浙江省永康市2008~2010年女性乳腺癌发病分析

[目的]分析2008~2010年永康市女性乳腺癌发病情况。[方法]利用2008~2010年永康市社会保障局医保和农保的医疗资料以及永康市人民医院就诊的新发乳腺癌患者的发病数据,计算性别、年龄别乳腺癌发病率。2008~2010年覆盖人口1 703 031人年,男性868 777人年,女性834 254人年。人口标化率采用全国1982年人口普查的人口结构和Segi’s世界标准人口结构。[结果]2008~2010年永康市恶性肿瘤新发病例4194例,女性乳腺癌新发病例288例,女性乳腺癌发病率为34.52/10万,中标率为23.84/10万,世标率为29.05/10万。女性乳腺癌年龄别发病率随年龄增长而增加,30岁以前处于较低水平,40~岁组达到高峰,发病率达106.04/10万。[结论]乳腺癌是威胁永康市居民健康的重大疾病之一,应加强对乳腺癌的预防和控制,重点防控人群为40~70岁女性。     

乳腺癌在中国的流行状况和疾病特征

中国女性乳腺癌发病率和死亡率在全球处于比较低的水平,但呈迅速增长的趋势,尤其是农村地区近10年来上升趋势明显。我国女性乳腺癌的发病率和死亡率的年龄和地区分布具有明显特征,总体生存率估计与发展中国家持平,地区和城乡差异明显。目前,尚缺乏以人群为基础的系统资料以描述女性乳腺癌组织病理学、诊断时期别和分子分型等疾病特征的分布。我国乳腺癌的防控策略应更多地侧重于疾病监测、病因学和生存研究,并采取措施提高农村地区乳腺癌预防、筛查和临床诊治服务能力,缩小城乡之间乳腺癌的生存率差距,遏制农村死亡率上升势头。现就中国女性乳腺癌的发病、死亡和生存概况,以及乳腺癌疾病特征的分布状况作一综述。     

新疆石河子市2010~2011年女性乳腺癌发病和死亡流行特征

[目的]了解2010~2011年石河子市女性乳腺癌发病与死亡流行特征,为乳腺癌的预防控制提供科学依据。[方法]根据石河子市肿瘤登记处2010~2011年女性乳腺癌发病及死亡资料,统计和分析粗发病率、粗死亡率、年龄别发病率、年龄别死亡率、中标率、世标率指标。[结果 ]2010~2011年石河子市女性乳腺癌新发病例209例,死亡病例64例。乳腺癌发病率为36.61/10万,中标率为19.11/10万,世标率为24.35/10万。乳腺癌死亡率为11.21/10万,中标率为5.72/10万,世标率为7.43/10万。石河子市女性乳腺癌发病从35岁开始,发病率最高峰为50~岁年龄组,死亡率最高峰为60~岁年龄组。[结论 ]石河子市女性乳腺癌死亡率较高,应加强35~54岁女性乳腺癌筛查,有效降低石河子市乳腺癌流行水平。     

上海市浦东新区1996~2007年前列腺癌流行趋势分析

[目的]分析上海市浦东新区1996～2007年前列腺癌发病、死亡的流行趋势及其特点,为防治工作提供科学依据.[方法]对1996～2007年浦东新区前列腺癌发病和死亡资料进行分析,计算发病(死亡)粗率、标化发病(死亡)率、年平均增长率、变化百分比(PC)和年度变化百分比(APC).[结果]浦东新区前列腺癌标化发病率1996～2007年间年平均增长率为12.15％,PC为70.69％,APC为7.8903％ (t=3.2703,P＜0.01).城区、城镇前列腺癌发病年平均增长率分别为10.60％、16.68％,PC分别为69.37％、396.24％,APC分别为6.4751％、11.1684％ (P＜0.05).前列腺癌标化死亡率12年间年平均增长率为5.65％,PC为33.72％,APC为3.0806％ (t=1.7070,P ＞0.05),城区、城镇前列腺癌死亡年平均增长率分别为3.81％、8.47％,PC分别为41.69％、120.15％,APC分别为4.7539％、5.1550％ (P＞0.05).前列腺癌发病、死亡均集中在60岁以上各年龄组.[结论]上海浦东新区前列腺癌发病呈现上升趋势,城镇高于城区;前列腺癌死亡未呈现上升趋势.60岁以上的男性是前列腺癌重点防治对象.     

