Repressor Proteins

抑制蛋白
  • 文章类型: Journal Article
    对诊断为乳腺癌和卵巢癌(BC/OC)的Tuvan女性的外周血样品进行全外显子组测序,以寻找与BC/OC发病机理有关的新基因。考虑到整个外显子组测序的高成本和研究材料的需求,从61个基因组DNA样品中选择9个样品。在BC患者中发现了与肿瘤介导的Wnt信号通路有关的LGR4基因(rs34804482)的突变和与染色质重塑有关的BRWD1基因(rs147211854)的突变。在患有OC和不孕症病史的患者中发现了与原发性卵巢功能不全的发病机制有关的CITED2基因(rs77963348)突变。在两名BC/OC患者中鉴定出PDGFRA基因(rs2291591)中的突变。LRG4,BRWD1,PDGFRA,首次在诊断为BC/OC的Tuvan妇女中发现了CITED2种系致病性突变。
    Whole exome sequencing of peripheral blood samples from Tuvan females diagnosed with breast and ovarian cancers (BC/OC) was performed to search for new genes involved in BC/OC pathogenesis. Considering the high cost of whole exome sequencing and study material requirements, 9 samples were selected from 61 genomic DNA samples. A mutation in the LGR4 gene (rs34804482) involved in the tumor-mediated Wnt signaling pathway and a mutation in the BRWD1 gene (rs147211854) involved in chromatin remodeling were identified in BC patients. A mutation in the CITED2 gene (rs77963348) involved in the pathogenesis of primary ovarian insufficiency was identified in a patient with OC and a history of infertility. A mutation in the PDGFRA gene (rs2291591) was identified in two BC/OC patients. LRG4, BRWD1, PDGFRA, and CITED2 germline pathogenic mutations were discovered in Tuvan women diagnosed with BC/OC for the first time.
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  • 文章类型: Journal Article
    已在多项研究中研究了通过下一代测序(NGS)使用综合突变分析评估急性髓细胞性白血病(AML)中可测量的残留病(MRD)。然而,关于DNMT3A中持续突变的检测存在争议的结果,TET2和ASXL1(DTA)。必须对NGS-MRD进行基准测试,同时考虑其他分子MRD策略。这里,在ALFA-0702研究(NCT00932412)中,我们对189例接受均匀治疗的患者进行了错误校正-NGS-MRD.非DTA突变的持久性(RFS的HR=2.23,OS的HR=2.26),在多变量分析中,DTA突变(OS的HR=2.16)与较差的预后相关。完全缓解(CR)中至少两个突变的持续存在与较高的累积复发率(CIR)相关(HR=3.71,p<0.0001)。较低的RFS(HR=3.36,p<0.0001)和OS(HR=3.81,p=0.00023),而仅一个突变的持久性没有。在100个可分析的患者中,WT1-MRD,但不是NGS-MRD,是RFS和OS的独立因素。在67例NPM1突变患者中,NPM1突变检测(p=0.0059)和NGS-MRD(p=0.035)状态均与CI相关。我们得出的结论是,包括DTA突变在内的可检测NGS-MRD与AML的不良预后相关。它与AML管理中的替代MRD策略的整合值得进一步调查。
    The evaluation of measurable residual disease (MRD) in acute myeloid leukemia (AML) using comprehensive mutation analysis by next-generation sequencing (NGS) has been investigated in several studies. However controversial results exist regarding the detection of persisting mutations in DNMT3A, TET2, and ASXL1 (DTA). Benchmarking of NGS-MRD taking into account other molecular MRD strategies has to be done. Here, we performed error-corrected-NGS-MRD in 189 patients homogeneously treated in the ALFA-0702 study (NCT00932412). Persistence of non-DTA mutations (HR = 2.23 for RFS and 2.26 for OS), and DTA mutations (HR = 2.16 for OS) were associated with poorer prognosis in multivariate analysis. Persistence of at least two mutations in complete remission (CR) was associated with a higher cumulative incidence of relapse (CIR) (HR = 3.71, p < 0.0001), lower RFS (HR = 3.36, p < 0.0001) and OS (HR = 3.81, p = 0.00023) whereas persistence of only one mutation was not. In 100 analyzable patients, WT1-MRD, but not NGS-MRD, was an independent factor for RFS and OS. In the subset of 67 NPM1 mutated patients, both NPM1 mutation detection (p = 0.0059) and NGS-MRD (p = 0.035) status were associated with CIR. We conclude that detectable NGS-MRD including DTA mutations correlates with unfavorable prognosis in AML. Its integration with alternative MRD strategies in AML management warrants further investigations.
