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1.
Chemosphere ; 262: 127830, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32763580

RESUMO

Atrazine residue in soil is one of the serious environmental problems and continues to risk ecosystem and human health. To address the environmental behaviors and dissipation of atrazine and better manage the application of atrazine in reality, we comprehensively investigated the adsorption and desorption, migration ability, and vanishing of atrazine in three distinct soils in China including Jiangxi (JX, pH 5.45, TOC 0.54%), Nanjing (NJ, pH 6.15, TOC 2.13%), and Yancheng (YC, pH 8.60, TOC 0.58%) soils. The atrazine adsorptive capacity to the soils was arranged in the order of NJ > YC > JX. The leaching assay with profiles of the soils showed strong migration, suggesting it had a high bioavailability to weeds and potential for underground water contamination. We further investigated the effects of environmental factors such as soil moisture, microbial activity and photolysis on atrazine degradation and showed that the degradation of atrazine in the soil mainly underwent the abiotic process, most likely through hydrolysis and photolysis-mediated mechanisms, and to less extend through soil microbial catabolism. Using HRLC-Q-TOF-MS/MS and by comparing the measured and theoretical m/z values and fragmentation data, ten metabolites comprising eight degraded products and two conjugates were characterized. Atrazine existing in the soils and sprayed coordinately blocked the growth of three common weeds, which prompted us to use the minimal atrazine in practice to control the waste of the pesticide and its impact on the environment. Overall, our work provided an insight into the mechanisms for the degradation of atrazine residues in the soils and contributed to the environmental risk assessment of the pesticide and management in its application control in the crop rotation and safe production.


Assuntos
Atrazina/química , Plantas Daninhas/metabolismo , Poluentes do Solo/metabolismo , Adsorção , Atrazina/metabolismo , Biodegradação Ambiental , Disponibilidade Biológica , China , Ecossistema , Herbicidas/química , Praguicidas/análise , Fotólise , Solo/química , Microbiologia do Solo , Poluentes do Solo/análise , Espectrometria de Massas em Tandem
2.
Clin Chim Acta ; 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33159948

RESUMO

PURPOSE: To evaluate the efficacy of diagnosis systems based upon instance segmentation with convolutional neural networks (CNNs) for diagnosing acute promyelocytic leukemia (APL) in bone marrow smear images. MATERIALS AND METHODS: A self-established dataset was used in this study that was exempted from review by the institution review board, which consisted of 13504 bone marrow smear images. One subset of the dataset with 12215 labeled images was split into training (80%) and validation (20%), another with 1289 labeled images was used to test, in which each test entry consists of about 130 images. An instance segmentation method named Mask R-CNN was used to detect and classify the nucleated cells. Here, we train a trained neural network from scratch; for comparison, we also use a network pre-trained on MS COCO (common objects in context, a data set provided by Microsoft which can be used for image recognition, the images in MS coco dataset are divided into training, validation and test sets) and fine-tuned with our dataset and both were trained with same data augmentation scheme. Diagnosis systems based on trained models and "FAB Classification" (French-American-British classification systems, a series of diagnostic criteria for acute leukemia, which was first proposed in 1976) were developed for diagnosing the test entry as APL or as not. Average precision (AP) and average recall (AR) were used to evaluate model performance. RESULTS: The best-performing model had an average precision of 62.5%, which was the augmented pre-trained Mask R-CNN with average recall 84.1%. The average precision of the pre-trained model was greater than that of the model trained from scratch (P < 0.05). Augmenting the dataset further increased accuracy (P <0 .03). CONCLUSION: Deep learning technology such as instance segmentation with Mask R-CNN may accurately diagnose APL in bone marrow smear images with an average precision of 62.5% when 0.5 as IoU thresholds. A data augmentation and pre-trained approach further improved accuracy.

