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1.
Cancer Med ; 13(7): e7137, 2024 Apr.
Article En | MEDLINE | ID: mdl-38545846

INTRODUCTION: Acral melanoma (AM) is the most common subtype of malignant melanoma in China, with a very poor prognosis. Despite the frequent reporting of trauma events in AM cases, the precise etiology of AM remains elusive. METHODS: A retrospective analysis was conducted on a cohort of 303 AM patients at Nanjing Drum Tower Hospital. The patients were categorized into four distinct groups based on different patterns of disease onset: trauma type (Type 1), pigmented nevus type (Type 2), pigmented nevi with trauma (Type 3), and pigmented nevi with natural ulceration (Type 4). Differences in clinicopathological features, genetic alterations, and tumor immune microenvironment (TIME) were analyzed. RESULTS: Traumatic events accounted for a large proportion of AM cases. Among these categories, Type 1 patients displayed the least favorable pathological traits and an immunosuppressive TIME. Common copy number variations (CNVs) were observed in CCND1, RB1, FGF19, and IL7R, while CNVs in CDK4 and TERT occurred less frequently in patients with a history of trauma (Type 1 and Type 3). Type 2 patients exhibited the most favorable pathological characteristics and genetic profiles, and demonstrated the lowest incidence of CCDN1 and RB1 CNVs but had the highest CDK4 CNVs. In contrast, the pathological behavior of Type 3 and Type 4 patients was in between Type 1 and Type 2. And patients in Type 3 and Type 4 displayed a more favorable overall microenvironment. CONCLUSION: This study provides a clinical classification of Chinese AM based on diverse clinical onset characteristics and highlights the important role of trauma in AM. These findings may help to guide the diagnosis, treatment, and prognosis of AM patients. Further investigations are imperative to elucidate the underlying mechanisms governing the association between trauma and AM.


Melanoma , Nevus, Pigmented , Skin Neoplasms , Humans , Melanoma/pathology , Retrospective Studies , DNA Copy Number Variations , Skin Neoplasms/epidemiology , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Nevus, Pigmented/pathology , Tumor Microenvironment/genetics
2.
Front Oncol ; 12: 1015232, 2022.
Article En | MEDLINE | ID: mdl-36387089

Aim: We aimed to evaluate the efficacy and safety of individualized chemotherapy combined with sequential immunotherapy based on BRCA1 mRNA expression in unresectable pancreatic cancer. Methods: The expression of BRCA1 mRNA in tumor tissues of 25 patients with pancreatic cancer was detected in this retrospective study. Patients in the medium and high expression groups were treated with paclitaxel-based chemotherapy: albumin paclitaxel 125mg/m2, gemcitabine 1g/m2, day 1. Patients in the low expression group were treated with oxaliplatin-based chemotherapy: oxaliplatin 85mg/m2, gemcitabine 1g/m2, day 1. Sequential GM-CSF and IL-2 immunotherapy were applied. Patient condition, treatment efficacy and safety were assessed every 4 cycles. Results: A total of 25 patients were enrolled in the study. All of them were observed for toxic side effects and 24 of them were evaluated for efficacy. The median overall survival and median progression-free survival were 11.9 months and 6.3 months. The disease control rate was 91.7%, of which 37.5% (9/24) patients achieved partial remission (PR), 54.2% (13/24) patients achieved stable disease (SD) and 8.3% (2/24) patients were assessed as progressive disease(PD). Of the 15 patients with medium or high expression in BRCA1 mRNA, 7 achieved PR and 8 achieved SD. Of the 9 patients with low BRCA1 mRNA expression, 2 achieved PR, 5 achieved SD and 2 had PD. The proportion of eosinophils in the blood of some patients with good therapeutic effects was significantly higher than that before treatment. Hematological and non-hematological toxicity during the treatment were mostly grade 1~2. The two most common grade 3 to 4 adverse events were fever and thrombocytopenia. Conclusion: Our results suggest that individualized selection of chemotherapy combined with sequential immunotherapy according to BRCA1 mRNA expression level in unresectable pancreatic cancer could control the disease and have controllable adverse reactions.

