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Potential of PSMA for breast cancer in nuclear medicine: digital quantitative immunohistochemical analysis and implications for a theranostic approach. 核医学中 PSMA 治疗乳腺癌的潜力:数字定量免疫组化分析及其对治疗方法的影响。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-29 DOI: 10.1186/s12885-024-13065-0
Zoé Neviere, Cécile Blanc-Fournier, Anne-Valérie Guizard, Nicolas Elie, Florence Giffard, Justine Lequesne, George Emile, Laurent Poulain, Charline Lasnon

Background: Further research is still needed to fully understand the potential of prostate-specific membrane antigen (PSMA) in breast cancer (BC) and to develop and optimize targeted therapies and imaging modalities. The objective of this study was to present a comprehensive analysis of immunohistochemistry data on PSMA staining in BC and to discuss its potential value in a theranostic approach.

Methods: Fifty-eight male and female patients were randomly selected from a retrospective database of patients who underwent surgery for breast cancer between January 2012 and December 2017 and for whom a specimen is available in our tumour library. Immunodetection of PSMA and CD31 was performed on serial slides. The digitized slides were reviewed and analysed by an experienced pathologist. Additionally, the corresponding TIFF images were processed to calculate the percentage of positive neovessels.

Results: Eighteen patients (31.6%) had no expression, 29 (50.9%) had PSMA neovascular expression scored as "1", and 10 (17.5%) had neovascular expression scored as "2". Digital immunohistochemistry analysis for this last specific group of patients showed a median proportion of positive neovessels equal to 5% (range: 3-19). A multivariable logistic regression demonstrated that the odds of PSMA positivity were 4.55 times higher in non-luminal tumours and decreased by a factor of 0.12 in lobular subtypes. There was no association between sex or the presence of a germline BRCA1/2 mutation and PSMA expression in tumours.

Conclusions: Our study highlights generally low neovascular expression of PSMA in specific histopathological subtypes of breast cancer, which will likely hamper the development of an adequate theranostic strategy.

Trial registration: The procedure has been retrospectively registered to the French National Institute for Health Data (N° F20220615153900).

背景:要充分了解前列腺特异性膜抗原(PSMA)在乳腺癌(BC)中的潜在作用,并开发和优化靶向疗法和成像模式,还需要进一步的研究。本研究的目的是全面分析乳腺癌中 PSMA 染色的免疫组化数据,并讨论其在治疗方法中的潜在价值:从回顾性数据库中随机抽取了58名男性和女性患者,这些患者均在2012年1月至2017年12月期间接受过乳腺癌手术,且我们的肿瘤库中有其标本。在连续切片上进行 PSMA 和 CD31 的免疫检测。数字化切片由经验丰富的病理学家进行审查和分析。此外,还对相应的 TIFF 图像进行了处理,以计算阳性新生血管的百分比:结果:18 名患者(31.6%)无表达,29 名患者(50.9%)的 PSMA 新生血管表达为 "1",10 名患者(17.5%)的新生血管表达为 "2"。对最后一组特定患者进行的数字免疫组化分析显示,阳性新生血管的中位比例为 5%(范围:3-19)。多变量逻辑回归显示,非腔隙性肿瘤中 PSMA 阳性的几率要高出 4.55 倍,而小叶亚型肿瘤中 PSMA 阳性的几率则降低了 0.12 倍。性别或是否存在种系BRCA1/2基因突变与肿瘤中PSMA的表达没有关系:我们的研究表明,在特定的乳腺癌组织病理学亚型中,PSMA的新生血管表达量普遍较低,这可能会阻碍适当的治疗策略的制定:试验登记:该程序已在法国国家健康数据研究所进行了回顾性登记(编号:F20220615153900)。
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引用次数: 0
The lncRNA AFAP1-AS1 is upregulated in metastatic triple-negative breast tumors and controls hypoxia-activated vasculogenic mimicry and angiogenesis. lncRNA AFAP1-AS1 在转移性三阴性乳腺肿瘤中上调,并控制缺氧激活的血管生成模拟和血管生成。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-29 DOI: 10.1186/s12885-024-13019-6
Alejandra Paola García-Hernández, David Núñez Corona, Ángeles Carlos-Reyes, Mónica Sierra-Martínez, Gustavo Acosta-Altamirano, Mireya Cisneros-Villanueva, Yussel Pérez-Navarro, Eloisa Ibarra-Sierra, Laurence A Marchat, César López-Camarillo
<p><strong>Background: </strong>Vasculogenic mimicry (VM) is an alternative intratumoral microcirculation system that depends on the capacity of tumor cells to reorganize and grow in three-dimensional (3D) channel architectures like the capillaries formed by endothelial cells. Both VM and angiogenesis may coordinately function to feed cancer cells, allowing tumor growth. Long noncoding RNAs (lncRNAs) regulate critical cellular functions in cancer cells, including cell proliferation, apoptosis, angiogenesis, invasion, and metastasis. The lncRNA, known as actin filament-associated protein 1-antisense RNA 1 (AFAP1-AS1), has been described as an oncogene in diverse types of cancers. However, its role in VM and metastasis in triple-negative breast cancer (TNBC) is unknown.</p><p><strong>Methods: </strong>Reverse transcription and quantitative polymerase chain reaction (RT‒qPCR) experiments were performed to evaluate the expression of 10 selected lncRNAs from literature in metastatic and nonmetastatic biopsies from TNBC patients. The expression of AFAP1-AS1 was analyzed in Genotype-Tissue Expression Genotype-Tissue Expression (GTEx) and The Cancer Genome Atlas (TCGA) datasets. The AFAP1-AS1 expression was knocked in TNBC Hs578T cells by transfection of specific siRNAs. Channel-like formation assays were performed using 3D cultures over Matrigel in hypoxia-treated Hs578T cancer cells with diminished expression of AFAP1-AS1. The angiogenesis tests were conducted using human umbilical vein endothelial cells (HUVECs) and AFAP1-AS1- silenced Hs578T cells on 3D cell cultures. The presence of VM (CD31-/PAS+) in tumor tissues from TNBC patients with and without metastasis was assessed through immunohistochemistry using endothelial marker CD31 antibodies and periodic acid-Schiff (PAS) staining.</p><p><strong>Results: </strong>Compared with normal mammary tissues, AFAP1-AS1 expression was higher in breast cancer tissues. Moreover, AFAP1-AS1 expression was upregulated in the TNBC subtype compared to receptor-positive breast tumors. In addition, the expression of AFAP1-AS1 was correlated with the expression of the thirteen genes characteristic of a previously reported hypoxia signature. Interestingly, AFAP1-AS1 was upregulated in primary TNBC tumors from patients who developed metastasis compared with the nonmetastatic group. Functional analysis revealed that the knockdown of AFAP1-AS1 in Hs578T cells significantly impaired the hypoxia-induced VM, accompanied by a decrease in the development of 3D channel networks. Similarly, AFAP1-AS1 knockdown counteracts the angiogenic potential of cancer cells, as indicated by a reduction in the number of polygons, sprouting cells, and nodes in HUVEC cells. Remarkably, an increase in CD31-/PAS + staining of 3D channel networks in primary breast tumors from metastatic patients was found compared with the nonmetastatic group. Finally, we found that the number of blood vessels increased in the nonmetastatic group more than in the
背景:血管生成模拟(VM)是一种可供选择的瘤内微循环系统,它依赖于肿瘤细胞在三维(3D)通道结构(如内皮细胞形成的毛细血管)中重组和生长的能力。VM和血管生成可能会协调发挥作用,为癌细胞提供养料,使肿瘤得以生长。长非编码 RNA(lncRNA)调控癌细胞的关键细胞功能,包括细胞增殖、凋亡、血管生成、侵袭和转移。被称为肌动蛋白丝相关蛋白1-反义RNA 1(AFAP1-AS1)的lncRNA已被描述为多种类型癌症的致癌基因。然而,它在三阴性乳腺癌(TNBC)的VM和转移中的作用尚不清楚:方法:研究人员进行了反转录和定量聚合酶链反应(RT-qPCR)实验,以评估 10 种从文献中筛选出的 lncRNA 在 TNBC 患者转移性和非转移性活检组织中的表达情况。基因型-组织表达基因型-组织表达(GTEx)和癌症基因组图谱(TCGA)数据集分析了AFAP1-AS1的表达。通过转染特异性 siRNA 敲除 TNBC Hs578T 细胞中 AFAP1-AS1 的表达。在AFAP1-AS1表达减少的缺氧处理的Hs578T癌细胞中,使用Matrigel进行三维培养,进行通道样形成试验。在三维细胞培养物上使用人脐静脉内皮细胞(HUVECs)和AFAP1-AS1沉默的Hs578T细胞进行了血管生成试验。使用内皮标志物 CD31 抗体和周期性酸-Schiff(PAS)染色,通过免疫组化方法评估了有转移和无转移的 TNBC 患者肿瘤组织中 VM(CD31-/PAS+)的存在情况:结果:与正常乳腺组织相比,AFAP1-AS1在乳腺癌组织中的表达量更高。此外,与受体阳性乳腺肿瘤相比,AFAP1-AS1在TNBC亚型中表达上调。此外,AFAP1-AS1 的表达与之前报道的缺氧特征的 13 个特征基因的表达相关。有趣的是,与非转移组相比,AFAP1-AS1在发生转移的TNBC原发肿瘤中上调。功能分析显示,在 Hs578T 细胞中敲除 AFAP1-AS1 会显著影响缺氧诱导的 VM,并伴随着三维通道网络发育的减少。同样,AFAP1-AS1 基因敲除也会抵消癌细胞的血管生成潜能,这表现在 HUVEC 细胞中多边形、发芽细胞和节点数量的减少。值得注意的是,与非转移组相比,转移患者原发性乳腺肿瘤中三维通道网络的 CD31-/PAS + 染色增加。最后,我们发现非转移组的血管数量比转移组增加得更多:我们的数据表明,AFAP1-AS1 控制着 Hs578T 乳腺癌细胞中的血管瘤和血管生成,而 TNBC 患者转移的增加与血管瘤有关。
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引用次数: 0
Development of a novel treatment based on PKMYT1 inhibition for cisplatin-resistant bladder cancer with miR-424-5p-dependent cyclin E1 amplification. 开发基于 PKMYT1 抑制剂的新型疗法,用于治疗 miR-424-5p 依赖性细胞周期蛋白 E1 扩增的顺铂耐药膀胱癌。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-29 DOI: 10.1186/s12885-024-13109-5
Wataru Fukumoto, Shunsuke Okamura, Motoki Tamai, Junya Arima, Ichiro Kawahara, Ikumi Fukuda, Akihiko Mitsuke, Takashi Sakaguchi, Satoshi Sugita, Ryosuke Matsushita, Shuichi Tatarano, Yasutoshi Yamada, Masayuki Nakagawa, Hideki Enokida, Hirofumi Yoshino