3.
Int J Chron Obstruct Pulmon Dis ; 15: 2857-2867, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33192059

RESUMO

Purpose: Tobacco smoking, biomass smoke, and occupational exposure are the main risk factors for chronic obstructive pulmonary disease (COPD). The present study analyzes data on exposure to these factors in a cohort of patients with COPD and assesses their differences in demographic and clinical characteristics. Patients and Methods: The cross-sectional observational study was conducted from November 2016 to December 2019. Inclusion criteria were patients aged over 40 years old with post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7. At baseline, demographic features and exposure history were recorded. Moreover, respiratory symptoms were assessed by the COPD Assessment Test (CAT) and modified Medical Research Council scale (mMRC). A generalized linear mixed model was used to adjust for potential confounders. Results: A total of 5183 patients with COPD were included in the final analysis. The results demonstrate that exposure to tobacco combined with other risk factors resulted in significantly higher CAT scores (16.0 ± 6.7 vs 15.3 ± 6.3, P = 0.003) and more severe dyspnea (patients with mMRC ≥ 2, 71.5% vs 61.6%, P < 0.001) than exposure to tobacco alone. In addition, COPD patients with biomass smoke exposure alone had higher CAT scores than patients with only tobacco or occupational exposure (17.5 ± 6.3 vs 15.3 ± 6.3, and 15.2 ± 6.3, respectively, P < 0.05 for each comparison) and were more likely to be female and older. In addition, COPD patients who suffered from occupational exposure developed more severe dyspnea than those exposed to tobacco alone (70.8% vs 61.6%, P < 0.05), as did those exposed to biomass smoke alone (74.2% vs 61.6%, P < 0.05). This difference remained strong even after adjustment for potential confounders. Conclusion: There are significant demographic and clinical differences among COPD patients with tobacco smoking, biomass smoke, and occupational exposures.

4.
Eur J Med Chem ; : 112946, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33129590

RESUMO

Identification of potent anticancer agents with high selectivity and low toxicity remains on the way to human health. Pyridazine featuring advantageous physicochemical properties and antitumor potential usually is regarded as a central core in numerous anticancer derivatives. There are several approved pyridazine-based drugs in the market and analogues currently going through different clinical phases or registration statuses, suggesting pyridazine as a promising drug-like scaffold. The current review is intended to provide a comprehensive and updated overview of pyridazine derivatives as potential anticancer agents. In particular, we focused on their structure-activity relationship (SAR) studies, design strategies, binding modes and biological activities in the hope of offering novel insights for further rational design of more active and less toxic anticancer drugs.

5.
Medicine (Baltimore) ; 99(45): e23105, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157985

RESUMO

The relationship between solar ultraviolet radiation and the risk of breast cancer is conflicting. The purpose of our study was to quantitatively assess the relationship between solar ultraviolet radiation and breast cancer risk and to analyze related factors such as age and sunscreen use.Articles indexed in PubMed and Embase and published between January 2005 and March 2020 were searched for relevant keywords. The relative risk was calculated using random-effect or fixed-effect models in the meta-analysis and dose-response meta-analysis, which were conducted according to the Meta-Analyses of Observational Studies in Epidemiology reporting guidelines. Sensitivity analyses for heterogeneity and publication bias were evaluated.Six studies were eligible for inclusion in the meta-analysis, and three of these were included in the dose-response analysis. We found a correlation between exposure to solar ultraviolet radiation and breast cancer risk (relative risk: 0.70, 95% confidence interval: 0.65, 0.75). We also found a linear dose-response relationship between the exposure and breast cancer risk (relative risk: 0.86, 95% confidence interval: 0.81, 0.91) in women over 40. Not tanning and covering the limbs were associated with breast cancer risk, but sunscreen use was not.Exposure to solar ultraviolet radiation is negatively correlated with breast cancer risk, and the association is linear in women over 40. This is the first dose-response meta-analysis on the topic, and the influence of factors such as estrogen receptor status, occupational exposure, and ethnicity requires in-depth study.

6.
Cities ; : 103010, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33162634

RESUMO

Understanding the processes and mechanisms of the spatial spread of epidemics is essential for making reasonable judgments on the development trends of epidemics and for adopting effective containment measures. Using multi-agent network technology and big data on population migration, this paper constructed a city-based epidemic and mobility model (CEMM) to stimulate the spatiotemporal of COVID-19. Compared with traditional models, this model is characterized by an urban network perspective and emphasizes the important role of intercity population mobility and high-speed transportation networks. The results show that the model could simulate the inter-city spread of COVID-19 at the early stage in China with high precision. Through scenario simulation, the paper quantitatively evaluated the effect of control measures "city lockdown" and "decreasing population mobility" on containing the spatial spread of the COVID-19 epidemic. According to the simulation, the total number of infectious cases in China would have climbed to 138,824 on February 2020, or 4.46 times the real number, if neither of the measures had been implemented. Overall, the containment effect of the lockdown of cities in Hubei was greater than that of decreasing intercity population mobility, and the effect of city lockdowns was more sensitive to timing relative to decreasing population mobility.

