Downregulation of CDC42 inhibits the proliferation and stemness of human trophoblast stem cell via EZRIN/YAP inactivation.

Placental dysplasia increases the risk of recurrent spontaneous abortion (RSA). However, the underlying mechanism regulating placental development remains unclear. In this study, we showed that the expression of CDC42 was decreased in the villous tissue of RSA samples compared to healthy controls. Further examination demonstrated that CDC42 deficiency led to the differentiation of human trophoblast stem cells (hTSCs) and inhibited their proliferation. Genetic manipulation of YAP and EZRIN in hTSCs revealed that CDC42 regulates the stemness and proliferation of hTSCs; this is dependent on EZRIN, which translocates YAP into the nucleus. Moreover, the expression pattern of EZRIN, YAP, and Ki67 was also abnormal in the villous tissue of RSA samples, consistent with in vitro experiments. In summary, these findings suggest that the CDC42/EZRIN/YAP pathway plays an important role in placental development.

The Risk of Postpartum Hemorrhage Following Prior Prelabor Cesarean Delivery Stratified by Abnormal Placentation: A Multicenter Historical Cohort Study.

Background: Prior prelabor cesarean delivery (CD) was associated with an increase in the risk of placenta previa (PP) in a second delivery, whether it may impact postpartum hemorrhage (PPH) independent of abnormal placentation. This study aimed to assess the risk of PPH stratified by abnormal placentation following a first CD before the onset of labor (prelabor) or intrapartum CD. Methods: This multicenter, historical cohort study involved singleton, pregnant women at 28 weeks of gestation or greater with a CD history between January 2017 and December 2017 in 11 public tertiary hospitals within 7 provinces of China. PPH was analyzed in the subsequent pregnancy between women with prior prelabor CD and women with intrapartum CD. Furthermore, PPH was analyzed in pregnant women stratified by complications with PP alone [without placenta accreta spectrum (PAS) disorders], complications with PP and PAS, complications with PAS alone (without PP), and normal placentation. We performed multivariate logistic regression to calculate adjusted odds ratios (aOR) and 95% CI controlling for predefined covariates. Results: Out of 10,833 pregnant women, 1,197 (11%) women had a history of intrapartum CD and 9,636 (89%) women had a history of prelabor CD. Prior prelabor CD increased the risk of PP (aOR 1.91, 95% CI 1.40-2.60), PAS (aOR 1.68, 95% CI 1.11-2.24), and PPH (aOR 1.33, 95% CI 1.02-1.75) in a subsequent pregnancy. After stratification by complications with PP alone, PP and PAS, PAS alone, and normal placentation, prior prelabor CD only increased the risk of PPH (aOR 3.34, 95% CI 1.35-8.23) in a subsequent pregnancy complicated with PP and PAS. Conclusion: Compared to intrapartum CD, prior prelabor CD increased the risk of PPH in a subsequent pregnancy only when complicated by PP and PAS.

Application of three-dimensional printing technology in obstetrics / 中华围产医学杂志

Three-dimensional (3D) printing, also known as additive manufacturing, is a fabrication technology that constructs three-dimensional objects by successive addition of materials. In recent years, the advancements in 3D printing technology, reductions in material costs, development of biomaterials, and improvements in cell culture techniques allow the application of 3D printing in the clinical medical fields, such as orthopedics, dentistry, and urinary surgery, to develop rapidly. Obstetrics, focusing on both theory and practice, is an emerging application field for 3D printing technology. 3D printing has been used in obstetrics for fetal and maternal diseases, such as prenatal diagnosis of fetal abnormalities and preoperative planning for placental implantation disorders. Additionally, 3D printing can simulate surgical scenarios and enable the targeted training for doctors. This review aims to provide a summary of the latest developments in the clinical application of 3D printing in obstetrics.

Analyzing the distribution characteristics of occupational pneumoconiosis in Sichuan Province, 2012-2021 / 中国职业医学

Objective: To analyze the distribution feature of occupational pneumoconiosis in Sichuan Province. Methods: The cases of newly diagnosed occupational pneumoconiosis from 2012 to 2021 in Sichuan Province were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. Results: From 2012 to 2021, there were 30 136 newly diagnosed occupational pneumoconiosis cases in Sichuan Province. The average age of patients was 55.2 years and the median work age was 12.1 years. There were 6 471 cases (accounting for 21.5%) exposed to dust for less than 5.0 years. The number of the cases declined in newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure. The numbers of coal workers' pneumoconiosis and silicosis were 16 210 and 13 577, respectively (accounting for 98.9% of the total cases). The majority of pneumoconiosis cases were classified as stage Ⅰ(accounting for 67.1%). The cases from Leshan City, Bazhong City, Dazhou City, Yibin City, Guangyuan City and Luzhou City accounted for 68.8% of the total cases. The main types of work were coal miner and excavation worker, which accounted for 31.7% and 18.8%, respectively. The scale of enterprises was mostly small and micro, accounting for 35.1% of the cases, and the industry distribution was mostly coal mining and washing, accounting for 53.4% of the cases. Conclusion: In Sichuan Province, the number of cases shows an overall decline in both newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure, with a relatively short duration of occupational exposure. The key cities for pneumoconiosis prevention and control are Leshan City, Bazhong City, and Dazhou City, while the key industry is coal mining and washing.