Background: Chemotherapy including cisplatin is recommended for the treatment of advanced bladder cancer, but its effectiveness is limited due to the acquisition of drug resistance. Although several mechanisms of cisplatin resistance have been reported, there are still many unknowns, and treatment of cisplatin-resistant bladder cancer remains difficult. Accordingly, in this study, we aimed to identify and characterize microRNAs involved in cisplatin resistance.

Methods: Small RNA sequencing analysis was performed to search for microRNAs related to cisplatin resistance. The identified microRNAs were then characterized using gain-of-function studies, sensitivity analysis, target gene analysis, and cellular assays.

Results: We identified miR-424-5p as a candidate microRNA that was downregulated in cisplatin-resistant strains compared with parental strains. Notably, in gain-of-function studies, miR-424-5p suppressed the proliferative ability of cisplatin-resistant bladder cancer (CDDP-R BC). Furthermore, miR-424-5p restored sensitivity to cisplatin. RNA sequence analysis revealed seven candidate genes targeted by this microRNA. Among them, cyclin E1 (CCNE1) was chosen for subsequent analyses because its expression was upregulated in cisplatin-resistant cells compared with parental cells and because recent studies have shown that CCNE1 amplification is synthetic lethal with PKMYT1 kinase inhibition. Therefore, we performed functional analysis using the PKMYT1 inhibitor RP-6306 and demonstrated that RP-6306 inhibited cell growth through suppression of mitotic entry and restored cisplatin sensitivity in CDDP-R BC.

Conclusions: Overall, our findings provided insights into the development of novel therapeutic strategies for CDDP-R BC.

背景:包括顺铂在内的化疗被推荐用于晚期膀胱癌的治疗,但由于耐药性的产生,其疗效有限。尽管顺铂耐药的几种机制已被报道,但仍有许多未知因素,因此顺铂耐药膀胱癌的治疗仍然困难重重。因此,在本研究中,我们旨在鉴定和描述参与顺铂耐药的微RNA:方法:进行小RNA测序分析,寻找与顺铂耐药相关的microRNA。然后利用功能增益研究、敏感性分析、靶基因分析和细胞测定对已鉴定的 microRNA 进行表征:结果:我们发现 miR-424-5p 是顺铂耐药菌株与亲本菌株相比下调的候选 microRNA。值得注意的是,在功能增益研究中,miR-424-5p抑制了顺铂耐药膀胱癌(CDDP-R BC)的增殖能力。此外,miR-424-5p 恢复了对顺铂的敏感性。RNA序列分析发现了该microRNA靶向的七个候选基因。其中,细胞周期蛋白 E1(CCNE1)被选中进行后续分析,因为与亲代细胞相比,它在顺铂耐药细胞中的表达上调,而且最近的研究表明,CCNE1 扩增与 PKMYT1 激酶抑制作用合成致死。因此,我们使用PKMYT1抑制剂RP-6306进行了功能分析,结果表明RP-6306通过抑制有丝分裂的进入抑制了细胞的生长,并恢复了CDDP-R BC对顺铂的敏感性:总之,我们的研究结果为开发 CDDP-R BC 的新型治疗策略提供了启示。
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引用次数: 0
First-line treatment with gefitinib in combination with bevacizumab and chemotherapy in advanced non-squamous NSCLC with EGFR-mutation. 吉非替尼联合贝伐单抗和化疗一线治疗表皮生长因子受体突变的晚期非鳞状 NSCLC。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-29 DOI: 10.1186/s12885-024-13084-x
Yanjuan Xiong, Lu Wang, Weihong Zhang, Yuan Meng, Yang Wang, Meng Shen, Li Zhou, Runmei Li, Yingge Lv, Shengguang Wang, Xiubao Ren, Liang Liu