3.
Front Plant Sci ; 13: 1016949, 2022.
Article En | MEDLINE | ID: mdl-36311116

In the coastal wetland, nitrogen is a limiting element for plant growth and reproduction. However, nitrogen inputs increase annually due to the rise in nitrogen emissions from human activity in coastal wetlands. Nitrogen additions may alter the coastal wetlands' soil properties, bacterial compositions, and plant growth. The majority of nitrogen addition studies, however, are conducted in grasslands and forests, and the relationship between soil properties, bacterial compositions, and plant growth driven by nitrogen addition is poorly understood in coastal marshes. We conducted an experiment involving nitrogen addition in the Phragmites australis population of the tidal marsh of the Yellow River Delta. Since 2017, four nitrogen addition levels (N0:0 g • m-2 • year-1, N1:5 g • m-2 • year-1, N2:20 g • m-2 • year-1, N3:50 g • m-2 • year-1) have been established in the experiment. From 2017 to 2020, we examined soil properties and plant traits. In 2018, we also measured soil bacterial composition. We analyzed the effect of nitrogen addition on soil properties, plant growth, reproduction, and plant nutrients using linear mixed-effect models. Moreover, structural equation modeling (SEM) was utilized to determine the direct and indirect effects of nitrogen addition, soil properties, and bacterial diversity on plant growth. The results demonstrated that nitrogen addition significantly affected plant traits of P. australis. N1 and N2 levels generally resulted in higher plant height, diameter, leaf length, leaf breadth, and leaf TC than N0 and N3 levels. Nitrogen addition had significantly impacted soil properties, including pH, salinity, soil TC, and soil TS. The SEM revealed that nitrogen addition had a direct and positive influence on plant height. By modifying soil bacterial diversity, nitrogen addition also had an small indirect and positive impact on plant height. However, nitrogen addition had a great negative indirect impact on plant height through altering soil properties. Thus, nitrogen inputs may directly enhance the growth of P. australis at N1 and N2 levels. Nonetheless, the maximum nitrogen addition (N3) may impede P. australis growth by reducing soil pH. Therefore, to conserve the coastal tidal marsh, it is recommended that an excess of nitrogen input be regulated.

4.
Sci Total Environ ; 766: 144254, 2021 Apr 20.
Article En | MEDLINE | ID: mdl-33421778

Consumers are often overlooked as key drivers of vegetation structure and ecosystem functioning in coastal wetlands. This oversight is particularly apparent in Asia, where much of the variation in coastal wetland plant growth and composition is attributed to physical stress gradients. To address this knowledge gap and quantify the relative importance of consumers in Asian coastal wetlands across temporal variation in environmental stress, we conducted a two-year experiment spanning relatively spring wet (2018) and spring dry (2019) years in which we manipulated the presence of the numerically dominant herbivorous crab, Helice tientsinensis, and evaluated its effects on Phragmites australis growth and structure in a Yellow River Delta salt marsh. In spring wetter 2018, Phragmites biomass and stem density were 75% and 34% higher in Crab Exclusion relative to Ambient Crab plots. In 2019 which experienced spring drought and elevated soil salinity, Phragmites biomass and stem density remained similarly high relative to 2018 in Crab Exclusion plots, but fell further, to only 16% and 39% of levels of 2018 observed in Ambient Crab plots. Phragmites' inflorescences density was also significantly reduced in Ambient Crab than Crab Exclusion plots in 2019. Together, these results highlight the significant role that crab herbivores can play in regulating Phragmites in Yellow River Delta salt marshes and suggest that the magnitude of their top-down control may be amplified, although in a non-additive manner, with spring drought stress in the region.


Brachyura , Wetlands , Animals , Asia , Droughts , Ecosystem , Herbivory , Poaceae , Rivers
5.
Sci Rep ; 10(1): 4435, 2020 03 10.
Article En | MEDLINE | ID: mdl-32157118

Hepatocellular carcinoma (HCC) is a common malignant tumor in China. In the present study, we aimed to construct and verify a prediction model of recurrence in HCC patients using databases (TCGA, AMC and Inserm) and machine learning methods and obtain the gene signature that could predict early relapse of HCC. Statistical methods, such as feature selection, survival analysis and Chi-Square test in R software, were used to analyze and select mutant genes related to disease free survival (DFS), race and vascular invasion. In addition, whole-exome sequencing was performed on 10 HCC patients recruited from our center, and the sequencing results were compared with the databases. Using the databases and machine learning methods, the prediction model of recurrence was constructed and optimized, and the selected mutant genes were verified in the test group. The accuracy of prediction was 74.19%. Moreover, these 10 patients from our center were used to verify these mutant genes and the prediction model, and a success rate of 80% was achieved. Collectively, we discovered recurrence-related genes and established recurrence prediction model of recurrence for HCC patients, which could provide significant guidance for clinical prediction of recurrence.


