In this editorial we comment on the article by Chen et al published in the recent issue of the World Journal of Clinical Oncology.Brain metastasis is one of the most serious complications of breast cancer and causes h...In this editorial we comment on the article by Chen et al published in the recent issue of the World Journal of Clinical Oncology.Brain metastasis is one of the most serious complications of breast cancer and causes high morbidity and mortality.Brain metastases may involve the brain parenchyma and/or leptomeninges.Symptomatic brain metastases develop in 10%-16%of newly recognized cases each year,and this rate increases to 30%in autopsy series.Depending on the size of the metastatic foci,it may be accompanied by extensive vasogenic edema or may occur as small tumor foci.Since brain metastases are a significant cause of morbidity and mortality,early diagnosis can have significant effects on survival and quality of life.The risk of developing brain metastases emerges progressively due to various patient and tumor characteristics.Patient variability may be particularly important in the susceptibility and distribution of brain metastases because malignant blood must cross the brain barrier and move within the brain parenchyma.Some characteristics of the tumor,such as gene expression,may increase the risk of brain metastasis.Clinical growth,tumor stage,tumor grade,growth receptor positivity,HER2 positivity,molecular subtype(such as triple negative status,luminal/nonluminal feature)increase the risk of developing breast cancer metastasis.Factors related to survival due to breast cancer brain metastasis include both tumor/patient characteristics and treatment characteristics,such as patient age,lung metastasis,surgery for brain metastasis,and HER2 positivity.If cases with a high risk of developing brain metastasis can be identified with the help of clinical procedures and artificial intelligence,survival and quality of life can be increased with early diagnosis and treatment.At the same time,it is important to predict the formation of this group in order to develop new treatment methods in cases with low survival expectancy with brain metastases.展开更多
BACKGROUND The incidence of colon cancer is increasing worldwide.Treatments for colon cancer include surgery and surgery combined with chemotherapy and radiotherapy,but the median survival rate is still poor.Colon can...BACKGROUND The incidence of colon cancer is increasing worldwide.Treatments for colon cancer include surgery and surgery combined with chemotherapy and radiotherapy,but the median survival rate is still poor.Colon cancer most commonly metastasizes to the lymph nodes,lungs,liver,peritoneum,and brain,but breast metastasis is rare.There is no agreement on its treatment.CASE SUMMARY A 23-year-old woman was admitted to our hospital for further treatment with a history of acute abdominal pain,nausea,and vomiting.Her physical examination and computed tomography scan revealed an abdominal tumor.Transverse colectomy was successfully performed.Histopathological examination revealed that the tumor was a mucosecretory adenocarcinoma with signet ring cells.The patient inadvertently found a mass in the outer upper quadrant of the right breast after four cycles of XELOX chemotherapy[oxaliplatin 130 mg/m^(2),d1,intravenous(iv)drip for 2 h;capecitabine 1000 mg/m^(2),po,bid,d1–d14].After discussion with the patient,we performed a lumpectomy and frozen biopsy.The latter revealed that the breast tumor was intestinal metastasis.Genetic testing showed wild-type RAS and BRAF.So we replaced the original chemotherapy with FOLFIRI[irinotecan 180 mg/m^(2),d1,iv drip for 3–90 min;leucovorin 400 mg/m^(2),d1,iv drip for 2 h;5-fluorouracil(5-FU)400 mg/m^(2),d1 and 5-FU 1200 mg/(m^(2)d)×2 d,continuous iv drip for 46–48 h]+cetuximab(500 mg/m^(2),d1,iv drip for 2 h).Serum levels of tumor markers returned to normal after several treatment cycles,and there was no evidence of tumor recurrence or metastasis.CONCLUSION Breast metastasis from colon cancer is rare.Radical breast surgery should be avoided unless needed for palliation.Chemotherapy combined with targeted therapy should be the first choice.展开更多