兰州市2005～2008年前列腺癌发病状况分析

[目的]了解2005～2008年兰州市男性前列腺癌发病状况,确定重点防治人群,为制定前列腺癌防治措施提供科学依据.[方法]采用肿瘤登记报告的方法,收集兰州市区2005年1月1日至2008年12月31日常住人口中所有恶性肿瘤病例,对前列腺癌登记报告资料进行统计分析.[结果] 2005～2008年兰州市共报告前列腺癌212例,粗发病率为2.50/10万,中国人口标化发病率为5.46/10万,居男性恶性肿瘤第10位;前列腺癌发病随年龄的增长快速上升,发病高峰主要集中在70岁以后.2005～2008年,前列腺癌发病率呈明显上升趋势,每年平均上升7.82％(趋势性x2=3.899,P=0.048).[结论]兰州市前列腺癌发病率居较低水平,但仍呈上升趋势.随着社会人口的老龄化和生活水平的提高,前列腺癌会进一步影响老年人的生活质量,应该引起重视.     

2010~2017年新疆石河子市女性乳腺癌流行趋势分析

摘 要：［目的］ 分析新疆石河子市2010～2017年女性乳腺癌发病与死亡流行趋势。［方法］ 根据石河子市2010～2017年肿瘤登记资料,计算女性乳腺癌发病率、死亡率及其标化率,并采用年度变化百分比(APC)模型分析其时间和年龄趋势。［结果］ 2010～2017年石河子市女性乳腺癌发病1221例,发病率为52.95/10万,中标率40.58/10万,世标率33.59/10万;死亡478例,死亡率为20.73/10万,中标率15.58/10万,世标率12.92/10万。女性乳腺癌发病率从2010年的27.41/10万上升到2017年的44.17/10万,增加了61.15%,APC为10.00%(95%CI：4.93%～26.96%,P>0.05);死亡率从2010年的11.60/10万上升到2017年的30.45/10万,增加了162.50%,APC为14.56%(95%CI：0.14%～31.06%,P<0.05)。乳腺癌50～54岁发病率和65～69岁死亡率上升有统计学意义,APC分别为19.46%和12.58%。［结论］ 2010～2017年石河子女性乳腺癌发病、死亡水平增长明显,且发病和死亡人群年轻化,应加强乳腺癌的早诊早治,尤其是中年女性乳腺癌防控工作亟待加强。     

江苏省连云港市2007~2013年女性乳腺癌流行状况分析

摘 要：［目的］ 分析连云港市2007~2013年女性乳腺癌的发病情况及流行特点。［方法］ 利用“连云港市恶性肿瘤登记系统”和“连云港市死因登记系统”提取2007~2013年连云港市女性乳腺癌发病和死亡资料,计算女性乳腺癌的发病（死亡）率、标化率、变化百分比( percent change,PC)和年度变化百分比( annual percent change,APC)等指标。［结果］ 女性乳腺癌是连云港市女性第2位高发恶性肿瘤,2007~2013年连云港市女性乳腺癌的年均粗发病率为26.00/10万,标化发病率为19.61/10万,35~64岁截缩发病率为64.56/10万,0~74岁累积发病率为2.61%;2007~2013年连云港市女性乳腺癌发病率呈现明显上升趋势（t=4.98,P=0.0042）;发病高峰年龄为55~岁,40~岁和45~岁年龄组发病率随时间变化呈现上升趋势（t=2.87,P=0.035;t=4.43,P=0.0069）,而85岁以上年龄组发病率随时间变化呈现明显下降趋势（t=-2.89,P=0.0446）;城市地区发病率显著性高于农村地区（P<0.001）。2007~2013年连云港市女性乳腺癌年均粗死亡率为7.94/10万,标化死亡率为6.00/10万,35~64岁截缩死亡率为17.96/10万,0~74岁累积死亡率为0.84%;2007~2013年连云港市女性乳腺癌死亡率无明显变化趋势（t=-0.89,P=0.4119）;死亡高峰年龄为55~岁;65~岁组死亡率随时间变化呈现明显上升趋势（t=3.80,P=0.0127）。［结论］ 2007~2013年连云港市女乳腺癌发病率呈明显上升趋势,城市地区发病率显著高于农村;但死亡率无明显变化趋势。     