Research progress on models for studying preeclampsia / 中华围产医学杂志

Preeclampsia, a serious complication in pregnancy, is a "placental disease" in obstetrics. The growth and development of human and other mammalian embryos are closely related to the placenta. This review summarizes several models for studying preeclampsia including in vitro cell models, placental explants, organoid models, rodent models and primates models, contributing to a deeper understanding of placental development and related pregnancy disorders.

Outcomes of the second pregnancy after Triple-P procedure in women complicated with placenta accreta spectrum disorders / 中华妇产科杂志

Objective:To investigate the safety of the Triple-P procedure in women complicated with severe placenta accreta spectrum disorders (PAS) and its influence on second pregnancy.Methods:From January 2015 to December 2017, the outcomes of the second pregnancy after the Triple-P procedure in 11 pregnant women complicated with PAS in the Third Affiliated Hospital of Guangzhou Medical University and the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:By December 2021, a total of 11 pregnant women who underwent the Triple-P procedure for PAS had a second pregnancy, with a median interval of 3 years (2-3 years). Of the 11 pregnant women, 7 delivered after 36 weeks of gestation. The median gestational age was 38 weeks, and 4 terminated within the first trimester. PAS recurred in 1 of 7 pregnant women (1/7) and was associated with placenta previa. All of the 7 pregnant women were delivered by cesarean section, with a median postpartum blood loss of 300 ml (200-450 ml), and only one pregnant woman required blood transfusion. None of the pregnant women were transferred to the intensive care unit, and there were no uterine rupture, bladder injury, puerperal infection, and neonatal adverse outcomes.Conclusion:Pregnant women who underwent the Triple-P procedure for severe PAS could be considered for second pregnancy with strictly management by an experienced multidisciplinary team, which may result in a good outcome.

Analysis of clinicopathological features and prognostic factors of breast cancer patients with different molecular subtypes / 肿瘤研究与临床

Objective:To explore the differences in clinicopathological features, survival status and prognostic influencing factors of breast cancer patients with different molecular subtypes, and to provide bases for the prevention and treatment of breast cancer.Methods:The clinicopathological data of new-onset female breast cancer patients hospitalized in Shanxi Province Cancer Hospital from January 2015 to December 2016 were retrospectively analyzed, and patients were followed up. The clinicopathological features of patients with different molecular subtypes were compared. The follow-up was performed until June 30, 2021. Kaplan-Meier method was used to analyze the survival of patients, and Cox proportional hazards model was used to analyze the factors affecting overall survival (OS) of patients with different molecular subtypes.Results:There were 272 (14.9%), 1 005 (55.2%), 277 (15.2%) and 268 (14.7%) patients with subtypes of Luminal A, Luminal B, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer (TNBC), respectively. The differences in the distribution of patients with age at diagnosis, age at menarche, menopausal status, age at menopause, pathological type, longest tumor diameter, T staging, N staging, histological grading, and TNM staging were statistically significant among the four groups (all P < 0.05). At a median follow-up of 60 months, the 5-year OS rates of Luminal A, Luminal B, HER2 overexpression and TNBC subtypes were 93.8%, 89.2%, 77.6% and 78.0%, respectively, and the difference was statistically significant ( χ2 = 58.76, P < 0.001). M staging was an independent influencing factor for OS in patients with Luminal A breast cancer ( HR = 16.789, 95% CI 4.972-56.690, P < 0.001); T staging ( HR = 2.721, 95% CI 1.715-4.319), N staging ( HR = 4.460, 95% CI 2.399-8.291) and M staging ( HR = 3.364, 95% CI 1.988-6.670) were independent influencing factors for OS in patients with Luminal B breast cancer (all P < 0.001); N staging ( HR = 4.428, 95% CI 1.836-10.677) and M staging ( HR = 13.489, 95% CI 6.043-30.107) were independent influencing factors for OS of patients with HER2 overexpression breast cancer (both P < 0.01); T staging ( HR = 3.052, 95% CI 1.575-5.915), N staging ( HR = 2.492, 95% CI 1.298-4.785) and M staging ( HR = 33.012, 95% CI 8.606-126.637) were independent influencing factors for OS of patients with TNBC (all P < 0.01). Conclusions:The clinicopathological features and prognostic influencing factors of breast cancer patients with different molecular subtypes are different, and the prognosis of HER2 overexpression and TNBC patients is poor. Clinicians should provide individualized treatment and follow-up programs for patients with different molecular subtypes of breast cancer.

