Making Sense of Intratumor Genetic Heterogeneity: Altered Frequency of Androgen Receptor CAG Repeat Length Variants in Breast Cancer Tissues

To examine the significance of intratumor genetic heterogeneity (ITGH) of the androgen receptor (AR) gene in breast cancer, patient‐matched samples of laser capture microdissected breast tumor cells, adjacent normal breast epithelia cells, and peripheral blood leukocytes were sequenced using a novel next generation sequencing protocol. This protocol measured the frequency of distribution of a variable AR CAG repeat length, a functional polymorphism associated with breast cancer risk. All samples exhibited some degree of ITGH with up to 30 CAG repeat length variants identified. Each type of tissue exhibited a different distribution profile of CAG repeat lengths with substantial differences in the frequencies of zero and 18–25 CAG AR variants. Tissue differences in the frequency of ARs with each of these CAG repeat lengths were significant as measured by paired, twin t‐tests. These results suggest that preferential selection of 18–25 CAG repeat length variants in breast tumors may be associated with breast cancer, and support the observation that shorter CAG repeats may protect against breast cancer. They also suggest that merely identifying variant genes will be insufficient to determine the critical mutational events of oncogenesis, which will require measuring the frequency of distribution of mutations within cancerous and matching normal tissues.     

HOXD Antisense Growth-Associated Long Noncoding RNA Promotes Triple-Negative Breast Cancer Progression by Activating Wnt Signaling Pathway

PurposeTriple-negative breast cancer (TNBC) is the most lethal subtype of breast cancer owing to high heterogeneity, aggressive nature, and lack of treatment options, which has a substantial deleterious effect on patients'' lives. HOXD antisense growth-associated long noncoding RNA (lncRNA) (HAGLR) plays tumor-promoting roles in many cancers. In this study, we aimed to explore the role of HAGLR in TNBC.MethodsQuantitative real-time polymerase chain reaction assays were used to examine the expression of RNAs. Functional experiments were conducted to test the biological behavior of TNBC cells. Moreover, MS2-RNA immunoprecipitation, luciferase reporter, and RNA pull-down assays were conducted to verify the binding relationship between HAGLR, microRNA-143-5p (miR-143-5p), and serine- and arginine-rich splicing factor 1 (SRSF1).ResultsHAGLR was found to be highly expressed in TNBC tissues and cells, and inhibiting HAGLR suppressed cell proliferation, migration, and invasion and promoted cell apoptosis in TNBC. Meanwhile, miR-93-5p was shown to bind to HAGLR and SRSF1. In addition, SRSF1 plays an oncogenic role in TNBC. Importantly, HAGLR could activate the Wnt signaling pathway by sponging miR-93-5p to upregulate SRSF1; thus, accelerating TNBC progression.ConclusionHAGLR could promote the progression of TNBC through the miR-93-5p/SRSF1 axis to activate the Wnt signaling pathway.     

乳腺癌对年轻未育病人配偶心理影响的质性研究

目的:了解乳腺癌对年轻未育病人配偶心理的影响。方法:采用质性研究中的现象学研究方法对10例年轻未育乳腺癌病人配偶的心理问题进行深入访谈。结果:提炼出强烈不确定感、配偶角色改变、对术后身体缺陷的感受、责任及适应力的改变、渴望了解疾病相关知识5个主题。结论:乳腺癌对年轻未育病人配偶的心理影响比较严重,医护人员在对乳腺癌病人进行诊治同时应密切注意配偶这一高危人群,并对他们进行心理咨询、健康指导、提供疾病信息等干预。     

乳腺癌术后上肢淋巴水肿病人自我感受负担与自我护理能力的相关性研究

目的:了解乳腺癌术后上肢淋巴水肿病人的自我感受负担、自我护理能力,并探讨二者的相关性。方法:采用方便抽样方法选取在中山大学肿瘤防治中心就诊的187例乳腺癌术后上肢淋巴水肿病人进行问卷调查。结果:乳腺癌术后上肢淋巴水肿病人自我感受负担总分为(30.40±7.65)分,自我护理能力总分为(109.36±18.57)分。自我感受负担与自我护理能力呈负相关(P<0.05)。结论:多数乳腺癌术后上肢淋巴水肿病人存在中重度自我感受负担,且自我护理能力有待提高。护理人员应关注病人的心理问题,及时进行心理疏导,同时提高病人的自我护理能力,减轻其心理负担。     

