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1.
Environ Res ; 255: 119108, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-38762004

RESUMEN

Addressing natural resource dependence is integral to achieving the Sustainable Development Goals by promoting economic diversification, environmental sustainability, and climate resilience. This study explores the effect of natural resource dependence on green development by adopting the balanced panel dataset from the "Belt and Road" countries from 2005 to 2019. Notably, the novelty of our analysis lies in the empirical analysis using instrument-based techniques that consolidate the "green development curse hypothesis" in the Belt and Road countries. The mechanism analysis reveals that natural resource dependence curbs green development by weakening innovative capability, disturbing institutional quality, reducing population density, and crowding out human capital. Further, the dynamic panel threshold model handling endogeneity verifies the nonlinear relationship between natural resource dependence and green development. Interestingly, digital trade offers greater "resilience" than traditional trade, correcting the resource curse dilemma. Finally, heterogeneity analyses indicate that the green development curse hypothesis only exists in countries with high-level environmental regulations and resource-based countries.


Asunto(s)
Conservación de los Recursos Naturales , Recursos Naturales , Desarrollo Sostenible , Humanos
2.
Chemosphere ; 356: 141880, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38570049

RESUMEN

As an emerging pollutant, microplastics (MPs) cause widespread concern around the world owing to the serious threat they pose to ecosystems. In particular, sediments are thought to be the long-term sink for the continual accumulation of MPs in freshwater ecosystems. Polyethylene (PE) and polyethylene terephthalate (PET) have been frequently detected with large concentration variations in freshwater sediments from the lower reaches of the Yangtze River, one of the most economically developed regions in China, characterized by accelerated urbanization and industrialization, high population density and high plastics consumption. However, the impact of PE and PET on the sedimental bacterial community composition and its function has not been well reported for this specific region. Herein, PE and PET particles were added to freshwater sediments to assess the effects of different MP types on the bacterial community and its function, using three concentrations (500, 1500 and 2500 items/kg) per MP and incubations of 35, 105 and 175 days, respectively. This study identified a total of 68 phyla, 211 classes, 518 orders, 853 families and 1745 genera. Specifically, Proteobacteria, Chloroflexi, Acidobacteriota, Actinobacteriota and Firmicutes were the top five phyla. A higher bacterial diversity was obtained in control sediments than in the MP-treated sediments. The presence of MPs, whether PET or PE, had significant impact on the bacterial diversity, community structure and community composition. PICRUSt2 and FAPOTAX predictions demonstrated that MPs could potentially affect the metabolic pathways and ecologically functional groups of bacteria in the sediment. Besides the MP-related factors, such as the type, concentration and incubation time, the physicochemical parameters had an effect on the structure and function of the bacterial community in the freshwater sediment. Taken together, this study provides useful information for further understanding how MPs affect bacterial communities in the freshwater sediment of the lower reaches of the Yangtze River, China.


Asunto(s)
Bacterias , Sedimentos Geológicos , Lagos , Microplásticos , Contaminantes Químicos del Agua , Microplásticos/toxicidad , Microplásticos/análisis , Sedimentos Geológicos/microbiología , Sedimentos Geológicos/química , Contaminantes Químicos del Agua/análisis , Bacterias/clasificación , Bacterias/efectos de los fármacos , China , Lagos/microbiología , Lagos/química , Tereftalatos Polietilenos , Monitoreo del Ambiente , Polietileno , Ecosistema , Agua Dulce/microbiología , Agua Dulce/química
3.
Sci Total Environ ; 913: 169697, 2024 Feb 25.
Artículo en Inglés | MEDLINE | ID: mdl-38163614

