luminal

管腔
  • 文章类型: Journal Article
    背景:钙化牙源性囊肿(COC)表现出广泛的临床和组织病理学变异以及多种生物学行为。这种多样性导致了对该病变的术语和分类的混淆和分歧。先前的分类试图将COC分类为两个概念。第一个概念,被称为“一元”,“表明所有COCs都是肿瘤性的,尽管大多数在结构上是囊性的,并且似乎是非肿瘤性的。第二个概念,被称为“二元论”,“认为COC包括两个不同的实体:囊肿和肿瘤。本研究讨论了文献中发现的各种先前的COC分类,并提出了一种新的,仅基于组织病理学的简单通用分类,旨在促进外科医生的理解。
    方法:收集了15例COC的临床病理参数,包括有关患者人口统计学的详细信息,症状,解剖部位,放射学特征,进化的持续时间,复发,以及根据建议的分类的组织病理学类型。
    结果:共分析15例COC。根据对建议的分类类型1:5(33.3)的组织学分析,第二类:4(26.6),III型:3(20),IV型:3例(20例),复发3例(20%)。
    结论:它简化了由IV型COC囊性衬里变化引起的复杂性,这在目前的研究中可能被忽视并导致复发。因此,得出经过验证和实用结论的关键要求在于钙化性牙源性囊肿的准确组织学分类及其对治疗的影响。
    BACKGROUND: The Calcifying Odontogenic Cysts (COC) displays a wide range of clinical and histopathological variations as well as diverse biological behaviors. This diversity has led to confusion and disagreement regarding the terminology and classification of this lesion. The previous classification attempts to categorize COC into two concepts. The first concept, termed \"monistic,\" suggests that all COCs are neoplastic despite the majority being cystic in structure and seemingly non-neoplastic. The second concept, known as \"dualistic,\" posits that COC comprises two distinct entities: a cyst and a neoplasm. This research discusses various previous classifications of COC found in the literature and proposes a new, straightforward universal classification based solely on histopathology, aiming to facilitate understanding for surgeons.
    METHODS: Fifteen cases of COC have been collected with clinicopathological parameters including detailed information regarding patient demographics, symptoms, anatomical site, radiological characteristics, duration of evolution, recurrence, and types of histopathology according to the proposed classification.
    RESULTS: A total of fifteen cases of COC were analyzed. According to the histological analysis of the proposed classification Type 1: 5 (33.3), Type II: 4 (26.6), Type III: 3(20), and Type IV:3(20) and recurrence in 3 (20 %) of cases.
    CONCLUSIONS: It simplifies the complexities arising from variations in the cystic linings of type IV of COC, which can be overlooked and have caused recurrence in the current research. Therefore, the key requirement for arriving at a validated and practical conclusion lies in the accurate histological classification of calcifying odontogenic cysts and their impact on treatment.
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  • 文章类型: Journal Article
    管腔乳腺癌在全球范围内发病率高,对健康构成严重威胁。雌激素受体α(ER-α)被17β-雌二醇(E2)激活,其过度表达促进癌变特征。管腔乳腺癌是一种上皮型;然而,肿瘤微环境中细胞分泌的细胞因子IL-6,刺激上皮-间质转化(EMT)并促进转移。此外,IL-6降低ER-α水平,有利于他莫昔芬(TMX)抗性发展。然而,在E2调节下的基因继续表达,即使该受体不存在。GPR30是存在于管腔和侵袭性三阴性乳腺癌中的替代E2受体,与TMX耐药性和癌症进展有关。GPR30和IL-6在转移中的作用已经单独确定;然而,它们的相互作用仍未被探索。本研究旨在阐明GPR30在IL-6诱导的MCF-7管腔乳腺癌细胞转移特性中的作用。结果表明,GPR30有助于E2诱导的MCF-7增殖,因为它与拮抗剂G15和百日咳毒素(PTX)的抑制作用降低了它。此外,GPR30上调MCF-7和TMX抗性(R-TMX)细胞中的波形蛋白和下调的E-cadherin水平,并且还参与IL-6诱导的迁移,入侵,MCF-7细胞中的TMX抗性。此外,在MDA-MB-231三阴性细胞中,基础和IL-6诱导的转移特性均与GPR30活性相关.这些结果表明GPR30受体调节乳腺癌细胞中IL-6诱导的EMT。
    Luminal breast cancer has a high incidence worldwide and poses a severe health threat. Estrogen receptor alpha (ER-α) is activated by 17β-estradiol (E2), and its overexpression promotes cancerous characteristics. Luminal breast cancer is an epithelial type; however, the cytokine IL-6, secreted by cells within the tumor microenvironment, stimulates the epithelial-to-mesenchymal transition (EMT) and promotes metastasis. Also, IL-6 decreases ER-α levels, favoring the tamoxifen (TMX) resistance development. However, genes under E2 regulation continue to be expressed even though this receptor is absent. GPR30 is an alternative E2 receptor present in both luminal and aggressive triple-negative breast cancer and is related to TMX resistance and cancer progression. The roles of GPR30 and IL-6 in metastasis have been individually established; however, their interplay remains unexplored. This study aims to elucidate the role of GPR30 in IL-6-induced metastatic properties of MCF-7 luminal breast cancer cells. Results showed that GPR30 contributes to the E2-induced MCF-7 proliferation because its inhibition with the antagonist G15 and the Pertussis toxin (PTX) reduced it. Besides, GPR30 upregulated vimentin and downregulated E-cadherin levels in MCF-7 and TMX-resistant (R-TMX) cells and is also involved in the IL-6-induced migration, invasion, and TMX resistance in MCF-7 cells. In addition, in MDA-MB-231 triple-negative cells, both basal and IL-6-induced metastatic properties were related to GPR30 activity. These results indicate that the GPR30 receptor regulates the EMT induced by IL-6 in breast cancer cells.