7.
Bioorg Chem ; : 104470, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33213892

RESUMO

Gynostemma pentaphyllum has been used as a medicine-food homologious health product in China for a long time. This research aimed to isolate and identify its active compounds with protective effects against hydrogen peroxide induced SH-SY5Y cell death. Four new dammarane-type saponins were isolated from G. pentaphyllum using various chromatographic methods. They were identified as gypenoside S1 (1), gypenoside S3 (2), gypenoside S2 (3) and gypenoside S4 (4), respectively by HRESIMS and NMR spectra. Their cytotoxic activity was evaluated against three human cancer cell lines, A549 (lung), HepG2 (liver), SH-SY5Y (nerve), by MTT method. They showed low cytotoxicities with the IC50 values of more than 100 µM on three cancer cell lines. However, they appeared protective effects against hydrogen peroxide induced SH-SY5Y cell death in a dose-dependent manner. They recovered cell viability more than 69% at the concentration of 20 µM from 66%, while as vitamin C to 67%. Compound 3 and 4 recovered more than 79% at 100 µM. The present study suggests that G. pentaphyllum has antioxidative potential and the saponins from G. pentaphyllum are considered as the active compounds with safe and neuroprotecitve effect.

8.
World Neurosurg ; 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33217593

RESUMO

The paper used toremifene to study the characteristics of hemodynamic changes before and after neoadjuvant chemotherapy in breast cancer by using resting state functional MRI quantitative method, and to analyse the effect of toremifene on the recent quality of life of advanced breast cancer. Methods: A total of 100 patients who received endocrine therapy after breast cancer surgery in our hospital from January 2016 to January 2019 were collected as the research objects. They were randomly divided into observation group and control group, with 50 cases in each group. The observation group was treated with tamoxifen Combined toremifene treatment, the control group was treated with toremifene. Before and after chemotherapy, the same scheme was used to perform breast dynamic MRI enhancement scan, using 1.5T superconducting MRI imager, 3ml/s bolus injection of adiphenine meglumine 0.2mmol/kg; semi-quantitative blood flow measurement was completed on the workstation, and before and after chemotherapy Compare the results. At the same time, analyse the patient's recent quality of life, progesterone, estrogenic levels, social function, physical function, mental function, and material function. The mean values of the early enhancement parameters Efirst, Vfirst, Ee and Ve before chemotherapy were greater than the residual lesions after chemotherapy (P<0.5). The semi-quantitative study of resting brain function before and after breast cancer neoadjuvant chemotherapy showed that the hemodynamic of the residual lesions were significantly reduced, and the blood flow rate was significantly reduced. Compared with the clinical effect of tamoxifen in the treatment of breast cancer after surgery, tamoxifen combined with toremifene has more advantages in improving the recent quality of life, progesterone levels, and reducing estrogenic levels, and it has no disadvantages to the endometrium influences.

9.
Anal Methods ; 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33165490

RESUMO

Acute myocardial infarction (AMI) is the single leading cause of worldwide mortality and morbidity. Heart-type fatty acid-binding protein (H-FABP) and cardiac troponin I (cTnI), as biomarkers emerging at different stages of AMI, have complementary advantages in terms of specificity and sensitivity. Therefore, we developed a magnetic immunoassay method based on surface-enhanced Raman scattering (SERS) to detect H-FABP and cTnI simultaneously. Herein, two mutually independent Raman reporter molecules were embedded between a gold core and silver shell and then combined with a tracer antibody to form a SERS immunoprobe. During detection, the SERS immunoprobe, target antigen and capture probe undergo an immune reaction to form a sandwich structure, and then the immune complex was enriched by a specific reaction of streptavidin on the surface of magnetic beads with biotin. Finally, the concentration of biomarkers was quantified by detecting the characteristic Raman peak intensities of the two Raman reporter molecules. Under the optimized conditions, the minimum detection limits of H-FABP and cTnI were 0.6396 and 0.0044 ng mL-1, respectively. Besides, the target antigen does not cross-react with non-specific proteins, showing good specificity. Therefore, our proposed SERS-based magnetic immunoassay method has the advantages of accuracy, rapidity and good selectivity, and has great potential for early diagnosis of acute myocardial infarction disease.