Effects of placenta previa on surgical and pregnancy outcomes in patients with total/subtotal or segmental hysterectomy attributed to placenta accreta spectrum disorders / 中华围产医学杂志

Objective:To investigate the effects of placenta previa on the surgical and pregnancy outcomes in patients with total/subtotal or segmental hysterectomy attributed to placenta accreta spectrum disorders (PAS).Methods:This study retrospectively enrolled 510 patients who gave birth and underwent total/subtotal hysterectomy or segmental hysterectomy (local implantation site) due to PAS at the third Affiliated Hospital of Guangzhou Medical University from January 1, 2017, to December 31, 2022. These subjects were divided into the placenta previa group (427 cases) and non-placenta previa group (83 cases). According to the type of hysterectomy, they were further divided into the total/subtotal hysterectomy and placenta previa subgroup (221 cases), total/subtotal hysterectomy and non-placenta previa subgroup (23 cases), segmental hysterectomy and placenta previa subgroup (206 cases), and segmental hysterectomy and non-placenta previa subgroup (60 cases). Nonparametric test or Chi-square test were used to compare the differences in the clinical features, surgical and pregnancy outcomes between different groups. Binary logistic regression was used to analyze the effects of placenta previa on the risk of additional surgical procedures and adverse maternal outcomes. Results:(1) Compared with the non-placenta previa group, the hemorrhage volume within 24 h postpartum [1 541 ml (1 036-2 368 ml) vs 1 111 ml (695-2 000 ml), Z=－3.91] and the proportion of women requiring additional surgical procedures [84.8% (362/427) vs 69.9% (58/83), χ2=10.61], with total/subtotal hysterectomy [51.8% (221/427) vs 27.7% (23/83), χ2=16.10], cystoscopy and/or ureteral stenting [60.7% (259/427) vs 31.3% (26/83), χ2=24.25], total adverse pregnancy outcomes [86.9% (371/427) vs 65.1% (54/83), χ2=17.75], hemorrhage volume>1 500 ml within 24 h postpartum [54.1% (231/427) vs 33.7% (28/83), χ2=29.94], transfusion of blood products [75.9% (324/427) vs 47.0% (39/83), χ2=28.27] were all higher in the placenta previa group (all P<0.05). Binary logistic regression analysis found that for PAS patients with hysterectomy, regardless of the hysterectomy type (total/subtotal/segmental), placenta previa was risk factor for requiring additional surgical procedures ( aOR=3.26, 95% CI: 1.85-5.72) and adverse pregnancy outcomes ( aOR=5.59, 95% CI: 2.01-6.42), even if adjusting for the confounding factors such as maternal age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology. (2) In patients with total/subtotal hysterectomy, the proportion of women requiring additional surgical procedures was higher in those with placenta previa [82.8% (183/221) vs 56.5% (13/23), χ2=9.11] than those without placenta previa, especially the proportion of cystoscopy and/or ureteral stenting [67.9% (150/221) vs 34.8% (8/23), χ2=9.99] (both P<0.05). However, no significant difference was found in adverse pregnancy outcomes [89.6% (198/221) vs 87.0% (20/23), χ2<0.01, P=0.972] between the two groups. In patients with segmental hysterectomy, higher proportions of women requiring additional surgery [86.9% (179/206) vs 75.0% (45/60), χ2=4.94], with adverse pregnancy outcomes [84.0% (173/206) vs 56.7% (34/60), χ2=25.31], cystoscopy and/or ureteral stenting [52.9% (109/206) vs 30.0% (18/60), χ2=9.78], vascular occlusion [94.2% (194/206) vs 71.7% (43/60), χ2=24.23], hemorrhage volume>1 500 ml within 24 h postpartum [46.6% (96/206) vs 23.3% (14/60), χ2=10.37], and transfusion of blood products [68.9% (142/206) vs 33.3% (20/60), χ2=24.73] were found in the placenta previa group (all P<0.05). Furthermore, patients with placenta previa had more hemorrhage volume within 24 h postpartum [1 368 ml (970-2 026 ml) vs 995 ml (654-1 352 ml), Z=－3.66, P<0.001] in the segmental hysterectomy subgroup. After adjusting for the confounding factors such as age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology, binary logistic regression analysis found that placenta previa did not increase the risk of additional surgical operations ( aOR=2.71, 95% CI: 0.99-7.42) and adverse pregnancy outcomes ( aOR=2.14, 95% CI: 0.54-8.42) in patients with total/subtotal hysterectomy but were risk factors of the two outcomes for those with segmental hysterectomy ( aOR=4.67, 95% CI: 2.15-10.10; aOR=3.80, 95% CI: 1.86-7.77). Conclusions:Placenta previa increases the risk of additional surgical procedures and adverse pregnancy outcomes in patients with total/subtotal or segmental hysterectomy caused by PAS. Appropriate preparation is required after the clinical diagnosis of PAS with placenta previa.