Biomarkers, Tumor/genetics , Carcinoma, Hepatocellular/genetics , Gene Expression Regulation, Neoplastic , Liver Neoplasms/genetics , Machine Learning , Neoplasm Recurrence, Local/genetics , Carcinoma, Hepatocellular/pathology , Disease-Free Survival , Gene Expression Profiling , Humans , Liver Neoplasms/pathology , Neoplasm Recurrence, Local/pathology , Survival Rate
6.
Pigment Cell Melanoma Res ; 33(4): 601-611, 2020 07.
Article En | MEDLINE | ID: mdl-31944535

The incidence of melanoma is rising globally including China. Comparing to Caucasians, the incidence of non-cutaneous melanomas is significantly higher in Chinese. Herein, we performed genomic profiling of 89 Chinese surgically resected primary melanomas, including acral (n = 54), cutaneous (n = 22), and mucosal (n = 13), by hybrid capture-based next-generation sequencing. We show that mucosal melanomas tended to harbor more pathogenic mutations than other types of melanoma, though the biological significance of this finding remains uncertain. Chromosomal arm-level alterations including 6q, 9p, and 10p/q loss were highly recurrent in all subtypes, but mucosal melanoma was significantly associated with increased genomic instability. Importantly, 7p gain significantly correlated with unfavorable clinical outcomes in non-cutaneous melanomas, representing an intriguing prognostic biomarker of those subtypes. Furthermore, focal amplification of 4q12 (KIT, KDR, and PDGFRα) and RAD51 deletion were more abundant in mucosal melanoma, while NOTCH2 amplification was enriched in acral melanoma. Additionally, cutaneous melanomas had higher mutation load than acral melanomas, while mucosal melanomas did not differ from other subtypes in mutation burden. Together, our data revealed important features of acral and mucosal melanomas in Chinese including distinctive driver mutation pattern and increased genomic instability. These findings highlight the possibilities of combination therapies in the clinical management of melanoma.


DNA Mutational Analysis , Genomics , Melanoma/genetics , Mucous Membrane/pathology , Mutation/genetics , Adult , Aged , Aged, 80 and over , Asian People/genetics , Disease-Free Survival , Ethnicity/genetics , Female , Gene Dosage , Humans , Kaplan-Meier Estimate , Male , Melanoma/enzymology , Middle Aged , Young Adult
7.
Zootaxa ; 4455(3): 582-584, 2018 Aug 03.
Article En | MEDLINE | ID: mdl-30314204

The paper described one new species from Sichuan, China. The new species, i.e. Pseudocosmetura wanglangensis sp. nov. differs from the known species of the genus in its distinctive male cercus and epiproct.


Animal Distribution , Orthoptera , Animals , China , Male
8.
Curr Biol ; 28(13): 2174-2180.e7, 2018 07 09.
Article En | MEDLINE | ID: mdl-30008333

Ecosystem services (the benefits to humans from ecosystems) are estimated globally at $125 trillion/year [1, 2]. Similar assessments at national and regional scales show how these services support our lives [3]. All valuations recognize the role of biodiversity, which continues to decrease around the world in maintaining these services [4, 5]. The giant panda epitomizes the flagship species [6]. Its unrivalled public appeal translates into support for conservation funding and policy, including a tax on foreign visitors to support its conservation [7]. The Chinese government has established a panda reserve system, which today numbers 67 reserves [8, 9]. The biodiversity of these reserves is among the highest in the temperate world [10], covering many of China's endemic species [11]. The panda is thus also an umbrella species [12]-protecting panda habitat also protects other species. Despite the benefits derived from pandas, some journalists have suggested that it would be best to let the panda go extinct. With the recent downlisting of the panda from Endangered to Vulnerable, it is clear that society's investment has started to pay off in terms of panda population recovery [13, 14]. Here, we estimate the value of ecosystem services of the panda and its reserves at between US$2.6 and US$6.9 billion/year in 2010. Protecting the panda as an umbrella species and the habitat that supports it yields roughly 10-27 times the cost of maintaining the current reserves, potentially further motivating expansion of the reserves and other investments in natural capital in China.