男性乳腺癌并前列腺癌1 例

患者,男性,67岁,因"左乳肿块40余年,增大2年"就诊.PE:左侧乳晕下可及直径约3cm肿块,质硬,边界清,活动差,表面皮温不高,乳头无溢乳,无橘皮征;查乳腺B超示:左乳头下方探及2.4cm×1.4cm低回声团块,于2009年5月29日行左乳肿块切除术,术中冰冻切片示:左乳浸润性癌.     

上海市杨浦区1980～1999年前列腺癌流行趋势分析

[目的]了解前列腺癌发病和死亡变化情况，为防治工作提供依据。[方法]对1980－1999年上海市杨浦区男性居民前列腺癌发病和死亡资料进行统计分析。[结果]杨浦区男性居民前列腺癌年平均发病率和死亡率分别为3.15/10万和1.98/10万，世界人口标化率分别为2.67/10万和1.81/10万；年龄别发病率和死亡率均从60岁起明显上升，至85岁组达到高峰；前列腺癌发病率、死亡率和标化发病率、死亡率均呈显著上升趋势。[结论]前列腺癌将成为危害男性健康的主要恶性肿瘤之一，应加强对其的监测和病因学研究，开展有针对性的防治工作。     

启东市1972~2011年乳腺癌发病趋势分析

[目的]探讨启东市1972-2011年乳腺癌发病变化趋势,为乳腺癌预防控制提供依据。[方法]根据启东市1972-2011年癌症发病登记数据库,对乳腺癌发病率作年龄、时间趋势分析,计算指标包括粗发病率、中国人口标化率（中标率）、世界人口标化率（世标率）、35-64岁截缩率、0-74岁累积率、累积风险、变化百分比（PC）及年均变化百分比（APC）等。[结果]1972-2011年启东男女性乳腺癌共发病3452例,粗发病率为7.68/10万,占全部癌症发病的3.72%,位居癌症发病第6位。中标率和世标率分别为4.65/10万和6.13/10万;35-64岁截缩发病率为15.31/10万;0-74岁累积发病率为0.64%;乳腺癌发病的累积风险为0.64%。男女性乳腺癌发病性别比为1∶62.93。女性乳腺癌位居女性癌症发病的第4位,粗率、中标率和世标率分别为14.94/10万、9.00/10万和11.78/10万。女性乳腺癌的发病率随年龄的增加而升高,35-岁组进入增长期,50-岁组达到发病率高峰,为37.10/10万。40年间女性乳腺癌发病的粗率、中标率和世标率的变化百分比（PC）分别为269.74%、73.80%和81.48%,年均变化百分比（APC）分别为3.38%、1.21%和1.31%。各时期女性乳腺癌发病率显示25-34岁年龄组的升降趋势不明显,35-岁以后各年龄组的发病率均有上升趋势。年龄-出生队列方法分析女性乳腺癌,显示40-岁以后各年龄组的发病率均呈上升趋势。[结论]启东近40年来女性乳腺癌发病率有上升趋势,40岁以上的女性是乳腺癌防治的重点。     