It is well documented that the glycosylation of E-cadherin is correlated with cancer metastasis, but whether E- cadherin could be core fucosylated remains largely unknown. We found that E-cadherin was core fucosylated...It is well documented that the glycosylation of E-cadherin is correlated with cancer metastasis, but whether E- cadherin could be core fucosylated remains largely unknown. We found that E-cadherin was core fucosylated in highly metastatic lung cancer cells while absent in lowly metastatic lung cancer cells. Since α-1,6 Fucosyltransferase (α-1,6 FucT) is known to catalyze the reaction of core fucosylation, we investigated the biological function of core fucosylation on E-cadherin by α-1,6 FucT targeted RNAi and transfecting α-1,6 FucT expression vector. As a result, calcium dependent cell-cell adhesion mediated by E-cadherin was strengthened with the reduction of core fucosylation on E- cadherin after RNAi and was weakened with the elevated core fucosylation on E-cadherin after α-1,6 FucT over expression. Our data indicated that α-1,6 FucT could regulate E-cadherin mediated cell adhesion and thus play an important role in cancer development and progression. Computer modeling showed that core fucosylation on E-cadherin could significantly impair three-dimensional conformation of N-glycan on E-cadherin and produce conformational asym- metry so as to suppress the function of E-cadherin. Furthermore, the relationship between the expression of core fucosylated E-cadherin and clinicopathological background of lung cancer patients was explored in lung cancer tissue of patients. It turns out to demonstrate that core fucosylated E-cadherin could serve as a promising prognostic indicator for lung cancer patients.展开更多
Objective： To investigate the expression of MDR-1 P-glycoprotein（MDR-1 Pgp） in breast cancer and analyze its correlation to the biological behavior and prognosis of the disease. Methods：The expression of MDR-1 Pgp...Objective： To investigate the expression of MDR-1 P-glycoprotein（MDR-1 Pgp） in breast cancer and analyze its correlation to the biological behavior and prognosis of the disease. Methods：The expression of MDR-1 Pgp was examined in 75 cases of breast cancer patients by using three different monoclonal antibodies（JSB1, C219 and C494） with S-P immunohistochemisty. These patients were followed up for 5 years, and the correlation between MDR-1 Pgp expression, survival rate and lymph metastasis was analyzed. Results： Positive detection of MDR-1 Pgp by JSB1, C219 and C494 in 75 cases of breast cancer was 86.7%, 48% and 85.3%, respectively. MDR-1 Pgp expression was not related to ages of patients （P 〉 0.05）. JSBl-detected expression of MDR-1 Pgp was related to lymph node metastasis（P〈 0.05）; while C219 and C494 were not（P 〉 0.05）. The patients with MDR-1 Pgp expression positively detected by either two of the three antibodies, had five-year survival rate that was significantly higher than those positively detected by all the three antibodies（P 〈 0.05）. Conclusion：Three antibodies should be used simultaneously to detect MDR-1 Pgp expression in breast cancer. Positive MDR-1 Pgp expression in breast cancer detected by all the three antibodies may represent a poor prognosis; while positive MDR-1 Pgp detection by JSB1 and C494 is associated with lymph metastasis.展开更多
Tumor budding, defined as a small number of cancer cells observed in pathology sections detached from the main tumor mass, is a common phenomenon in cancer. It issuggested that cells in buds are in the process of acti...Tumor budding, defined as a small number of cancer cells observed in pathology sections detached from the main tumor mass, is a common phenomenon in cancer. It issuggested that cells in buds are in the process of actively moving away from the primary tumor in the first step of metastasis. Tumor budding has been observed in a variety of carcinomas and is best studied in colorectal cancers where it portends poor prognosis. More recently, tumor budding was found to be of prognostic significance in other cancers including breast cancer. Tumor budding in breast cancer is associated with other adverse pathologic factors, such as larger tumor size and lymphovascular invasion, but may have additional independent prognostic value. In the future, standardization of the quantification criteria for tumor budding may further aid in its adoption as a prognostic marker.展开更多
Objective： To study interpectoral nodes metastasis rate in breast cancer and its clinical significance. Methods： 171 female patients undergone surgery for breast cancer were reviewed, of whom the interpectoral nodes...Objective： To study interpectoral nodes metastasis rate in breast cancer and its clinical significance. Methods： 171 female patients undergone surgery for breast cancer were reviewed, of whom the interpectoral nodes were subjected to pathological examination. Results： Interpectoral nodes were identified in 25.7% of the 171 female patients, and the interpectoral nodes metastasis rate was 9.9%. The patients with interpectoral nodes metastasis had larger tumor size, later TNM classification, higher axillary apical nodes metastasis rate and lower ER positive rate. Conclusion： Dissection of interpectoral nodes should be regard as routine clinical practice in modified radical mastectomy, and interpectoral nodes should be subjected to pathological examination.展开更多
Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcom...Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival （OS）, disease-free survival （DFS）, and short-term outcomes of BCLM were performed. Results： Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate （combined odds ratio （OR） 0.41, 95% confidence interval （CI） 0.29-0.59, P〈0.001）, 5-year OS rate （combined OR 0.38, 95% CI 0.32-0.46, P〈0.001）, 3-year DFS （combined OR 0.36, 95% CI 0.27-0.49, P〈0.001）, and 5-year DFS （combined OR 0.51, 95% CI 0.40-0.66, P〈0.001）. RFA had fewer postoperative compli- cations （combined OR 0.30, 95% CI 0.20-0.44, P〈0.001） and shorter hospital stays （combined OR -9.01, 95% CI -13.49-4.54, P〈0.001） than HR. Conclusions： HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hos- pital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.展开更多
Background:Breast cancer patients with ipsilateral supraclavicular lymph node metastasis(ISLNM)but without distant metastasis are considered to have a poor prognosis.This study aimed to develop a nomogram to predict t...Background:Breast cancer patients with ipsilateral supraclavicular lymph node metastasis(ISLNM)but without distant metastasis are considered to have a poor prognosis.This study aimed to develop a nomogram to predict the overall survival(OS)of breast cancer patients with ISLNM but without distant metastasis.Methods:Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University,Jiyuan People’s Hospital and Huaxian People’s Hospital between December 21,2012 and June 30,2020 were reviewed retrospectively.Overall,345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified.They were further randomized 2:1 and divided into training(n=231)and validation(n=114)cohorts.A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses.The predictive accuracy and discriminative ability were measured by calibration plots,concordance index(C-index),and risk group stratification.Results:Univariable analysis showed that estrogen receptor-positive(ER+),progesterone receptor-positive(PR+),human epidermal growth factor receptor 2-positive(HER2+)with Herceptin treatment,and a low axillary lymph node ratio(ALNR)were prognostic factors for better OS.PR+,HER2+with Herceptin treatment,and a low ALNR remained independent prognostic factors for better OS on multivariable analysis.These variables were incorporated into a nomogram to predict the 1-,3-,and 5-year OS of breast cancer patients with ISLNM.The C-indexes of the nomogram were 0.737(95%confidence interval[CI]:0.660–0.813)and 0.759(95%CI:0.636–0.881)for the training and the validation cohorts,respectively.The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years,but not 1 year,OS in both the cohorts.The nomogram was also able to stratify patients into different risk groups.Conclusions:In this study,we established and validated a novel nomogram for predicting survival of patients with ISLNM.This nomogram may,to some extent,allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.展开更多
文摘In this editorial we comment on the article by Chen et al published in the recent issue of the World Journal of Clinical Oncology.Brain metastasis is one of the most serious complications of breast cancer and causes high morbidity and mortality.Brain metastases may involve the brain parenchyma and/or leptomeninges.Symptomatic brain metastases develop in 10%-16%of newly recognized cases each year,and this rate increases to 30%in autopsy series.Depending on the size of the metastatic foci,it may be accompanied by extensive vasogenic edema or may occur as small tumor foci.Since brain metastases are a significant cause of morbidity and mortality,early diagnosis can have significant effects on survival and quality of life.The risk of developing brain metastases emerges progressively due to various patient and tumor characteristics.Patient variability may be particularly important in the susceptibility and distribution of brain metastases because malignant blood must cross the brain barrier and move within the brain parenchyma.Some characteristics of the tumor,such as gene expression,may increase the risk of brain metastasis.Clinical growth,tumor stage,tumor grade,growth receptor positivity,HER2 positivity,molecular subtype(such as triple negative status,luminal/nonluminal feature)increase the risk of developing breast cancer metastasis.Factors related to survival due to breast cancer brain metastasis include both tumor/patient characteristics and treatment characteristics,such as patient age,lung metastasis,surgery for brain metastasis,and HER2 positivity.If cases with a high risk of developing brain metastasis can be identified with the help of clinical procedures and artificial intelligence,survival and quality of life can be increased with early diagnosis and treatment.At the same time,it is important to predict the formation of this group in order to develop new treatment methods in cases with low survival expectancy with brain metastases.