10.
JBI Evid Synth ; 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33136710

RESUMO

OBJECTIVE: The objective of the review is to evaluate circulating levels of leptin in people diagnosed with myalgic encephalomyelitis chronic fatigue syndrome or fibromyalgia syndrome and to investigate the differences compared with healthy controls. INTRODUCTION: Myalgic encephalomyelitis chronic fatigue syndrome is a condition that has major symptoms, including self-reported fatigue, post-exertional malaise, and unexplained pain across the body. The widespread pain is measured in a systematic way and is often referred to as fibromyalgia. The two disorders have many similarities, but their association with leptin has indicated that leptin may affect the role of pro-inflammatory cytokines and symptom severity. INCLUSION CRITERIA: This review will consider observational studies of varying study designs including prospective and retrospective cohort studies, case-control studies, time-series, and analytical cross-sectional studies that include both cases and healthy comparators. Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants. Only studies published in English will be included due to limited resources for translation. METHODS: This protocol will be reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist and will follow the JBI methodology for systematic reviews of etiology and risk. A comprehensive search strategy will include PubMed, Embase, Scopus, Science Direct, and PsycINFO. Two reviewers will screen, critically appraise eligible articles, and extract data using a standardized data extraction tool informed by JBI SUMARI. The authors will complete a quantitative analysis that synthesizes findings across studies using pooled effect sizes and confidence intervals of the measures provided. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO [CRD42020169903].

11.
Eur J Med Chem ; : 112970, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33153765

RESUMO

To discover novel anticancer agents with potent and low toxicity, we designed and synthesized a range of new thiosemicarbazone-indole analogues based on lead compound 4 we reported previously. Most compounds displayed moderate to high anticancer activities against five tested tumor cells (PC3, EC109, DU-145, MGC803, MCF-7). Specifically, the represented compound 16f possessed strong antiproliferative potency and high selectivity toward PC3 cells with the IC50 value of 0.054 µM, compared with normal WPMY-1 cells with the IC50 value of 19.470 µM. Preliminary mechanism research indicated that compound 16f could significantly suppress prostate cancer cells (PC3, DU-145) growth and colony formation in a dose-dependent manner. Besides, derivative 16f induced G1/S cycle arrest and apoptosis, which may be related to ROS accumulation due to the activation of MAPK signaling pathway. Furthermore, molecule 16f could effectively inhibit tumor growth through a xenograft model bearing PC3 cells and had no evident toxicity in vivo. Overall, based on the biological activity evaluation, analogue 16f can be viewed as a potential lead compound for further development of novel anti-prostate cancer drug.

12.
Environ Pollut ; : 115802, 2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33143979

RESUMO

Developing a biotechnical system with rapid degradation of pesticide is critical for reducing environmental, food security and health risks. Here, we investigated a novel epigenetic mechanism responsible for the degradation of the pesticide atrazine (ATZ) in rice crops mediated by the key component CORONATINE INSENSITIVE 1a (OsCOI1a) in the jasmonate-signaling pathway. OsCOI1a protein was localized to the nucleus and strongly induced by ATZ exposure. Overexpression of OsCOI1a (OE) significantly conferred resistance to ATZ toxicity, leading to the improved growth and reduced ATZ accumulation (particularly in grains) in rice crops. HPLC/Q-TOF-MS/MS analysis revealed increased ATZ-degraded products in the OE plants, suggesting the occurrence of vigorous ATZ catabolism. Bisulfite-sequencing and chromatin immunoprecipitation assays showed that ATZ exposure drastically reduced DNA methylation at CpG context and histone H3K9me2 marks in the upstream of OsCOI1a. The causal relationships between the DNA demethylation (hypomethylatioin), OsCOI1a expression and subsequent detoxification and degradation of ATZ in rice and environment were well established by several lines of biological, genetic and chemical evidence. Our work uncovered a novel regulatory mechanism implicated in the defense linked to the epigenetic modification and jasmonate signaling pathway. It also provided a modus operandi that can be used for metabolic engineering of rice to minimize amounts of ATZ in the crop and environment.