Biodiversity , Conservation of Natural Resources , Ecosystem , Ursidae , Animals , China , Conservation of Natural Resources/economics , Endangered Species
9.
Medicine (Baltimore) ; 97(19): e0413, 2018 May.
Article En | MEDLINE | ID: mdl-29742685

To assess the association of plasma cytokines and growth factor levels with clinical characteristics and inflammatory indices in patients with gastric cancer.Plasma samples derived from 99 gastric cancer patients were used for analysis. Levels of interferon (IFN)-γ, tumor growth factor (TGF)-ß1, tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p40, IL-12p70, and vascular endothelial growth factor (VEGF) were measured by Luminex suspension array technology. The association between cytokine/growth factor levels and demographic/clinical characteristics was assessed. Correlation between cytokines and growth factor levels was assessed by Pearson's correlation analysis.Male patients had significant higher levels of plasma TNF-α, IL-12p70, IL-4, IL-10, and VEGF as compared with those in women (P < .05). Plasma levels of TNF-α in older patients with gastric cancer (≥60 years) were higher than those in young patients (P < .05). Elevated plasma levels of IL-8 and IL-10 were identified as risk factors for increased tumor size (diameter ≥5 cm). Higher plasma levels of TGF-ß1 were associated with increased risk of vascular or nerve invasion and advanced tumor stage. The levels of systemic inflammatory markers, including white blood cell counts, neutrophil/lymphocyte proportion, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), C-reactive protein and modified Glasgow prognostic score (mGPS) were closely associated with a series of plasma cytokines. A prominent correlation was observed between the plasma IL-12p70 and IFN-γ levels (r = 0.729, P < .01).Our findings suggest that plasma cytokines and growth factor levels may help predict the development and progression of gastric cancer. Our findings need to be validated by larger studies.


Interleukins , Stomach Neoplasms , Tumor Necrosis Factors , Vascular Endothelial Growth Factor A/blood , China/epidemiology , Female , Humans , Inflammation/blood , Interleukins/blood , Interleukins/classification , Male , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Prognosis , Reproducibility of Results , Stomach Neoplasms/blood , Stomach Neoplasms/epidemiology , Stomach Neoplasms/pathology , Tumor Necrosis Factors/blood , Tumor Necrosis Factors/classification
10.
Oncol Lett ; 9(2): 609-613, 2015 Feb.
Article En | MEDLINE | ID: mdl-25624889

Clinical reports of primary sphenoid sinus melanoma and isolated gastric metastatic melanoma are rare. Thus, to the best of our knowledge, the present study reports the first case of isolated gastric metastasis from a sphenoid sinus melanoma. The aim of the present study was to discuss the clinicopathological and radiographic characteristics, the treatment strategy and the prognosis of sphenoid sinus metastatic malignant melanoma of the stomach. Although almost 60% of patients who succumb to melanoma exhibit gastrointestinal metastases at autopsy, antemortem diagnosis is uncommon; this is predominantly due to gastric metastatic melanoma presenting with non-specific symptoms similar to other common gastrointestinal diseases. Gastrectomy may prolong overall survival and improve the quality of life for gastric metastatic melanoma patients, and the present case emphasizes the importance of palliative surgery in such cases.