Background: The safety and efficacy of combination of gefitinib with chemotherapy and bevacizumab in treatment patients with epidermal growth factor receptor (EGFR) mutations are currently unknown. This study was designed to evaluate the safety and preliminary efficacy of a combination therapy consisting of gefitinib, bevacizumab, pemetrexed, and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) harboring EGFR mutations.

Methods: Eligible patients with EGFR-mutated advanced non-squamous NSCLC were recruited and received gefitinib combination with bevacizumab plus pemetrexed and carboplatin treatment. The primary endpoints were safety and progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and overall survival (OS).

Results: From June 2019 to June 2021, 20 patients were enrolled in this study. The median follow-up was 33.8 months (95% CI, 31.0-36.6). Grade ≥ 3 adverse events was 65%, including neutropenia (30%), thrombocytopenia (20%), nausea (20%), skin rash (20%), bleeding (10%), and increased ALT (10%). There was no death related to toxicity occurred. The median PFS was 28 months (95% CI, 20.4-35.6). the ORR was 95% (95% CI, 75.1-99.9%), the DCR was 100% (95% CI, 83.2-100%), and the median DOR was 26.4 months (95% CI, 18.9-33.9). The median OS has not been reached.

Conclusion: The results of this study demonstrate that the four-drug combination regimen, led by gefitinib, is manageable and tolerated and effective for patients with EGFR-mutated advanced non-squamous NSCLC.

背景:吉非替尼与化疗和贝伐单抗联合治疗表皮生长因子受体(EGFR)突变患者的安全性和疗效目前尚不清楚。本研究旨在评估吉非替尼、贝伐单抗、培美曲塞和卡铂联合疗法对携带表皮生长因子受体突变的晚期非鳞状非小细胞肺癌(NSCLC)患者的安全性和初步疗效:招募符合条件的EGFR突变晚期非鳞状NSCLC患者,接受吉非替尼联合贝伐单抗、培美曲塞和卡铂治疗。主要终点是安全性和无进展生存期(PFS)。次要终点包括客观反应率(ORR)、疾病控制率(DCR)、反应持续时间(DOR)和总生存期(OS):从 2019 年 6 月到 2021 年 6 月,20 名患者参与了这项研究。中位随访时间为 33.8 个月(95% CI,31.0-36.6)。≥3级不良事件占65%,包括中性粒细胞减少(30%)、血小板减少(20%)、恶心(20%)、皮疹(20%)、出血(10%)和ALT升高(10%)。没有出现与毒性相关的死亡病例。中位 PFS 为 28 个月(95% CI,20.4-35.6),ORR 为 95%(95% CI,75.1-99.9%),DCR 为 100%(95% CI,83.2-100%),中位 DOR 为 26.4 个月(95% CI,18.9-33.9)。中位 OS 尚未达到:本研究结果表明,以吉非替尼为主导的四药联合治疗方案对于表皮生长因子受体(EGFR)突变的晚期非鳞癌NSCLC患者是可控的、可耐受的和有效的。
{"title":"First-line treatment with gefitinib in combination with bevacizumab and chemotherapy in advanced non-squamous NSCLC with EGFR-mutation.","authors":"Yanjuan Xiong, Lu Wang, Weihong Zhang, Yuan Meng, Yang Wang, Meng Shen, Li Zhou, Runmei Li, Yingge Lv, Shengguang Wang, Xiubao Ren, Liang Liu","doi":"10.1186/s12885-024-13084-x","DOIUrl":"10.1186/s12885-024-13084-x","url":null,"abstract":"<p><strong>Background: </strong>The safety and efficacy of combination of gefitinib with chemotherapy and bevacizumab in treatment patients with epidermal growth factor receptor (EGFR) mutations are currently unknown. This study was designed to evaluate the safety and preliminary efficacy of a combination therapy consisting of gefitinib, bevacizumab, pemetrexed, and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) harboring EGFR mutations.</p><p><strong>Methods: </strong>Eligible patients with EGFR-mutated advanced non-squamous NSCLC were recruited and received gefitinib combination with bevacizumab plus pemetrexed and carboplatin treatment. The primary endpoints were safety and progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and overall survival (OS).</p><p><strong>Results: </strong>From June 2019 to June 2021, 20 patients were enrolled in this study. The median follow-up was 33.8 months (95% CI, 31.0-36.6). Grade ≥ 3 adverse events was 65%, including neutropenia (30%), thrombocytopenia (20%), nausea (20%), skin rash (20%), bleeding (10%), and increased ALT (10%). There was no death related to toxicity occurred. The median PFS was 28 months (95% CI, 20.4-35.6). the ORR was 95% (95% CI, 75.1-99.9%), the DCR was 100% (95% CI, 83.2-100%), and the median DOR was 26.4 months (95% CI, 18.9-33.9). The median OS has not been reached.</p><p><strong>Conclusion: </strong>The results of this study demonstrate that the four-drug combination regimen, led by gefitinib, is manageable and tolerated and effective for patients with EGFR-mutated advanced non-squamous NSCLC.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The real-world efficacy and safety of nivolumab plus chemotherapy in patients with HER2-negative advanced gastric cancer. nivolumab联合化疗对HER2阴性晚期胃癌患者的实际疗效和安全性。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1186/s12885-024-13066-z
Yu-Yin Liu, Ming-Yen Tsai, Ting-Ting Liu, Yueh-Wei Liu, Yu-Hung Lin, Cheng-Hsi Yeh, Yu-Cheng Lin, Yen-Hao Chen

Background: The aim of this study is to investigate the real-world efficacy and safety of nivolumab in combination with chemotherapy for patients with advanced human epidermal growth factor receptor 2 (HER2)-negative gastric cancer (GC).

Methods: We enrolled patients diagnosed with unresectable advanced or metastatic GC who received nivolumab plus chemotherapy as first-line systemic treatment. The combined positive score (CPS), indicating the number of programmed cell death-ligand 1 (PD-L1)-stained cells, was utilized. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Adverse events (AEs) were graded, and treatment was ceased upon disease progression or intolerance.