文摘BACKGROUND The incidence of colon cancer is increasing worldwide.Treatments for colon cancer include surgery and surgery combined with chemotherapy and radiotherapy,but the median survival rate is still poor.Colon cancer most commonly metastasizes to the lymph nodes,lungs,liver,peritoneum,and brain,but breast metastasis is rare.There is no agreement on its treatment.CASE SUMMARY A 23-year-old woman was admitted to our hospital for further treatment with a history of acute abdominal pain,nausea,and vomiting.Her physical examination and computed tomography scan revealed an abdominal tumor.Transverse colectomy was successfully performed.Histopathological examination revealed that the tumor was a mucosecretory adenocarcinoma with signet ring cells.The patient inadvertently found a mass in the outer upper quadrant of the right breast after four cycles of XELOX chemotherapy[oxaliplatin 130 mg/m^(2),d1,intravenous(iv)drip for 2 h;capecitabine 1000 mg/m^(2),po,bid,d1–d14].After discussion with the patient,we performed a lumpectomy and frozen biopsy.The latter revealed that the breast tumor was intestinal metastasis.Genetic testing showed wild-type RAS and BRAF.So we replaced the original chemotherapy with FOLFIRI[irinotecan 180 mg/m^(2),d1,iv drip for 3–90 min;leucovorin 400 mg/m^(2),d1,iv drip for 2 h;5-fluorouracil(5-FU)400 mg/m^(2),d1 and 5-FU 1200 mg/(m^(2)d)×2 d,continuous iv drip for 46–48 h]+cetuximab(500 mg/m^(2),d1,iv drip for 2 h).Serum levels of tumor markers returned to normal after several treatment cycles,and there was no evidence of tumor recurrence or metastasis.CONCLUSION Breast metastasis from colon cancer is rare.Radical breast surgery should be avoided unless needed for palliation.Chemotherapy combined with targeted therapy should be the first choice.
基金supported by the National Nature Science Foundation of China(No.30070183,No.30470398)Key Subject Foundation of Shanghai Municipal Education Committee(No.B9808010).
文摘It is well documented that the glycosylation of E-cadherin is correlated with cancer metastasis, but whether E- cadherin could be core fucosylated remains largely unknown. We found that E-cadherin was core fucosylated in highly metastatic lung cancer cells while absent in lowly metastatic lung cancer cells. Since α-1,6 Fucosyltransferase (α-1,6 FucT) is known to catalyze the reaction of core fucosylation, we investigated the biological function of core fucosylation on E-cadherin by α-1,6 FucT targeted RNAi and transfecting α-1,6 FucT expression vector. As a result, calcium dependent cell-cell adhesion mediated by E-cadherin was strengthened with the reduction of core fucosylation on E- cadherin after RNAi and was weakened with the elevated core fucosylation on E-cadherin after α-1,6 FucT over expression. Our data indicated that α-1,6 FucT could regulate E-cadherin mediated cell adhesion and thus play an important role in cancer development and progression. Computer modeling showed that core fucosylation on E-cadherin could significantly impair three-dimensional conformation of N-glycan on E-cadherin and produce conformational asym- metry so as to suppress the function of E-cadherin. Furthermore, the relationship between the expression of core fucosylated E-cadherin and clinicopathological background of lung cancer patients was explored in lung cancer tissue of patients. It turns out to demonstrate that core fucosylated E-cadherin could serve as a promising prognostic indicator for lung cancer patients.
基金This work was supported by the Science Development Foundation of the Nanjing Medical University(2006NMUZ023)The research in Dr. W. Zhang's laboratory was supported by funding from the National Research Council of Canada and a Canadian Research Program spon- sored by CIHR, HSFC, ASC and Pfizer(PG-04-0248)
文摘Objective： To investigate the expression of MDR-1 P-glycoprotein（MDR-1 Pgp） in breast cancer and analyze its correlation to the biological behavior and prognosis of the disease. Methods：The expression of MDR-1 Pgp was examined in 75 cases of breast cancer patients by using three different monoclonal antibodies（JSB1, C219 and C494） with S-P immunohistochemisty. These patients were followed up for 5 years, and the correlation between MDR-1 Pgp expression, survival rate and lymph metastasis was analyzed. Results： Positive detection of MDR-1 Pgp by JSB1, C219 and C494 in 75 cases of breast cancer was 86.7%, 48% and 85.3%, respectively. MDR-1 Pgp expression was not related to ages of patients （P 〉 0.05）. JSBl-detected expression of MDR-1 Pgp was related to lymph node metastasis（P〈 0.05）; while C219 and C494 were not（P 〉 0.05）. The patients with MDR-1 Pgp expression positively detected by either two of the three antibodies, had five-year survival rate that was significantly higher than those positively detected by all the three antibodies（P 〈 0.05）. Conclusion：Three antibodies should be used simultaneously to detect MDR-1 Pgp expression in breast cancer. Positive MDR-1 Pgp expression in breast cancer detected by all the three antibodies may represent a poor prognosis; while positive MDR-1 Pgp detection by JSB1 and C494 is associated with lymph metastasis.