11.
Dig Dis Sci ; 59(3): 664-73, 2014 Mar.
Article En | MEDLINE | ID: mdl-24395380

BACKGROUND: We conducted a systematic review and meta-analysis of meat intake and esophageal cancer risk, with subgroup analyses based on meat type and histological type of cancer. AIMS: The purpose of this study was to investigate the association between meat intake and risk of esophageal cancer. METHODS: We searched MEDLINE, EMBASE and Cochrane Library (April 2013) for cohort and case-control studies that assessed meat intake and esophageal cancer risk. Random-effect or fixed-effect models were used to pool relative risks (RRs) from individual studies with heterogeneity and publication bias analyses carried out. Seven cohort and 28 case-control studies were included. RESULTS: The summary RRs for esophageal cancer for the highest versus lowest consumption categories were 1.19 (95 % confidence interval [CI] 0.98-1.46) for total meat, 1.55 (95 % CI 1.22-1.96) for red meat, 1.33 (95 % CI 1.04-1.69) for processed meat, 0.72 (95 % CI 0.60-0.86) for white meat, 0.83 (95 % CI 0.72-0.96) for poultry, and 0.95 (95 % CI 0.76-1.19) for fish. When striated by histological subtype, positive associations were seen among esophageal squamous cell carcinoma and red meat, white meat and poultry, and esophageal adenocarcinoma with total meat and processed meat. CONCLUSIONS: Meat consumption is associated with esophageal cancer risk, which depends on meat type and histological type of esophageal cancer. High intake of red meat and low intake of poultry are associated with an increased risk of esophageal squamous cell carcinoma. High meat intake, especially processed meat, is likely to increase esophageal adenocarcinoma risk. And fish consumption may not be associated with incidence of esophageal cancer.


Adenocarcinoma/etiology , Carcinoma, Squamous Cell/etiology , Diet/adverse effects , Esophageal Neoplasms/etiology , Meat/adverse effects , Animals , Cattle , Humans , Meat Products/adverse effects , Models, Statistical , Poultry , Risk Factors , Seafood/adverse effects
12.
Tumour Biol ; 35(3): 2825-30, 2014 Mar.
Article En | MEDLINE | ID: mdl-24293391

Hypoxia-inducible factor-1 (HIF-1) influences cancer progression and metastasis through various mechanisms, and HIF-1α polymorphisms are reportedly associated with many cancers; however, the associations of HIF-1α P582S and A588T polymorphisms with the risk of digestive system cancer remain inconclusive. To understand the role of HIF-1α P582S and A588T genotypes in digestive cancer development, we conducted a comprehensive meta-analysis involving 1,517 cases and 3,740 controls. Overall, the P582S polymorphism was not significantly associated with digestive system cancers in all genotypes. By contrast, the A588T polymorphism was significantly associated with digestive system cancers in the dominant model (TT/AT vs. AA: OR = 3.17, 95% CI: 1.21, 8.25; P heterogeneity < 0.001). In subgroup analysis for cancer types, the two polymorphisms were only associated with increased risk of pancreatic cancer (P582S: SS vs. PP: OR = 2.51, 95% CI: 1.31, 4.81; SS vs. PP/PS: OR = 8.73, 95% CI: 1.33, 57.1; A588T: TT vs. AA: OR = 9.30, 95% CI: 1.12, 77.6; P heterogeneity = 0.478; TT vs. AA/AT: OR = 3.14, 95% CI: 1.99, 4.97; P heterogeneity = 0.098; TT/AT vs. AA: OR = 8.65, 95% CI: 1.05, 71.6; P heterogeneity = 0.418). According to the source of ethnicity, the P582S and the A588T polymorphisms are both significantly associated with an increased risk of cancer among Caucasians in the homozygote model (SS vs. PP: OR = 2.41, 95% CI: 1.24, 4.691; P heterogeneity = 0.010; TT vs. AA: OR = 98.6, 95% CI: 4.37, 2,224; P heterogeneity = 0.040) and the recessive model (SS vs. PP/PS: OR = 9.48, 95% CI: 1.12, 80.3; P heterogeneity < 0.001; TT vs. AA/AT: OR = 82.7, 95% CI: 3.79, 1,802; P heterogeneity = 0.041). Our findings suggest that the HIF-1α A588T polymorphism is significantly associated with higher cancer risk and the P582S polymorphism is significantly associated with pancreatic cancer risk. Furthermore, the effect of both polymorphisms on digestive system cancer is more pronounced among Caucasians than that among Asians.