Pertuzumab in Breast Cancer: A Systematic Review

Pertuzumab is a monoclonal antibody that represents the first among a new class of agents known as human epidermal growth factor receptor (HER) dimerization inhibitors. This is the first systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize all available data of pertuzumab in breast cancer. The search strategy retrieved 11 studies that evaluated pertuzumab. One study was conducted in the neoadjuvant setting (417 patients), whereas all the others dealt with patients with recurrent, metastatic, or refractory disease (1023 patients). Six studies were conducted in HER2⁺ breast cancer population (1354 patients), whereas 5 studies (86 patients) were conducted in HER2^– (or unknown HER2 status) disease. Pertuzumab is the most recent agent approved by the US Food and Drug Administration in combination with trastuzumab and docetaxel for the treatment of patients with HER2⁺ metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. This approval has been based on data from a phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) study. The antitumor activity with the significant reduction in the risk of progression or death, as reflected upon the increase of 6.1 months in median progression-free survival, indicates that pertuzumab may provide an avenue for achieving additional benefit for patients with HER2⁺. Moreover, pertuzumab seems to have a putative role in the management of patients with HER2 who are resistant to trastuzumab. The promising role of pertuzumab in the neoadjuvant and adjuvant settings remains to be further investigated and established in the future.     

Personalized Medicine in Breast Cancer: A Systematic Review

The recent advent of "-omics" technologies have heralded a new era of personalized medicine. Personalized medicine is referred to as the ability to segment heterogeneous subsets of patients whose response to a therapeutic intervention within each subset is homogeneous. This new paradigm in healthcare is beginning to affect both research and clinical practice. The key to success in personalized medicine is to uncover molecular biomarkers that drive individual variability in clinical outcomes or drug responses. In this review, we begin with an overview of personalized medicine in breast cancer and illustrate the most encountered statistical approaches in the recent literature tailored for uncovering gene signatures.     

mTOR Inhibitors in Castration-Resistant Prostate Cancer: A Systematic Review

Background

The progression of prostate cancer to castration-resistant prostate cancer (CRPC) is often a result of somatic alterations in the PI3K/Akt/mTOR (mammalian target of rapamycin) pathway, suggesting that therapies targeting this pathway might lead to improved survival and efficacy. Here, we systematically evaluate the results of clinical trials investigating mTOR inhibition in CRPC and utilize preclinical data to predict clinical outcomes.

Methods

Trials included in the study were identified through PubMed and via review of conference abstracts cited by relevant review articles. The eligibility of trials was independent of sample size, clinical setting, or date.

Results

A total of 14 studies were eligible for qualitative analysis. The clinical setting was variable among studies, and all utilized an allosteric mTOR inhibitor as either a monotherapy or in combination. Molecular criteria were evaluated in three trials. Among most studies, the prostate-specific antigen level declined during treatment, but often increased shortly thereafter. Partial responses to treatment were minimal, and no complete responses were reported. Two studies exploring therapy with an mTOR inhibitor in combination with bicalutamide resulted in minimal efficacy. Overall, allosteric mTOR inhibition was deemed to be inadequate for the treatment of CRPC.

Conclusion

Preclinical data suggest that a reciprocal feedback mechanism between PI3K and androgen receptor signaling is a potential mechanism behind the clinical inefficacy of mTOR inhibitors in CRPC, indicating combinatorial targeting of PI3K, mTORC1/2, and the androgen receptor might be more effective. Comprehensive analysis of preclinical data to assess clinical trial targets and efficacy may reduce the number of unproductive trials and identify potentially beneficial combinatorial therapies for resistant disease.

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Ablative Therapies in Metastatic Breast Cancer: A Systematic Review

Purpose

Patients with oligometastatic breast cancer are being increasingly offered ablative therapies, yet it is unclear which subpopulations may derive long-term benefit. This study sought to explore factors that could define a clinically relevant oligometastatic breast cancer population that benefits from ablative therapies.

