose approach and a SIB approach. A relative biological effectiveness (RBE)-weighted dose (DRBE) of 55.2 Gy (RBE) in 12 fractions was prescribed to the planning target volume (PTV) in the conventional approach. In the SIB approach, DRBE of 67.2 Gy (RBE) and 43.2 Gy (RBE) in 12 fractions were prescribed to a high-risk PTV (HR-PTV) and low-risk PTV (LR-PTV), respectively. The DRBE and dose-averaged linear energy transfer (LETd) of targets and gastrointestinal tracts as organs at risk (OARs) were evaluated.

Results: The HR-PTV D90% and LR-PTV D90% were 64.4±0.6 and 42.5±0.1 Gy (RBE) in SIB approach compared to the PTV D90% of 54.1±0.4 Gy (RBE) in the conventional approach. All SIB plans achieved the D2cc lower than 46 Gy (RBE) and V30 lower than 4 cm3 within OARs. The SIB approach increased the minimum LETd within the GTV to 44 keV/μm or higher for 20 out of 21 patients as compared to 16 out of 21 patients in the conventional approach.

Conclusion: The SIB approach effectively increased the RBE-weighted dose and LETd within the HR-PTV and GTV by accumulating the high-LET stopping carbon-ions into the HR-PTV in addition to the decreased RBE-weighted dose to OARs.

背景/目的:碳离子放疗(CiRT)已被用于治疗局部晚期胰腺癌(LAPC),并采用统一的剂量计划。本研究的目的是探讨扫描碳离子放疗与同步综合增强(SIB)技术对局部晚期胰腺癌的疗效:21例LAPC患者的数据用于比较两种治疗计划方法:传统的均匀剂量方法和SIB方法。在传统方法中,规划靶体积(PTV)的相对生物效应(RBE)加权剂量(DRBE)为 55.2 Gy(RBE),共分 12 次。在 SIB 方法中,对高风险 PTV(HR-PTV)和低风险 PTV(LR-PTV)分别规定了 12 次分割的 67.2 Gy(RBE)和 43.2 Gy(RBE)的 DRBE。评估了靶点和胃肠道作为危险器官(OAR)的DRBE和剂量平均线性能量转移(LETd):结果:SIB方法的HR-PTV D90%和LR-PTV D90%分别为64.4±0.6和42.5±0.1 Gy (RBE),而传统方法的PTV D90% 为54.1±0.4 Gy (RBE)。所有SIB计划的D2cc均低于46 Gy(RBE),OAR内的V30均低于4 cm3。SIB方法将21名患者中的20名患者GTV内的最小LETd提高到44 keV/μm或更高,而传统方法则将21名患者中的16名患者GTV内的最小LETd提高到44 keV/μm或更高:结论:SIB方法通过将高LET停止碳离子聚集到HR-PTV,有效地增加了RBE加权剂量以及HR-PTV和GTV内的LETd,同时降低了OARs的RBE加权剂量。
{"title":"<i>In Silico</i> Study of Simultaneous Integrated Boost Carbon-Ion Radiotherapy for Locally Advanced Pancreatic Cancer.","authors":"Taku Nakaji, Makoto Shinoto, Shigeru Yamada, Taku Inaniwa","doi":"10.21873/anticanres.17208","DOIUrl":"https://doi.org/10.21873/anticanres.17208","url":null,"abstract":"<p><strong>Background/aim: </strong>Carbon-ion radiotherapy (CiRT) has been used for the treatment of locally advanced pancreatic cancer (LAPC) with uniform dose plan. The aim of the present study is to investigate the effectiveness of a simultaneous integrated boost (SIB) technique with scanned CiRT against LAPC.</p><p><strong>Materials and methods: </strong>Data of 21 patients with LAPC were used to compare two treatment planning approaches: a conventional uniform dose approach and a SIB approach. A relative biological effectiveness (RBE)-weighted dose (D<sub>RBE</sub>) of 55.2 Gy (RBE) in 12 fractions was prescribed to the planning target volume (PTV) in the conventional approach. In the SIB approach, D<sub>RBE</sub> of 67.2 Gy (RBE) and 43.2 Gy (RBE) in 12 fractions were prescribed to a high-risk PTV (HR-PTV) and low-risk PTV (LR-PTV), respectively. The D<sub>RBE</sub> and dose-averaged linear energy transfer (LET<sub>d</sub>) of targets and gastrointestinal tracts as organs at risk (OARs) were evaluated.</p><p><strong>Results: </strong>The HR-PTV D<sub>90%</sub> and LR-PTV D<sub>90%</sub> were 64.4±0.6 and 42.5±0.1 Gy (RBE) in SIB approach compared to the PTV D<sub>90%</sub> of 54.1±0.4 Gy (RBE) in the conventional approach. All SIB plans achieved the D<sub>2cc</sub> lower than 46 Gy (RBE) and V<sub>30</sub> lower than 4 cm<sup>3</sup> within OARs. The SIB approach increased the minimum LET<sub>d</sub> within the GTV to 44 keV/μm or higher for 20 out of 21 patients as compared to 16 out of 21 patients in the conventional approach.</p><p><strong>Conclusion: </strong>The SIB approach effectively increased the RBE-weighted dose and LET<sub>d</sub> within the HR-PTV and GTV by accumulating the high-LET stopping carbon-ions into the HR-PTV in addition to the decreased RBE-weighted dose to OARs.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of Near-infrared Photoimmunotherapy Combined With Immune Checkpoint Inhibitor Therapy in Unresectable Head and Neck Cancer. 近红外光免疫疗法联合免疫检查点抑制剂疗法治疗无法切除的头颈癌的可行性。
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17218
Hitoshi Hirakawa, Taro Ikegami, Hidetoshi Kinjyo, Yoshikazu Hayashi, Shinya Agena, Teruyuki Higa, Shunsuke Kondo, Masatomo Toyama, Hiroyuki Maeda, Mikio Suzuki

