Care of Seniors with Breast Cancer – Treatment Received and Refining Decision Making

AimsTreatment decisions for older patients with breast cancer are complex and evidence is largely extrapolated from younger populations. Frailty and comorbidity need to be considered. We studied the baseline characteristics and treatment decisions in older patients in Christchurch with breast cancer and assessed survival outcomes and prognostic/discriminatory performance of several tools.Materials and methodsWe searched the Canterbury Breast Cancer Registry and identified patients aged 70 years or older at diagnosis with invasive, non-metastatic breast cancer between 1 June 2009 and 30 June 2015. We retrieved demographics, treatment and outcome information. Overall survival and breast cancer-specific survival were estimated. Tools analysing performance status and comorbidity were assessed for their prognostic and discriminatory power.ResultsIn total, 440 patients were identified. Primary surgery was carried out for 362 patients (82.3%): breast-conserving surgery in 114 (of whom 88.6% received radiation therapy); mastectomy in 248 (of whom 24.6% received radiation). Hormone therapy was given for 265 (71.1%) patients with oestrogen receptor-positive cancers. Two hundred and seventy-four (62.3%) patients received full standard treatment, which was associated with significantly improved 5-year survival and 5-year breast cancer-specific survival. The median estimated overall survival was 8.2 years (95% confidence interval 7.3–9.1 years). Of those who died, 71.3% of deaths were due to causes other than breast cancer or unknown causes. The comorbidity-adjusted life expectancy (CALE) showed partial prognostic accuracy. CALE, Charlson and Eastern Cooperative Oncology Group tools all showed discriminatory value.ConclusionIn this population-based series of older patients with breast cancer, showing high levels of primary and adjuvant treatment, patients were more likely to die of causes other than breast cancer. Performance status and comorbidity tools showed prognostic and discriminatory potential in this population supporting their use in treatment decision making. CALE showed the most potential to improve treatment decisions but requires validation in this population to improve prognostic accuracy.     

染料木黄酮对前列腺癌细胞增殖、迁移和侵袭的影响及机制

本研究拟探讨染料木黄酮对前列腺癌细胞LNCaP和CWR22RV1的增殖、迁移和侵袭能力的影响。一、材料与方法1.材料:前列腺癌细胞株LNCaP和CWR22RV1(中国科学院上海生命科学研究院);Genistein(天津科瑞泰科技有限公司);RPMI 1640、胎牛血清(FBS)、胰蛋白酶(美国Gibco公司);E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、波形蛋白(Vimentin,Abcam公司);聚氰基丙烯酸正丁酯(BCA)试剂盒、十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)上样缓冲液(×5)及蛋白质印迹法(Western blot)试剂盒(上海市碧云天生物公司);2.实验方法:采用噻唑蓝(MTT)实验、划痕实验和Transwell实验检测Genistein对细胞增殖、迁移及侵袭能力的影响。采用Western blot检测E-cadherin、N-cadherin、Vimentin、CD44和Oct-4的表达水平。     

Association of weight-adjusted-waist index with incident hypertension: The Rural Chinese Cohort Study

AimsTo explore the association between WWI and the incidence of HTN in the Rural Chinese Cohort Study.Methods and ResultsWe examined data for 10,338 non-hypertensive participants (39.49% men) aged ≥ 18 years from the Rural Chinese Cohort Study who completed a baseline examination during 2007–2008 and follow-up during 2013–2014. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Multiple logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the probability of HTN across four WWI categories. Restricted cubic splines analysis was used to model the dose–response association of WWI and HTN. A total of 2078 participants had HTN during a median follow-up of 6 years. After adjusting for potential confounders, as compared with the lowest WWI category (<9.94 cm/√kg), with WWI 9.94 to 10.42, 10.42 to 10.91 and ≥ 10.91 cm/√kg, the ORs (95% CIs) for HTN were 1.12 (0.93–1.35), 1.40 (1.17–1.69) and 1.50 (1.24–1.82), respectively. Results of the sensitivity analyses were robust. The ORs were generally consistent on subgroup analysis by sex, smoking status, systolic blood pressure and diastolic blood pressure. Multiple logistic regression models with restricted cubic splines showed a non-linear positive association between WWI and HTN (P_nonlinearity < 0.001).ConclusionThe highest WWI category was significantly associated with increased risk of HTN. Our findings may facilitate the development and promotion of obesity prevention strategies aimed at reducing the risk of HTN and provide evidence for healthcare policy in rural China.     