Methods

A systematic review using MEDLINE for English language articles published between 1985 and April 2014 was undertaken. Criteria for review included studies that reported overall survival (OS) or progression-free survival (PFS) in breast cancer patients with distant metastases which also: quantified the extent of disease, had metachronous presentation of metastases, and reported on at least 5 patients.

Results

Of 59 674 screened studies, 41 studies of 1813 individual patients were identified. All studies were observational cohort studies (level 2B or 4 evidence) and underwent critical review. All outcomes pertaining to OS and PFS were extracted. Extracted data were too heterogeneous to facilitate a meta-analysis. The only factor that suggested worse outcomes was positive margins post-metastasectomy. There was no clear signal for improved outcomes in regards to age, disease extent, disease-free interval, or receptor status.

Conclusion

Existing evidence does not provide meaningful direction on which metastatic breast cancer patients should have ablation of their residual disease due to heterogeneous reporting of disease factors, patient factors, and outcomes. Thorough demonstration of the absence of high- or moderate-level evidence and the absence of clinical data to guide patient selection suggests that metastatic breast cancer patients being treated with ablative modalities should be placed on clinical trial.

     

Vitamin A and Breast Cancer Survival: A Systematic Review and Meta-analysis

Background

The association between vitamin A intake and breast cancer survival has been inconsistent. We conducted a systemic review and meta-analysis to summarize the results on the association between dietary or supplement vitamin A and its derivatives and breast cancer-specific survival and overall survival (OS).

Taxanes for Breast Cancer During Pregnancy: A Systematic Review

Landmark studies have established taxanes in the treatment of patients with breast cancer; however, recommendations regarding their administration during pregnancy are controversial. The present systematic review aims to synthesize all available data that stem exclusively from breast cancer case series to evaluate the efficacy and safety of taxanes during pregnancy. Overall, 16 studies (50 pregnancies) were eligible for the systematic review according to prisma guidelines. The mean age of patients with breast cancer at pregnancy was 34.6 years. The gestational age (GA) at chemotherapy administration varied from 12 to 36 weeks. The mean GA at delivery was 35.9 weeks. The mean weight of babies at delivery was 2380 g. In 76.7% of cases, a completely healthy neonate was born; in the remaining cases, a neonate who was dystrophic and premature, one with mild hydrocephalus, one with signs of bacterial sepsis, one with hyperbilirubinemia, one with apnea of prematurity, respiratory distress syndrome and gastroesophageal reflux, one with meconium-stained fluid, and another neonate with neutropenia and pyloric stenosis were reported. Ninety percent of children were completely healthy, with a median follow-up of 16 months; in the remaining cases, one child with recurrent otitis media, one with immunoglobulin A deficiency and mild constipation, and another child with delayed speech were reported. In conclusion, available data suggest that taxanes may potentially play a promising role in the optimal therapeutic strategy of patients with breast cancer diagnosed during pregnancy.     

Breast Cancer Frequency and Exposure to Cadmium: A Meta- Analysis and Systematic Review

Background: In this meta-analysis we review evidence suggesting that exposure to cadmium is a cause ofbreast cancer. Materials and Methods: We conducted Medline/PubMed and Scopus searches using selectedMeSH keywords to identify papers published from January 1, 1980 through January 1, 2013. Data weremerged and summary mean differences were estimated using either a random-effects model or a fixed-effectsmodel. Results: There were 13 studies including 978 exposed cases and 1,279 controls. There was no statisticallysignificant difference in the frequencies of breast cancer between cadmium-exposed and control groups, and thesummary estimate of mean difference was 0.71 (95%CI: 0.33-1.08). However, stratification showed that therewere statistically significant differences in the frequencies of breast cancer between cadmium-exposed and controlgroups among Asian compared with Caucasian population, and the summary estimates of mean difference were1.45 (95%CI: 0.62-2.28) vs. 0.25 (95%CI: -0.09-0.6), respectively. There was a difference in the frequencies ofbreast cancer between cadmium-exposed and control groups in peripheral venous blood sampling methods,and the summary estimate of mean difference was 1.41 (95%CI: 0.46-2.37). Conclusions: Data indicate that thefrequencies of breast cancer might be an indicator of early genetic effects for cadmium-exposed populations.However, our meta-analysis was performed on population-based studies; meta-analysis based on individualdata might provide more precise and reliable results. Therefore, it is necessary to construct an internationaldatabase on genetic damage among populations exposed to cadmium that may contain all raw data of studiesexamining genetic toxicity.     

