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Inspired by novel radiopharmaceuticals: Rush hour of nuclear medicine. 受新型放射性药物的启发:核医学的高峰时刻。
2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.05
Yang Liu, Ya-Nan Ren, Yan Cui, Song Liu, Zhi Yang, Hua Zhu, Nan Li

Nuclear medicine plays an irreplaceable role in the diagnosis and treatment of tumors. Radiopharmaceuticals are important components of nuclear medicine. Among the radiopharmaceuticals approved by the Food and Drug Administration (FDA), radio-tracers targeting prostate-specific membrane antigen (PSMA) and somatostatin receptor (SSTR) have held essential positions in the diagnosis and treatment of prostate cancers and neuroendocrine neoplasms, respectively. In recent years, FDA-approved serials of immune-therapy and targeted therapy drugs targeting programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1), human epidermal growth factor receptor 2 (HER2), and nectin cell adhesion molecule 4 (Nectin 4). How to screen patients suitable for these treatments and monitor the therapy? Nuclear medicine with specific radiopharmaceuticals can visualize the expression level of those targets in systemic lesions and evaluate the efficacy of treatment. In addition to radiopharmaceuticals, imaging equipment is also a key step for nuclear medicine. Advanced equipment including total-body positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) has been developed, which contribute to the diagnosis and treatment of tumors, as well as the development of new radiopharmaceuticals. Here, we conclude most recently advances of radiopharmaceuticals in nuclear medicine, and they substantially increase the "arsenal" of clinicians for tumor therapy.

核医学在肿瘤的诊断和治疗中发挥着不可替代的作用。放射性药物是核医学的重要组成部分。在美国食品和药物管理局(FDA)批准的放射性药物中,靶向前列腺特异性膜抗原(PSMA)和生长抑素受体(SSTR)的放射性示踪剂分别在前列腺癌和神经内分泌肿瘤的诊断和治疗中占有重要地位。近年来,fda批准了一系列针对程序性死亡1 (PD-1)/程序性死亡配体1 (PD-L1)、人表皮生长因子受体2 (HER2)和连接素细胞粘附分子4 (nectin 4)的免疫治疗和靶向治疗药物。如何筛选适合这些治疗的患者并监测治疗效果?特异放射性药物的核医学可以可视化这些靶点在全身病变中的表达水平,并评估治疗效果。除了放射性药物,成像设备也是核医学的关键一步。开发了包括全身正电子发射断层扫描/计算机断层扫描(PET/CT)和正电子发射断层扫描/磁共振成像(PET/MRI)在内的先进设备,为肿瘤的诊断和治疗以及新型放射性药物的开发做出了贡献。在这里,我们总结了核医学中放射性药物的最新进展,它们大大增加了临床医生治疗肿瘤的“武器库”。
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引用次数: 0
Update of latest data for combined therapy for esophageal cancer using radiotherapy and immunotherapy: A focus on efficacy, safety, and biomarkers. 食管癌放疗和免疫联合治疗的最新数据更新:关注疗效、安全性和生物标志物。
2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.06
Shuping Cheng, Butuo Li, Jinming Yu, Linlin Wang

Esophageal cancer usually has a poor prognosis. Given the significant breakthrough with tumor immunotherapy, an increasing number of clinical studies have demonstrated that the combination of radiotherapy and immune checkpoint inhibitors (ICIs) may have a synergistic effect and good outcome in esophageal cancer. Clinical studies of immunoradiotherapy (iRT) for esophageal cancer have proliferated enormously from 2021 to the present. However, a summary of the efficacy and toxicity of combined therapy to guide esophageal cancer treatment in clinical practice is lacking. For this review, we integrate the latest data to analyze and assess the efficacy and safety of iRT for esophageal cancer. In addition, we discuss better predictive biomarkers, therapeutic options for specific populations, and other challenges to identify directions for future research design.