The impact of PTEN deletion and ERG rearrangement on recurrence after treatment for prostate cancer: a systematic review and meta-analysis

Clinical and Translational Oncology - The specific association between PTEN deletion or ERG rearrangement and the recurrence of prostate cancer (PC) treated with radical prostatectomy (RP) or...     

PTEN及Bcl-2蛋白在膀胱移行细胞癌中的表达及其意义

目的：探讨PTEN及Bcl-2蛋白在膀胱移行细胞癌的表达规律及其临床意义。方法：应用免疫组织化学链亲和素-生物素-霉复合物（SP）方法检测43例膀胱移行细胞癌和7例正常黏膜组织中PTEN及Bcl-2蛋白的表达．分析二者的表达与膀胱癌病理参数的关系。结果：（1）G1、G2、G3肿瘤PTEN表达阳性率分别为85．7％、80．4％、73．3％，浸润性肿瘤和表浅性肿瘤表达阳性率分别为70．4％和93．8％，说明PTEN表达阳性率与肿瘤病理分级、临床分期有关。（2）G。、G2、G3肿瘤Bcl-2表达阳性率分别为14．2％、57．14％、66．67％，浸润性肿瘤和表浅性肿瘤表达阳性率分别为59．3％和43．8％，说明Bcl-2表达阳性率与肿瘤病理分级、临床分期有关。（3）随着肿瘤恶性程度的增高和临床分期进展，PTEN蛋白阳性率呈下降，Bcl-2表达呈增高趋势，二者表达呈负相关关系。结论：PTEN的抑癌作用可能与Bcl-2有关．二者的异常表达在膀胱移行细胞癌的发生、发展过程中起重要作用。二者同时检测有助于判断预后。     

负载膀胱癌冻融抗原对树突状细胞分泌IL-12的影响

目的 探讨负载膀胱癌冻融抗原对树突状细胞（DCs）分泌IL-12的影响。方法 反复冻融法获得膀胱癌细胞株BIU-87细胞抗原；联合应用重组人的GM-CSF、IL-4和TNF-α体外诱导健康志愿者DCs并负载膀胱癌肿瘤抗原；用ELISA法检测第3、6和9天培养细胞的上清液，评价DCs分泌IL-12 p70的能力。结果 联合应用重组人的GM-CSF、IL-4和TNF-α可在体外诱导出DCs；经ELISA方法检测，不同时期的DCs分泌IL-12的量不同，而且负载抗原DCs较未负载抗原DCs有更强的分泌能力（P〈0．05）。结论 IL-12 p70的分泌量受DCs的成熟状态及某些刺激信号的影响，膀胱癌冻融抗原是其刺激信号之一。     

TGF—β1对膀胱移行细胞癌细胞粘附性的调节

为了解ＴＧＦβ１对肿瘤粘附性的调节，采用Ｎｏｒｔｈｅｒｎ杂交分析测定了两个膀胱癌细胞系ＴＧＦβ１及ＦＮｍＲＮＡ的表达，并用体外测定方法检测了ＴＧＦβ１对两细胞系粘附性质的调节。结果表明：ＴＧＦβ１仅可使低表达ＦＮ的２５３Ｊ细胞的粘附性增强，而这种增强与ＦＮ表达的增加成正比；同样浓度的ＴＧＦβ１对高表达ＦＮ的６４７Ｖ细胞的粘附性无明显影响。提示肿瘤细胞粘附能力的可变性是其具有转移能力的原因之一。