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Benefits and harms of screening: Overdiagnosis and anticipatory medicine – A secondary publication 筛查的利弊:过度诊断和预见性医学-二次出版
Pub Date : 2022-11-17 DOI: 10.36922/td.v1i2.228
A. Zarazaga Monzón, Á. Franco-López, J. Culebras
The treatment of breast cancer has changed markedly since the publication of works that recommend screening for the early diagnosis of breast cancer. Retrospective reevaluations have revealed errors in screening; moreover, advances in oncological therapy and a better understanding of the disease have raised doubts toward the efficacy of these procedures, which might also cause side effects alongside the risk of overdiagnosis and overtreatment. On the other hand, the lack of information or even misinformation might cause confusion among the potential beneficiaries of these procedures, particularly the patients. These procedures are constantly being recommended by institutions, but the possible risks accompanied by these procedures are often not explained. It is easy to promote mammography screening if the majority believe that it reduces the risk of breast cancer and saves lives. Unfortunately, this is not the case. Many critics of screening are now demanding clear and precise explanations of the procedure and emphasizing on the importance of physical examination. Women must make informed decisions before screening by discussing their own risk profile, the possible benefits, and the eventual risks and harms of mammogram with their physicians. Women should be classified into two groups: those who would gain potential benefits from the procedure and those whose risks outweigh the benefits. A screening program that clearly does not offer more benefits than risks cannot be implemented by public heath institutions. Providing complete and unbiased information, promoting appropriate care, as well as preventing overdiagnosis and overtreatment would be the best option.
自从推荐乳腺癌早期诊断的筛查工作发表以来,乳腺癌的治疗发生了显著变化。回顾性重新评估揭示了筛查中的错误;此外,肿瘤治疗的进步和对这种疾病更好的了解使人们对这些手术的疗效产生了怀疑,这些手术除了有过度诊断和过度治疗的风险外,还可能导致副作用。另一方面,信息的缺乏甚至错误的信息可能会导致这些程序的潜在受益者,特别是患者之间的混乱。各机构不断推荐这些程序,但这些程序可能带来的风险往往没有得到解释。如果大多数人认为乳房x光检查可以降低患乳腺癌的风险并挽救生命,那么推广乳房x光检查是很容易的。不幸的是,事实并非如此。许多对筛查持批评态度的人现在要求对筛查程序作出清晰准确的解释,并强调体格检查的重要性。在筛查前,女性必须与医生讨论自己的风险状况、可能的益处以及乳房x光检查的最终风险和危害,从而做出明智的决定。女性应该分为两组:一组可以从手术中获得潜在的好处,另一组风险大于好处。公共卫生机构不能实施一个明显利大于弊的筛查项目。提供完整和公正的信息,促进适当的护理,以及防止过度诊断和过度治疗将是最好的选择。
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引用次数: 1
A N6-methyladenosine-related long noncoding RNA is a potential biomarker for predicting pancreatic cancer prognosis n6 -甲基腺苷相关长链非编码RNA是预测胰腺癌预后的潜在生物标志物
Pub Date : 2022-10-11 DOI: 10.36922/td.v1i2.165
Yiyang Chen, Wanbang Zhou, Yiju Gong, Xi Ou
Pancreatic cancer is a common malignant tumor of the digestive system, with insidious onset, difficult early diagnosis, easy metastasis, and poor prognosis. N6-methyladenosine (m6A) and long non-coding RNA (lncRNA) play important roles in the prognostic value and immunotherapy response of pancreatic adenocarcinoma (PAAD). Therefore, it is crucial to recognize m6A-related-lncRNAs in PAAD patients. In this study, m6A-related lncRNAs were obtained by coexpression analysis. Univariate, the Least Absolute Shrinkage, and Selection Operator (LASSO) and multivariate Cox regression analyses were performed to construct m6A-related lncRNA prognostic models. Kaplan–Meier analysis, principal component analysis, feature-rich annotation, and nomogram were used to analyze the accuracy of risk models. Potential drugs targeting this model are also discussed. A prognostic model based on m6A-related lncRNAs was constructed, potential drugs targeting this m6A-related lncRNAs feature were discovered, and the relationship with immunotherapy response was studied. Finally, a nomogram was established to predict survival in PAAD patients. This m6A-based lncRNAs risk prognostic model may be promising for clinical prediction of prognosis and immunotherapy response in PAAD patients.