食管癌通常预后较差。鉴于肿瘤免疫治疗的重大突破,越来越多的临床研究表明,放疗与免疫检查点抑制剂(ici)联合治疗食管癌可能具有协同效应和良好的预后。从2021年到现在,食管癌免疫放射治疗(iRT)的临床研究激增。然而,目前还缺乏对综合治疗的疗效和毒性的总结,以指导食管癌的临床治疗。在这篇综述中,我们整合了最新的数据来分析和评估iRT治疗食管癌的有效性和安全性。此外,我们还讨论了更好的预测性生物标志物,针对特定人群的治疗选择以及其他挑战,以确定未来研究设计的方向。
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引用次数: 0
A novel multimodal prediction model based on DNA methylation biomarkers and low-dose computed tomography images for identifying early-stage lung cancer. 基于DNA甲基化生物标志物和低剂量计算机断层扫描图像的新型多模态预测模型用于识别早期肺癌。
IF 5.1 2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.08
Jing Zhang, Haohua Yao, Chunliu Lai, Xue Sun, Xiujuan Yang, Shurong Li, Yubiao Guo, Junhang Luo, Zhihua Wen, Kejing Tang

Objective: DNA methylation alterations are early events in carcinogenesis and immune signalling in lung cancer. This study aimed to develop a model based on short stature homeobox 2 gene (SHOX2)/prostaglandin E receptor 4 gene (PTGER4) DNA methylation in plasma, appearance subtype of pulmonary nodules (PNs) and low-dose computed tomography (LDCT) images to distinguish early-stage lung cancers.

Methods: We developed a multimodal prediction model with a training set of 257 individuals. The performance of the multimodal prediction model was further validated in an independent validation set of 42 subjects. In addition, we explored the association between SHOX2/PTGER4 DNA methylation and driver gene mutations in lung cancer based on data from The Cancer Genome Atlas (TCGA) portal.

Results: There were significant differences between the early-stage lung cancers and benign groups in the methylation levels. The area under a receiver operator characteristic curve (AUC) of SHOX2 in patients with solid nodules, mixed ground-glass opacity nodules and pure ground-glass opacity nodules were 0.693, 0.497 and 0.864, respectively, while the AUCs of PTGER4 were 0.559, 0.739 and 0.619, respectively. With the highest AUC of 0.894, the novel multimodal prediction model outperformed the Mayo Clinic model (0.519) and LDCT-based deep learning model (0.842) in the independent validation set. Database analysis demonstrated that patients with SHOX2/PTGER4 DNA hypermethylation were enriched in TP53 mutations.

Conclusions: The present multimodal prediction model could more efficiently distinguish early-stage lung cancer from benign PNs. A prognostic index based on DNA methylation and lung cancer driver gene alterations may separate the patients into groups with good or poor prognosis.

目的:DNA甲基化改变是肺癌癌变和免疫信号传导的早期事件。本研究旨在建立一种基于血浆、肺结节(PNs)外观亚型和低剂量计算机断层扫描(LDCT)图像中矮个子同源盒2基因(SHOX2)/前列腺素E受体4基因(PTGER4) DNA甲基化的模型来区分早期肺癌。方法:建立了一个包含257个个体的多模态预测模型。在42名受试者的独立验证集中进一步验证了多模态预测模型的性能。此外,基于癌症基因组图谱(TCGA)门户网站的数据,我们探讨了肺癌中SHOX2/PTGER4 DNA甲基化与驱动基因突变之间的关系。结果:早期肺癌组与良性肺癌组在甲基化水平上存在显著差异。实性结节、混合性磨玻璃混浊结节和单纯磨玻璃混浊结节患者SHOX2的受试者算子特征曲线下面积(AUC)分别为0.693、0.497和0.864,PTGER4的AUC分别为0.559、0.739和0.619。该模型的AUC最高为0.894,在独立验证集中优于Mayo Clinic模型(0.519)和基于ldct的深度学习模型(0.842)。数据库分析表明,SHOX2/PTGER4 DNA高甲基化的患者中TP53突变富集。结论:建立的多模态预测模型能更有效地区分早期肺癌和良性PNs。基于DNA甲基化和肺癌驱动基因改变的预后指标可以将患者分为预后好或预后差的组。
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引用次数: 0
Genetic abnormalities assist in pathological diagnosis and EBV-positive cell density impact survival in Chinese angioimmunoblastic T-cell lymphoma patients. 遗传异常有助于病理诊断,ebv阳性细胞密度影响中国血管免疫母细胞淋巴瘤患者的生存。
IF 5.1 2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.10
Yunfei Shi, Haojie Wang, Yanfei Liu, Mengping Long, Ning Ding, Lan Mi, Yumei Lai, Lixin Zhou, Xinting Diao, Xianghong Li, Weiping Liu, Jun Zhu

Objective: To explore the application of genetic abnormalities in the diagnosis of angioimmunoblastic T-cell lymphoma (AITL) and the reliable pathological prognostic factors.