RESUMEN

Microplastics (MPs), as a new substrate, provide a unique niche for microbial colonization in the freshwater ecosystems; however, the impacts of long-term MP exposure on colonized bacteria are still unclear. In this study, five MP types were exposed in a freshwater lake for approximately one year, and the MP particles, together with the surrounding water, were collected on days 60, 150, 250 and 330 during the in situ field experiment. Bacteria on the MP surface, as well as free-living bacteria in the surrounding water, were analyzed to evaluate the temporal dynamics of these bacterial communities. Results show that all five MP types exhibited signs of degradation during the exposure process. Additionally, the alpha diversity, community structure and composition of MP-attached bacteria significantly differed from that of the free-living bacteria in the surrounding water, indicating that the five MP types could provide a preferable niche for bacterial colonization in a freshwater environment. Proteobacteria, Chloroflexi, Verrucomicrobiota, Actinobacteriota and Firmicutes were the top five dominant phyla. Some plastic-degrading bacteria included in these phyla were detected, verifying that MP-attached biofilms had a certain degree of MP degradation potential. Some potentially pathogenic bacteria were also detected, suggesting an ecological threat for spreading disease in the aquatic ecosystem. Furthermore, the bacterial community and some metabolic pathways were significantly affected by the MP type (P < 0.01) and exposure time (P < 0.01), indicating that the presence of MPs not only alters the bacterial community structure and composition, but also influences their potential functional properties in freshwater ecosystems. Multiple factors, including the physicochemical properties related to MPs and the environmental parameters of the surrounding water, affect the community composition and the function of MP-attached bacteria to different degrees. Our findings indicate that the presence of MPs has a potential ecological impact on freshwater ecosystems.


Asunto(s)
Microplásticos , Contaminantes Químicos del Agua , Plásticos , Lagos , Ecosistema , Contaminantes Químicos del Agua/análisis , Bacterias , Agua
4.
J Environ Manage ; 352: 120106, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38244410

RESUMEN

Certain nations have opted for stimulus-based regulations to curtail emissions, build a liveable, environmentally friendly setting, and work towards aspirational mitigation targets. New Zealand (NZ) prefers an Emission Trading Scheme (ETS) to taxation, mitigating emissions on one hand while retaining incentives for economic growth on the other. As a result, NZ has initiated a legal framework since 2008 to allow its economic sectors to engage in ETS and minimize emissions. Yet, selecting the appropriate sectors and effectively adjusting sector-specific regulations remain critical and complex challenges in the global design of ETS since both excessive and insufficient intervention can lead to inefficiencies in the system's functioning. Therefore, this study begins validating the NZ ETS's abatement potential regarding sectoral carbon intensity by executing the double machine learning techniques, consolidating the ETS efficacy that has robustly mitigated sectoral carbon intensity in NZ during 2006-2020. However, this conclusion seems invalid at the disaggregated level when focusing on forward-backward linkages, where NZ's input-output tables furnish a compelling scenario of sectoral dependencies and the products (residuals) they provide. Altogether, the regulatory requirements are either too strict or too lax, leaving out five of the 24 (as a whole) key sectors. Rather, the ETS could be powerful, providing these five key sectors are well tackled, necessitating a reformulation of the ongoing ETS regulatory regime.


Asunto(s)
Gases de Efecto Invernadero , Nueva Zelanda , Desarrollo Económico , Carbono/análisis , Dióxido de Carbono/análisis , China
5.
J Environ Manage ; 347: 119081, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-37812902

RESUMEN

Understanding the significance of financial clustering in the context of green development holds immense importance for China as it strives towards achieving high-quality green development. Using a balanced panel dataset encompassing China's 283 cities from 2009 to 2020, we aim to explore the impact of financial clustering on green development from both linear and nonlinear perspectives. Empirical evidence suggests that when the level of financial clustering increases by 1%, the city-level green development increases by 0.1012%. A mediation effect model certifies that there are three essential channels through which financial clustering robustly boosts green development: technical, structural and scale effects. Subsequently, a novel program handling endogeneity is designed and verifies the nonlinear nexus between financial clustering and green development. Moreover, the spatial Durbin model demonstrates that financial clustering significantly sustains local green development, despite its relatively weak spill over effects. Heterogeneity analysis presents that the promoting effect is particularly predominant in Central China, as well as in cities characterized by high levels of financial clustering and large population sizes.


Asunto(s)
Desarrollo Económico , China , Ciudades , Análisis por Conglomerados , Densidad de Población
6.
J Environ Manage ; 347: 119170, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-37820516

RESUMEN

In the context of globalization, the role of the digital economy in carbon emissions may generate spatial spill over effects. This study comprehensively applies a spatial model to understand the nexus between the digital economy and carbon emissions in 67 economies from 2010 to 2019. Specifically, this study contributes by introducing a spatial panel threshold model, which helps to present the new evidence regarding decarbonization process. Empirical findings exemplify that the digital economy remarkably reduces local carbon emissions, with the positive spatial spill over effects being salient. The spatial moderating effect model uncover that globalization positively affects the nexus between the digital economy and carbon emissions. Interestingly, the spatial panel threshold model designates that the digital economy's reduction effect on local carbon emissions will be tightened, whereas the positive spatial spill over effects turn negative only when globalization surpasses a threshold. Our model has the potential to explain some results that traditional models cannot reach.


