ObjectiveTo understand the progress of postmastectomy radiotherapy (PMRT) in patients with T1–2N1M0 breast cancer. MethodThe studies and the treatment guidelines relevant to PMRT in the patients with T1–2N1M0 breast cancer in recent years were analyzed and summarized. ResultsThe ability of PMRT to improve the prognosis of patients with T1–2N1M0 breast cancer remained controversial. Owing to the patients with T1–2N1M0 breast cancer were heterogeneous, and the indications for PMRT had not been standardized. With the increasing use of neoadjuvant chemotherapy for early-stage breast cancer, some studies had attempted to formulate decisions about PMRT based on changes in tumor characteristics before and after neoadjuvant chemotherapy, but the findings were currently controversial. ConclusionsWhether PMRT can improve prognosis and decision-making for patients with T1–2N1M0 breast cancer is still controversial. Some ongoing clinical trials may provide some references for the optimal decision-making of PMRT for patients with T1–2N1M0 breast cancer.
ObjectiveTo summarize the latest advances in copper and cuproptosis in the field of breast cancer, and to provide a reference for clinical treatment decisions. MethodThe literatures related to copper and cuproptosis in recent years were read and summarized, and the research progress on the role of copper in breast cancer, the application of cuproptosis in the diagnosis and treatment of breast cancer were reviewed. ResultsCuproptosiswas a novel form of programmed cell death, which occurred via direct binding of copper to lipoylated components of the tricarboxylic acid (TCA) cycle, this resulted in lipoylated protein aggregation and subsequent iron-sulfur cluster protein loss, leading to proteotoxic stress and ultimately cell death. Cuproptosis induced proliferation and migration of breast cancer cell , mediated personalized immunotherapy, and participated in endocrine and chemotherapeutic drug resistance. ConclusionExploring the mechanism of cuproptosis provides potential applications for subsequent immunotherapy, endocrine therapy, and chemotherapy for breast cancer, leading to new effective strategies for patients.
ObjectiveTo summarize the research progress of Hippo signaling pathway in triple negative breast cancer (TNBC). MethodLiteratures about studies the role of Hippo signaling pathway in cancer stem cells, epithelial-mesenchymal transformation, tumorigenesis and development, distant metastasis, treatment resistance, and treatment strategies were retrieved. ResultsIn TNBC, overexpression of Yes-associated protein and PDZ-binding motif could promote the development of tumor stem cells, induce epithelial-mesenchymal transformation of TNBC cells, and promote tumor development, distant metastasis, and chemotherapy resistance. ConclusionHippo/Yes-associated protein axis plays an important role in carcinogenesis and progression of TNBC, and targeting Hippo signaling pathway might be a potential therapeutic target for TNBC.
ObjectiveTo compare the diagnostic accuracy, sampling satisfaction, and safety of ultrasound-guided core needle biopsy (CNB) and fine needle aspiration biopsy (FNA) for thyroid nodules.MethodsThe databases of PubMed, Medline, Web of Science, Cochrane Library, Wanfang, CNKI, and CBM were searched to collect the relevant studies on the diagnostic performance, sampling satisfaction, and safety of ultrasound-guided CNB and FNA for thyroid nodules. Revman 5.3 and Stata 15 software were used for meta-analysis.ResultsA total of 24 studies involving 25 388 patients were included. Meta analysis showed that: compared with CNB, FNA had poor diagnostic accuracy ［OR=0.26, 95%CI (0.15, 0.46), P<0.000 01］, poor sampling satisfaction ［OR=0.20, 95%CI (0.12, 0.33), P<0.000 01］, lower incidence of total complications ［OR=0.28, 95%CI (0.16, 0.50), P<0.000 1］, and lower incidence of bleeding after biopsy ［OR=0.62, 95%CI (0.48, 0.81), P=0.000 3］. However, there was no significant difference in the pain score ［WMD=–0.21, 95%CI (–0.57, 0.15), P=0.26］ between the two groups. Subgroup analysis showed that there was no significant difference in the accuracy of biopsy diagnosis of thyroid nodules with diameter less than 10 mm between the two groups ［OR=0.52, 95%CI (0.15, 1.81), P=0.30］, however, the accuracy of CNB in the diagnosis of thyroid nodules with diameter ≥ 10 mm was still better than FNA ［OR=0.26, 95%CI (0.12, 0.56), P=0.000 5］.ConclusionsCompared with FNA, ultrasound-guided CNB has a certain advantages in sampling satisfaction and the diagnosis accuracy of thyroid nodules with diameter ≥ 10 mm. CNB is better than FNA, but will bring higher risk of complication.