Methods: This study included 53 AITL cases, which were reviewed for morphological patterns, immunophenotypes, presence of Hodgkin and Reed-Sternberg (HRS)-like cells, and co-occurrence of B cell proliferation. The Epstein-Barr virus (EBV)-positive cells in tissues were counted, and cases were classified into "EBV encoded RNA (EBER) high-density" group if >50/HPF. Targeted exome sequencing was performed.

Results: Mutation data can assist AITL diagnosis: 1) with considerable HRS-like cells (20 cases): RHOA mutated in 14 cases (IDH2 co-mutated in 3 cases, 4 cases with rare RHOA mutation), TET2 was mutated in 5 cases (1 case co-mutated with DNMT3A), and DNMT3A mutated in 1 case; 2) accompanied with B cell lymphoma (7 cases): RHOA mutated in 4 cases (1 case had IDH2 mutation), TET2 mutated in 2 cases and DNMT3A mutated in 1 case; 3) mimic peripheral T cell lymphoma, not otherwise specified (5 cases): RHOA mutated in 2 cases (IDH2 co-mutated in 1 case), TET2 mutated in 3 cases, and DNMT3A mutated in 1 case; 4) pattern 1 (1 case), RHOA and TET2 co-mutated. Besides RHOAG17V (30/35), rare variant included RHOAK18N, RHOAR68H, RHOAC83Y, RHOAD120G and RHOAG17del, IDH2R172 co-mutated with IDH2M397V in one case. There were recurrent mutations of FAT3, PCLO and PIEZO1 and genes of epigenetic remodeling, T-cell activation, APC and PI3K/AKT pathway. EBER high-density independently indicated adverse overall survival and progression-free survival (P=0.046 and P=0.008, Kaplan-Meier/log-rank).

Conclusions: Over half AITL cases might be confused in diagnosis for certain conditions without mutation data. Targeted exome sequencing with a comprehensive panel is crucial to detect both hot-spot and rare mutation variants for RHOA and IDH2 and other recurrent mutated genes in addition to TET2 and DNMT3A. EBER high-density independently indicated adverse survival.

目的:探讨遗传异常在血管免疫母细胞性t细胞淋巴瘤(AITL)诊断中的应用及可靠的病理预后因素。方法:对53例AITL患者的形态学、免疫表型、HRS样细胞的存在及B细胞增殖的共现情况进行回顾性分析。统计组织中eb病毒(EBV)阳性细胞数,将>50/HPF归为“EBV编码RNA (EBER)高密度”组。进行靶向外显子组测序。结果:突变资料可辅助AITL诊断:1)有相当数量的hrs样细胞(20例):RHOA突变14例(IDH2共突变3例,RHOA罕见突变4例),TET2突变5例(与DNMT3A共突变1例),DNMT3A突变1例;2)伴有B细胞淋巴瘤(7例):RHOA突变4例(1例伴有IDH2突变),TET2突变2例,DNMT3A突变1例;3)模拟外周T细胞淋巴瘤,无其他特异性(5例):RHOA突变2例(IDH2共突变1例),TET2突变3例,DNMT3A突变1例;4)模式1(1例),RHOA与TET2共突变。除RHOAG17V(30/35)外,罕见变异包括RHOAK18N、RHOAR68H、RHOAC83Y、RHOAD120G和RHOAG17del, IDH2R172与IDH2M397V共突变1例。FAT3、PCLO、PIEZO1及表观遗传重塑、t细胞活化、APC、PI3K/AKT通路基因反复突变。EBER高密度独立显示不良的总生存期和无进展生存期(P=0.046和P=0.008, Kaplan-Meier/log-rank)。结论:超过半数的AITL病例在没有突变数据的情况下可能会对某些情况的诊断产生混淆。综合面板的靶向外显子组测序对于检测RHOA和IDH2以及除TET2和DNMT3A外的其他复发突变基因的热点和罕见突变变体至关重要。EBER高密度独立提示生存不良。
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引用次数: 0
OpenNAU: An open-source platform for normalizing, analyzing, and visualizing cancer untargeted metabolomics data. OpenNAU:一个用于规范化、分析和可视化癌症非靶向代谢组学数据的开源平台。
IF 5.1 2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.11
Qingrong Sun, Qingqing Xu, Majie Wang, Yongcheng Wang, Dandan Zhang, Maode Lai