Asunto(s)
Dióxido de Carbono , Desarrollo Económico , Dióxido de Carbono/análisis , Internacionalidad , Carbono , China
7.
BMC Pulm Med ; 23(1): 207, 2023 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-37316870

RESUMEN

BACKGROUND: For patients with advanced non-small-cell lung cancer (NSCLC) with EGFR mutations, the suggested course of action is epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). Even with a high disease control rate, a majority of patients develop acquired EGFR-TKIs resistance and eventually advance. To increase the benefits of treatment, clinical trials are increasingly exploring the value of EGFR-TKIs combined with angiogenesis inhibitors as a first-line treatment in advanced NSCLC carrying EGFR mutations. METHOD: Using PubMed, EMBASE and Cochrane Library, to locate published full-text articles in print or online, a thorough literature search was done from the database's inception to February 2021. Additionally, oral presentation RCTs from ESMO and ASCO were obtained. We sifted out RCTs that used EGFR-TKIs along with angiogenesis inhibitors as first-line therapy for advanced EGFR-mutant NSCLC. ORR, AEs, OS, and PFS were the endpoints. Review Manager version 5.4.1 was used for data analysis. RESULTS: One thousand eight hundred twenty-one patients were involved in 9 RCTs. According to the results, combining EGFR-TKIs with angiogenesis inhibitors therapy prolonged PFS of advanced EGFR-mutation NSCLC patients on the whole [HR:0.65 (95%CI: 0.59~0.73, P<0.00001)]. No significant statistical difference was identified between the combination group and single drug group in OS(P=0.20) and ORR (P=0.11). There are more adverse effects when EGFR-TKIs are used in combination with angiogenesis inhibitors than when used alone. CONCLUSION: The combination of EGFR-TKIs and angiogenesis inhibitors prolonged PFS in patients with EGFR-mutant advanced NSCLC, but the OS and ORR benefit was not significant, and the risk of adverse events was higher, more pronounced with hypertension and proteinuria; PFS in subgroups suggested that the combination was associated with better PFS in the smoking, liver metastasis, and no brain metastasis groups, and the included studies suggested that the smoking group , liver metastasis group, and brain metastasis group may have a potential OS benefit.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Hepáticas , Neoplasias Pulmonares , Humanos , Inhibidores de la Angiogénesis/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , Receptores ErbB/genética
8.
J Environ Manage ; 335: 117553, 2023 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-36842359

RESUMEN

Based on an extended STIRPAT framework, this paper investigates the effects of financial development on carbon emission intensity in OECD countries from linear and non-linear perspectives, where financial development is proxied by three dimensions: financial deepening, financial deepening, and financial size, and financial efficiency. Fortunately, three types of financial development significantly alleviate carbon emission intensity. An extended moderation effect model is built to estimate the effect of financial development via information and communication technology on carbon emission intensity. The results reveal that internet-based information and communication technology and service-based information and communication technology are positively correlated with carbon emission intensity. To effectively handle the endogeneity issue triggered by causal relationships between variables and allow potential non-linear nexus, an advanced dynamic panel threshold model incorporating the generalised method of moments is employed to investigate how financial development affects carbon emission intensity under different types of information and communication technology. Empirical evidence demonstrates the significance of the non-linear nexus between financial development and carbon emission intensity. Lastly, heterogeneity analysis demonstrates the existence of heterogeneity associated with institutional quality, degree of economic development, and resource endowment concerning the effect of financial development on carbon emission intensity among the OECD countries.