The impact of cesarean section frequency on the outcome of patients with placental implantation disease undergoing hysterectomy / 中国医师杂志

Objective:To investigate whether the number of previous cesarean sections affects the outcomes of patients with placental implantation disease undergoing hysterectomy.Methods:Using a retrospective cohort study design, the study samples were from the obstetric clinical database of the Third Affiliated Hospital of Guangzhou Medical University, and the study subjects were patients with placental implantation disease who underwent hysterectomy. Patients were grouped according to different previous cesarean section frequencies, and their clinical characteristics, surgical outcomes, and adverse maternal outcomes were compared in each group; The impact of previous cesarean sections on adverse outcomes in pregnant women was analyzed using multivariate logistic regression.Results:Among the 244 enrolled patients, 26 had no previous history of cesarean section (11%), 132 had a previous cesarean section once (54%), and 86 had a previous cesarean section ≥2 times (35%). There was no statistically significant difference in the usage rates of uterine artery embolization, suture hemostasis, and internal iliac artery embolization among the three groups of patients (all P>0.05). Among the adverse outcomes of pregnant and postpartum women, there was no statistically significant difference in the rates of shock, bladder injury, postpartum hemorrhage, postpartum hemorrhage >1 500 ml, admission to the intensive care unit (ICU), and transfusion of blood products among the three groups (all P>0.05). Univariate logistic regression analysis showed that the number of previous cesarean sections did not increase the risk of adverse outcomes, such as shock, postpartum hemorrhage, postpartum hemorrhage ≥1 500 ml, entry into the ICU, and transfusion of blood products. Multivariate logistic regression analysis found that the number of previous cesarean sections did not increase the risk of adverse outcomes in pregnant women. Conclusions:For patients with placental implantation disease undergoing hysterectomy, the number of previous cesarean sections may not be the main factor determining maternal outcomes. It is necessary to consider other possible influencing factors more comprehensively, including previous uterine surgery history, basic health status of pregnant women, comorbidities, and availability of medical resources.

Clinical study of association between breast cancer and thyroid diseases / 肿瘤研究与临床

Objective:To investigate the association between breast cancer and thyroid diseases, and to provide evidence for the prevention and treatment of thyroid diseases in breast cancer patients.Methods:A total of 511 newly diagnosed breast cancer patients were recruited between March 2018 and August 2019 from Shanxi Province Cancer Hospital, and 303 age-matched newly diagnosed breast benign disease patients and 341 age-matched healthy controls were recruited during the same time-frame. Thyroid B-ultrasound and thyroid function test were performed in the three groups. By reviewing the medical records, the general and clinicopathological data of the patients were collected, and the differences in the prevalence of thyroid diseases among the three groups were compared. The changes of thyroid function in breast cancer patients before treatment, in the middle stage of chemotherapy and at the end of chemotherapy were compared.Results:Among breast cancer group, breast benign disease group and healthy control group, the differences in the prevalence rates of hypothyroidism [32.5% (166/511), 25.7% (78/303) and 21.7% (74/341)], thyroid nodules [50.7% (259/511), 43.2% (131/303) and 41.6% (142/341)] and Thyroid Imaging Reports and Data System(TI-RADS) grade 4 and above thyroid nodules [15.4% (40/259), 14.5% (19/131) and 4.9% (7/142)] were statistically significant (all P < 0.05). The abnormal rates of thyroid stimulating hormone (TSH) and free thyroxine (fT4) in breast cancer group were higher than those in breast benign disease group and healthy control group [34.1% (174/511) vs. 26.1% (79/303), 23.5% (80/341); 24.9% (127/511) vs. 8.6% (26/303), 3.2% (11/341)], and the differences were statistically significant (both P < 0.05). The levels of fT4, free three iodide thyroxine (fT3), thyroid immunoglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) in breast cancer patients before treatment, in the middle stage of chemotherapy and at the end of chemotherapy were statistically different (all P < 0.05). The abnormal rates of fT4, TgAb and TPOAb in the last chemotherapy cycle were lower than those before chemotherapy [11.5% (59/511) vs. 24.9% (127/511), 5.1% (26/511) vs. 17.4% (89/511), 11.9% (61/511) vs. 20.4% (104/511)] in breast cancer patients, and the differences were statistically significant (all P < 0.001). Conclusions:The breast cancer is associated with thyroid diseases. Clinicians should pay more attention to the changes of thyroid diseases and thyroid function during the treatment and in the follow-up process of breast cancer patients, so as to detect the thyroid diseases early and carry out standardized treatment.

Analysis of clinicopathological features and factors influencing the survival of young breast cancer patients / 肿瘤研究与临床

Objective:To explore the clinicopathological characteristics and factors influencing the survival of young breast cancer patients with diagnostic age below 35 years, and to provide the basis for the prevention and treatment of young breast cancer patients.Methods:Epidemiological and clinicopathological data of young female patients with newly diagnosed breast cancer from Shanxi Province Cancer Hospital between January 2015 and December 2016 were retrospectively analyzed. The data included age at diagnosis, reproductive history, history of abortion, menopausal status, and immunohistochemical results. Univariate and multivariate analysis were performed by using Cox regression model.Results:A total of 118 young breast cancer patients were collected, and the median age was 31 years old. Among them, the vast majority of 118 young breast cancer patients were invasive cancer (113 cases, accounting for 95.8%); there were 65 cases (55.1%) with tumor diameter ≤ 20 mm, 61 cases (51.7%) at N 0 stage, and 112 cases (94.9%) at M 0 stage. The positive rates of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) were 73.7% (87/118), 69.5% (82/118) and 28.8% (34/118), respectively. Luminal B breast cancer was the predominant molecular subtype, accounting for 55.1% (65/118). By the end of follow-up (median follow-up period of 60 months), the overall survival rate of young breast cancer patients was 78.8%. Multivariate analysis showed that TNM staging was an independent factor affecting overall survival in young breast cancer patients ( HR = 7.858, 95% CI 2.924-21.120, P < 0.001). Conclusions:Young breast cancer patients have unique clinicopathological features and TNM staging is an independent factor affecting the prognosis. Individualized treatment helps to improve the quality of life and prolong the survival time of patients.