Objective: As an important part of metabolomics analysis, untargeted metabolomics has become a powerful tool in the study of tumor mechanisms and the discovery of metabolic markers with high-throughput spectrometric data which also poses great challenges to data analysis, from the extraction of raw data to the identification of differential metabolites. To date, a large number of analytical tools and processes have been developed and constructed to serve untargeted metabolomics research. The different selection of analytical tools and parameter settings lead to varied results of untargeted metabolomics data. Our goal is to establish an easily operated platform and obtain a repeatable analysis result.

Methods: We used the R language basic environment to construct the preprocessing system of the original data and the LAMP (Linux+Apache+MySQL+PHP) architecture to build a cloud mass spectrum data analysis system.

Results: An open-source analysis software for untargeted metabolomics data (openNAU) was constructed. It includes the extraction of raw mass data and quality control for the identification of differential metabolic ion peaks. A reference metabolomics database based on public databases was also constructed.

Conclusions: A complete analysis system platform for untargeted metabolomics was established. This platform provides a complete template interface for the addition and updating of the analysis process, so we can finish complex analyses of untargeted metabolomics with simple human-computer interactions. The source code can be downloaded from https://github.com/zjuRong/openNAU.

目的:作为代谢组学分析的重要组成部分,非靶向代谢组学已经成为研究肿瘤机制和利用高通量光谱数据发现代谢标志物的有力工具,这也给数据分析带来了巨大的挑战,从原始数据的提取到差异代谢物的鉴定。迄今为止,已经开发和构建了大量的分析工具和过程来服务于非靶向代谢组学研究。分析工具的不同选择和参数设置导致非靶向代谢组学数据的结果不同。我们的目标是建立一个易于操作的平台,并获得可重复的分析结果。方法:采用R语言基础环境构建原始数据预处理系统,采用LAMP (Linux+Apache+MySQL+PHP)架构构建云质谱数据分析系统。结果:构建了非靶向代谢组学数据的开源分析软件openNAU。它包括原始质量数据的提取和鉴别差异代谢离子峰的质量控制。建立了基于公共数据库的参考代谢组学数据库。结论:建立了完整的非靶向代谢组学分析系统平台。该平台为分析过程的添加和更新提供了完整的模板界面,因此我们可以通过简单的人机交互完成非靶向代谢组学的复杂分析。源代码可以从https://github.com/zjuRong/openNAU下载。
{"title":"OpenNAU: An open-source platform for normalizing, analyzing, and visualizing cancer untargeted metabolomics data.","authors":"Qingrong Sun, Qingqing Xu, Majie Wang, Yongcheng Wang, Dandan Zhang, Maode Lai","doi":"10.21147/j.issn.1000-9604.2023.05.11","DOIUrl":"10.21147/j.issn.1000-9604.2023.05.11","url":null,"abstract":"<p><strong>Objective: </strong>As an important part of metabolomics analysis, untargeted metabolomics has become a powerful tool in the study of tumor mechanisms and the discovery of metabolic markers with high-throughput spectrometric data which also poses great challenges to data analysis, from the extraction of raw data to the identification of differential metabolites. To date, a large number of analytical tools and processes have been developed and constructed to serve untargeted metabolomics research. The different selection of analytical tools and parameter settings lead to varied results of untargeted metabolomics data. Our goal is to establish an easily operated platform and obtain a repeatable analysis result.</p><p><strong>Methods: </strong>We used the R language basic environment to construct the preprocessing system of the original data and the LAMP (Linux+Apache+MySQL+PHP) architecture to build a cloud mass spectrum data analysis system.</p><p><strong>Results: </strong>An open-source analysis software for untargeted metabolomics data (openNAU) was constructed. It includes the extraction of raw mass data and quality control for the identification of differential metabolic ion peaks. A reference metabolomics database based on public databases was also constructed.</p><p><strong>Conclusions: </strong>A complete analysis system platform for untargeted metabolomics was established. This platform provides a complete template interface for the addition and updating of the analysis process, so we can finish complex analyses of untargeted metabolomics with simple human-computer interactions. The source code can be downloaded from https://github.com/zjuRong/openNAU.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650614","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
Epidemiology of pancreatic cancer: New version, new vision. 胰腺癌流行病学:新版本,新视野。
2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.03
Wenhao Luo, Jun Wang, Hao Chen, Liyuan Ye, Jiangdong Qiu, Yueze Liu, Ruobing Wang, Guihu Weng, Tao Liu, Dan Su, Jinxin Tao, Chen Ding, Lei You, Taiping Zhang