Results: A total of 27 patients were included in the study, comprising 15 patients with CPS ≥ 5 and 12 patients with CPS < 5. The objective response rate (ORR) was 55.6%, with a disease control rate (DCR) of 74.1%. Patients in the CPS ≥ 5 group exhibited higher ORR and DCR compared to those in the CPS < 5 group. Median PFS and OS were 6.1 months and 14.6 months, respectively; patients with CPS ≥ 5 showed a trend towards better PFS and OS than those with CPS < 5. Most AEs were grade 1-2, with a few instances of grade 3-4 toxicities reported, including neutropenia, thrombocytopenia, diarrhea, and anemia. There were no grade 5 AEs reported in our cohort. Furthermore, 64.7% of patients received subsequent anticancer treatment following disease progression on nivolumab plus chemotherapy.

Conclusions: The results of our study demonstrate the efficacy and safety of nivolumab plus chemotherapy in real-world practice support its adoption as a new standard first-line treatment for patients with advanced HER2-negative GC, particularly those with CPS ≥ 5.

研究背景本研究旨在探讨nivolumab联合化疗治疗晚期人表皮生长因子受体2(HER2)阴性胃癌(GC)患者的实际疗效和安全性:我们招募了确诊为不可切除的晚期或转移性胃癌患者,这些患者接受了nivolumab联合化疗作为一线系统治疗。综合阳性评分(CPS)表示程序性细胞死亡配体1(PD-L1)染色细胞的数量。无进展生存期(PFS)和总生存期(OS)采用卡普兰-梅耶法进行分析。对不良事件(AEs)进行分级,并在疾病进展或不耐受时停止治疗:研究共纳入 27 名患者,包括 15 名 CPS≥5 的患者和 12 名 CPS 的患者:我们的研究结果证明了nivolumab联合化疗在实际应用中的有效性和安全性,支持将其作为晚期HER2阴性GC患者,尤其是CPS≥5的患者的一线治疗新标准。
{"title":"The real-world efficacy and safety of nivolumab plus chemotherapy in patients with HER2-negative advanced gastric cancer.","authors":"Yu-Yin Liu, Ming-Yen Tsai, Ting-Ting Liu, Yueh-Wei Liu, Yu-Hung Lin, Cheng-Hsi Yeh, Yu-Cheng Lin, Yen-Hao Chen","doi":"10.1186/s12885-024-13066-z","DOIUrl":"10.1186/s12885-024-13066-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to investigate the real-world efficacy and safety of nivolumab in combination with chemotherapy for patients with advanced human epidermal growth factor receptor 2 (HER2)-negative gastric cancer (GC).</p><p><strong>Methods: </strong>We enrolled patients diagnosed with unresectable advanced or metastatic GC who received nivolumab plus chemotherapy as first-line systemic treatment. The combined positive score (CPS), indicating the number of programmed cell death-ligand 1 (PD-L1)-stained cells, was utilized. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Adverse events (AEs) were graded, and treatment was ceased upon disease progression or intolerance.</p><p><strong>Results: </strong>A total of 27 patients were included in the study, comprising 15 patients with CPS ≥ 5 and 12 patients with CPS < 5. The objective response rate (ORR) was 55.6%, with a disease control rate (DCR) of 74.1%. Patients in the CPS ≥ 5 group exhibited higher ORR and DCR compared to those in the CPS < 5 group. Median PFS and OS were 6.1 months and 14.6 months, respectively; patients with CPS ≥ 5 showed a trend towards better PFS and OS than those with CPS < 5. Most AEs were grade 1-2, with a few instances of grade 3-4 toxicities reported, including neutropenia, thrombocytopenia, diarrhea, and anemia. There were no grade 5 AEs reported in our cohort. Furthermore, 64.7% of patients received subsequent anticancer treatment following disease progression on nivolumab plus chemotherapy.</p><p><strong>Conclusions: </strong>The results of our study demonstrate the efficacy and safety of nivolumab plus chemotherapy in real-world practice support its adoption as a new standard first-line treatment for patients with advanced HER2-negative GC, particularly those with CPS ≥ 5.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A 16-year evaluation of opportunistic lung cancer screening with low-dose CT in China: comparative findings between non-smokers and smokers. 中国低剂量 CT 机会性肺癌筛查 16 年评估:非吸烟者与吸烟者的比较结果。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1186/s12885-024-13056-1
Yanyan Tang, Shijun Zhao, Lina Zhou, Yao Huang, Jianwei Wang, Min Liang, Fei Wang, Haohua Zhu, Linlin Qi, Li Zhang, Li Liu, Donghui Hou, Zhijian Xu, Kai Zhang, Wei Tang, Ning Wu
<p><strong>Background: </strong>Although low-dose computed tomography (LDCT) screening effectively reduces LC mortality in high-risk individuals with a history of smoking in China, the feasibility and efficacy of lung cancer screening (LCS) in individuals who never smoked versus individuals who smoked remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of prospective cohort studies at the National Cancer Center (NCC) in China from January 2006 to December 2022. A comprehensive LCS initiative was undertaken, involving 30,468 participants (54.5% male). Participants underwent LCS using LDCT. Potential malignancies were managed through joint consensus between patients and their physicians. Epidemiology, screening eligibility criteria, and LC detection rates and survival outcomes were compared between individuals who smoked and individuals who never smoked.</p><p><strong>Results: </strong>Among 30,468 participants, 339 LCs were pathologically confirmed in 289 patients. The LC detection rate was 0.9% (289/30,468) overall, 0.8% in individuals who smoked (71/9,042), and 1.0% in individuals who never smoked (218/21,426). In individuals who smoked, LC detection rates were 0.5% (21/4516) and 1.1% (50/4526) in the < 20 and ≥ 20 pack-year subgroups, respectively (P = 0.001). Early-stage LC (stage 0 or I) was detected in 73.8% of the individuals who smoked and in 78.8% of individuals who never smoked, while advanced LC (stage III-IV) was found 8.8% of individuals who smoked and 4.2% of individuals who never smoked, respectively. Significant differences in histologic types were found between individuals who smoked and individuals who never smoked (P = 0.01), although adenocarcinoma was the most prevalent in both groups, at 83.0% and 78.8%, respectively. The median nodule size was 9.9 mm (IQR, 8.0-13.8) in individuals who smoked and 9.2 mm (IQR, 6.8-13.6) in individuals who never smoked (P = 0.228). Individuals who never smoked tended to favour surgical treatment alone (88.0%) more than individuals who smoked (81.3%). The 10-year survival rate was higher in individuals who never smoked (92.6%) than in individuals who smoked (88.8%). Only 15.6% (45/289) of patients with LC met the United States Preventive Services Task Force (USPSTF) criteria for LDCT eligibility, while 29.0% (84/289) met the China guideline for the screening and early detection of lung cancer (CGSL) criteria. Median follow-up for those followed was 25.4 (IQR, 13.7-43.3) months.</p><p><strong>Conclusions: </strong>LDCT screening improves early LC detection and treatment outcomes for both individuals who smoked and individuals who never smoked. Significant differences exist in epidemiology, histologic type, and survival between these groups. The USPSTF and CGSL criteria miss a significant number of LC cases, particularly among individuals who never smoked. Integrating individuals who never smoked into LCS programs is essential, yet it comes with its own challenge