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  • 文章类型: Journal Article
    与年龄相关的听力损失是一种由遗传和环境因素共同引起的复杂疾病,一项研究进行了动物实验,以探索BCL11B杂合性与年龄相关的听力损失之间的关系。本研究使用已建立的遗传模型来检查BCL11B基因多态性与年龄相关的听力损失之间的关联。来自青岛两个社区的410名老年人,中国,参与了这项研究。病例组包括年龄≥60岁的与年龄相关的听力损失的个体,对照组包括来自同一社区的无年龄相关听力损失的个体.两组在年龄和性别上匹配为1:1。使用Mann-WhitneyU检验和卡方检验对参与者的个体特征进行描述性分析。探讨BCL11B基因多态性与年龄相关性听力损失的关系,进行条件逻辑回归以构建BCL11B的两个单核苷酸多态性(SNP)的遗传模型,并进行单倍型分析以构建其单倍型结构域。BCL11B基因的两个SNP位点,rs1152781的四个遗传模型(相加,支配,隐性,和共同支配),和rs1152783的五个遗传模型(相加,支配,隐性,共显性,在所有协变量的未调整和调整模型中,和过显性)与年龄相关的听力损失显着相关(P<0.05)。此外,通过单倍型分析揭示了rs1152781和rs1152783之间的连锁不平衡。我们的研究表明,BCL11B基因多态性与年龄相关的听力损失显着相关。
    Age-related hearing loss is a complex disease caused by a combination of genetic and environmental factors, and a study have conducted animal experiments to explore the association between BCL11B heterozygosity and age-related hearing loss. The present study used established genetic models to examine the association between BCL11B gene polymorphisms and age-related hearing loss. A total of 410 older adults from two communities in Qingdao, China, participated in this study. The case group comprised individuals aged ≥ 60 years with age-related hearing loss, and the control group comprised individuals without age-related hearing loss from the same communities. The groups were matched 1:1 for age and sex. The individual characteristics of the participants were analyzed descriptively using the Mann-Whitney U test and the chi-square test. To explore the association between BCL11B gene polymorphisms and age-related hearing loss, conditional logistic regression was performed to construct genetic models for two single-nucleotide-polymorphisms (SNPs) of BCL11B, and haplotype analysis was conducted to construct their haplotype domains. Two SNP sites of the BCL11B gene, four genetic models of rs1152781 (additive, dominant, recessive, and codominant), and five genetic models of rs1152783 (additive, dominant, recessive, codominant, and over dominant) were significantly associated with age-related hearing loss in the models both unadjusted and adjusted for all covariates (P < 0.05). Additionally, a linkage disequilibrium between rs1152781 and rs1152783 was revealed through haplotype analysis. Our study revealed that BCL11B gene polymorphisms were significantly associated with age-related hearing loss.