Diagnostic Performance of the Prostate Cancer Antigen 3 Test in Prostate Cancer: Systematic Review and Meta-analysis

PurposeTo explore the diagnostic accuracy of prostate cancer antigen 3 (PCA3) test for the diagnosis of prostate cancer in this systematic review and meta-analysis.Patients and MethodsA systematic literature search of Medline, Embase, and Cochrane Library databases up to October 2019 was performed. The sensitivity, specificity, and diagnostic odds ratio with 95% confidence intervals (CIs) were calculated. The summary receiver operator characteristic graph came from individual studies. We also conducted metaregression analysis to identify the moderated factors.ResultsAcross 54 studies (17,575 patients), the pooled sensitivity, specificity, and diagnostic odds ratio of PCA3 were 0.71 (95% CI, 0.67-0.74), 0.68 (95% CI, 0.63-0.74), and 5.28 (95% CI, 4.28-6.51), respectively. The area under the summary receiver operator characteristic curve was 0.75 (95% CI, 0.71-0.79).ConclusionPooled data indicated that the PCA3 test had moderate sensitivity and specificity in the diagnosis of prostate cancer. PCA3 could be used as a noninvasive method for the diagnosis of prostate cancer.     

乳腺癌患者原发性肺癌发生风险的系统评价和Meta分析

目的 系统评价乳腺癌患者发生原发性肺癌的风险.方法 通过计算机检索Medline、Scopus以及Embase数据库中有关乳腺癌患者发生原发性肺癌风险的英文文献.由两位研究者独立完成筛选文献、提取资料以及评估偏倚风险后,采用Stata 15.5软件进行统计分析.结果 共纳入7篇文献,女性乳腺癌患者发生原发性肺癌的总体风...     

Prevalence of HER-2-Positive Invasive Breast Cancer: A Systematic Review from Iran

Background: The HER-2/neu gene is altered in 15-20% of breast cancer patients. Immunohistochemistry (IHC)is considered to be the most cost-effective method for HER-2 detection in many countries. Approximately 8,000new cases of breast cancer are observed annually in Iran. The aims of this study were to conduct a systematicreview of the literature on the rate of HER-2-positive breast cancer diagnosed by IHC in Iran. Methods: Asystematic search of the medical literature using the Medline/PubMed, ISI and SID databases revealed articlespublished in the English and Persian languages evaluating HER-2-positive breast cancer in Iran. Results: From22 studies, 3,033 patients were evaluated, of whom 1,350 were diagnosed as HER-2-positive by IHC HER-2testing. The mean percentage of HER-2-positive patients was 44.5%, which is higher than that recorded ininternational statistics. Results of this meta-analysis showed a significant heterogeneity between ratios. There wasa statistically significant difference between the results of pre- and post implementation of 2007 American Societyof Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline. IHC HER-2 testing has beenperformed in Iran for over 10 years. Similar to many other countries, before establishment of an infrastructurefor IHC diagnostic tests, HER-2 testing was routinely performed in Iran. Our study showed that the statisticsreported from Iran varied widely; for instance, the rate of HER-2-positive cases varied from 23.3% to 81.0%.Conclusions: Our results demonstrate that the lack of standardization and harmonization of this test have ledto marked variations in breast cancer diagnosis in Iran.