Pancreatic cancer (PC) is a devastating malignancy with an extremely high mortality rate and poses significant challenges to healthcare systems worldwide. The prevalence of PC risk factors spiked over the years, leading to a global increase in PC incidence rates. The contribution of different risk factors, however, varied from region to region due to genetic predisposition, environmental, social, and political factors underlying disease prevalence in addition to public health strategies. This comprehensive review aims to provide a thorough analysis of the epidemiology of PC, discussing its incidence, risk factors, screening strategies and socioeconomic burden. We compiled a wide range of seminal studies as well as epidemiological investigations to serve this review as a comprehensive guide for researchers, healthcare professionals, and policymakers keen for a more profound understanding of PC epidemiology. This review highlights the essentiality of persistent research efforts, interdisciplinary collaboration, and public health initiatives to address the expanding burden of this malignancy.

胰腺癌(PC)是一种具有极高死亡率的毁灭性恶性肿瘤,对全球卫生保健系统构成了重大挑战。多年来,PC危险因素的流行率飙升,导致全球PC发病率增加。然而,由于遗传易感性、环境、社会和政治因素以及公共卫生战略,不同风险因素的贡献因地区而异。本文旨在全面分析前列腺癌的流行病学,探讨其发病率、危险因素、筛查策略和社会经济负担。我们汇编了广泛的开创性研究和流行病学调查,为研究人员、医疗保健专业人员和决策者提供了全面的指南,以更深入地了解PC流行病学。这篇综述强调了坚持不懈的研究努力、跨学科合作和公共卫生倡议的重要性,以解决这种恶性肿瘤不断扩大的负担。
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引用次数: 0
Advances, breakthroughs, and challenges in gastric cancer surgery. 胃癌手术的进展、突破与挑战。
2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.02
Hayun Kim, Sungsoo Park

Gastric cancer (GC) remains a substantial health burden worldwide, ranking fifth in incidence and third in mortality among all cancer types. Surgeons have persistently attempted to address this growing burden through surgical management of GC encompassing various aspects of surgery, including advances in surgical techniques and tools for minimally invasive surgery, novel technology for real-time image-guided surgery, and function-preserving and oncometabolic surgeries, aimed at improving patients' quality of life. The current perspective discusses the five most critical dimensions of the recent technical improvements and conceptual changes in GC surgery. We recommend further exploration of long-term benefits of these advancements, identification of breakthrough solutions to address current challenges, and delivery of the best quality of care.

胃癌(GC)仍然是世界范围内的一个重大健康负担,在所有癌症类型中发病率排名第五,死亡率排名第三。外科医生一直试图通过手术管理来解决这一日益增长的负担,包括手术的各个方面,包括微创手术的手术技术和工具的进步,实时图像引导手术的新技术,以及旨在提高患者生活质量的功能保留和肿瘤代谢手术。目前的观点讨论了五个最关键的方面,最近的技术改进和概念上的变化在GC手术。我们建议进一步探索这些进步的长期效益,确定解决当前挑战的突破性解决方案,并提供最高质量的护理。
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引用次数: 0
Genetic susceptibility loci of lung cancer are associated with malignant risk of pulmonary nodules and improve malignancy diagnosis based on CEA levels. 肺癌的遗传易感位点与肺结节的恶性风险相关,并改善基于CEA水平的恶性诊断。
2区 医学 Pub Date : 2023-10-30 DOI: 10.21147/j.issn.1000-9604.2023.05.07
Zhi Li, Liming Lu, Yibin Deng, Amei Zhuo, Fengling Hu, Wanwen Sun, Guitian Huang, Linyuan Liu, Boqi Rao, Jiachun Lu, Lei Yang

Objective: The heightened prevalence of pulmonary nodules (PN) has escalated its significance as a public health concern. While the precise identification of high-risk PN carriers for malignancy remains an ongoing challenge, genetic variants hold potentials as determinants of disease susceptibility that can aid in diagnosis. Yet, current understanding of the genetic loci associated with malignant PN (MPN) risk is limited.