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  • 文章类型: Journal Article
    染色质结构对于决定真核生物发育的基因的时间和组织特异性激活至关重要。增强子和启动子之间的功能性相互作用由支持特定长距离相互作用的绝缘体和系链元件控制。然而,基因组调控元件之间的长程相互作用的形成和维持机制仍然知之甚少,主要是由于缺乏方便的模型系统。果蝇成为第一个描述决定绝缘体活性的结构蛋白的模型生物。在果蝇中,研究得最好的DNA结合结构蛋白之一,Su(Hw),与Mod(mdg4)-67.2和CP190蛋白形成复合物。使用CRISPR/Cas9基因组编辑和ATTP依赖性整合技术的组合,我们创建了一个模型系统,其中两个报告基因的启动子和增强子间隔28kb。在这种情况下,增强子仅在存在人工Su(Hw)结合位点(SBS)的情况下有效刺激顺式和反式报告基因启动子,在这两种构造中。突变体Su(Hw)蛋白的表达,不能与CP190相互作用,突变失活Mod(mdg4)-67.2,导致增强子-启动子相互作用完全丧失或显著减弱,分别。结果表明,新的模型系统有效地识别了建筑蛋白复合物的各个亚基在D.melanogaster模型中形成和维持特定的长距离相互作用中的作用。
    Chromatin architecture is critical for the temporal and tissue-specific activation of genes that determine eukaryotic development. The functional interaction between enhancers and promoters is controlled by insulators and tethering elements that support specific long-distance interactions. However, the mechanisms of the formation and maintenance of long-range interactions between genome regulatory elements remain poorly understood, primarily due to the lack of convenient model systems. Drosophila became the first model organism in which architectural proteins that determine the activity of insulators were described. In Drosophila, one of the best-studied DNA-binding architectural proteins, Su(Hw), forms a complex with Mod(mdg4)-67.2 and CP190 proteins. Using a combination of CRISPR/Cas9 genome editing and attP-dependent integration technologies, we created a model system in which the promoters and enhancers of two reporter genes are separated by 28 kb. In this case, enhancers effectively stimulate reporter gene promoters in cis and trans only in the presence of artificial Su(Hw) binding sites (SBS), in both constructs. The expression of the mutant Su(Hw) protein, which cannot interact with CP190, and the mutation inactivating Mod(mdg4)-67.2, lead to the complete loss or significant weakening of enhancer-promoter interactions, respectively. The results indicate that the new model system effectively identifies the role of individual subunits of architectural protein complexes in forming and maintaining specific long-distance interactions in the D. melanogaster model.
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  • 文章类型: Journal Article
    背景:胰岛素瘤相关蛋白1(INSM1)是神经内分泌(NE)肿瘤的新特征敏感和特异性免疫组织化学标志物。而更传统的NE标记,如嗜铬粒蛋白A和突触素,是细胞质的,INSM1是独特的核,因此可以作为NE肿瘤治疗的有用补充。虽然将免疫组织化学研究应用于细胞学标本变得越来越重要,了解某些固定剂的作用以及免疫表达的模式和强度是重要的考虑因素。
    方法:在2015年至2021年间诊断为胰腺神经内分泌肿瘤(PanNET)的16例患者均接受了细针穿刺,随后在CytoLyt®固定的细胞学细胞块(CCB)中制备,和手术切除,其中标本制备成福尔马林固定石蜡包埋块(FFPE)。对于所有样品,INSM1免疫反应性根据染色强度和程度进行分类,然后在CCB和匹配的FFPE之间进行比较。
    结果:所有16个FFPE标本均表现出强而弥散的INSM1免疫反应性,而只有10/16(62.5%)的CCB呈阳性。在这10人中,只有2/10(20%)表现出强烈的扩散反应性。
    结论:固定剂的选择对PanNET中INSM1的免疫反应性具有明显的影响。即使在CytoLyt®固定的细胞块标本中灵敏度较低,添加INSM1是有用的,特别是在一个或多个传统NE标记可能为阴性的具有挑战性的情况下。
    BACKGROUND: Insulinoma-associated protein 1 (INSM1) is a newly characterized sensitive and specific immunohistochemical marker for neuroendocrine (NE) tumors. Whereas more traditional NE markers, such as chromogranin A and synaptophysin, are cytoplasmic, INSM1 is uniquely nuclear and thus could serve as a useful addition to NE tumor workup. While application of immunohistochemical studies to cytology specimens is becoming increasingly relevant, knowledge of the effects of the certain fixatives as well as the pattern and intensity of immunoexpression are important considerations.