背景:在中国,虽然低剂量计算机断层扫描(LDCT)筛查能有效降低有吸烟史的高危人群的肺癌死亡率,但从未吸烟者与吸烟者进行肺癌筛查(LCS)的可行性和有效性仍不清楚:我们对中国国家癌症中心(NCC)2006 年 1 月至 2022 年 12 月的前瞻性队列研究进行了回顾性分析。国家癌症中心开展了一项全面的低密度脂蛋白血症研究,共有 30,468 名参与者(54.5% 为男性)参与其中。参与者使用 LDCT 进行了 LCS 检查。潜在的恶性肿瘤由患者和医生共同协商处理。对吸烟者和从不吸烟者的流行病学、筛查资格标准、LC检出率和生存结果进行了比较:在 30,468 名参与者中,有 289 名患者的 339 例 LC 得到病理证实。总的 LC 检出率为 0.9%(289/30,468),吸烟者为 0.8%(71/9,042),从不吸烟者为 1.0%(218/21,426)。结论:在吸烟者中,低密度脂蛋白胆固醇的检出率分别为 0.5%(21/4516)和 1.1%(50/4526):无论是吸烟者还是从不吸烟者,LDCT筛查都能提高早期乳腺癌的检出率和治疗效果。这些群体在流行病学、组织学类型和存活率方面存在显著差异。USPSTF 和 CGSL 标准遗漏了大量 LC 病例,尤其是从未吸烟者。将从不吸烟者纳入 LCS 项目是非常必要的,但这也带来了自身的挑战,如管理辐射风险、有效分配资源和考虑财务问题。因此,中国的LCS项目迫切需要更好地识别易患LC的非吸烟 "高危 "人群,并确保降低筛查带来的潜在风险。
{"title":"A 16-year evaluation of opportunistic lung cancer screening with low-dose CT in China: comparative findings between non-smokers and smokers.","authors":"Yanyan Tang, Shijun Zhao, Lina Zhou, Yao Huang, Jianwei Wang, Min Liang, Fei Wang, Haohua Zhu, Linlin Qi, Li Zhang, Li Liu, Donghui Hou, Zhijian Xu, Kai Zhang, Wei Tang, Ning Wu","doi":"10.1186/s12885-024-13056-1","DOIUrl":"10.1186/s12885-024-13056-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although low-dose computed tomography (LDCT) screening effectively reduces LC mortality in high-risk individuals with a history of smoking in China, the feasibility and efficacy of lung cancer screening (LCS) in individuals who never smoked versus individuals who smoked remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis of prospective cohort studies at the National Cancer Center (NCC) in China from January 2006 to December 2022. A comprehensive LCS initiative was undertaken, involving 30,468 participants (54.5% male). Participants underwent LCS using LDCT. Potential malignancies were managed through joint consensus between patients and their physicians. Epidemiology, screening eligibility criteria, and LC detection rates and survival outcomes were compared between individuals who smoked and individuals who never smoked.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 30,468 participants, 339 LCs were pathologically confirmed in 289 patients. The LC detection rate was 0.9% (289/30,468) overall, 0.8% in individuals who smoked (71/9,042), and 1.0% in individuals who never smoked (218/21,426). In individuals who smoked, LC detection rates were 0.5% (21/4516) and 1.1% (50/4526) in the &lt; 20 and ≥ 20 pack-year subgroups, respectively (P = 0.001). Early-stage LC (stage 0 or I) was detected in 73.8% of the individuals who smoked and in 78.8% of individuals who never smoked, while advanced LC (stage III-IV) was found 8.8% of individuals who smoked and 4.2% of individuals who never smoked, respectively. Significant differences in histologic types were found between individuals who smoked and individuals who never smoked (P = 0.01), although adenocarcinoma was the most prevalent in both groups, at 83.0% and 78.8%, respectively. The median nodule size was 9.9 mm (IQR, 8.0-13.8) in individuals who smoked and 9.2 mm (IQR, 6.8-13.6) in individuals who never smoked (P = 0.228). Individuals who never smoked tended to favour surgical treatment alone (88.0%) more than individuals who smoked (81.3%). The 10-year survival rate was higher in individuals who never smoked (92.6%) than in individuals who smoked (88.8%). Only 15.6% (45/289) of patients with LC met the United States Preventive Services Task Force (USPSTF) criteria for LDCT eligibility, while 29.0% (84/289) met the China guideline for the screening and early detection of lung cancer (CGSL) criteria. Median follow-up for those followed was 25.4 (IQR, 13.7-43.3) months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;LDCT screening improves early LC detection and treatment outcomes for both individuals who smoked and individuals who never smoked. Significant differences exist in epidemiology, histologic type, and survival between these groups. The USPSTF and CGSL criteria miss a significant number of LC cases, particularly among individuals who never smoked. Integrating individuals who never smoked into LCS programs is essential, yet it comes with its own challenge","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contrast-enhanced ultrasound combined with percutaneous ultrasound-guide core needle biopsies in the diagnosis of pancreatic lesions: a propensity score-matched study. 对比增强超声结合经皮超声引导核心针活检诊断胰腺病变:倾向评分匹配研究。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1186/s12885-024-13106-8
Quan Dai, Yi Tao, Zihao Wang, Likun Cui, Li Han, Tiefeng Shi, Xiaobo Wu

Objective: To compare the diagnostic performance of pancreatic lesions using percutaneous ultrasound (US)-guided core needle biopsy (CNB) with and without contrast-enhanced ultrasound (CEUS).

Method: The patients were divided into two groups, US and CEUS group, based on whether CEUS was performed prior to biopsy. Before and after propensity score matching (PSM), the CNB-relevant characteristics of the two groups, including the first puncture success rate, the number of sampling, complication rate, type of complications, and degree of abdominal pain, were compared. The accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of percutaneous US-guided CNB were compared between the groups.

Results: This study included 277 patients (173 men and 104 women) with pancreatic lesions who underwent percutaneous CNB before PSM; 190 patients in the CEUS group, and 87 in the US group prior to CNB. After controlling for potential biases using PSM, no significant differences were observed in the complication rate, type of complications, or degree of abdominal pain between the CEUS and US groups (P > 0.05). However, significant differences were observed in the first puncture success rate and the number of sampling (P < 0.05). Importantly, before and after PSM, the CEUS group achieved a higher first-puncture success rate while obtaining a lower number of sampling (P < 0.05). Compared to the US group, the CEUS group demonstrated improved accuracy, sensitivity, specificity, PPV, and NPV of 13.1%, 14.9%, 13.4%, 2.5%, and 38.7%, respectively. Furthermore, the significant difference was observed in the AUC for diagnostic performance between the two groups when compared using DeLong's test (P = 0.043).