Asunto(s)
Carbono , Administración Financiera , Organización para la Cooperación y el Desarrollo Económico , Comunicación , Tecnología , Dióxido de Carbono , Desarrollo Económico
9.
PLoS One ; 17(12): e0278128, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36454765

RESUMEN

The Chinese central government established eight pilot zones in five provinces for green finance reform and innovations (GFRI) in 2017. The pilot zones promote green finance development and explore the propagable and reproducible experiences regarding mechanisms and institutions. Adopting a sample of China's listed companies from 2012 to 2021, this paper constructed a quasi-natural experiment and investigated the GFRI policy's effect on firms' total factor productivity (TFP) using the difference-in-differences (DID) method to verify the implementation effect of the GFRI policy. Furthermore, heterogeneity analysis and mechanism analysis were conducted to identify the guidance effect and deep mechanisms of the GFRI policy. The empirical results demonstrated that firms' TFP in pilot zones increased substantially after implementing the GFRI pilot policy, confirming that the policy had a strong incentive effect. The corresponding promoting effect was particularly significant for non-state-owned companies, the eastern and central regions, and firms in the growth stage. Further mechanism analysis revealed that the GFRI pilot policy can stimulated firms' TFP by promoting technological innovation and improving resource allocation efficiency. This paper's empirical findings are essential in improving relevant policies and expanding the pilot zones.


Asunto(s)
Política Fiscal , Políticas , Humanos , Pueblo Asiatico , Gobierno Federal , Asignación de Recursos
10.
Environ Sci Process Impacts ; 24(12): 2336-2344, 2022 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-36278318

RESUMEN

Submicron soot particles (<1.0 µm in aerodynamic diameter) are responsible for global warming and health burdens worldwide. However, studies on bio-monitoring of submicron soot particles and their associated sources by using tree leaves are not comprehensively illustrated. Here, we determined the seasonal trends of submicron soot particles on the leaves of the Platanus acerifolia collected from two cities (Lu'an, Anhui Province, and Nanjing, Jiangsu Province) in the Yangtze River Delta region, China. The source apportionment of submicron soot particles was performed using stable carbon isotopic analyses. Significant seasonal trends of submicron soot particles were observed in two cities with averaged levels of 0.41-1.36 mg m-2 in cold seasons and averaged levels of 0.13-0.24 mg m-2 in warm seasons. The levels of δ13C for submicron soot at the suburban site of Lu'an city were observed to be in the range of -25.6‰ to -18.2‰ with fossil fuels dominated (∼58%) in summer and -23.0‰ to -15.6‰ with biomass burning dominated in winter (∼67%). In comparison, the ranges in the levels of δ13C in submicron soot were found to be from -26.5‰ to -20.4‰ in winter, and -24.2‰ to -17.9‰ in summer at the urban site of Nanjing. Fossil fuels accounted for a large fraction of submicron soot with average contributions of 53% in winter and 73% in summer, respectively. These findings demonstrate that Platanus acerifolia trees could be used as an effective and low-cost bio-monitoring tool for monitoring the pollution status of submicron soot and associated source contribution.


Asunto(s)
Contaminantes Atmosféricos , Hollín , Hollín/análisis , Árboles , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente , Combustibles Fósiles/análisis , Carbono/análisis , Estaciones del Año , China , Aerosoles/análisis , Material Particulado/análisis
11.
Front Oncol ; 12: 899927, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36119535

RESUMEN

Colorectal adenocarcinoma (CRC) is the third most common malignancy worldwide. Metastatic CRC has a poor prognosis because of chemotherapy resistance. Our previous study demonstrated that semaphorin 3F (SEMA3F) signaling may contribute to reversing chemotherapy resistance in CRC cells by reducing E-cadherin and integrin αvß3 expression levels. Another study showed that upregulation of p27 significantly increase the expression of E-cadherin and integrin. This study aimed to evaluate the effect of SEMA3F on P27 and whether it can reverse resistance in CRC cells. We compared the chemosensitivity of human colorectal cancer cell lines with different SEMA3F expression levels to 5-Fu through cell experiment and animal experiment. Then the interaction between SEMA3F and p27 and its possible mechanism were explored by Western Blot, immunofluorescence and immunocoprecipitation. We also compared the disease-free survival of 118 CRC patients with high or low expression of SEMA3F.The results showed that overexpresstion of SEMA3F enhanced the chemotherapy sensitivity and apoptosis of CRC cells in vitro and in vivo. Among 118 postoperative CRC specimens, the disease-free survival of patients with positive SEMA3F expression was significantly longer than that with negative SEMA3F expression after adjuvant treatment. Upregulation of SEMA3F in multicellular spheroid culture (MSC) could increase p27 phosphorylation at serine 10 (Ser10), subsequently promote the cytosolic translocation of P27. Overall, our results reveal a novel molecular mechanism: SEMA3F mediates the degradation of p27 and regulates its subcellular localization to enhance chemosensitivity to 5-Fu in CRC cells, rather than inhibits p27 expression.