胰腺癌是一种常见的消化系统恶性肿瘤,起病隐匿,早期诊断困难,易转移,预后差。n6 -甲基腺苷(m6A)和长链非编码RNA (lncRNA)在胰腺腺癌(PAAD)的预后价值和免疫治疗应答中发挥重要作用。因此,在PAAD患者中识别m6a相关的lncrna至关重要。本研究通过共表达分析获得了m6a相关的lncrna。采用单因素、最小绝对收缩、选择算子(LASSO)和多因素Cox回归分析构建m6a相关的lncRNA预后模型。采用Kaplan-Meier分析、主成分分析、富特征标注和nomogram分析风险模型的准确性。并讨论了针对该模型的潜在药物。构建基于m6a相关lncRNAs的预后模型,发现靶向m6a相关lncRNAs特征的潜在药物,并研究其与免疫治疗应答的关系。最后,建立了一个nomogram来预测PAAD患者的生存。该基于m6的lncRNAs风险预后模型有望用于临床预测PAAD患者的预后和免疫治疗反应。
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引用次数: 3
Cystic hygroma in a young adult: A case report and recent management 青年人囊性水肿1例报告及近期处理
Pub Date : 2022-08-30 DOI: 10.36922/td.v1i2.151
S. Kadam, Tejaswini Kadam
We are reporting a case of a 27-year-old young female who presented with right side neck swelling without any associated obstructive symptoms and any other grave signs and symptoms. She noticed a gradual increase in the size of the swelling within a period of 2 years. After investigation and surgical excision, the swelling was diagnosed as cystic hygroma. The root cause of the development of cervical lymphangioma is the congenital malformation of the developing lymphatic system. Cystic hygroma is benign in nature and the cause in adults is still unclear. The most common site of origin is in head and neck region, and cystic hygroma accounts for 75% of lymphatic malformations. The most common presentation of cystic hygroma is painless swelling with ill-defined lesion, most commonly located at the posterior triangle of the neck. The common age group is between birth and 2 years of age, with very rare presentation in adults. Hence, it is necessary to rule out all differential diagnosis of cervical lymphangioma, which is presented with cystic neck swelling. Complete surgical excision is the recommended standard treatment.
我们报告一例27岁的年轻女性,她表现为右侧颈部肿胀,没有任何相关的阻塞性症状和任何其他严重体征和症状。她注意到在两年的时间里,肿胀的大小逐渐增大。经检查及手术切除后,诊断为囊性水肿。颈淋巴管瘤发生的根本原因是发育中的淋巴系统先天畸形。囊性水肿本质上是良性的,成人的病因尚不清楚。最常见的起源部位是头颈部,囊性湿肿占淋巴畸形的75%。囊性水肿最常见的表现是无痛性肿胀,病灶界限不清,最常见于颈部后三角。常见的年龄组是出生到2岁之间,在成人中非常罕见。因此,有必要排除所有颈部淋巴管瘤的鉴别诊断,其表现为颈部囊性肿胀。完全手术切除是推荐的标准治疗方法。
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引用次数: 0
Editor’s foreword to the inaugural issue of Tumor Discovery 《肿瘤发现》创刊号的编者前言
Pub Date : 2022-05-11 DOI: 10.36922/td.v1i1.86
Mingzhu Yin
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引用次数: 0
Combined anti-PD1 immunotherapy for patient with advanced pancreatic cancer: A case report 联合抗pd1免疫治疗晚期胰腺癌1例报告
Pub Date : 2022-05-06 DOI: 10.36922/td.v1i1.52
Zhe Jiang, Hongyan Li, Fei Li
Pancreatic cancer (PC) is a highly lethal malignancy with a dismal 5-year survival rate. The current treatment modalities for the treatment-associated toxicity of immunotherapy-based approaches are limited. Immunotherapy for PC was needed to be further investigated. This report illustrates the combined use of anti PD-1 immunotherapy with other therapeutic strategies for cancer pain. In this case, a patient with PC was treated with surgical resection, chemotherapy, molecular targeted medicine, and anti-PD1 immunotherapy. The survival period of the patient was more than 6 years since diagnosis. Finally, we will present our perspective on the future development of immunotherapy for PC. In a word, this case report sheds lights on information that would be helpful for more rigorous exploration of PC treatments.