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  • 文章类型: Journal Article
    目的:本研究旨在评估乳腺造影(CEM)的影像学特征与乳腺癌分子亚型之间的相关性。
    方法:这是一项针对2019年12月至2023年8月接受CEM的患者的回顾性单机构研究。每位患者至少有一个组织学证实的浸润性乳腺癌,并进行了核心活检。排除具有乳腺癌治疗史和未完全包括在CEM图像中的病变的患者。使用美国放射学院乳腺成像报告和数据系统(ACRBI-RADS)CEM词典解释图像,2022年出版。不同的成像特征,包括钙化的存在,建筑扭曲,非质量增强,质量形态,内部增强模式,增强的程度,和病变明显,进行了分析。将分子亚型作为二分变量进行研究,包括管腔A,管腔B,HER2和基底样。用Fisher精确检验分析成像特征与分子亚型之间的关联。当p值<0.05时,假定有统计学显著性。
    结果:本研究共纳入31例患者,36例恶性病变。16个病灶(44.4%)为管腔A,四个病变(11.1%)为管腔B,10个病变(27.8%)为HER2,6个病变(16.7%)为基底样亚型。钙化的存在与HER2亚型相关(p=0.024)。重组图像的边缘增强与基底样亚型相关(p=0.001)。重组图像的非均匀增强与非基底样乳腺癌相关(p=0.027)。在其他分析的CEM成像特征和分子亚型之间没有发现统计学上的显着相关性。
    结论:CEM成像特征,包括钙化的存在和某些内部增强模式,与区分乳腺癌分子亚型相关,因此可能进一步扩大CEM的作用。
    OBJECTIVE: This study aims to assess the correlation between imaging features of contrast-enhanced mammography (CEM) and molecular subtypes of breast cancer.
    METHODS: This is a retrospective single-institution study of patients who underwent CEM from December 2019 to August 2023. Each patient had at least one histologically proven invasive breast cancer with a core biopsy performed. Patients with a history of breast cancer treatment and lesions not entirely included in the CEM images were excluded. The images were interpreted using the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) lexicon for CEM, published in 2022. Different imaging features, including the presence of calcifications, architectural distortion, non-mass enhancement, mass morphology, internal enhancement pattern, the extent of enhancement, and lesion conspicuity, were analyzed. The molecular subtypes were studied as dichotomous variables, including luminal A, luminal B, HER2, and basal-like. The association between the imaging features and molecular subtypes was analyzed with a Fisher\'s exact test. Statistical significance was assumed when the p-value was <0.05.
    RESULTS: A total of 31 patients with 36 malignant lesions were included in this study. Sixteen lesions (44.4%) were luminal A, four lesions (11.1%) were luminal B, 10 lesions (27.8%) were HER2, and six (16.7%) were basal-like subtypes. The presence of calcifications was associated with the HER2 subtype (p=0.024). Rim-enhancement on recombined images was associated with a basal-like subtype (p=0.001). Heterogeneous enhancement on recombined images was associated with non-basal-like breast cancer (p=0.027). No statistically significant correlation was found between other analyzed CEM imaging features and molecular subtypes.
    CONCLUSIONS: CEM imaging features, including the presence of calcifications and certain internal enhancement patterns, were correlated with distinguishing breast cancer molecular subtypes and thus may further expand the role of CEM.