Conclusions: Performing CEUS before percutaneous CNB for pancreatic lesions can help achieve better biopsy results, reduce the number of punctures samples, increase the success rate of biopsies, and avoid the need for repeat biopsies.

目的比较在经皮超声(US)引导下进行核心针穿刺活检(CNB)和不进行造影剂增强超声(CEUS)对胰腺病变的诊断效果:根据活检前是否进行CEUS,将患者分为两组,即US组和CEUS组。在倾向得分匹配(PSM)前后,比较两组患者的 CNB 相关特征,包括首次穿刺成功率、取样次数、并发症发生率、并发症类型和腹痛程度。比较了两组经皮 US 引导 CNB 的准确性、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和曲线下面积(AUC):该研究纳入了277名胰腺病变患者(男性173名,女性104名),他们在PSM前接受了经皮CNB检查;其中CEUS组190名患者,US组87名患者在CNB前接受了经皮CNB检查。使用 PSM 控制潜在偏差后,CEUS 组和 US 组在并发症发生率、并发症类型或腹痛程度方面没有观察到显著差异(P > 0.05)。然而,在首次穿刺成功率和取样次数上却观察到了明显差异(P 结论:CEUS 和 US 组的首次穿刺成功率和取样次数均高于 CEUS 组:胰腺病变经皮 CNB 检查前进行 CEUS 可帮助获得更好的活检结果,减少穿刺样本数量,提高活检成功率,避免重复活检。
{"title":"Contrast-enhanced ultrasound combined with percutaneous ultrasound-guide core needle biopsies in the diagnosis of pancreatic lesions: a propensity score-matched study.","authors":"Quan Dai, Yi Tao, Zihao Wang, Likun Cui, Li Han, Tiefeng Shi, Xiaobo Wu","doi":"10.1186/s12885-024-13106-8","DOIUrl":"10.1186/s12885-024-13106-8","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performance of pancreatic lesions using percutaneous ultrasound (US)-guided core needle biopsy (CNB) with and without contrast-enhanced ultrasound (CEUS).</p><p><strong>Method: </strong>The patients were divided into two groups, US and CEUS group, based on whether CEUS was performed prior to biopsy. Before and after propensity score matching (PSM), the CNB-relevant characteristics of the two groups, including the first puncture success rate, the number of sampling, complication rate, type of complications, and degree of abdominal pain, were compared. The accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of percutaneous US-guided CNB were compared between the groups.</p><p><strong>Results: </strong>This study included 277 patients (173 men and 104 women) with pancreatic lesions who underwent percutaneous CNB before PSM; 190 patients in the CEUS group, and 87 in the US group prior to CNB. After controlling for potential biases using PSM, no significant differences were observed in the complication rate, type of complications, or degree of abdominal pain between the CEUS and US groups (P > 0.05). However, significant differences were observed in the first puncture success rate and the number of sampling (P < 0.05). Importantly, before and after PSM, the CEUS group achieved a higher first-puncture success rate while obtaining a lower number of sampling (P < 0.05). Compared to the US group, the CEUS group demonstrated improved accuracy, sensitivity, specificity, PPV, and NPV of 13.1%, 14.9%, 13.4%, 2.5%, and 38.7%, respectively. Furthermore, the significant difference was observed in the AUC for diagnostic performance between the two groups when compared using DeLong's test (P = 0.043).</p><p><strong>Conclusions: </strong>Performing CEUS before percutaneous CNB for pancreatic lesions can help achieve better biopsy results, reduce the number of punctures samples, increase the success rate of biopsies, and avoid the need for repeat biopsies.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Short-term outcomes and quality of life of esophagogastrostomy versus the double-tract reconstruction after laparoscopic proximal gastrectomy. 腹腔镜近端胃切除术后食管胃造口术与双管重建术的短期疗效和生活质量对比。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1186/s12885-024-13095-8
Yong Sun, Chao Chen, Lei Hou, Enhong Zhao
<p><strong>Background: </strong>There is no optimal reconstruction technique after proximal gastrectomy. The esophagogastrostomy (EG) is a rather simple procedure technically, but the incidences of reflux esophagitis and anastomotic stricture are higher. While the double-tract reconstruction (DTR) can lessen postoperative reflux esophagitis, it is technically complex with a long operation time. The purpose of this study was to evaluate the quality of life (QoL) and short-term outcomes of the two reconstruction techniques.</p><p><strong>Methods: </strong>We retrospectively collected consecutive patients with upper-third gastric adenocarcinoma and adenocarcinoma of the esophagogastric junction (AEG) at our center between 2019 June and 2023 May. Patients who underwent laparoscopic proximal gastrectomy (LPG) with EG or DTR were included in this study. A comparison was made between the clinical and pathological characteristics of patients and their surgical parameters, postoperative complications, and its 1-year QoL in two groups. The QoL of the two groups was assessed by Visick grading, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-STO22 scales at 1 year after operation. The nutritional status of the two groups was evaluated by BMI, hemoglobin and serum albumin.</p><p><strong>Results: </strong>AII the qualified patients were divided EG group (n = 63) and DTR group (n = 93). Compared to the DTR group, the blood loss volume of EG group was more (p = 0.001). There were no significant differences in operation duration, number of lymph nodes dissected, and postoperative length of stay between the two groups(p > 0.05). No statistical differences were observed in terms of the incidence of early complications and Clavien-Dindo classification as well(p > 0.05). After one year, the Visick grade of the DTR group was better than EG group (p = 0.040). The multivariable logistic regression analysis showed the only independent risk factor for reflux esophagitis was the reconstruction method. According to the EORTC QLQ-C30 questionnaire, patients in the DTR group had a better global health status(p = 0.001) and complained less about nausea and vomiting(p = 0.033), and appetite loss (p = 0.022). Patients in the DTR group complained less about reflux (p = 0.030) based on the EORTC QLQ-STO22 questionnaire. The multiple linear regression analysis revealed that the reconstruction method, reflux esophagitis and age had a linear relationship with the global health status score. Regarding nutritional status, BMI of the two groups both decreased 1 year after operation, and BMI decline value of the DTR group was lower than EG group (p = 0.001). There is no statistically significant difference between the two groups as for postoperative change in hemoglobin and serum albumin.</p><p><strong>Conclusion: </strong>Our findings suggest that it is possible for skilled surgeons to achieve minimal blood loss volume without significantly i