A single center study on the relationship between the depth of remission and the efficacy of first-line TKI drugs / 中国医师杂志

Objective The aim of the study was to investigate association of response depth and prognosis in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC)patients treated with first-line tyrosine kinase inhibitors (TKIs).Methods The clinicopathological data and prognosis information of patients with locally advanced or metastatic (Ⅲ B or Ⅳ) lung adenocarcinoma with EGFR classical (19del or 21L858R) mutation who were treated in our hospital from 2015 to 2016 were collected.The tumor remission depth [stable disease (SD),partial response (PR),complete response (CR)] was measured by recist 1.1 standard.The survival curve was drawn by Kaplan-Meier method and log rank test was performed.Results During the study period,204 advanced lung adenocarcinoma patients with 19del or 21L858R mutation were treated with TKI drugs of the first generation.Among them,24 patients were lost or unable to evaluate the efficacy,20 patients were evaluated as progression disease (PD),62 patients as SD,98 patients as CR or PR.Disease control rate (DCR) and objective remission rate (ORR) were 88.9％ and 54.4％,respectively.The median progression free survival time (PFS) was 12.6 months (95％ CI:10.9-14.4 months) and 13.1 months (95％ CI:11.6-14.7) for patients assessed as SD (group A) and CR or PR (group B),respectively,with no significant difference (P =0.27).Subgroup analysis showed that the median overall survival of patients with EGFR 19del and 21L858R mutations was 12.5 months (95％ CI:9.9-15.4) and 12.7 months (95％ CI:9.4-16.1),respectively,with no significant difference (P =0.66);Similar result was also observed in Group B with a median PFS of 13.9 months (95％ CI:12.3-15.5 months) and 12.3 months (95％ CI:9.5-15.1 months) in patients who had EGFR 19del or 21L858R mutations (P =0.41).Conclusions Response depth was not a positive predictor for prognosis in EGFR-mutant NSCLC patients treated with first-line TKIs.

A single center study on the relationship between the depth of remission and the efficacy of first-line TKI drugs / 中国医师杂志

Objective@#The aim of the study was to investigate association of response depth and prognosis in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC)patients treated with first-line tyrosine kinase inhibitors (TKIs).@*Methods@#The clinicopathological data and prognosis information of patients with locally advanced or metastatic (ⅢB or Ⅳ) lung adenocarcinoma with EGFR classical (19del or 21L858R) mutation who were treated in our hospital from 2015 to 2016 were collected. The tumor remission depth [stable disease (SD), partial response (PR), complete response (CR)] was measured by recist 1.1 standard. The survival curve was drawn by Kaplan-Meier method and log rank test was performed.@*Results@#During the study period, 204 advanced lung adenocarcinoma patients with 19del or 21L858R mutation were treated with TKI drugs of the first generation. Among them, 24 patients were lost or unable to evaluate the efficacy, 20 patients were evaluated as progression disease (PD), 62 patients as SD, 98 patients as CR or PR. Disease control rate (DCR) and objective remission rate (ORR) were 88.9% and 54.4%, respectively. The median progression free survival time (PFS) was 12.6 months (95% CI: 10.9-14.4 months) and 13.1 months (95% CI: 11.6-14.7) for patients assessed as SD (group A) and CR or PR (group B), respectively, with no significant difference (P=0.27). Subgroup analysis showed that the median overall survival of patients with EGFR 19del and 21L858R mutations was 12.5 months (95% CI: 9.9-15.4) and 12.7 months (95% CI: 9.4-16.1), respectively, with no significant difference (P=0.66); Similar result was also observed in Group B with a median PFS of 13.9 months (95% CI: 12.3-15.5 months) and 12.3 months (95% CI: 9.5-15.1 months) in patients who had EGFR 19del or 21L858R mutations (P=0.41).@*Conclusions@#Response depth was not a positive predictor for prognosis in EGFR-mutant NSCLC patients treated with first-line TKIs.

Serum and tissue levels of six trace elements and copper/zinc ratio in patients with cervical cancer and uterine myoma.