乳房下垂采用垂直切口法乳房悬吊术的临床效果及安全性评价

目的探讨乳房下垂采用垂直切口法乳房悬吊术的临床效果及安全性。方法:选择2019年4月-2020年7月进行治疗的乳房下垂患者84例作为研究对象,根据手术治疗方法将所有患者分成对照组和观察组。每组患者各为42例。给予对照组进行传统的双环形切口手术治疗,观察组采用垂直切口法乳房悬吊术治疗,术后3个月对患者效果进行评估,比较乳房形态情况、对乳房形态的满意度及术后并发症。结果两组治疗后乳房下皱襞中点至乳头距离、胸骨上凹至乳头距离、过乳头胸围及乳晕直径均低于治疗前(P<0.05);经过治疗后,观察组患者的乳房下皱襞中点至乳头距离、胸骨上凹至乳头距离、过乳头胸围及乳晕直径均低于对照组(P<0.05);两组治疗后乳房形态满意度均高于治疗前(P<0.05);治疗后观察组患者对乳房对称性、乳房形态、乳房大小及松弛状态的满意度均高于对照组(P<0.05);观察组患者出现血肿、皮瓣坏死、伤口愈合不良、血压波动并发症总发生率为4.76%,低于对照组26.19%(P<0.05)。结论乳房下垂采用垂直切口法乳房悬吊术的临床效果较好,有效改善患者的乳房形态,提高患者满意度,减少并发症的发生,值得推广应用。     

Visualization analysis of research "hot spots": self-management in breast cancer patients

Objective: To identify the research on "hot spots" and frontiers of self-management in patients with breast cancer.Methods: We searched the Web of Science database for articles associated with keywords, and used CiteSpaceⅢ to analyze the data.Results: A total of 958 documents were included. High-frequency keywords covered "quality of life (QOL)," "randomized controlled trial," "depression," "fatigue," and "meta-analysis." Research on self-management by patients with breast cancer has mainly been conducted in the United States of American (USA) and other western countries, whereas the Asian country, China ranked eighth among the top 10 countries.Conclusions: The analysis revealed research on "hot spots" particularly research on psychological health and QOL. Promoting clinical research, encouraging evidence-based practice, and developing nursing specialization may improve research on self-management interventions for patients with breast cancer.     

乳腺磁共振背景实质强化的研究进展

乳腺癌作为女性最常见的恶性肿瘤,其发病率及死亡率都较高,且不同分子亚型乳腺癌生物学表现及临床治疗、预后各不相同,寻找乳腺癌针对性和个性化诊断及治疗的影像学标记物是目前研究的热点。乳腺背景实质强化(background parenchymal enhancement,BPE)是正常纤维腺体组织的生理性强化,受多种因素的影响,并在乳腺疾病的诊断及治疗预后方面有着重要的诊断价值,BPE水平升高与乳腺癌发病风险相关,并可能评估乳腺癌新辅助化疗的疗效。作者就BPE的影响因素及在乳腺癌筛查、诊断及治疗评估中的作用加以综述。     

乳腺癌MRI影像组学的研究进展

乳腺癌是全世界女性最常见的恶性肿瘤之一,也是患癌女性的主要死因。提高诊断准确性、早期评估乳腺癌预后及治疗效果是临床实践中的关键问题。MRI因其较高的软组织分辨率,目前仍是诊断乳腺癌的常用成像方式。相对于乳房X线摄影和超声,MRI可以提供更全面的诊断信息。影像组学是一个高通量提取和定量分析影像特征的新研究领域,近年来受到广泛关注并应用于肿瘤领域。作者就乳腺癌MRI影像组学方面的研究进展进行综述。     

乳腺癌DCE-MRI参数及ADC与病理分子预后标记物的相关性分析

目的分析乳腺癌动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)参数、表观扩散系数(apparent diffusion coefficient,ADC)与病理分子预后标记物的相关性。材料与方法回顾性分析我院106例乳腺癌患者临床资料,分别比较雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、细胞增殖抗原Ki67及雄激素受体(androgen receptor,AR)阳性表达与阴性表达者DCE-MRI参数、ADC差异,并分析DCE-MRI参数、ADC与ER、PR、Ki67、AR表达的相关性。结果经Spearman秩相关检验,发现ER、PR及AR阳性表达与直径、边缘毛刺呈显著负相关(P<0.05),AR表达阳性表达还与达峰时间(time to peak,TTP)、ADC值呈显著正相关(P<0.05);Ki67阳性表达与直径、边缘毛刺呈显著正相关(P<0.05),与TTP、ADC值呈显著负相关(P<0.05)。结论DCE-MRI形态学参数及TTP、ADC值与乳腺癌分子生物学标记物具有一定相关性,对判断乳腺癌预后有利。