12.
Zhen Ci Yan Jiu ; 47(6): 553-8, 2022 Jun 25.
Artículo en Chino | MEDLINE | ID: mdl-35764525

RESUMEN

Acupuncture has an unique advantage in treatment of ischemic stroke, which not only promotes the repair of synaptic structure and function, but also regulates the transmission of neurotransmitters and receptors, as well as induces glial cell to repair neurons, and then to protect them. At present, the mechanism study on acupuncture for advancing synaptic plasticity in cerebral ischemia is of the high priority. In the paper, from the following three aspects, i.e. synaptic plasticity (structure and function), interaction between synapses (neurotransmitters and receptors), and interconnection between synapses and environments (synaptic-glial structure), the progress of mechanism study of acupuncture in recent years was reviewed on regulating synaptic plasticity in treatment of ischemic stroke.


Asunto(s)
Terapia por Acupuntura , Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Isquemia Encefálica/terapia , Humanos , Plasticidad Neuronal/fisiología , Sinapsis/fisiología
13.
Front Cell Dev Biol ; 9: 634347, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33777942

RESUMEN

Cerebral ischemia is one of the leading causes of death. Reperfusion is a critical stage after thrombolysis or thrombectomy, accompanied by oxidative stress, excitotoxicity, neuroinflammation, and defects in synapse structure. The process is closely related to the dephosphorylation of actin-binding proteins (e.g., cofilin-1) by specific phosphatases. Although studies of the molecular mechanisms of the actin cytoskeleton have been ongoing for decades, limited studies have directly investigated reperfusion-induced reorganization of actin-binding protein, and little is known about the gene expression of actin-binding proteins. The exact mechanism is still uncertain. The motor cortex is very important to save nerve function; therefore, we chose the penumbra to study the relationship between cerebral ischemia-reperfusion and actin-binding protein. After transient middle cerebral artery occlusion (MCAO) and reperfusion, we confirmed reperfusion and motor function deficit by cerebral blood flow and gait analysis. PCR was used to screen the high expression mRNAs in penumbra of the motor cortex. The high expression of cofilin in this region was confirmed by immunohistochemistry (IHC) and Western blot (WB). The change in cofilin-1 expression appears at the same time as gait imbalance, especially maximum variation and left front swing. It is suggested that cofilin-1 may partially affect motor cortex function. This result provides a potential mechanism for understanding cerebral ischemia-reperfusion.

14.
Medicine (Baltimore) ; 98(50): e18227, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852082

RESUMEN

OBJECTIVE: To identify the optimal treatment strategy after first-line induction chemotherapy for metastatic colorectal cancer (mCRC). METHODS: We conducted a meta-analysis of randomized controlled trials comparing bevacizumab-based maintenance therapy, observation, and continuous chemotherapy.We searched the PubMed, Embase, and Cochrane databases for relevant articles published through March 2018. All randomized phase-III trials evaluating bevacizumab-based maintenance treatment after bevacizumab-based induction treatment were eligible for inclusion. The primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. Hazard ratios (HRs) with 95% confidence intervals (CIs) or data for calculating HRs with 95% CIs were extracted. The RevMan v5.3 (Copenhagen, Denmark) software was used for data analysis. RESULTS: Nine trials (3121 patients) were included in this meta-analysis. Compared with observation alone, bevacizumab-based maintenance therapy significantly improved PFS (HR: 0.62, 95% CI: 0.47-0.82) and showed a trend toward prolonged OS (HR: 0.93, 95% CI: 0.83-1.05). The incidence of grade 3/4 toxicity, including hypertension and fatigue, was higher after maintenance therapy than after observation alone. PFS (HR: 0.91, 95% CI: 0.70-1.18) and OS (HR: 0.88, 95% CI: 0.74-1.04) did not differ between the maintenance treatment and continuous chemotherapy groups. Grade 3/4 toxicity, including diarrhea and sensory neuropathy, was less common after maintenance therapy than after continuous chemotherapy. CONCLUSION: Bevacizumab-based maintenance therapy significantly improved PFS, showed a trend toward prolonged OS, and reduced cumulative grade 3/4 toxicity relative to continuous chemotherapy with comparable efficacy. Although maintenance therapy was beneficial, the optimal strategy should be individualized.