胰腺癌(PC)是一种高致死率的恶性肿瘤,其5年生存率很低。目前基于免疫疗法的治疗相关毒性的治疗方式是有限的。PC的免疫治疗有待进一步研究。本报告阐述了联合使用抗PD-1免疫疗法与其他治疗策略的癌症疼痛。本例PC患者接受手术切除、化疗、分子靶向药物和抗pd1免疫治疗。自诊断以来,患者生存期超过6年。最后,我们将对PC免疫治疗的未来发展提出展望。总之,本病例报告提供的信息将有助于更严格地探索PC治疗。
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引用次数: 1
Dual-targeting and specific delivery of tamoxifen to cancer cells by modified magnetic nanoparticles using hyaluronic acid and folic acid 利用透明质酸和叶酸修饰的磁性纳米颗粒对癌细胞的双靶向和特异性递送他莫昔芬
Pub Date : 2022-04-28 DOI: 10.36922/td.v1i1.41
Mostafa Heidari Majd
Tamoxifen (TMX) which serves as the best clinical option for the treatment of breast cancer may trigger major dose-dependent side effects due to its poor solubility. Therefore, the use of lower TMX doses utilizing nano-enabled drug delivery systems offers multiple benefits to improving drug specified concentration, safety, and long-term release. In this study, we synthesized targeted magnetic nanoparticles (MNPs) containing folic acid (FA) and hyaluronic acid (HA) to improve drug delivery of TMX. After investigations utilizing Fourier-transform infrared spectroscopy and field emission scanning electron microscope, we found that the surface of MNPs was well modified with targeting agents, and the size of the Fe3O4-DPN-HA-FA NPs was determined at ∼153 (±3.3) nm. Furthermore, the release of 81% TMX after 120 h indicated that there was a controlled pattern of drug release from the modified MNPs. Besides that, the MTT assay revealed that the viability of MDA-MB-231 cell lines after 48 h and 72 h of treatment is dependent on the time and concentration of Fe3O4-DPN-HA-FA-TMX NPs. Finally, real-time polymerase chain reaction demonstrated that Fe3O4-DPN-HA-FA-TMX NPs could upregulate the expression of Bak1 genes and downregulated the expression of Bclx genes during 24 h treatment. All data confirmed that the presence of HA and FA on the surface of nanocarriers and the active targeting employing the nanocarriers can be a useful step to obliterate the breast cancer cells.
他莫昔芬(TMX)作为治疗乳腺癌的最佳临床选择,由于其溶解度差,可能会引发严重的剂量依赖性副作用。因此,利用纳米给药系统使用较低剂量的TMX,在提高药物指定浓度、安全性和长期释放方面具有多种益处。在这项研究中,我们合成了含有叶酸(FA)和透明质酸(HA)的靶向磁性纳米颗粒(MNPs),以改善TMX的药物传递。通过傅里叶变换红外光谱和场发射扫描电镜的研究,我们发现MNPs的表面被靶向剂很好地修饰,Fe3O4-DPN-HA-FA NPs的尺寸在~ 153(±3.3)nm处被确定。此外,120 h后,81%的TMX释放表明修饰的MNPs具有控制的药物释放模式。此外,MTT实验显示,MDA-MB-231细胞株在处理48 h和72 h后的活力与Fe3O4-DPN-HA-FA-TMX NPs的时间和浓度有关。最后,实时聚合酶链反应表明,在处理24 h时,Fe3O4-DPN-HA-FA-TMX NPs可以上调Bak1基因的表达,下调Bclx基因的表达。所有数据都证实了HA和FA在纳米载体表面的存在以及利用纳米载体的主动靶向可以是消灭乳腺癌细胞的有用步骤。
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引用次数: 2
The clinicopathological and prognostic significance of PD-1 expression in cancers: A bioinformatics analysis 肿瘤中PD-1表达的临床病理和预后意义:生物信息学分析
Pub Date : 2022-04-15 DOI: 10.36922/td.v1i1.59
Shuai Shi, Zhi-Gang Zhang, Guangtao Ma, Hongyan Ma
Background: Programmed cell death protein 1 (PD-1), which is encoded by PDCD1 gene, is a cell-surface protein of immunoglobin family. A number of published studies have reported the relationship between PD-1 expression and prognosis in cancers. The purpose of our study was to identify an independent prognostic marker. Methods: In the present study, we investigated the prognostic value of PD-1 mRNA expression through the Kaplan–Meier plotter databases. Results: The expression of PD-1 mRNA was negatively related with the overall survival (OS) rate of gastric cancer, but positively associated with the OS rate of breast cancer, ovarian cancer and liver cancer (P < 0.05). High PD-1 mRNA expression was linked to an improved relapse-free survival rate of breast cancer, ovarian cancer, and liver cancer (P < 0.05). There was a negative correlation with post-progression survival in gastric cancer (P < 0.05). Besides, there was a positive correlation with progression-free survival and disease specific survival in liver cancer. We also further evaluated the prognostic value of PD-1 in relation to different clinicopathological features of cancers. Conclusion: Our results showed that PD-1 expression might be a good marker for the prognosis of patients with cancers, which highlights new methods and ideas for preventive treatment.