背景:近端胃切除术后没有最佳的重建技术。食管胃切除术(EG)在技术上相当简单,但反流性食管炎和吻合口狭窄的发生率较高。虽然双管重建术(DTR)可以减轻术后反流性食管炎,但其技术复杂,手术时间长。本研究旨在评估两种重建技术的生活质量(QoL)和短期疗效:我们回顾性收集了本中心在2019年6月至2023年5月期间连续收治的上三分之一胃腺癌和食管胃交界处腺癌(AEG)患者。本研究纳入了接受腹腔镜近端胃切除术(LPG)并伴有EG或DTR的患者。比较了两组患者的临床和病理特征及其手术参数、术后并发症及其 1 年 QoL。两组患者术后 1 年的 QoL 采用 Visick 分级、欧洲癌症研究与治疗组织(EORTC)QLQ-C30 和 EORTC QLQ-STO22 量表进行评估。两组患者的营养状况通过体重指数、血红蛋白和血清白蛋白进行评估:合格患者分为 EG 组(63 人)和 DTR 组(93 人)。与 DTR 组相比,EG 组失血量更多(P = 0.001)。两组在手术时间、淋巴结清扫数量和术后住院时间上无明显差异(P > 0.05)。在早期并发症的发生率和 Clavien-Dindo 分级方面,两组也没有统计学差异(P > 0.05)。一年后,DTR 组的 Visick 分级优于 EG 组(P = 0.040)。多变量逻辑回归分析显示,重建方法是导致反流性食管炎的唯一独立危险因素。根据 EORTC QLQ-C30 问卷,DTR 组患者的总体健康状况较好(p = 0.001),对恶心、呕吐(p = 0.033)和食欲不振(p = 0.022)的抱怨较少。根据 EORTC QLQ-STO22 调查问卷,DTR 组患者对反流的抱怨较少(p = 0.030)。多元线性回归分析显示,重建方法、反流性食管炎和年龄与总体健康状况评分呈线性关系。在营养状况方面,两组患者术后 1 年的 BMI 均有所下降,其中 DTR 组的 BMI 下降值低于 EG 组(P = 0.001)。两组术后血红蛋白和血清白蛋白的变化差异无统计学意义:我们的研究结果表明,熟练的外科医生在进行 DRT 时,有可能在不明显增加手术时间的情况下,将失血量降到最低,而这并不会增加风险。在抗反流、术后 QoL 和 BMI 维持方面,术后 1 年随访结果显示 DRT 优于 EG,值得进一步研究和推广。
{"title":"Short-term outcomes and quality of life of esophagogastrostomy versus the double-tract reconstruction after laparoscopic proximal gastrectomy.","authors":"Yong Sun, Chao Chen, Lei Hou, Enhong Zhao","doi":"10.1186/s12885-024-13095-8","DOIUrl":"10.1186/s12885-024-13095-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is no optimal reconstruction technique after proximal gastrectomy. The esophagogastrostomy (EG) is a rather simple procedure technically, but the incidences of reflux esophagitis and anastomotic stricture are higher. While the double-tract reconstruction (DTR) can lessen postoperative reflux esophagitis, it is technically complex with a long operation time. The purpose of this study was to evaluate the quality of life (QoL) and short-term outcomes of the two reconstruction techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively collected consecutive patients with upper-third gastric adenocarcinoma and adenocarcinoma of the esophagogastric junction (AEG) at our center between 2019 June and 2023 May. Patients who underwent laparoscopic proximal gastrectomy (LPG) with EG or DTR were included in this study. A comparison was made between the clinical and pathological characteristics of patients and their surgical parameters, postoperative complications, and its 1-year QoL in two groups. The QoL of the two groups was assessed by Visick grading, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-STO22 scales at 1 year after operation. The nutritional status of the two groups was evaluated by BMI, hemoglobin and serum albumin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AII the qualified patients were divided EG group (n = 63) and DTR group (n = 93). Compared to the DTR group, the blood loss volume of EG group was more (p = 0.001). There were no significant differences in operation duration, number of lymph nodes dissected, and postoperative length of stay between the two groups(p &gt; 0.05). No statistical differences were observed in terms of the incidence of early complications and Clavien-Dindo classification as well(p &gt; 0.05). After one year, the Visick grade of the DTR group was better than EG group (p = 0.040). The multivariable logistic regression analysis showed the only independent risk factor for reflux esophagitis was the reconstruction method. According to the EORTC QLQ-C30 questionnaire, patients in the DTR group had a better global health status(p = 0.001) and complained less about nausea and vomiting(p = 0.033), and appetite loss (p = 0.022). Patients in the DTR group complained less about reflux (p = 0.030) based on the EORTC QLQ-STO22 questionnaire. The multiple linear regression analysis revealed that the reconstruction method, reflux esophagitis and age had a linear relationship with the global health status score. Regarding nutritional status, BMI of the two groups both decreased 1 year after operation, and BMI decline value of the DTR group was lower than EG group (p = 0.001). There is no statistically significant difference between the two groups as for postoperative change in hemoglobin and serum albumin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings suggest that it is possible for skilled surgeons to achieve minimal blood loss volume without significantly i","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interobserver variability of clinical target volume delineation in patients undergoing breast-conserving surgery without surgical clips: a pilot study on preoperative magnetic resonance simulation. 无手术夹保乳手术患者临床目标体积划分的观察者间变异性:术前磁共振模拟试验研究。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-26 DOI: 10.1186/s12885-024-13076-x
Shuning Jiao, Yiqing Wang, Jiabin Ma, Jing Shen, Xi-Qian Zhang, Bing Zhou, Xiansong Sun, Haoran Xu, Xia Liu, Ke Hu, Fuquan Zhang, Xiaorong Hou, Jie Qiu

