Exploring risk factors for totally implantable venous access devices (TIVADs)-related thrombotic occlusion in the off-treatment period.

Totally implantable venous access devices (TIVADs) have been widely used for many years in the management of patients suffering from cancer. Thrombotic occlusion is the most common functional complication in the off-treatment period. This study aims to investigate the incidence of and risk factors for TIVADs-related thrombotic occlusion in patients with breast cancer. The clinical data of 1586 eligible patients with breast cancer with TIVADs at the Fourth Affiliated Hospital of Hebei Medical University from 1 January 2019 to 31 August 2021 were analysed. Thrombotic occlusion was confirmed by angiography with signs of partial or total occlusion. Thrombotic occlusion occurred in 96 (6.1%) cases. Multivariable logistic regression analysis showed that the insertion site of the catheter (P = 0.004), size of the catheter (P < 0.001), and indwelling time (P < 0.001) were significant factors for thrombotic occlusion. Insertion in the right internal jugular vein, smaller catheter size and shorter indwelling time can lower the incidence of thrombotic occlusion in breast cancer patients with TIVADs in the off-treatment period.

Circ_0,007,331 Promotes the PTX Resistance and Progression of Breast Cancer via miR-200b-3p/ANLN.

INTRODUCTION: The objective of our study was to explore the expression pattern of circular ribonucleic acid (RNA)_0,007,331 (circ_0,007,331) in breast cancer (BC) and its functional association with cellular paclitaxel (PTX) resistance and proliferation, migration, invasion and apoptosis. METHODS: Real-time quantitative polymerase chain reaction was applied to measure RNA expression. The PTX resistance of BC cells was analyzed by cell counting kit-8 assay. Flow cytometry was applied to assess cell cycle progression and cell apoptosis. Transwell assays were utilized to analyze cell migration and invasion abilities. Protein expression was determined by Western blot assay. The target relationship between microRNA-200b-3p (miR-200b-3p) and circ_0,007,331 or Anillin (ANLN) was verified by dual-luciferase reporter assay and RNA-pull down assay. The in vivo role of circ_0,007,331 was analyzed using xenograft tumor model. RESULTS: Circ_0,007,331 expression was elevated in PTX-resistant BC cell lines relative to parental BC cell lines. Circ_0,007,331 contributed to the PTX resistance, proliferation, migration, invasion and suppressed the apoptosis of BC cells. Circ_0,007,331 interacted with miR-200b-3p in BC cells. Circ_0,007,331 silencing-mediated effects in BC cells were largely overturned by the knockdown of miR-200b-3p. ANLN was a target of miR-200b-3p in BC cells. Circ_0,007,331 silencing reduced ANLN expression partly through upregulating miR-200b-3p in BC cells. miR-200b-3p overexpression-induced effects in BC cells were largely counteracted by the accumulation of ANLN. Circ_0,007,331 silencing aggravated PTX-mediated inhibitory effect on tumor growth in vivo. CONCLUSIONS: Circ_0,007,331 contributed to the PTX resistance, proliferation and motility and inhibited the apoptosis of BC cells through mediating miR-200b-3p/ANLN signaling.

Systemic thrombolysis and anticoagulation therapy for catheter-related right atrial thrombosis caused by TIVAP: A case report and review of the literature.

INTRODUCTION: As an under-reported, severe, and life-threatening complication, catheter-related right atrial thrombosis (CRAT) can appear at any age with any type of central venous catheter (CVC). However, most reports are limited to hemodialysis patients with CVC. Totally implantable venous access port (TIVAP) is widely used for the infusion of high-concentration chemotherapeutic drugs in cancer patients. However, these catheters may cause CRAT. CASE DESCRIPTION: A 27-year-old female patient with TIVAP was referred for neoadjuvant chemotherapy because of breast cancer. At 60 days after TIVAP implantation, routine transthoracic ultrasound examination confirmed a mass of 3.4 × 2.5 cm in the right atrium (RA). The mass was attached to the atrial wall and close to the catheter tip. Initially, we chose systemic anticoagulation therapy, but it failed. Subsequently, we decided to adopt a combination of systemic thrombolysis and anticoagulation therapy via a cubital vein. After 9 days of treatment, the thrombus disappeared, and the TIVAP was eventually removed. CONCLUSIONS: Systemic thrombolysis and anticoagulation therapy seemed to be safe and effective for asymptomatic patients who had TIVAP-induced CRAT. We should position the catheter tip at the junction of the Superior Vena Cava with the Right Atrium during the implantation procedure in cancer patients undergoing chemotherapy.

Exosome miR-134-5p restrains breast cancer progression via regulating PI3K/AKT pathway by targeting ARHGAP1.