    METHODS: Sixteen cases of pancreatic neuroendocrine tumor (PanNET) diagnosed between 2015 and 2021 underwent both fine-needle aspiration, which was subsequently prepared in CytoLyt®-fixed cytology cell block (CCB), and surgical resection, in which specimens were prepared into formalin-fixed paraffin embedded blocks (FFPE). For all samples, INSM1 immunoreactivity was classified according to staining intensity and extent, then compared between CCBs and matched FFPEs.
    RESULTS: All 16 FFPE specimens demonstrated strong and diffuse INSM1 immunoreactivity, while only 10/16 (62.5%) CCBs were positive. Of those 10, only 2/10 (20%) demonstrated strong and diffuse reactivity.
    CONCLUSIONS: The choice of fixative has a demonstrable effect on the immunoreactivity of INSM1 in PanNET. Even though the sensitivity is lower in CytoLyt®-fixed cell block specimens, the addition of INSM1 is useful, especially in challenging cases that may be negative for one or more of the traditional NE markers.
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  • 文章类型: Journal Article
    三舌综合征1(TRPS1)是一种在乳腺上皮细胞中高表达的核蛋白。TRPS1免疫组织化学(IHC)已被建议作为乳腺癌标志物。为了确定TRPS1IHC的诊断和预后效用,分析了来自152种不同肿瘤类型和亚型的19,201个样本的组织微阵列.在先前的研究中进行GATA3IHC。在152个肿瘤类别中的86个中观察到TRPS1染色,其中36个包含至少一个强阳性病例。TRPS1染色在各种类型的乳腺癌中占主导地位(51%-100%),软组织肿瘤(高达100%),唾液腺肿瘤(高达46%),鳞状细胞癌(高达35%),和妇科癌症(高达40%)。TRPS1阳性发生在1083例尿路上皮肿瘤中的1.8%。在非特殊类型的浸润性乳腺癌中,低TRPS1表达与高级别相关(P=0.0547),高pT(P<0.0001),淋巴结转移(P=0.0571),雌激素受体和孕激素受体表达缺失(P<0.0001),和三阴性状态(P<0.0001),但与患者生存率无关(P=0.8016)。在11个不同部位的鳞状细胞癌中,TRPS1低表达与肿瘤表型无关.TRPS1和GATA3的阳性发生在47.4%至100%的乳腺癌中,高达30%的唾液腺肿瘤,和来自134个其他癌症实体的9835个肿瘤中的29个(0.3%)。TRPS1IHC对于识别乳腺癌(或唾液腺)起源的癌症具有很高的实用性,特别是与GATA3的组合。在尿路上皮肿瘤中实际上没有TRPS1阳性可用于区分GATA3阳性尿路上皮癌与乳腺癌。
    Trichorhinophalangeal syndrome 1 (TRPS1) is a nuclear protein highly expressed in breast epithelial cells. TRPS1 immunohistochemistry (IHC) has been suggested as a breast cancer marker. To determine the diagnostic and prognostic utility of TRPS1 IHC, tissue microarrays containing 19,201 samples from 152 different tumor types and subtypes were analyzed. GATA3 IHC was performed in a previous study. TRPS1 staining was seen in 86 of 152 tumor categories with 36 containing at least one strongly positive case. TRPS1 staining predominated in various types of breast carcinomas (51%-100%), soft tissue tumors (up to 100%), salivary gland tumors (up to 46%), squamous cell carcinomas (up to 35%), and gynecological cancers (up to 40%). TRPS1 positivity occurred in 1.8% of 1083 urothelial neoplasms. In invasive breast carcinoma of no special type, low TRPS1 expression was linked to high grade ( P = 0.0547), high pT ( P < 0.0001), nodal metastasis ( P = 0.0571), loss of estrogen receptor and progesterone receptor expression ( P < 0.0001 each), and triple-negative status ( P < 0.0001) but was unrelated to patient survival ( P = 0.8016). In squamous cell carcinomas from 11 different sites, low TRPS1 expression was unrelated to tumor phenotype. Positivity for both TRPS1 and GATA3 occurred in 47.4% to 100% of breast cancers, up to 30% of salivary gland tumors, and 29 (0.3%) of 9835 tumors from 134 other cancer entities. TRPS1 IHC has high utility for the identification of cancers of breast (or salivary gland) origin, especially in combination with GATA3. The virtual absence of TRPS1 positivity in urothelial neoplasms is useful for the distinction of GATA3-positive urothelial carcinoma from breast cancer.