Background: In patients undergoing breast-conserving therapy without surgical clip implantation, the accuracy of tumor bed identification and the consistency of clinical target volume (CTV) delineation under computed tomography (CT) simulation remain suboptimal. This study aimed to investigate the feasibility of implementing preoperative magnetic resonance (MR) simulation on delineations by assessing interobserver variability (IOV).

Methods: Preoperative MR and postoperative CT simulations were performed in patients who underwent breast-conserving surgery with no surgical clips implanted. Custom immobilization pads were used to ensure the same supine position. Three radiation oncologists independently delineated the CTV of tumor bed on the images acquired from MR and CT simulation registration and CT simulation alone. Cavity visualization score (CVS) was assigned to each patient based on the clarity of the tumor bed on CT simulation images. IOV was indicated by generalized conformity index (CIgen), denoted as CIgen-CT and CIgen-MR/CT, and the distance between the centroid of mass (dCOM), denoted as dCOMCT and dCOMMR/CT. The variation of IOV in different CVS subgroups was analyzed.

Results: A total of 10 patients were enrolled in this study. The median and interquartile range (IQR) of maximum pathological diameter of the tumors in all patients were 1.55 (0.80-1.92) cm. No statistical significance was found between the volumes of CTVs on CT simulation and on MR/CT simulation registration images (p = 0.387). CIgen-MR/CT was significantly larger than CIgen-CT (p = 0.005). dCOMMR/CT was significantly smaller than dCOMCT (p = 0.037). The median and IQR of CVS in all patients were 2.34 (2.00-3.08). The difference of CIgen between CIgen-MR/CT and CIgen-CT was larger in the low CVS group (p = 0.016). The difference of dCOM showed a decreasing trend when CVS was lower, although it did not reach statistical significance (p = 0.095).

Conclusions: For patients who underwent breast-conserving surgery without surgical clip implantation, the use of preoperative MR simulation in delineating the CTV of tumor bed decreased the IOV among observers. The consistency of tumor bed identification was improved especially in cases where the margins of tumor bed were challenging to visualize on CT simulation images. The study findings offer potential benefits in reducing local recurrence and minimizing tissue irritation in the surrounding areas. Future investigation in a larger patient cohort to validate our results is warranted.

背景:在未植入手术夹的情况下接受保乳治疗的患者中,计算机断层扫描(CT)模拟下肿瘤床识别的准确性和临床靶体积(CTV)划定的一致性仍不理想。本研究旨在通过评估观察者间变异性(IOV),研究术前磁共振(MR)模拟划线的可行性:方法:对接受保乳手术且未植入手术夹的患者进行术前磁共振和术后 CT 模拟。使用定制的固定垫以确保相同的仰卧姿势。三位放射肿瘤专家分别根据 MR 和 CT 模拟注册图像以及单独的 CT 模拟图像对肿瘤床的 CTV 进行了划分。根据 CT 模拟图像上肿瘤床的清晰度,对每位患者进行空洞可视化评分(CVS)。IOV 用广义符合性指数(CIgen)(表示为 CIgen-CT 和 CIgen-MR/CT)和肿块中心距(dCOM)(表示为 dCOMCT 和 dCOMMR/CT)表示。结果:本研究共纳入 10 名患者。所有患者肿瘤最大病理直径的中位数和四分位数间距(IQR)均为 1.55(0.80-1.92)厘米。CT模拟图像和MR/CT模拟登记图像上的CTV体积之间没有统计学意义(P = 0.387)。CIgen-MR/CT明显大于CIgen-CT(p = 0.005),dCOMMR/CT明显小于dCOMCT(p = 0.037)。所有患者的 CVS 中位数和 IQR 均为 2.34 (2.00-3.08)。CIgen-MR/CT 和 CIgen-CT 之间的 CIgen 差异在低 CVS 组更大(p = 0.016)。当 CVS 较低时,dCOM 的差异呈下降趋势,但未达到统计学意义(p = 0.095):结论:对于未植入手术夹而接受保乳手术的患者,术前使用磁共振模拟来划定肿瘤床的 CTV 降低了观察者之间的 IOV。肿瘤床识别的一致性得到了提高,尤其是在 CT 模拟图像上难以观察到肿瘤床边缘的病例中。研究结果为减少局部复发和降低对周围组织的刺激提供了潜在的益处。未来有必要在更大的患者群体中进行研究,以验证我们的结果。
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引用次数: 0
Identification of molecular subtypes based on bile acid metabolism in cholangiocarcinoma. 根据胆管癌的胆汁酸代谢鉴定分子亚型。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-10-25 DOI: 10.1186/s12885-024-13081-0
Mingxia Deng, Jing Liu, Li Zhang, Yan Lou, Yunqing Qiu

Background: Cholangiocarcinoma is a highly heterogeneous tumor with bile acid metabolism involving in its development. The aim of this study was to characterize bile acid metabolism and identify specific subtypes to better stratify cholangiocarcinoma patients for individualized treatment and prognostic assessment.

Methods: A total of 30 bile acids were quantified using the ultra-performance liquid chromatography tandem mass spectrometry. Using Consensus clustering, the molecular subtypes related to bile acid metabolism were identified. The prognosis, clinicopathologic characteristics, immune landscape, and therapeutic response were compared between these subtypes. The single-cell RNA sequencing (scRNA-seq) analysis and preliminary cell experiment were also conducted to verify our findings.

Results: The altered bile acid profile and genetic variation of bile acid metabolism-related genes in cholangiocarcinoma were demonstrated. The cholangiocarcinoma was categorized into bile acid metabolism-active and -inactive subtypes with different prognoses, clinicopathologic characteristics, tumor microenvironments (TME) and therapeutic responses. This categorization was reproducible and predictable. Specifically, the bile acid metabolism-active subtype showed a poor prognosis with an immunosuppressive microenvironment and an inactive response to immunotherapy, while the bile acid metabolism-inactive subtype showed the opposite characteristics. Moreover, the scRNA-seq revealed that immunotherapy altered bile acid metabolism in TME of cholangiocarcinoma. Finally, a prognostic signature related to bile acid metabolism was developed, which exhibited strong power for prognostic assessment of cholangiocarcinoma. Consistently, these results were verified by immunohistochemistry, cell proliferation, migration, and apoptosis assays.

Conclusion: In conclusion, a novel cholangiocarcinoma classification based on bile acid metabolism was established. This classification was significant for the estimation of TME and prognosis.

背景:胆管癌是一种高度异质性肿瘤,胆汁酸代谢与胆管癌的发生发展密切相关。本研究的目的是分析胆汁酸代谢的特点并确定特定亚型,以便更好地对胆管癌患者进行分层,从而进行个体化治疗和预后评估:方法:采用超高效液相色谱串联质谱法对30种胆汁酸进行了定量分析。方法:采用超高效液相色谱串联质谱法对 30 种胆汁酸进行定量分析,并利用共识聚类技术确定了与胆汁酸代谢相关的分子亚型。比较了这些亚型的预后、临床病理特征、免疫状况和治疗反应。为了验证我们的发现,还进行了单细胞 RNA 测序(scRNA-seq)分析和初步细胞实验:结果:胆管癌中胆汁酸谱的改变和胆汁酸代谢相关基因的遗传变异得到了证实。胆管癌被分为胆汁酸代谢活跃亚型和胆汁酸代谢不活跃亚型,它们的预后、临床病理特征、肿瘤微环境(TME)和治疗反应各不相同。这种分类具有可重复性和可预测性。具体来说,胆汁酸代谢活跃的亚型预后较差,具有免疫抑制微环境,对免疫疗法反应不活跃,而胆汁酸代谢不活跃的亚型则表现出相反的特征。此外,scRNA-seq还发现,免疫疗法改变了胆管癌TME中的胆汁酸代谢。最后,与胆汁酸代谢相关的预后特征被建立起来,该特征对胆管癌的预后评估具有很强的说服力。同时,免疫组化、细胞增殖、迁移和凋亡测定也验证了这些结果:总之,基于胆汁酸代谢的新型胆管癌分类方法已经建立。结论:根据胆汁酸代谢建立了一种新的胆管癌分类方法,这种分类方法对TME的估计和预后具有重要意义。
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