AIM: Exosomes has been shown to be involved in the regulation of cancer progression. However, the role of exosome miR-134-5p in breast cancer (BC) progression is unclear. METHODS: Exosomes were extracted from BC cells (MCF-7 and MDA-MB-231) using differential centrifugation and were observed by transmission electron microscope (TEM). The protein levels of exosome markers, apoptosis markers, Rho GTPase activating protein 1 (ARHGAP1, an important oncogene in BC) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) markers were detected by western blot (WB) assay. Quantitative real-time PCR was used to measure the expression levels of miR-134-5p and ARHGAP1. Cell cycle and apoptosis, colony number, viability, migration, and invasion were determined by flow cytometry, colony formation assay, MTT assay, and transwell assay, respectively. The interaction between miR-134-5p and ARHGAP1 was confirmed using a dual-luciferase reporter assay. Xenograft models were constructed to verify the role of exosome miR-134-5p in BC tumor growth in vivo. RESULTS: MiR-134-5p was lowly expressed in BC cells and in the exosomes of BC cells. Overexpressed exosome miR-134-5p suppressed the proliferation, migration, invasion, and promoted the apoptosis of BC cells. ARHGAP1 was a target of miR-134-5p, and its silencing could inhibit BC progression. In addition, ARHGAP1 overexpression could reverse the negative regulation of miR-134-5p on BC progression. MiR-134-5p could target ARHGAP1 to inhibit the activity of PI3K/AKT pathway. Exosome miR-134-5p overexpression could suppress BC tumor growth via targeting ARHGAP1 in vivo. CONCLUSION: Exosome miR-134-5p restrained BC progression through regulating ARHGAP1/PI3K/AKT signaling pathway, suggesting that miR-134-5p might be a therapeutic target for BC.

Prognostic Value of LRG1 in Breast Cancer: A Retrospective Study.

BACKGROUND: High expression of leucine-rich alpha-2-glycoprotein 1 (LRG1) is closely related to angiogenesis, which may play an important role in promoting invasion and metastasis. However, the current literature has yet to clarify the clinical significance of LRG1 in breast cancer. OBJECTIVES: The purpose of this work was to validate the correlation between LRG1 expression and prognosis in early breast cancer. METHODS: We utilized an LRG1 detection agent in 330 cases of early breast cancer. The correlation of LRG1 expression with clinicopathological features, patient recurrence, and survival was investigated. RESULTS: Compared with adjacent tissue samples, an elevated expression of LRG1 was observed in breast cancer samples. Moreover, LRG1 expression is associated with the number of lymphatic metastases and TNM pathological stage (p = 0.000, p = 0.000, respectively). For disease-free survival (DFS), the Kaplan-Meier curve indicated a poorer prognosis for the group with high LRG1 levels compared with the low LRG1 group (p = 0.000). A similar result was found for overall survival (OS; p = 0.000). The multivariate Cox regression indicated that LRG1 was still associated with DFS (HR 2.090, 95% CI 1.205-3.625, p = 0.009) and OS (HR 2.112, 95% CI 1.167-3.822, p = 0.013). The histological grade, TNM pathological stage, and molecular subtype were identified as independent risk factors affecting OS. CONCLUSION: In the malignant progression of breast cancer, high LRG1 levels are associated with lymphatic metastasis, histological grade, poor DFS, and poor OS. This study validates the use of LRG1 as a potential prognosis biomarker for early breast cancer.

Clinicians versus patients subjective adverse events assessment: based on patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE).

PURPOSE: Adverse events (AEs) assessment by clinicians is a standard practice in a clinical setting. However, studies have found clinicians tend to report fewer AEs, especially subjective AEs. We aimed to explore the difference of subjective AEs assessment between clinicians and patients based on PRO-CTCAE, and to discuss the necessity of incorporating patient into the evaluation of AEs. METHODS: Between April and July 2019, two different questionnaires with the same subjective AEs were given to patients and clinicians in the Day Chemotherapy ward of Breast Center in the Fourth Hospital of HeBei Medical University. Patients completed a Simplified Chinese version of PRO-CTCAE, including six common subjective AEs of chemotherapy: nausea, vomiting, diarrhea, fatigue, pain, and constipation. Clinicians completed the common terminology criteria for adverse events (CTCAE) with the same AEs. General information of enrolled patients and results from the questionnaires were collected and analyzed. RESULTS: 384 paired questionnaires were collected. Clinicians reported less subjective AEs than patients, and the general agreement between patients and clinicians was poor. When considering the grade difference, we utilize weighted kappa coefficient to analysis, and agreement between patients and clinicians was poor (k < 0.4) regardless of the frequency, the severity and interfering with daily life of AEs, and the most discrepancies were within one point. Patients tended to grade severer than the clinician. CONCLUSIONS: The results of this study showed that there were differences between clinicians and patients in subjective adverse events evaluation. Patient reporting of symptoms can be used as a supplementary method to incorporate the current approach to monitor subjective AEs, to improve the timeliness and accuracy of clinical evaluation of subjective AEs.

[Endocrine therapy for breast cancer: past and present].

The endocrine therapy for breast cancer could be traced back to the excision of the metastatic breast cancer by oophorectomy in a premenopausal women performed by Beatson in 1896. After the development of more than 100 years, endocrine therapy plays an important role in adjuvant therapy, the rescuing treatment of its recurrence due to metastasis, and the new adjuvant endocrine therapy for breast cancer. Through analyzing the changes in the 4 aspects of endocrine treatment of breast cancer, i.e., the original simple excision of the endocrine organs, tamoxifen, drug-induced ovarian castration and the 3th generation aromatase inhibitor, the characteristics of different ages of endocrine therapy can be summarized, which would provide the reference for the new developmental trend of this therapy.