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  • 文章类型: Journal Article
    背景:与西方国家相比,印度的TNBC患病率更高。存在与TNBC的不同临床结果相关的大量生物标志物,具有相互矛盾的报道。从文献中报道的许多蛋白质中鉴定一组特异性生物标志物以预测TNBC的预后是迫切需要的临床需求。
    方法:对队列研究中的关键分子生物标志物进行了系统评价,这些标志物在乳腺癌预后中的作用进行了研究。遵循系统审查和荟萃分析(PRISMA)方法的首选报告项目。使用荟萃分析来评估其合并风险比(HR)和相应的95%置信区间(95%CI)。在200个回顾性TNBC和100个非TNBC患者组织的队列中进行了meta分析标志物的免疫组织化学表征。Kaplan-Meier图用于评估无病生存率(DFS),总生存率(OS)。Cox回归模型用于评估DFS和OS的预测因子。
    结果:使用荟萃分析方法,我们合并了与乳腺癌生存结局相关的生物标志物特征.为预测DFS和OS而出现的有希望的标记包括E-Cadherin,幸存者,p53,MTA1,HIF1A,CD133、Vimentin和CK5/6。对肿瘤组织中这些标志物的评估表明,p53,MTA1和HIF1A的亚细胞定位在预测TNBC预后方面具有显着相关性。KaplanMeier图显示p53(OSp=0.007,DFSp=0.004),发现原发性肿瘤组织中HIF1A(OSp=0.054,DFSp=0.009)和MTA1(OSp=0.043,DFS=p=0.001)的表达与不良OS和DFS显著相关,而TNBC中Survivin(DFSp=0.024)和ECadherin(DFSp=0.027)的表达与单独的DFS相关。单因素分析显示p53、HIF1A和MTA1可能是独立的预后标志物。
    结论:我们的研究提示HIF1A的细胞质过度表达,TNBC原发肿瘤组织中MTA1和突变型p53的核过表达作为预测TNBC患者生存的标志物具有重要意义。
    BACKGROUND: The prevalence of TNBC in India is higher compared to western countries. There is a multitude of biomarkers associated with different clinical outcomes of TNBC with contradictory reports. Identification of a set of specific biomarkers from the very many number of proteins reported in the literature to predict prognosis of TNBC is an urgent clinical need.
    METHODS: A systematic review of key molecular biomarkers in cohort studies that have been investigated for their role in breast cancer prognosis was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. A meta-analysis was used to evaluate their pooled hazard ratio (HR) and the corresponding 95% confidence interval (95% CI) statistically. Immunohistochemical characterization of the meta-analyzed markers were performed in a cohort of 200 retrospective TNBC and 100 non TNBC patient tissues. Kaplan-Meier plot were used to evaluate disease free survival (DFS), and overall survival (OS). Cox regression models were used to evaluate predictors of DFS and OS.
    RESULTS: Using a meta-analytical approach, we consolidated the biomarker signatures associated with survival outcomes in breast cancers. The promising markers that emerged for the prediction of DFS and OS included E-Cadherin, Survivin, p53, MTA1, HIF1A, CD133, Vimentin and CK5/6. Evaluation of these markers in tumor tissue revealed that subcellular localization of p53, MTA1 and HIF1A had a significant association in predicting TNBC prognosis. Kaplan Meier plot revealed that p53 (OS p = 0.007, DFS p = 0.004), HIF 1 A (OS p = 0.054, DFS p = 0.009) and MTA1 (OS p = 0.043, DFS = p = 0.001) expression in the primary tumor tissue were found to be significantly correlated with poor OS and DFS, whereas expression of Survivin (DFS p = 0.024) and E Cadherin (DFS p = 0.027) correlated with DFS alone in TNBC. Univariate analysis revealed that p53, HIF1A and MTA1 could be independent prognostic markers.