The aim of this study is to investigate the relationship between trace elements and the incidence of cervical cancer. Tissue and serum levels of six elements (Cu, Zn, Fe, Mn, Ca, and Se) and the Cu/Zn ratio in 40 cases of patients with cervical cancer, 30 cases of uterine myoma, and 50 healthy subjects were measured by atomic absorption spectrophotometry; the selenium content was determined by atomic fluorescence spectrometry. The results showed that the tissue contents of Zn, Se, and Ca were significantly lower and the Cu and Fe concentrations and Cu/Zn ratio were significantly higher in cervical cancer tissue than that for paired nonlesion tissue (p<0.02 and p<0.001, respectively). The serum levels of Zn, Se, Ca, and Fe were lower and Cu and Mn levels and Cu/Zn ratio were higher in patients with cervical cancer than in healthy subjects (p<0.01 and p<0.001, respectively) and in the uterine myoma group compared with healthy subjects (p<0.05-0.001). There are no significant differences in the contents of six elements and the Cu/Zn ratio between uterine myoma tissue and paired nonlesion tissue. The results showed also that the Fe level and Cu/Zn ratio were significantly higher and the Zn and Se levels were significantly lower in cervical cancer tissue than in uterine myoma tissue (p<0.01 and p<0.001, respectively). The serum Cu level and Cu/Zn ratio were significantly higher in the cervical cancer group than the uterine myoma group (p<0.01). Data were also analyzed using multivarate logistic regression. After adjustment for age, occupation, life habit, and other covariates for the development of cervical cancer, the odds ratios were 22.64 (95% confidence interval [CI]: 5.64-90.88, p=0.001) for Cu, 0.11 (95% CI: 0.034-0.373; p=0.005) for Zn, and 0.60 (95% CI: 0.36-0.99, p=0.01) for Se. Thus, the serum and tissue levels of Cu increase and the deficiency of Zn and Se may be risk factors for the development of cervical cancer.

Impact of metabolic syndrome on clinicopathological characteristics and survival of patients with colorectal cancer / 中华全科医师杂志

Objective To examine the impact of metabolic syndrome (MS) on the clinicopathological characteristics and prognosis of patients with colorectal cancer (CRC).Methods The clinical data of 650 patients with CRC admitted in Shanxi Provincial Cancer Hospital between January 2010 and December 2011 were retrospectively analyzed.Among 650 patients there were 190 cases complicated with MS (MS group) and 460 cases without MS (non-MS group),the clinicopathological features and prognosis were compared between two groups.Results The serum insulin and insulin-like growth factor-1 (IGF-1) levels in MS group were significantly higher than those in non-MS group [(9.2±4.7) vs.(6.8±4.7)μIU/L,t=8.88,P＜0.01 and (200.2±44.1) vs.(136.7±63.2)mg/L,t=12.63,P＜0.01].The proportions of stage T3 and T4 cancer,extra-regional lymph node metastasis (ELN),and TNM stage Ⅲ and Ⅳ patients in MS group were significantly higher than those in non-MS group [(83.2％ (158/190) vs.72.6％ (334/460),x2=8.19,P=0.04;9.5％ (18/190) vs.4.8％(22/460),x2=8.61,P=0.04;56.3％ (107/190) vs.45.2％(208/460),x2=8.22,P=0.04,respectively].The 5-year disease-free survival (DFS) in MS group was significantly lower than that in non-MS group [57.9％(99/171)vs.66.1％(279/422),P＜0.01].Multivariate analysis indicated that MS(HR=1.623,95％CI:1.511-1.963,P=0.03),IGF(HR=1.382,95％CI:1.031-1.765,P=0.02) and,ELN(HR=4.270,95％CI:2.177-7.463,P＜0.01)were independent factors affecting the prognosis of CRC patients.Conclusion Metabolic syndrome is one of the risk factors affecting the prognosis of CRC patients.

Impact of metabolic syndrome on clinicopathological characteristics and survival of patients with colorectal cancer / 中华全科医师杂志

Objective@#To examine the impact of metabolic syndrome (MS) on the clinicopathological characteristics and prognosis of patients with colorectal cancer (CRC).@*Methods@#The clinical data of 650 patients with CRC admitted in Shanxi Provincial Cancer Hospital between January 2010 and December 2011 were retrospectively analyzed. Among 650 patients there were 190 cases complicated with MS (MS group) and 460 cases without MS (non-MS group), the clinicopathological features and prognosis were compared between two groups.@*Results@#The serum insulin and insulin-like growth factor-1 (IGF-1) levels in MS group were significantly higher than those in non-MS group [(9.2±4.7) vs.(6.8±4.7)μIU/L, t=8.88, P<0.01 and (200.2±44.1) vs.(136.7±63.2)mg/L,t=12.63, P<0.01]. The proportions of stage T3 and T4 cancer, extra-regional lymph node metastasis (ELN), and TNM stage Ⅲ and Ⅳ patients in MS group were significantly higher than those in non-MS group [(83.2% (158/190) vs. 72.6% (334/460), χ2=8.19, P=0.04; 9.5% (18/190) vs. 4.8%(22/460),χ2=8.61, P=0.04; 56.3% (107/190) vs. 45.2%(208/460), χ2=8.22, P=0.04, respectively]. The 5-year disease-free survival (DFS) in MS group was significantly lower than that in non-MS group [57.9%(99/171)vs. 66.1%(279/422), P<0.01]. Multivariate analysis indicated that MS(HR=1.623, 95%CI:1.511-1.963, P=0.03), IGF(HR=1.382, 95%CI:1.031-1.765, P=0.02) and, ELN(HR=4.270, 95%CI:2.177-7.463, P<0.01)were independent factors affecting the prognosis of CRC patients.@*Conclusion@#Metabolic syndrome is one of the risk factors affecting the prognosis of CRC patients.