13.
Front Endocrinol (Lausanne) ; 11: 580380, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133023

RESUMO

Aims: To compare the effects of maternal subclinical hypothyroidism (SCH) diagnosed by the 2011 or 2017 "Guidelines of the American Thyroid Association (ATA) for the diagnosis and management of thyroid disease during pregnancy and the postpartum" during the first trimester on adverse pregnancy outcomes in thyroid peroxidase antibody (TPOAb)-negative pregnant women. Methods: There were 1,556 Chinese singleton pregnant women with negative TPOAb diagnosed with either SCH or euthyroidism who were investigated, and the prevalence and risk of obstetric outcomes were compared between the two groups using 2011 and 2017 ATA standards, respectively. The effects of a mildly elevated thyroid-stimulating hormone (TSH) concentration on adverse pregnancy outcomes were evaluated by binary logistic regression. Results: Maternal SCH identified by the 2011 ATA guidelines correlated with higher rates and risks of pregnancy-induced hypertension (PIH), preeclampsia, and low-birth-weight infants, while maternal SCH diagnosed by the 2017 ATA guidelines was more likely to develop PIH, preeclampsia, cesarean delivery, preterm delivery, placenta previa, and total adverse maternal and neonatal outcomes. Moreover, a mildly elevated TSH level was significantly associated with PIH after adjustment for confounding factors. Conclusions: Compared with the 2011 ATA guidelines, the 2017 ATA guidelines could be more applicable to Chinese pregnant women to screen the effects of SCH on the majority of adverse pregnancy outcomes.

14.
Eur J Med Chem ; 209: 112861, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33045661

RESUMO

CBP/p300, functioning as histone acetyltransferases and transcriptional co-factors, represents an attractive target for various diseases, including malignant tumor. The development of small-molecule inhibitors targeting the bromodomain and HAT domains of CBP/p300 has aroused broad interests of medicinal chemist in expectation of providing new hope for anti-cancer treatment. In particular, the CBP/p300 bromodomain inhibitor CCS1477, identified by CellCentric, is currently undergone clinical evaluation for the treatment of haematological malignancies and prostate cancer. In this review, we depict the development of CBP/p300 inhibitors reported from 2010 to 2020 and particularly highlight their structure-activity relationships (SARs), binding modes, selectivity and pharmacological functions with the aim to facilitate rational design and development of CBP/p300 inhibitors.

15.
Zool Res ; 41(6): 705-708, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33045776

RESUMO

Since the first reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic, spreading to more than 200 countries and regions worldwide. With continued research progress and virus detection, SARS-CoV-2 genomes and sequencing data have been reported and accumulated at an unprecedented rate. To meet the need for fast analysis of these genome sequences, the National Genomics Data Center (NGDC) of the China National Center for Bioinformation (CNCB) has established an online coronavirus analysis platform, which includes de novoassembly, BLAST alignment, genome annotation, variant identification, and variant annotation modules. The online analysis platform can be freely accessed at the 2019 Novel Coronavirus Resource (2019nCoVR) (https://bigd.big.ac.cn/ncov/online/tools).


Assuntos
Betacoronavirus/genética , Biologia Computacional/métodos , Infecções por Coronavirus/diagnóstico , Genoma Viral/genética , Genômica/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Pneumonia Viral/diagnóstico , Animais , Betacoronavirus/classificação , Betacoronavirus/fisiologia , China , Biologia Computacional/organização & administração , Infecções por Coronavirus/virologia , Variação Genética , Humanos , Internet , Anotação de Sequência Molecular , Pandemias , Pneumonia Viral/virologia
17.
Cancer Cell ; 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33125861

RESUMO

Brain metastasis is a major cause of cancer mortality, but its molecular mechanisms are severely understudied. In addition, little is known regarding the role of m6A reader YTHDF3 in human diseases. Here, we show that YTHDF3 overexpression clinically correlates with brain metastases in breast cancer patients. YTHDF3 promotes cancer cell interactions with brain endothelial cells and astrocytes, blood-brain barrier extravasation, angiogenesis, and outgrow. Mechanistically, YTHDF3 enhances the translation of m6A-enriched transcripts for ST6GALNAC5, GJA1, and EGFR, all associated with brain metastasis. Furthermore, overexpression of YTHDF3 in brain metastases is attributed to increased gene copy number and the autoregulation of YTHDF3 cap-independent translation by binding to m6A residues within its own 5' UTR. Our work uncovers an essential role of YTHDF3 in controlling the interaction between cancer cells and brain microenvironment, thereby inducing brain metastatic competence.