文摘Tumor budding, defined as a small number of cancer cells observed in pathology sections detached from the main tumor mass, is a common phenomenon in cancer. It issuggested that cells in buds are in the process of actively moving away from the primary tumor in the first step of metastasis. Tumor budding has been observed in a variety of carcinomas and is best studied in colorectal cancers where it portends poor prognosis. More recently, tumor budding was found to be of prognostic significance in other cancers including breast cancer. Tumor budding in breast cancer is associated with other adverse pathologic factors, such as larger tumor size and lymphovascular invasion, but may have additional independent prognostic value. In the future, standardization of the quantification criteria for tumor budding may further aid in its adoption as a prognostic marker.
文摘Objective： To study interpectoral nodes metastasis rate in breast cancer and its clinical significance. Methods： 171 female patients undergone surgery for breast cancer were reviewed, of whom the interpectoral nodes were subjected to pathological examination. Results： Interpectoral nodes were identified in 25.7% of the 171 female patients, and the interpectoral nodes metastasis rate was 9.9%. The patients with interpectoral nodes metastasis had larger tumor size, later TNM classification, higher axillary apical nodes metastasis rate and lower ER positive rate. Conclusion： Dissection of interpectoral nodes should be regard as routine clinical practice in modified radical mastectomy, and interpectoral nodes should be subjected to pathological examination.
文摘Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival （OS）, disease-free survival （DFS）, and short-term outcomes of BCLM were performed. Results： Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate （combined odds ratio （OR） 0.41, 95% confidence interval （CI） 0.29-0.59, P〈0.001）, 5-year OS rate （combined OR 0.38, 95% CI 0.32-0.46, P〈0.001）, 3-year DFS （combined OR 0.36, 95% CI 0.27-0.49, P〈0.001）, and 5-year DFS （combined OR 0.51, 95% CI 0.40-0.66, P〈0.001）. RFA had fewer postoperative compli- cations （combined OR 0.30, 95% CI 0.20-0.44, P〈0.001） and shorter hospital stays （combined OR -9.01, 95% CI -13.49-4.54, P〈0.001） than HR. Conclusions： HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hos- pital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.
基金the Science and Technology development plan of He’nan(No.202102310428).
文摘Background:Breast cancer patients with ipsilateral supraclavicular lymph node metastasis(ISLNM)but without distant metastasis are considered to have a poor prognosis.This study aimed to develop a nomogram to predict the overall survival(OS)of breast cancer patients with ISLNM but without distant metastasis.Methods:Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University,Jiyuan People’s Hospital and Huaxian People’s Hospital between December 21,2012 and June 30,2020 were reviewed retrospectively.Overall,345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified.They were further randomized 2:1 and divided into training(n=231)and validation(n=114)cohorts.A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses.The predictive accuracy and discriminative ability were measured by calibration plots,concordance index(C-index),and risk group stratification.Results:Univariable analysis showed that estrogen receptor-positive(ER+),progesterone receptor-positive(PR+),human epidermal growth factor receptor 2-positive(HER2+)with Herceptin treatment,and a low axillary lymph node ratio(ALNR)were prognostic factors for better OS.PR+,HER2+with Herceptin treatment,and a low ALNR remained independent prognostic factors for better OS on multivariable analysis.These variables were incorporated into a nomogram to predict the 1-,3-,and 5-year OS of breast cancer patients with ISLNM.The C-indexes of the nomogram were 0.737(95%confidence interval[CI]:0.660–0.813)and 0.759(95%CI:0.636–0.881)for the training and the validation cohorts,respectively.The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years,but not 1 year,OS in both the cohorts.The nomogram was also able to stratify patients into different risk groups.Conclusions:In this study,we established and validated a novel nomogram for predicting survival of patients with ISLNM.This nomogram may,to some extent,allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.