Gastrointestinal Neoplasms/genetics , Genetic Predisposition to Disease/genetics , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Polymorphism, Single Nucleotide/genetics , Genotype , Humans , Odds Ratio , Pancreatic Neoplasms/genetics , Risk Factors , White People/genetics
13.
PLoS One ; 8(11): e80396, 2013.
Article En | MEDLINE | ID: mdl-24260383

BACKGROUND: HIF-1 activates various genes in cancer progression and metastasis. HIF-1α 1772 C/T and 1790 G/A polymorphisms are reportedly associated with cancer risk; however, the results are inconclusive. METHODOLOGY/PRINCIPAL FINDINGS: A meta-analysis of 34 studies that involved 7522 cases and 9847 controls for 1772 C/T and 24 studies that involved 4884 cases and 8154 controls for 1790 G/A was conducted to identify the association of C/T and G/A polymorphisms with cancer risk. Odds ratio (OR) and 95% confidence intervals (95% CI) were used to assess the strength of association. HIF-1α 1772 C/T and 1790 G/A polymorphisms were associated with higher cancer risk in homozygote comparison (1772C/T: TT vs. CC: OR = 2.45, 95% CI: 1.52, 3.96; P heterogeneity = 0.028; 1790G/A: AA vs. GG: OR=4.74, 95% CI: 1.78, 12.6; P heterogeneity < 0.01), dominant model (1772C/T: TT/CT vs. CC: OR = 1.27, 95% CI: 1.04, 1.55; P heterogeneity < 0.01, 1790G/A: AA/GA vs. GG: OR = 1.65, 95% CI: 1.05, 2.60; P heterogeneity < 0.01), T allele versus C allele (T vs. C: OR = 1.42, 95% CI: 1.18, 1.70; P heterogeneity < 0.01), and A allele versus G allele (A vs. G: OR = 1.83, 95% CI: 1.13, 2.96; P heterogeneity < 0.01). On a subgroup analysis, the 1772 C/T polymorphism was significantly linked to higher risks for breast cancer, lung cancer, prostate cancer, and cervical cancer, whereas the 1790 G/A polymorphism was significantly linked to higher risks for lung cancer and prostate cancer. A significantly increased cancer risk was found in both Asians and Caucasians for 1772C/T polymorphism, whereas a significantly increased cancer risk was found in Caucasians in the heterozygote comparison and recessive model for 1790G/A polymorphism. CONCLUSIONS: HIF-1α 1772 C/T and 1790 G/A polymorphisms are significantly associated with higher cancer risk.


Genetic Predisposition to Disease/genetics , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Neoplasms/genetics , Polymorphism, Genetic/genetics , Alleles , Case-Control Studies , Humans , Risk
14.
PLoS One ; 8(8): e70955, 2013.
Article En | MEDLINE | ID: mdl-23967140

BACKGROUND: Red and processed meat was concluded as a limited-suggestive risk factor of gastric cancer by the World Cancer Research Fund. However, recent epidemiological studies have yielded inconclusive results. METHODS: We searched Medline, EMBASE, and the Cochrane Library from their inception to April 2013 for both cohort and case-control studies which assessed the association between red and/or processed meat intake and gastric cancer risk. Study-specific relative risk estimates were polled by random-effect or fixed-effect models. RESULTS: Twelve cohort and thirty case-control studies were included in the meta-analysis. Significant associations were found between both red (RR: 1.45, 95% CI: 1.22-1.73) and processed (RR: 1.45, 95% CI: 1.26-1.65) meat intake and gastric cancer risk generally. Positive findings were also existed in the items of beef (RR: 1.28, 95% CI: 1.04-1.57), bacon (RR: 1.37, 95% CI: 1.17-1.61), ham (RR: 1.44, 95% CI: 1.00-2.06), and sausage (RR: 1.33, 95% CI: 1.16-1.52). When conducted by study design, the association was significant in case-control studies (RR: 1.63, 95% CI: 1.33-1.99) but not in cohort studies (RR: 1.02, 95% CI: 0.90-1.17) for red meat. Increased relative risks were seen in high-quality, adenocarcinoma, cardia and European-population studies for red meat. And most subgroup analysis confirmed the significant association between processed meat intake and gastric cancer risk. CONCLUSIONS: Our findings indicate that consumption of red and/or processed meat contributes to increased gastric cancer risk. However, further investigation is needed to confirm the association, especially for red meat.


Eating , Epidemiologic Studies , Food Handling , Meat/adverse effects , Observational Studies as Topic/methods , Stomach Neoplasms/epidemiology , Humans , Risk
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