背景:程序性细胞死亡蛋白1 (Programmed cell death protein 1, PD-1)是免疫球蛋白家族的一种细胞表面蛋白,由PDCD1基因编码。许多已发表的研究报道了PD-1表达与癌症预后之间的关系。我们研究的目的是确定一个独立的预后指标。方法:在本研究中,我们通过Kaplan-Meier绘图仪数据库研究PD-1 mRNA表达的预后价值。结果:PD-1 mRNA表达与胃癌总生存率呈负相关,与乳腺癌、卵巢癌、肝癌总生存率呈正相关(P < 0.05)。PD-1 mRNA的高表达与乳腺癌、卵巢癌和肝癌的无复发生存率的提高有关(P < 0.05)。与胃癌进展后生存率呈负相关(P < 0.05)。此外,与肝癌的无进展生存期和疾病特异性生存期呈正相关。我们还进一步评估了PD-1与不同癌症临床病理特征的预后价值。结论:PD-1的表达可能是癌症患者预后的良好标志,为预防治疗提供了新的方法和思路。
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引用次数: 1
Advances in the study of the pathogenesis of cancer-related cognitive impairment 癌症相关认知障碍发病机制的研究进展
Pub Date : 2022-03-22 DOI: 10.36922/td.v1i1.46
Jiwei Jiang, Z. Du, Yanli Wang, H. Shi, Wenyi Li, Yuan Zhang, Mengfan Sun, Zhimin Bian, Jun Xu
Advances in diagnostic and therapeutic strategies have significantly contributed to an increase in the survival rate of cancer patients. Recently, several studies suggested that cancer patients may exhibit symptoms of cognitive impairment before, during and even many years after the completion of therapies, negatively impacting the quality of life and functional independence of cancer survivors. Clinically, the coexistence of cancer and cognitive impairment reminds scientists of paraneoplastic syndrome, especially limbic encephalitis. However, some cancer patients show symptoms of cognition deterioration after treatment, without any typical psychiatric symptoms, epileptic seizures or positive antineuronal antibodies, suggesting that the relationship between cancer and cognitive deficits is more common than previously anticipated. Most importantly, many aspects of the association between cancer and cognitive impairment remain uncertain. The definitive connection between systemic cancer and central nervous system is yet to be established. Therefore, this review summarizes the current evidence on the potential pathophysiology in these patients with cancer-related cognitive impairment, and reviews the knowledge gaps and the potential counteracting strategies.