Methods: A frequency-matched case-control study was performed, comprising 247 MPN cases and 412 benign NP (BNP) controls. We genotyped 11 established susceptibility loci for lung cancer in a Chinese cohort. Loci associated with MPN risk were utilized to compute a polygenic risk score (PRS). This PRS was subsequently incorporated into the diagnostic evaluation of MPNs, with emphasis on serum tumor biomarkers.

Results: Loci rs10429489G>A, rs17038564A>G, and rs12265047A>G were identified as being associated with an increased risk of MPNs. The PRS, formulated from the cumulative risk effects of these loci, correlated with the malignant risk of PNs in a dose-dependent fashion. A high PRS was found to amplify the MPN risk by 156% in comparison to a low PRS [odds ratio (OR)=2.56, 95% confidence interval (95% CI), 1.40-4.67]. Notably, the PRS was observed to enhance the diagnostic accuracy of serum carcinoembryonic antigen (CEA) in distinguishing MPNs from BPNs, with diagnostic values rising from 0.716 to 0.861 across low- to high-PRS categories. Further bioinformatics investigations pinpointed rs10429489G>A as an expression quantitative trait locus.

Conclusions: Loci rs10429489G>A, rs17038564A>G, and rs12265047A>G contribute to MPN risk and augment the diagnostic precision for MPNs based on serum CEA concentrations.