Asunto(s)
Bevacizumab/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Quimioterapia de Mantención/métodos , Antineoplásicos Inmunológicos/uso terapéutico , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/secundario , Humanos , Metástasis de la Neoplasia , Resultado del Tratamiento
15.
Medicine (Baltimore) ; 96(40): e7981, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28984757

RESUMEN

BACKGROUND: The predictive roles of diabetes in the prognosis of many types of cancer have been well studied, but its role in predicting the prognosis of cervical cancer is still controversial. The aim of the study is to evaluate the association between diabetes/hyperglycemia and the prognosis of cervical cancer. METHODS: We conducted a systematic review for peer-reviewed studies indexed in PubMed, Embase, Web of Science, and Wanfang published before December 2016. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were pooled in the meta-analysis. RESULTS: This systematic review identified 13 studies with a total of 11,091 cervical cancer patients, of which 11 studies were included in the meta-analysis. The study indicated that diabetes was related to poorer overall survival (HR = 1.59, 95% CI: 1.35-1.87, P < .001) and poorer recurrence-free survival (HR = 1.98, 95% CI: 1.47-2.66, P < .001) in cervical cancer patients. The meta-analysis of adjusted HRs also indicated that diabetes was independently associated with poor overall survival (HR = 1.69, 95% CI: 1.38-2.05, P < .001) and poor recurrence-free survival (HR = 1.98, 95% CI: 1.47-2.66, P < .001) in cervical cancer patients. Sensitivity analysis and subgroup analyses showed similar results. No significant heterogeneity was observed for the included studies. CONCLUSIONS: The meta-analysis suggests that diabetes is an important predictive factor for cervical cancer prognosis, and it is linked to poorer survival of cervical cancer patients. Diabetes can serve as a useful index in the prognostic evaluation for patients with cervical cancer.


Asunto(s)
Complicaciones de la Diabetes/complicaciones , Hiperglucemia/complicaciones , Neoplasias del Cuello Uterino/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Pronóstico , Modelos de Riesgos Proporcionales , Neoplasias del Cuello Uterino/etiología
16.
Medicine (Baltimore) ; 96(51): e9384, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29390540

RESUMEN

BACKGROUND: A pathological complete response (pCR) after neoadjuvant chemotherapy (NCT) is a strong indicator of the benefit of therapy and presents an early surrogate for a favorable long-term outcome. It remains unclear whether Ki-67, a marker for tumor proliferation, can function as a predictor of the response to NCT in breast cancer. The objective of this meta-analysis was to compare the pCR rate and clinical outcomes in breast cancer patients with different Ki-67 labeling indexes (Ki-67 LI) who received NCT. METHODS: Clinical studies were retrieved from the electronic databases of PubMed, Embase, Clinical Trials, Wanfang, and the Chinese National Knowledge Infrastructure, from their inception to July 31, 2017. Meta-analysis was performed on pool eligible studies to determine whether Ki-67 LI was associated with the pCR rate and clinical outcomes of breast cancer patients who were treated with NCT. Pooled analyses were performed using fixed effects models. Two reviewers screened all titles and abstracts and independently assessed all articles. RESULTS: A total of 36 studies involving 6793 patients were included in the meta-analysis. Pooled analysis results revealed that patients with high Ki-67 LI exhibited significantly higher pCR rates (odds ratio [OR] = 3.94, 95% confidence interval [CI]: 3.33-4.67, P <.001) but poorer relapse-free survival (OR = 1.99, 95% CI: 1.39-2.85, P <.001) than those with low Ki-67 LI, but there was no significant difference in objective tumor response rate. CONCLUSION: The meta-analysis reported here demonstrates that pretherapeutic Ki-67 LI is associated with pCR in breast cancer patients undergoing NCT. More phase III randomized clinical trials will be required to confirm our findings.


Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Antígeno Ki-67/metabolismo , Mastectomía , Terapia Neoadyuvante , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/cirugía , Quimioterapia Adyuvante , Femenino , Humanos , Modelos Estadísticos , Resultado del Tratamiento
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