Background/aim: Near-infrared photoimmunotherapy (NIR-PIT) is a recently developed cancer treatment modality that selectively kills cancer cells and may induce a therapeutic host immune response. The aim of this study was to determine the feasibility of combining NIR-PIT with immune checkpoint inhibitor (ICI) therapy for unresectable recurrent head and neck cancer.

Patients and methods: Five patients underwent NIR-PIT at Ryukyu University Hospital between January 2022 and April 2024. These patients had unresectable recurrent head and neck squamous cell carcinoma. Among these five patients, four received a combination NIR-PIT and pembrolizumab administration.

Results: A total of seven lesions in the oropharynx and oral cavity were targeted. One patient was treated for three different target lesions. The best observed response (BOR) rate was 100%, with three complete responses and four partial responses. The most common treatment-related adverse event was Grade 1 or 2 local pain lasting one to two days postoperatively, which occurred in all patients. Grade 3 adverse events occurred in three cases (42.9%), including pneumonia, pharynx-cutaneous fistula, and trismus. Three patients received ICI therapy following NIR-PIT, achieving a 60% BOR rate. No immune-related adverse events were noted, and the aforementioned Grade 3 adverse events did not worsen during ICI therapy. At a median follow-up of 376 days (range=157-845 days), four target lesions showed no recurrence, while three had recurred. All five patients were alive, including three with no evidence of disease.

Conclusion: The combination of NIR-PIT and ICI therapy for unresectable recurrent head and neck cancer was feasible.