    CONCLUSIONS: Our study suggests cytoplasmic over expression of HIF1A, nuclear over expression of MTA1 and mutated p53 in the primary tumor tissue of TNBC have significance as markers predicting survival of TNBC patients.
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  • 文章类型: Meta-Analysis
    背景:饮食中摄入n-3多不饱和脂肪酸(PUFA)可能对心血管疾病的发展具有保护作用,糖尿病,抑郁症和癌症,而据报道,高摄入n-6PUFA通常与炎症相关性状有关。PUFA对健康结果的影响可能由DNA甲基化(DNAm)介导。我们研究的目的是在奥格斯堡地区的合作健康研究(KORA)FF4队列和莱顿长寿研究(LLS)中确定PUFA摄入对DNAm的影响。
    结果:在基于人群的KORAFF4研究(N=1354)和LLS(N=448)的全血中测量DNA甲基化水平,使用IlluminaMethylationitionEPICBeadChip和IlluminaHumanMetrylation450阵列,分别。我们评估了DNAm与KORA和LLS中8种和4种PUFA摄入量之间的关联,分别。在可能的情况下,结果进行荟萃分析。低于Bonferroni校正阈值(p<7.17×10-8),在KORA研究中,我们确定了与PUFA摄入相关的两个差异甲基化位置(DMPs).在模型1中,DMPcg19937480与二十二碳六烯酸(DHA)呈正相关(β:2.00×10-5,95CI:1.28×10-5-2.73×10-5,P值:6.98×10-8),而在我们的完全调整模型中,标记为MARK2基因的cg05041783与二十二碳五烯酸(DPA)呈正相关(β:9.80×10-5,95CI:6.25×10-5-1.33×10-4,P值:6.75×10-8)。在荟萃分析中,我们确定了CpG位点(cg15951061),注释为低于Bonferroni校正(1.23×10-7)的基因CDCA7L,与模型1中二十碳五烯酸(EPA)的摄入量相关(β:2.00×10-5,95%CI:1.27×10-5-2.73×10-5,P值=5.99×10-8),我们分别确认了模型1和2中cg19937480-10×10-91-5-5
    结论:我们的研究确定了三个与PUFA摄入相关的CpG位点。这些网站的机制在很大程度上仍未被探索,强调我们发现的新颖性。进一步的研究对于理解CpG位点甲基化与PUFA结果之间的联系至关重要。
    Dietary intake of n-3 polyunsaturated fatty acids (PUFA) may have a protective effect on the development of cardiovascular diseases, diabetes, depression and cancer, while a high intake of n-6 PUFA was often reported to be associated with inflammation-related traits. The effect of PUFAs on health outcomes might be mediated by DNA methylation (DNAm). The aim of our study is to identify the impact of PUFA intake on DNAm in the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort and the Leiden Longevity Study (LLS).
    DNA methylation levels were measured in whole blood from the population-based KORA FF4 study (N = 1354) and LLS (N = 448), using the Illumina MethylationEPIC BeadChip and Illumina HumanMethylation450 array, respectively. We assessed associations between DNAm and intake of eight and four PUFAs in KORA and LLS, respectively. Where possible, results were meta-analyzed. Below the Bonferroni correction threshold (p < 7.17 × 10-8), we identified two differentially methylated positions (DMPs) associated with PUFA intake in the KORA study. The DMP cg19937480, annotated to gene PRDX1, was positively associated with docosahexaenoic acid (DHA) in model 1 (beta: 2.00 × 10-5, 95%CI: 1.28 × 10-5-2.73 × 10-5, P value: 6.98 × 10-8), while cg05041783, annotated to gene MARK2, was positively associated with docosapentaenoic acid (DPA) in our fully adjusted model (beta: 9.80 × 10-5, 95%CI: 6.25 × 10-5-1.33 × 10-4, P value: 6.75 × 10-8). In the meta-analysis, we identified the CpG site (cg15951061), annotated to gene CDCA7L below Bonferroni correction (1.23 × 10-7) associated with eicosapentaenoic acid (EPA) intake in model 1 (beta: 2.00 × 10-5, 95% CI: 1.27 × 10-5-2.73 × 10-5, P value = 5.99 × 10-8) and we confirmed the association of cg19937480 with DHA in both models 1 and 2 (beta: 2.07 × 10-5, 95% CI: 1.31 × 10-5-2.83 × 10-5, P value = 1.00 × 10-7 and beta: 2.19 × 10-5, 95% CI: 1.41 × 10-5-2.97 × 10-5, P value = 5.91 × 10-8 respectively).