ObjectiveTo investigate the relationship between the expression of IL-8 protein in triple negative breast cancer (TNBC) and clinicopathological features and survival prognosis.MethodsThe expression of IL-8 protein in 80 cases of TNBC was detected by immunohistochemical staining, and the relationship between the expression of IL-8 protein and clinicopathological features and prognosis of TNBC patients was analyzed by χ2 test, log-rank test, and Cox proportional hazards regression.ResultsIn 80 TNBC patients, the high expression of IL-8 protein accounted for 22.5% (18/80). The expression level of IL-8 protein in TNBC tumor tissue was correlated with T stage, clinical stage, Ki-67 expression, WHO grade and lymph node metastasis (P<0.05). However, it was not related to age, menopausal status, pathological type of tumor and whether they had received neoadjuvant chemotherapy (P>0.05). The results of log-rank analysis showed that the disease-free survival rate (DFS) of high expression group of IL-8 protein was poor than that of low expression group of IL-8 protein (P<0.05). Multivariate Cox proportional hazards regression analysis showed that the expression of IL-8 protein was an independent factor affecting the survival and prognosis of TNBC patients [HR=1.180, 95%CI (1.001, 1.391), P=0.049]. The prognosis of TNBC patients with high expression of IL-8 protein was poor.ConclusionThe expression level of IL-8 protein is an independent risk factor affecting the survival and prognosis of patients with TNBC.
Objective To screen the lapatinib resistance-related hub genes of breast cancer by bioinformatics initially in order to lay the foundation for further study. Methods We screened and downloaded the gene expression profile data of GSE16179 and GSE38376 from the gene expression omnibus (GEO), and used the limma package of R software to identify the differential expressed genes (DEGs) in breast cancer cells. Then we used the DAVID online website for pathway and function enrichment. With the usage of STRING and Cytoscape, the protein-protein interaction network (PPI) was constructed, and the plug-in app MCODE in Cytoscape was applied to screen hub genes. Then we performed the function enrichment and co-expression analysis of hub genes by DAVID and GeneMANIA. Kaplan-Meier Plotter was used to conduct survival analysis of hub genes. Results A total of 206 kinds of DEGs were screened, and there were 126 kinds of up-regulated genes and 80 kinds of down-regulated genes. DAVID results showed that DEGs were mainly enriched in the biological processes of extracellular space and extracellular region, including extracellular matrix organization, oxygen binding, integrin binding, cell adhesion, positive regulation of angiogenesis, Hippo signaling pathway, transforming growth factor-β signaling pathway and so on. PPI network visualized 74 nodes, the top 10 kinds of hub genes with high connectivity in the gene expression network were screened by MCODE. The Kaplan-Meier Plotter analysis confirmed that 6 of the 10 kinds of hub genes, including peroxisome proliferator activated receptor gamma, transforming growth factor beta receptor 2, tissue inhibitor of metalloproteinase 1, transforming growth factor beta induced, serpin family E member 1, and thrombospondin 1, were correlated with the prognosis of breast cancer patients. Conclusion This 6 kinds of genes may play a significant role in lapatinib resistance of breast cancer.
ObjectiveTo understand the current progress of surgical treatment, radiotherapy, chemical drug therapy, endocrine therapy, targeted therapy, and immunotherapy of metaplastic breast cancer (MBC), so as to provide reference for the clinical therapy selection of MBC. MethodThe literature relevant to MBC therapy research in recent years was comprehensively reviewed. ResultsAt present, the pathogenesis of MBC was not clear. The histopathology of MBC was more complex and the prognosis was poor. Compared with the invasive ductal carcinoma, the MBC patients had older age of onset, larger tumor diameter, faster growth and stronger invasiveness. The simple mastectomy was currently used in surgical treatment. The axillary lymph node involvement rate of MBC patients was lower, so the sentinel lymph node biopsy was widely used. The chemical drug therapy, endocrine therapy, and targeted therapy had limited effects on MBC patients. However, with its unique molecular expression by the genomic analysis of MBC and rise of precision medicine, targeted therapy and immunotherapy had become current research hotspots, providing potential therapeutic strategies for MBC patients. ConclusionsDue to the complex histopathology and poor prognosis of MBC, and most research on MBC is retrospective studies, lacking sufficient prospective studies with sufficient sample size, so there is currently no clear consensus on the optimal treatment method for MBC. In order to better improve prognosis of MBC patients, further in-depth research on MBC histopathology, prospective studies with sufficient sample size, and development of targeted and effective therapeutic drugs are needed in the future.