背景/目的:近红外光免疫疗法(NIR-PIT)是最近开发的一种癌症治疗方式,它能选择性地杀死癌细胞,并可诱导治疗性宿主免疫反应。本研究旨在确定将NIR-PIT与免疫检查点抑制剂(ICI)疗法结合治疗不可切除的复发性头颈癌的可行性:五名患者于2022年1月至2024年4月期间在琉球大学医院接受了NIR-PIT治疗。这些患者都患有无法切除的复发性头颈部鳞状细胞癌。在这五名患者中,有四名患者接受了NIR-PIT和pembrolizumab联合治疗:结果:口咽和口腔中共有七个病灶接受了靶向治疗。结果:口咽和口腔共有七个病灶接受了靶向治疗,其中一名患者接受了三个不同靶病灶的治疗。最佳观察反应(BOR)率为100%,其中3例完全反应,4例部分反应。最常见的治疗相关不良反应是术后持续一到两天的1级或2级局部疼痛,所有患者均有发生。3例(42.9%)患者出现了3级不良反应,包括肺炎、咽部皮肤瘘和肢体瘫痪。三名患者在 NIR-PIT 术后接受了 ICI 治疗,BOR 率达到 60%。在 ICI 治疗期间,未发现与免疫相关的不良事件,上述 3 级不良事件也未恶化。在中位 376 天(范围=157-845 天)的随访中,4 个靶病灶没有复发,3 个复发。五名患者全部存活,其中三人无疾病迹象:结论:NIR-PIT 和 ICI 联合治疗无法切除的复发性头颈癌是可行的。
{"title":"Feasibility of Near-infrared Photoimmunotherapy Combined With Immune Checkpoint Inhibitor Therapy in Unresectable Head and Neck Cancer.","authors":"Hitoshi Hirakawa, Taro Ikegami, Hidetoshi Kinjyo, Yoshikazu Hayashi, Shinya Agena, Teruyuki Higa, Shunsuke Kondo, Masatomo Toyama, Hiroyuki Maeda, Mikio Suzuki","doi":"10.21873/anticanres.17218","DOIUrl":"https://doi.org/10.21873/anticanres.17218","url":null,"abstract":"<p><strong>Background/aim: </strong>Near-infrared photoimmunotherapy (NIR-PIT) is a recently developed cancer treatment modality that selectively kills cancer cells and may induce a therapeutic host immune response. The aim of this study was to determine the feasibility of combining NIR-PIT with immune checkpoint inhibitor (ICI) therapy for unresectable recurrent head and neck cancer.</p><p><strong>Patients and methods: </strong>Five patients underwent NIR-PIT at Ryukyu University Hospital between January 2022 and April 2024. These patients had unresectable recurrent head and neck squamous cell carcinoma. Among these five patients, four received a combination NIR-PIT and pembrolizumab administration.</p><p><strong>Results: </strong>A total of seven lesions in the oropharynx and oral cavity were targeted. One patient was treated for three different target lesions. The best observed response (BOR) rate was 100%, with three complete responses and four partial responses. The most common treatment-related adverse event was Grade 1 or 2 local pain lasting one to two days postoperatively, which occurred in all patients. Grade 3 adverse events occurred in three cases (42.9%), including pneumonia, pharynx-cutaneous fistula, and trismus. Three patients received ICI therapy following NIR-PIT, achieving a 60% BOR rate. No immune-related adverse events were noted, and the aforementioned Grade 3 adverse events did not worsen during ICI therapy. At a median follow-up of 376 days (range=157-845 days), four target lesions showed no recurrence, while three had recurred. All five patients were alive, including three with no evidence of disease.</p><p><strong>Conclusion: </strong>The combination of NIR-PIT and ICI therapy for unresectable recurrent head and neck cancer was feasible.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Matrix Metalloproteinase-8 Polymorphisms on Nasopharyngeal Carcinoma Risk. 基质金属蛋白酶-8 多态性对鼻咽癌风险的影响
IF 1.6 4区 医学 Q4 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.21873/anticanres.17207
Chao-Hsuan Chen, Yu-Ting Chin, Shih-Wei Hsu, Liang-Chun Shih, Hui-Chi Tien, Chia-Wen Tsai, Yun-Chi Wang, Yen-Fang Liu, DA-Tian Bau, Wen-Shin Chang

Background/aim: Upregulation of matrix metallo-proteinase-8 (MMP-8) serves as a protein-based indicator for predicting nasopharyngeal carcinoma (NPC) metastasis. Nevertheless, the role of MMP-8 genotypes in NPC has never been investigated. This study aimed to explore the involvement of MMP-8 genotypes in NPC development.

Materials and methods: We employed the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique to analyze MMP-8 genotypes, specifically C-799T (rs11225395), Val436Ala (rs34009635), and Lys460Thr (rs35866072), in a Taiwanese cohort comprising 208 NPC cases and 416 healthy controls.

Results: Individuals with either heterozygous or homozygous variant genotypes of MMP-8 rs11225395 showed no significant change in NPC risk compared to those with the wild-type genotype [odds ratio (OR)=0.97 and 0.79, 95% confidence intervals (95%CI)=0.68-1.38 and 0.46-1.36; p=0.9304 and 0.4736, respectively]. Similarly, there was no significant association between the heterozygous genotypes of MMP-8 rs34009635 and NPC risk (OR=0.66, 95%CI=0.24-1.84; p=0.5738). For MMP-8 rs35866072, all individuals in the study were of the TT genotype. Furthermore, the presence of variant alleles at MMP-8 rs11225395 or rs34009635 did not result in altered NPC risk (OR=0.91 and 0.66, 95%CI=0.71-1.16 and 0.24-1.84, p=0.4876 and 0.5769, respectively). Additionally, no significant association was observed between MMP-8 rs11225395 variant genotypes and NPC risk among individuals regardless of smoking, alcohol consumption, or betel quid chewing habits (all p>0.05).

Conclusion: There was no association between the MMP-8 genotypes rs11225395, rs34009635, or rs35866072 and NPC risk among Taiwanese individuals. Moreover, no combined effects of MMP-8 genotype with smoking, alcohol consumption, or betel quid chewing habits on NPC risk were observed.