目的:肺结节(PN)的高患病率已经升级其重要性作为一个公共卫生问题。虽然准确识别恶性肿瘤的高风险PN携带者仍然是一个持续的挑战,但遗传变异具有作为疾病易感性决定因素的潜力,可以帮助诊断。然而,目前对与恶性PN (MPN)风险相关的遗传位点的了解是有限的。方法:进行频率匹配的病例对照研究,包括247例MPN病例和412例良性NP (BNP)对照。我们在一个中国队列中对11个已建立的肺癌易感位点进行了基因分型。利用与MPN风险相关的位点计算多基因风险评分(PRS)。该PRS随后被纳入mpn的诊断评估,重点是血清肿瘤生物标志物。结果:基因座rs10429489G>A、rs17038564A>G和rs12265047A>G与mpn风险增加相关。PRS是根据这些基因座的累积风险效应制定的,与PNs的恶性风险呈剂量依赖关系。研究发现,与低PRS相比,高PRS可使MPN风险增加156%[比值比(OR)=2.56, 95%可信区间(95% CI), 1.40-4.67]。值得注意的是,在区分mpn和bpn方面,PRS提高了血清癌胚抗原(CEA)的诊断准确性,在低至高PRS分类中,诊断值从0.716上升到0.861。进一步的生物信息学研究确定rs10429489G >a为表达数量性状位点。结论:rs10429489G>A、rs17038564A>G和rs12265047A>G基因座与MPN发病风险有关,可提高血清CEA浓度对MPN诊断的准确性。
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引用次数: 0
Current situation of programmed cell death protein 1/programmed cell death ligand 1 inhibitors in advanced triple-negative breast cancer 程序性细胞死亡蛋白1/程序性细胞死亡配体1抑制剂在晚期三阴性乳腺癌中的研究现状
IF 5.1 2区 医学 Pub Date : 2022-04-30 DOI: 10.21147/j.issn.1000-9604.2022.02.07
Yuehua Liang, Xiao-ran Liu, Kun Li, Huiping Li
Triple-negative breast cancer (TNBC) has the worst prognosis among all molecular types of breast cancer. Because of the strong immunogenicity of TNBC cells, programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors, two kinds of immune checkpoint blockade agents, might help improve the prognosis of TNBC. However, how to better use PD-1/PD-L1 inhibitors and select patients who may benefit from treatment options remains controversial. This article summarizes published clinical studies in which PD-1/PD-L1 inhibitors were used in patients with advanced TNBC to explore how to maximize effectiveness of these medications.
癌症三阴性(TNBC)是癌症所有分子类型中预后最差的。由于TNBC细胞具有较强的免疫原性,程序性死亡1/程序性死亡配体1(PD-1/PD-L1)抑制剂这两种免疫检查点阻断剂可能有助于改善TNBC的预后。然而,如何更好地使用PD-1/PD-L1抑制剂并选择可能从治疗方案中受益的患者仍然存在争议。本文总结了已发表的PD-1/PD-L1抑制剂用于晚期TNBC患者的临床研究,以探索如何最大限度地提高这些药物的有效性。
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引用次数: 1
Prognostic and incremental value of computed tomography-based radiomics from tumor and nodal regions in esophageal squamous cell carcinoma 基于计算机断层扫描的食管鳞状细胞癌肿瘤和淋巴结区域放射组学的预后和增量价值
IF 5.1 2区 医学 Pub Date : 2022-04-30 DOI: 10.21147/j.issn.1000-9604.2022.02.02
B. Cao, Kun Mi, W. Dai, Tong Liu, T. Xie, Qiang Li, J. Lang, Yongtao Han, Lin Peng, Qifeng Wang
Objective This study aimed to evaluate the prognostic value of preoperative radiomics and establish an integrated model for esophageal squamous cell cancer (ESCC). Methods A total of 931 patients were retrospectively enrolled in this study (training cohort, n=624; validation cohort, n=307). Radiomics features were obtained by contrast-enhanced computed tomography (CT) before esophagectomy. A radiomics index was set based on features of tumor and reginal lymph nodes by using the least absolute shrinkage and selection operator (LASSO) Cox regression. Prognostic nomogram was built based on radiomics index and other independent risk factors. The prognostic value was assessed by using Harrell’s concordance index, time-dependent receiver operating characteristics and Kaplan-Meier curves. Results Twelve radiomic features from tumor and lymph node regions were identified to build a radiomics index, which was significantly associated with overall survival (OS) in both training cohort and validation cohort. The radiomics index was highly correlated with clinical tumor-node-metastasis (cTNM) and pathologic TNM (pTNM) stages, but it demonstrated a better prognostic value compared with cTNM stage and was almost comparable with pTNM stage. Multivariable Cox regression showed that the radiomics index was an independent prognostic factor. An integrated model was constructed based on gender, preoperative serum sodium concentration, pTNM and the radiomics index for clinical usefulness. The integrated model demonstrated discriminatory ability better compared with the traditional clinical-pathologic model and pTNM alone, indicating incremental value for prognosis. Conclusions CT-based radiomics for primary tumor and reginal lymph nodes was sufficient in predicting OS for patients with ESCC. The integrated model demonstrated incremental value for prognosis and was robust for clinical applications.
目的评价术前放射组学对癌症食管鳞状细胞癌(ESCC)预后的价值,建立食管鳞状细胞瘤综合模型。方法共有931名患者被回顾性纳入本研究(训练队列,n=624;验证队列,n=307)。在食管切除术前通过对比增强计算机断层扫描(CT)获得放射组学特征。基于肿瘤和区域淋巴结的特征,使用最小绝对收缩和选择算子(LASSO)Cox回归设置放射组学指数。根据放射组学指数和其他独立的危险因素建立预后列线图。采用Harrell一致性指数、时间依赖性受试者操作特征和Kaplan-Meier曲线评估预后价值。结果确定了来自肿瘤和淋巴结区域的12个放射组学特征,以建立放射组学指数,该指数与训练队列和验证队列的总生存率(OS)显著相关。放射组学指标与临床肿瘤淋巴结转移(cTNM)和病理TNM(pTNM)分期高度相关,但与cTNM分期相比具有更好的预后价值,几乎与pTNM分期相当。多变量Cox回归显示放射组学指数是一个独立的预后因素。基于性别、术前血清钠浓度、pTNM和放射组学指数构建了一个综合模型,用于临床应用。与传统的临床病理模型和单独的pTNM相比,整合模型表现出更好的辨别能力,表明其对预后的价值增加。结论基于CT的原发肿瘤和区域淋巴结放射组学足以预测ESCC患者的OS。该综合模型显示了对预后的增量价值,并且在临床应用中是稳健的。
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引用次数: 3
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Chinese Journal of Cancer Research
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