Clinical assessment and prognostic evaluation of tumor markers in patients with gastric cancer.

AIM: To investigate the relationship between the serum levels of CEA, CA19-9, CA24-2, CA72-4, and AFP in patients with gastric cancer (GC) and their clinicopathological characteristics; to analyze the efficacy of these tumor markers in evaluating the prognosis of GC. METHODS: Overall, 389 patients with GC either located in the gastric cardia (132), the pyloric antrum (112) or the body of the stomach (145) were included in the study. Serum levels of CEA, CA19-9, CA72-4, and AFP were detected with the ECLIA method, while CA24-2 was measured with ELISA. RESULTS: First, the serum level of CEA in GC patients with a cardia-located cancer was significantly higher than in patients with pyloric antrum-located cancer (p=0.050). CA72-4 level in patients with GC located in the gastric body was significantly higher than in patients with cardia and pyloric antrum-located cancers (p=0.042 and p=0.039, respectively). Secondly, serum CA19-9 and CA24-2 levels in females with cardia-located GC were significantly higher than those in males with the same type of tumor (p=0.037 and p=0.033, respectively). Additionally, for females with gastric body-located GC the levels of CEA and CA72-4 were significantly higher than those in male patients with the same type of tumor (p=0.047 and p=0.048, respectively). Conversely, in female GC patients with pyloric antrum-located cancer the serum levels of CA19-9 and CA24-2 were significantly lower than those in male patients with the same type of cancer (p=0.013 and p=0.007, respectively). Moreover, CEA, CA19-9, CA24-2, and CA72-4 levels were strongly related to TNM grade and histological anatomy stage, whereas CEA and CA72-4 levels were strongly related to lymph node stage (p=0.000 and p=0.042, respectively). Patients with vascular embolism had higher serum levels of CEA, CA19-9, CA24-2, and CA72-4 compared with patients without vascular embolism (p=0.005, p=0.031, p=0.007, and p=0.014, respectively). In patients with distant metastases and ascites the levels of CEA, CA19-9, and CA24-2 were higher than in patients without these conditions (p=0.003, p=0.001, p=0.001, p=0.016, p= 0.011, and p=0.030, respectively). Serum CEA, CA19-9, and CA24-2 levels showed correlations with tumor invasive depth and growth types (p=0.001, p=0.040, and p=0.035, respectively). Patients with lump and catheter tumor growth types had significantly higher AFP levels than patients with invasion and anabrosis growth types (p=0.034 and p=0.005, respectively). Tumor size was correlated with the preoperative serum levels of CEA, AFP, and CA72-4 (p=0.007, p=0.020, and p=0.008, respectively). Additionally multiple linear regression analysis showed that preoperative levels of CEA and CA72-4 were correlated to TNM stages, CA19-9 and CA24-2 levels were correlated to both gender and distant metastasis, and AFP was correlated only to ascites. During follow-up there were 115 deaths. Median survival time for GC patients with negative preoperative CEA was 18.07 months, and was 10.97 months for patients with preoperative CEA positive levels (p=0.0005). Similarly, the median survival time for GC patients with negative preoperative CA72-4 was 33.60, and was 16.03 months for patients with preoperative CA72-4 positive levels (p=0.0041). CONCLUSIONS: The preoperative levels of CEA, CA19-9, CA24-2, CA72-4, and AFP were closely related to TNM grade, gender, distant metastasis and ascites. These makers seem to play important roles in predicting recurrence and metastasis, and in evaluating prognosis.

Effect of miR-204 in cell biological characteristics of breast cancer MDA-MB-231 cell / 重庆医学

Objective To study the effect of microRNA-204 (miR-204) on the biological characteristics of breast cancer cells.Methods Real-time PCR was used to detect the expression of miR-204 in human breast cancer cell MDA-MB-231 after transfection of miR-204 mimics and inhibitor for 48 h.Flow cytometry was used to analyse the effect of miR-204 on the proliferation and apoptosis of MDA-MB-231 cells.The effect of miR-204 on the migration of MDA-MB-231 cells was detected by Transwell migration assay.Results Real-time PCR analysis showed that miR-204 mimics and inhibitors had significant effect compared with normal control group(P<0.01).Flow cytometry analysis showed that compared with normal control group,the number of G1 phase cells of miR-204 mimics group was significantly decreased(P<0.01),while the number of G2/M cells of miR-204 mimics group was significantly increased(P<0.01).In contrast,the number of G1 phase cells of miR-204 inhibitor group was significantly increased(P<0.01),while the number of G2/M cells of miR-204 inhibitor group was significantly decreased(P<0.01).miR-204 mimics group significantly promoted apoptosis,while the inhibitor group significantly inhibited apoptosis(P<0.01).Transwell migration analysis showed that the number of cells of miR-204 mimics group were significantly reduced,while the number of cells was significantly increased in the inhibitor group(P<0.01).Conclusion We find miR-204,which can promote cell apoptosis and inhibit cell proliferation and migration,is a negative factor in the breast cancer cell line MDA-MB-231.