背景/目的:基质金属蛋白酶-8(MMP-8)的上调是预测鼻咽癌(NPC)转移的蛋白质指标。然而,MMP-8基因型在鼻咽癌中的作用却从未被研究过。本研究旨在探讨 MMP-8 基因型在鼻咽癌发展中的参与作用:我们采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术分析了由208例鼻咽癌病例和416例健康对照组成的台湾队列中的MMP-8基因型,特别是C-799T(rs11225395)、Val436Ala(rs34009635)和Lys460Thr(rs35866072):与野生型基因型的人相比,MMP-8 rs11225395杂合子或同合子变异基因型的人患鼻咽癌的风险没有显著变化[几率比(OR)分别为0.97和0.79,95%置信区间(95%CI)分别为0.68-1.38和0.46-1.36;P=0.9304和0.4736]。同样,MMP-8 rs34009635的杂合基因型与鼻咽癌风险之间也没有明显关联(OR=0.66,95%CI=0.24-1.84;P=0.5738)。就 MMP-8 rs35866072 而言,研究中的所有个体均为 TT 基因型。此外,MMP-8 rs11225395 或 rs34009635 的变异等位基因不会导致鼻咽癌风险的改变(OR=0.91 和 0.66,95%CI=0.71-1.16 和 0.24-1.84,p=0.4876 和 0.5769)。此外,无论是否有吸烟、饮酒或嚼槟榔的习惯,MMP-8 rs11225395变异基因型与鼻咽癌风险之间均无明显关联(均为P>0.05):结论:台湾人的MMP-8基因型rs11225395、rs34009635或rs35866072与鼻咽癌风险之间没有关联。此外,也没有观察到 MMP-8 基因型与吸烟、饮酒或嚼槟榔习惯对鼻咽癌风险的联合影响。
{"title":"Impact of Matrix Metalloproteinase-8 Polymorphisms on Nasopharyngeal Carcinoma Risk.","authors":"Chao-Hsuan Chen, Yu-Ting Chin, Shih-Wei Hsu, Liang-Chun Shih, Hui-Chi Tien, Chia-Wen Tsai, Yun-Chi Wang, Yen-Fang Liu, DA-Tian Bau, Wen-Shin Chang","doi":"10.21873/anticanres.17207","DOIUrl":"https://doi.org/10.21873/anticanres.17207","url":null,"abstract":"<p><strong>Background/aim: </strong>Upregulation of matrix metallo-proteinase-8 (MMP-8) serves as a protein-based indicator for predicting nasopharyngeal carcinoma (NPC) metastasis. Nevertheless, the role of MMP-8 genotypes in NPC has never been investigated. This study aimed to explore the involvement of MMP-8 genotypes in NPC development.</p><p><strong>Materials and methods: </strong>We employed the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique to analyze MMP-8 genotypes, specifically C-799T (rs11225395), Val436Ala (rs34009635), and Lys460Thr (rs35866072), in a Taiwanese cohort comprising 208 NPC cases and 416 healthy controls.</p><p><strong>Results: </strong>Individuals with either heterozygous or homozygous variant genotypes of MMP-8 rs11225395 showed no significant change in NPC risk compared to those with the wild-type genotype [odds ratio (OR)=0.97 and 0.79, 95% confidence intervals (95%CI)=0.68-1.38 and 0.46-1.36; p=0.9304 and 0.4736, respectively]. Similarly, there was no significant association between the heterozygous genotypes of MMP-8 rs34009635 and NPC risk (OR=0.66, 95%CI=0.24-1.84; p=0.5738). For MMP-8 rs35866072, all individuals in the study were of the TT genotype. Furthermore, the presence of variant alleles at MMP-8 rs11225395 or rs34009635 did not result in altered NPC risk (OR=0.91 and 0.66, 95%CI=0.71-1.16 and 0.24-1.84, p=0.4876 and 0.5769, respectively). Additionally, no significant association was observed between MMP-8 rs11225395 variant genotypes and NPC risk among individuals regardless of smoking, alcohol consumption, or betel quid chewing habits (all p>0.05).</p><p><strong>Conclusion: </strong>There was no association between the MMP-8 genotypes rs11225395, rs34009635, or rs35866072 and NPC risk among Taiwanese individuals. Moreover, no combined effects of MMP-8 genotype with smoking, alcohol consumption, or betel quid chewing habits on NPC risk were observed.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","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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Anticancer research
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