    Our study identified three CpG sites associated with PUFA intake. The mechanisms of these sites remain largely unexplored, highlighting the novelty of our findings. Further research is essential to understand the links between CpG site methylation and PUFA outcomes.
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  • 文章类型: Journal Article
    背景:真性红细胞增多症(PV)患者根据年龄和血栓形成病史分为高或低血栓风险。尽管坚持治疗建议,血管事件仍然频繁,导致我们质疑血栓危险分层是否可以改善。我们先前报道了血栓形成事件与DTA基因突变之间的关联(DNMT3A,TET2和ASXL1)。这项研究的目的是在更大系列的PV患者中证实这种观察。
    方法:从8个欧洲中心招募最少随访3年的PV患者。搜索病史以了解在任何时间记录的血栓形成事件,并使用髓样面板进行下一代测序。多变量逻辑回归评估变量对血栓风险的影响。通过LogRank检验比较Kaplan-Meier无血栓形成存活曲线。在一项病例对照研究中确认了整个队列中的关联,以排除选择偏倚。
    结果:在招募的136名患者中,74例(56.1%)发生血栓性事件,发病率密度为2.83/100人年。在多变量分析中,年龄≥60岁不是血栓形成事件的危险因素,而DTA突变的存在是,也可预测无血栓形成生存期较短(p=0.007)。一项性别和年龄匹配的病例对照研究证实了血栓形成事件与DTA突变之间的关联,包括年龄≤60岁的患者亚组。
    结论:我们的结果支持在诊断中使用分子检测来帮助预测哪些PV患者发生血栓形成的风险更高。
    BACKGROUND:  Polycythemia vera (PV) patients are classified as high or low thrombotic risk based on age and prior history of thrombosis. Despite adherence to treatment recommendations, vascular events remain frequent, leading us to question whether thrombotic risk stratification could be improved. We previously reported an association between thrombotic events and mutations in DTA genes (DNMT3A, TET2, and ASXL1). The objective of this study was to confirm this observation in a larger series of PV patients.
    METHODS:  PV patients with a minimum follow-up of 3 years were recruited from 8 European centers. Medical history was searched for thrombotic event recorded at any time and next-generation sequencing carried out with a myeloid panel. Multivariable logistic regression evaluated the impact of variables on thrombotic risk. Kaplan-Meier thrombosis-free survival curves were compared by the log rank test. Associations in the total cohort were confirmed in a case-control study to exclude selection bias.
    RESULTS:  Of the 136 patients recruited, 74 (56.1%) had a thrombotic event, with an incidence density of 2.83/100 person-years. In multivariable analysis, DTA mutation was a risk factor for thrombotic event, being predictive for shorter thrombosis-free survival in the whole cohort (p = 0.007), as well as in low-risk patients (p = 0.039) and older patients (p = 0.009), but not for patients with a prediagnostic event. A gender- and age-matched case-control study confirmed the increased risk of thrombotic event for PV patients with a DTA mutation.
    CONCLUSIONS:  Our results support the use of molecular testing at diagnosis to help predict which PV patients are at higher risk of developing thrombosis.