Correlation between pre-surgery thyroid function and lymphatic metastasis in patients with papillary thyroid carcinoma / 肿瘤研究与临床

Objective To explore the correlation between lymphatic metastasis and central lymph node metastasis and pre-surgery levels of serum thyrotropin (TSH), thyrobolulin (TG), anti-thyrobolulin antibodies (A-TG), anti-thyroid peroxidase antibodies (A-TPO) in patients with papillary thyroid carcinoma (PTC). Methods The clinical characteristics such as sex, age, tumor diameter, and some markers of thyroid function detection in 289 simple PTC cases were retrospectively analyzed, and their roles in lymphatic metastasis and central lymph node metastasis were discussed. Results Age < 45 years old (χ2= 5.86, P =0.02),multifocal(χ2=38.95, P<0.001), serum increased A-TG level(χ2=13.31,P <0.001) or A-TPO level (χ2= 7.30, P< 0.01) leaded to higher rate of lymphatic metastasis. Different TSH levels had different impact on lymphatic metastasis (χ2= 11.81, P = 0.02). When at 1.81-2.52 mU/L, the lowest rate of lymphatic metastasis was 34.68 %. Multivariable logistic regression analysis showed that focus (OR= 3.29, 95 % CI 1.85-5.52) and serum A-TG level (OR= 2.17, 95 % CI 1.11-4.26) were risk factors, whereas TSH at 1.81-2.52 mIU/L was more safe factor in simple PTC cases with lymphatic metastasis (OR= 0.28,95 % CI 0.09-0.85). Different groups of age (χ2= 11.54, P= 0.001), focal (χ2= 38.95, P< 0.001), serum TG level (χ2=9.01, P=0.01), A-TG level (χ2=14.51, P <0.001) or A-TPO level (χ2= 6.78, P= 0.02) leaded to statistically different central lymph node metastasis ending; further analysis showed that age (OR= 0.96, 95 % CI 0.94-0.98) and focus (OR= 5.47, 95 % CI 3.09-9.69) were risk factors of central lymph node metastatic in PTC patients. Conclusion Higher pre-surgery serum A-TG level and multifocal predict lymphatic metastasis, TSH level in 1.81-2.52 mU/L indicates lower rate of lymphatic metastasis, but age<45 years old and multifocal PTC patients are apt to occur central lymph node metastasis.

Influencing factors of thyroid disease in breast cancer patients / 肿瘤研究与临床

Objective To understand the status and influencing factors of thyroid disease in breast cancer patients, and to identify the high-risk people with thyroid disease. Methods Breast cancer patients were continually collected from Jan 2016 to Mar 2016 in Shanxi Cancer Hospital. Age, surgery time, the state of thyroid disease, medical record, the general condition, immunohistochemistry and pathological findings, thyroid B-mode ultrasonography were investigated respectively. All cases were divided into two groups according to whether to suffer from thyroid disease or not. The influencing factors for thyroid disease in patients with breast cancer were screened. Logistic regression was used for univariate and multivariate analysis. Results A total of 293 cases (69.3 %) suffered from thyroid disease in 423 breast cancer patients. The univariate analysis showed that prevalence rate of thyroid disease had statistical differences in age [<50 years old:49.5%(145/293) vs. 76.1%(99/130); ≥50 years old:50.5%(148/293) vs. 23.9%(31/130);χ2=24.297, P<0.001], body mass index [18.5-23.9 kg/m2:41.0%(120/293) vs. 52.3%(68/130);24.0-27.9 kg/m2:45.4%(133/293) vs. 40.8 % (53/130); ≥28.0 kg/m2: 13.7 % (40/293) vs. 6.9 % (9/130); χ2= 6.395, P=0.041], menopausal state [not: 59.7%(175/293) vs. 77.7%(101/130); yes: 40.3%(118/293) vs. 22.3%(29/130);χ2=12.443, P<0.001], estrogen receptor (ER) [ER--ER+: 44.0%(129/293) vs. 56.9%(74/130);ER++ - ER+++: 56.0 % (164/293) vs. 43.1 % (56/130); χ2 = 5.951, P= 0.015]. There were no significant differences in the times of pregnancy and production, history of abortion, progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), triple negative breast cancer, T stage, N stage, histological grade and TNM stage (P> 0.05). Multivariate analysis showed that the risk factors were age (OR= 3.928, 95 %CI=1.819-8.482, P<0.001) and ER++-ER+++(OR= 1.696, 95 %CI= 1.094-2.628, P= 0.018). Conclusion Age≥50 and ER++-ER+++are the major influencing factors of thyroid disease for patients with breast cancer.