Objective To explore the axillary lymph node dissection (ALND) could be safely exempted in younger breast cancer patients (≤40 years of age) who receiving breast-conserving surgery combined with radiotherapy in metastasis of 1–2 sentinel lymph node (SLN) and T1–T2 stage. Methods The data of pathological diagnosis of invasive breast cancer from 2004 to 2015 in SEER database were extracted. Patients were divided into SLN biopsy group (SLNB group) and ALND group according to axillary treatment. Propensity matching score (PSM) method was used to match and equalize the clinicopathological features between two groups at 1∶1. Multivariate Cox proportional risk model was used to analyze the relationship between axillary management and breast cancer specific survival (BCSS), and stratified analysis was performed according to clinicopathological features. Results A total of 1 236 patients with a median age of 37 years (quartile: 34, 39 years) were included in the analysis, including 418 patients (33.8%) in the SLNB group and 818 patients (66.2%) in the ALND group. The median follow-up period was 82 months (quartile: 44, 121 months), and 111 cases (9.0%) died of breast cancer, including 33 cases (7.9%) in the SLNB group and 78 cases (9.5%) in the ALND group. The cumulative 5-year BCSS of the SLNB group and the ALND group were 90.8% and 93.4%, respectively, and the log-rank test showed no significant difference (χ2=0.70, P=0.401). After PSM, there were 406 cases in both the SLNB group and the ALND group. The cumulative 5-year BCSS rate in the ALND group was 4.1% higher than that in the SLNB group (94.8% vs. 90.7%). Multivariate Cox proportional hazard analysis showed that ALND could further improve BCSS rate in younger breast cancer patients [HR=0.578, 95%CI (0.335, 0.998), P=0.049]. Stratified analyses showed that ALND improved BCSS in patients diagnosed before 2012 or with a character of lymph node macrometastases, histological grade G3/4, ER negative or PR negative. Conclusions It should be cautious to consider the elimination of ALND in the stage T1–T2 younger patients receiving breast-conserving surgery combined with radiotherapy when 1–2 SLNs positive, especially in patients with high degree of malignant tumor biological behavior or high lymph node tumor burden. Further prospective trials are needed to verify the question.
Objective To explore the relationship between the metastatic sites and prognosis in newly diagnosed stage Ⅳ breast cancer. Methods The data of newly diagnosed female patients with stage Ⅳ invasive breast cancer with complete follow-up data from SEER database from 2010 to 2015 were grouped according to different metastatic sites, and the differences of breast cancer-specific survival (BCSS) in different metastatic sites were analyzed by univariate and multivariate Cox. Kaplan-Meier method was used to draw the survival curve, and log-rank test was used to analyze the prognostic factors of BCSS in newly diagnosed stage ⅳ breast cancer. Results A total of 8 407 patients were included in the final analysis. Among them, 5 619 (66.84%) patients were confirmed with bone metastasis only, 1 483 (17.64%) patients with lung metastasis only, 1 096 (13.04%) patients with liver metastasis only, and 209 (2.49%) patients with brain metastasis only. The median follow-up time was 22 months, with 4 180 (49.72%) breast cancer-related deaths and a median BCSS of 39 months in those patients. The location of metastasis in newly diagnosed stage Ⅳ invasive breast cancer was significantly correlated with BCSS (χ2=151.07, P<0.001). Multivariate Cox model analysis showed that the BCSS was worse in patients with liver metastasis [HR=1.34, 95%CI (1.21, 1.49), P<0.001], lung metastasis [HR=1.09, 95%CI (1.04, 1.14), P<0.001] and brain metastases [HR=1.28, 95%CI (1.20, 1.36), P<0.001] than in patients with bone metastases. Further subgroup analysis showed that the BCSS of breast cancer patients with different molecular subtypes and different metastatic sites were also significantly different (P<0.05). Patients with brain and liver metastases in the HR+/HER2– subtype had worse BCSS than those with bone metastases (P<0.001). Patients with brain metastases in the HR+/HER2+ subtype had worse BCSS than those with bone metastases (P=0.001). In HR–/HER2+ subtype, the BCSS of patients with liver metastasis, lung metastasis and brain metastasis were worse than that of patients with bone metastasis (P<0.05). In HR–/HER2– subtype, the BCSS of patients with brain metastasis and liver metastasis were worse than that of patients with bone metastasis (P<0.05) . Conclusion The prognosis of newly diagnosed stage ⅳ breast cancer patients with different metastatic sites is different, and the prognosis of different molecular subtypes and different metastatic sites is also different.