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  • 文章类型: Journal Article
    带有EWSR1::PATZ1的软组织肉瘤是最近公认的具有可变形态和异质性免疫组织化学特征的实体。我们研究了17个这样的肿瘤。肿瘤发生在12名男性和5名女性(中位年龄50岁,范围15-71岁),胸腹软组织受累(14例,82%),下肢(2例;12%)和舌头(1例;6%),范围为0.7-11.3厘米(中位数:4.7厘米)。除一名患者外,所有患者均接受了完整的手术切除;7例还接受了新辅助化学/放射疗法治疗。所有病例均显示EWSR1::PATZ1肉瘤的典型特征,包括均匀的圆形到纺锤状的细胞,纤维粘液样基质,纤维带,透明血管,和假肺泡/微囊空间。不寻常的特征,在一个子集的案例中看到,包括出现退行性核异型,上皮样细胞形态学,成熟脂肪,丰富的横纹肌母细胞,高有丝分裂活性,细胞性和核异型性增加的病灶。免疫组化阳性结果为:desmin(16/17,94%),MyoD1(13/14,93%),肌原蛋白(6/14,43%),GFAP(10/10,100%),S100蛋白(15/17,88%),SOX10(7/13,46%),角蛋白(10/17,59%),CD99(4/11,36%),H3K27me3(保留表达9/9,100%),p16(无表达;1/4,25%)和p53(野生型3/3,100%)。融合事件包括EWSR1外显子8::PATZ1外显子1(14/17,82%),EWSR1外显子9::PATZ1外显子1(2/17,12%)和EWSR1外显子7::PATZ1外显子1(1/17,6%)。没有评估的肿瘤具有CDKN2A/B和/或TP53或MDM2扩增的改变。临床随访(16例患者:中位数,13.5个月;范围:1-77个月)显示1例患者发生远处转移(出现时转移),无局部复发。在最后的随访中,14例患者无病,1患有疾病,1人死于疾病(13个月时),1个有不确定的肺结节。我们得出的结论是,EWSR1::PATZ1的形态谱比以前认识到的要宽。虽然需要更多的长期随访,这些非常罕见的肉瘤的预后可能比以前报道的更有利。
    Soft tissue sarcomas harboring EWSR1::PATZ1 are a recently recognized entity with variable morphology and a heterogeneous immunohistochemical profile. We studied 17 such tumors. The tumors occurred in 12 men and 5 women (median age, 50 years; range, 15-71 years), involved the thoracoabdominal soft tissues (14 cases; 82%), lower extremities (2 cases; 12%), and tongue (1 case; 6%), and ranged from 0.7 to 11.3 cm (median, 4.7 cm). All but 1 patient received complete surgical resection; 7 were also treated with neoadjuvant chemo/radiotherapy. All cases showed typical features of EWSR1::PATZ1 sarcoma, including uniform round to spindled cells, fibromyxoid matrix, fibrous bands, hyalinized vessels, and pseudoalveolar/microcystic spaces. Unusual features, seen in a subset of cases, included degenerative-appearing nuclear atypia, epithelioid cytomorphology, mature fat, abundant rhabdomyoblasts, high mitotic activity, and foci with increased cellularity and nuclear atypia. Positive immunohistochemical results were desmin (16/17, 94%), MyoD1 (13/14, 93%), myogenin (6/14, 43%), GFAP (10/10, 100%), S100 protein (15/17, 88%), SOX10 (7/13, 54%), keratin (10/17, 59%), CD99 (4/11, 36%), H3K27me3 (retained expression 9/9, 100%), p16 (absent expression 1/4, 25%), and p53 (wild type 3/3, 100%). Fusion events included EWSR1 exon 8::PATZ1 exon 1 (14/17, 82%), EWSR1 exon 9::PATZ1 exon 1 (2/17, 12%), and EWSR1 exon 7::PATZ1 exon 1 (1/17, 6%). No evaluated tumor had alterations of CDKN2A/B and/or TP53, or MDM2 amplification. Clinical follow-up (16 patients: median, 13.5 months; range, 1-77 months) showed distant metastases in 3 patients (1/3 at time of presentation) and no local recurrences. At the time of last follow-up, 14 patients were disease free, 1 was alive with disease, 1 was dead of disease (at 13 months), and 1 had an indeterminant pulmonary nodule. We conclude that the morphologic spectrum of EWSR1::PATZ1 is broader than has been previously appreciated. Although more long-term follow-up is needed, the prognosis of these very rare sarcomas may be more favorable than previously reported.
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