诊断和治疗策略的进步大大提高了癌症患者的存活率。最近,一些研究表明,癌症患者在治疗完成之前、期间甚至多年后可能会出现认知障碍症状,对癌症幸存者的生活质量和功能独立性产生负面影响。在临床上,癌症与认知功能障碍的共存让科学家们想起了副肿瘤综合征,尤其是边缘脑炎。然而,一些癌症患者在治疗后表现出认知恶化的症状,没有任何典型的精神症状、癫痫发作或抗神经元抗体阳性,这表明癌症与认知缺陷之间的关系比之前预期的更为普遍。最重要的是,癌症和认知障碍之间的关系在许多方面仍不确定。全身性癌症和中枢神经系统之间的确切联系尚未确定。因此,本文综述了目前关于这些癌症相关认知障碍患者潜在病理生理的证据,并对知识差距和潜在的对抗策略进行了综述。
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引用次数: 0
Monocytes in tumor: from the sight of Single-cell analysis 肿瘤中的单核细胞:从单细胞的角度分析
Pub Date : 2022-03-10 DOI: 10.36922/td.v1i1.4
Xin Fu, Mingzhu Yin
Mononuclear phagocytes infiltration in the tumor microenvironment orchestra the tumor progression and are generally considered to impede the clinical effects of immune checkpoint blockade therapies. To overcome the traditional biased definition of monocytes, we reviewed some recent advances on the functions of monocytes and macrophages in tumor microenvironment based on single-cell analysis. We also summarized different subpopulations of monocytes and macrophages involved in immunotherapies and their potential applications in clinical study. In this script, we briefly introduce the developmental trajectory of mononuclear phagocytes, including monocytes, tumor associated macrophages (TAMs), DCs, myeloid-derived suppressive cells (MDSC) and their multiple functions in TME. We demonstrate the potential of monocytes and its derived cells being diagnostic and therapeutic targets, especially highlight the interaction between monocytes and immune checkpoint therapies.
肿瘤微环境中的单核吞噬细胞浸润控制肿瘤的进展,通常被认为会阻碍免疫检查点阻断疗法的临床效果。为了克服传统的单核细胞定义的偏见,我们基于单细胞分析综述了单核细胞和巨噬细胞在肿瘤微环境中功能的最新进展。我们还总结了参与免疫治疗的单核细胞和巨噬细胞的不同亚群及其在临床研究中的潜在应用。在本文中,我们简要介绍了单核吞噬细胞的发育轨迹,包括单核细胞、肿瘤相关巨噬细胞(tam)、dc、髓源性抑制细胞(MDSC)及其在TME中的多种功能。我们展示了单核细胞及其衍生细胞作为诊断和治疗靶点的潜力,特别强调了单核细胞和免疫检查点疗法之间的相互作用。
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引用次数: 1
Receptors of advanced glycation end products in oral squamous cell carcinoma: A systematic review 口腔鳞状细胞癌晚期糖基化终产物受体:系统综述
Pub Date : 2020-08-23 DOI: 10.36922/td.244
Sinduja Palati, P. Ramani, H. Sherlin, S. Gheena, A. Ramasubramanian, K. Don, G. Jayaraj, Archana Santhanam
Oxidative stress markers have been shown to be elevated in oral squamous cell carcinomas; plays a crucial role in the build-up of advanced glycation end-receptors of advanced glycation end (AGE-RAGE) products; and has been shown to exacerbate cellular dysfunction, vascular change, apoptosis, and activate inflammatory pathways. The purpose of this study is to assess comprehensively the involvement of RAGE in oral squamous cell malignancies. The findings imply that these receptors and their associated ligands play a significant role in the growth and spread of the tumor, hence impacting the prognosis and life expectancy of the affected individual. This comprehensive review uncovers promising evidence for the clinical use of these molecules, such as RAGEs, in prognostic considerations or as molecular targets for therapy. The available literature shows a role for RAGE in invasion, migration, and angiogenesis in oral cancers. These preliminary findings are encouraging for the therapeutic use of these molecules for prognostic considerations or molecularly targeted therapy.
氧化应激标志物已被证明在口腔鳞状细胞癌中升高;在晚期糖基化末端(AGE-RAGE)产物的晚期糖基化末端受体的构建中起着至关重要的作用;并已被证明会加剧细胞功能障碍、血管改变、细胞凋亡和激活炎症途径。本研究的目的是全面评估RAGE在口腔鳞状细胞恶性肿瘤中的作用。研究结果表明,这些受体及其相关配体在肿瘤的生长和扩散中起着重要作用,从而影响患者的预后和预期寿命。这项全面的综述揭示了这些分子(如RAGEs)在预后考虑或作为治疗分子靶点方面的临床应用的有希望的证据。现有文献显示RAGE在口腔癌的侵袭、迁移和血管生成中起作用。这些初步发现对于这些分子用于预后考虑或分子靶向治疗的治疗用途是令人鼓舞的。
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引用次数: 1
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Tumor discovery
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