18.
Int J Mol Sci ; 21(20)2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33050201

RESUMO

Variations in anxiety-related behavior are associated with individual allostatic set-points in chronically stressed rats. Actively offensive rats with the externalizing indicators of sniffling and climbing the stimulus and material tearing during 10 days of predator scent stress had reduced plasma corticosterone, increased striatal glutamate metabolites, and increased adrenal 11-dehydrocorticosterone content compared to passively defensive rats with the internalizing indicators of freezing and grooming, as well as to controls without any behavioral changes. These findings suggest that rats that display active offensive activity in response to stress develop anxiety associated with decreased allostatic set-points and increased resistance to stress.

19.
Sci Rep ; 10(1): 18132, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33093581

RESUMO

Stage IV breast cancer is metastatic breast cancer (MBC). Because real-world data are lacking in China, our research attempts to explore the effect of locoregional surgery on the prognosis of patients with MBC. A total of 987 patients from 10 hospitals and 2 databases in East China (2004-2018) were included in this study. Overall, 47% of patients underwent locoregional surgery, and 53% did not. Surgeons tended to perform surgery on patients with small tumours (T1/T2), positive hormone receptor (HR) markers, and metastatic sites confined to a single organ and non-visceral sites (bone only/others) (each p < 0.05). Kaplan-Meier survival curves and the log-rank test showed that median survival was longer for patients who had locoregional surgery than for those who did not (45.00 vs. 28.00 months; p < 0.001). Patients who underwent surgery after systemic treatment had better survival than those who underwent surgery immediately (p < 0.001). In most subgroups, overall survival (OS) was significantly longer in the surgery group than in the no-surgery group (each p < 0.05), except for brain metastases and triple negative breast cancer. Therefore, we concluded that locoregional surgery for the primary tumour in MBC patients was associated with a marked reduction in risk of dying except for patients with brain metastases or triple-negative subtype.

20.
Medicine (Baltimore) ; 99(44): e22929, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126355

RESUMO

RATIONALE: The incidence of pregnancy-associated breast cancer (PABC) is increasing nowadays, and its diagnosis and treatment remain complicated due to the consideration of the fetus. The available data on PABC are primarily derived from case reports since there are ethical restrictions on conducting randomized clinical trials. In the present work, we reported a case of the human epidermal growth factor receptor 2 (HER2)-positive PABC and described the diagnosis and treatment for such type of breast cancer. PATIENT CONCERNS: A 27-year-old patient was admitted to our hospital with the complaints of right breast mass for 3 days, and she was a first-time pregnant woman with a single live intrauterine fetus at 26 + 3 weeks of gestation. Physical examination of the right breast revealed a palpable and hard mass with obscure boundaries (5.0 cm × 4.0 cm) in the upper outer quadrant. Significant axillary lymph nodes (2.0 cm) were also present. DIAGNOSIS: PABC. INTERVENTION: To protect the fetus, breast ultrasonography was used to test her breast mass, a core needle biopsy was adopted to confirm the diagnosis, and abdominal ultrasound and chest X-ray were used to evaluate the metastasis. The patient was scheduled for neoadjuvant therapy using bi-weekly pirarubicin in combination with cyclophosphamide (AC) without anti-HER2 therapy for consideration of the fetus's safety. After 4 cycles of AC, the patient delivered a healthy male infant. After the delivery, all the treatments were carried out according to the standard recommendation for HER2 + breast cancer as non-pregnant patients. OUTCOMES: After the surgery, the disease-free survival for the patient was 12 months until brain metastasis was diagnosed. She was still undergoing second-line anti-HER2 therapy and currently in a stable situation. Besides, the child was also healthy so far. LESSONS: The methods for the diagnosis and treatment of PABC that result in teratogenesis should be avoided to protect the fetus. Mammogram and chest X-ray were safe approaches for the fetus. Moreover, chemotherapy-based on pirarubicin in combination with cyclophosphamide had no risk to the fetus.


Assuntos
Neoplasias da Mama , Ciclofosfamida/administração & dosagem , Doxorrubicina/análogos & derivados , Mastectomia Radical Extensa/métodos , Cuidado Pós-Natal/métodos , Complicações Neoplásicas na Gravidez , Receptor ErbB-2/antagonistas & inibidores , Trastuzumab/administração & dosagem , Adulto , Antineoplásicos/administração & dosagem , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Doxorrubicina/administração & dosagem , Feminino , Idade Gestacional , Humanos , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/metabolismo , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/terapia , Resultado da Gravidez , Ultrassonografia Mamária/métodos
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