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  • 文章类型: Journal Article
    比较单次回波平面成像(ss-EPI)和读出分段回波平面成像(rs-EPI)的扩散峰度成像(DKI)和扩散加权成像(DWI)参数在腔内与腔内的区别使用直方图分析的非管腔乳腺癌。这项研究招募了一百六十名患有111个管腔和49个非管腔乳腺病变的妇女。所有患者在3.0T扫描仪上接受了ss-EPI和rs-EPI序列。直方图指标来自平均峰度(MK),两个DWI序列的平均扩散(MD)和表观扩散系数(ADC)图。进行学生t检验或Mann-WhitneyU检验以区分腔亚型与非腔亚型。绘制ROC曲线以评估显著直方图度量在区分腔与非腔BC中的诊断性能。直方图度量MKmean,MK50,两个DWI序列的管腔BCMK75值均明显高于非管腔BC(均P<0.05)。与来自ss-EPI序列的直方图度量相比,来自rs-EPI序列的直方图度量在区分管腔与非管腔乳腺癌方面具有更好的诊断性能。从rs-EPI序列得出的MK75是最有价值的单一指标(AUC,0.891;灵敏度,78.4%;特异性,87.8%)用于在所有直方图度量中区分管腔与非管腔BC。与ss-EPI相比,rs-EPI得出的MK直方图指标在区分腔与非腔BC方面具有更好的诊断性能。MK75是所有直方图度量中最有价值的度量。
    To compare diffusion-kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) parameters of single-shot echo-planar imaging (ss-EPI) and readout-segmented echo-planar imaging (rs-EPI) in the differentiation of luminal vs. non-luminal breast cancer using histogram analysis. One hundred and sixty women with 111 luminal and 49 non-luminal breast lesions were enrolled in this study. All patients underwent ss-EPI and rs-EPI sequences on a 3.0T scanner. Histogram metrics were derived from mean kurtosis (MK), mean diffusion (MD) and the apparent diffusion coefficient (ADC) maps of two DWI sequences respectively. Student\'s t test or Mann-Whitney U test was performed for differentiating luminal subtype from non-luminal subtype. The ROC curves were plotted for evaluating the diagnostic performances of significant histogram metrics in differentiating luminal from non-luminal BC. The histogram metrics MKmean, MK50th, MK75th of luminal BC were significantly higher than those of non-luminal BC for both two DWI sequences (all P<0.05). Histogram metrics from rs-EPI sequence had better diagnostic performance in differentiating luminal from non-Luminal breast cancer compared to those from ss-EPI sequence. MK75th derived from rs-EPI sequence was the most valuable single metric (AUC, 0.891; sensitivity, 78.4%; specificity, 87.8%) for differentiating luminal from non-luminal BC among all the histogram metrics. Histogram metrics of MK derived from rs-EPI yielded better diagnostic performance for distinguishing luminal from non-luminal BC than that from ss-EPI. MK75th was the most valuable metric among all the histogram metrics.
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  • 文章类型: Journal Article
    背景:EndoPredict®(EP)是一种多基因检测方法,用于预测管腔内乳腺癌的远处复发风险。EP通过qRT-PCR从福尔马林固定的石蜡包埋(FFPE)组织中测量原发性肿瘤中12个基因的表达,并计算指示远处复发风险的EP风险评分。我们使用来自新鲜冷冻(FF)组织的微阵列数据评估了EP在预测远处复发风险方面的性能。我们还检查了EP对来自FFPE组织的微阵列数据的适用性。
    方法:我们分析了431例淋巴结阴性和270例淋巴结阳性的腔内乳腺癌患者的公开数据,这些患者仅接受内分泌治疗。我们使用来自FF组织的微阵列数据评估EP的预后价值。接下来,我们使用来自FFPE组织的微阵列数据创建了一种计算EP风险评分的算法.我们使用来自39名患者的FFPE/FF组织对的微阵列数据检查了EP风险评分的相关系数和EP风险高/低的一致率。
    结果:在431个淋巴结阴性患者中,EP风险评分较高的患者的无远处复发生存率(DRFS)明显较差(P=3.68×10-6,log-rank).在低EP风险评分的患者中,5年DRFS为95.2%。在验证集中,EP风险评分的相关系数为0.93,EP风险高/低的一致率为91.7%。
    结论:EP使用来自FF组织的微阵列数据可用于预测管腔乳腺癌的远处复发风险,和EP可用于来自FFPE组织的微阵列数据。
    BACKGROUND: EndoPredict® (EP) is a multigene assay to predict distant recurrence risk in luminal breast cancer. EP measures the expression of 12 genes in primary tumor by qRT-PCR from formalin-fixed paraffin-embedded (FFPE) tissues and calculates EP risk score that indicates the risk of distant recurrence. We evaluated the performance of EP in predicting distant recurrence risk using microarray data from fresh frozen (FF) tissues. We also examined the applicability of EP to microarray data from FFPE tissues.
    METHODS: We analyzed the publicly available data of 431 node-negative and 270 node-positive patients with luminal breast cancer who received endocrine therapy alone. We evaluated the prognostic value of EP using microarray data from FF tissues. Next, we created an algorithm to calculate EP risk score using microarray data from FFPE tissues. We examined the correlation coefficient of EP risk score and concordance rate of EP risk high/low using microarray data from FFPE/FF tissue pairs in a validation set of 39 patients.
    RESULTS: In 431 node-negative patients, the distant recurrence-free survival (DRFS) rate was significantly worse in those with high EP risk scores (P = 3.68 × 10-6, log-rank). The 5-year DRFS was 95.2% in those with low EP risk score. In the validation set, the correlation coefficient of EP risk score was 0.93 and the concordance rate of EP risk high/low was 91.7%.
    CONCLUSIONS: EP using microarray data from FF tissues was useful in predicting distant recurrence risk in luminal breast cancer, and EP might be utilized in microarray data from FFPE tissues.
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  • 文章类型: Preprint
    背景原发性管腔乳腺癌细胞在标准组织培养中迅速失去身份,这对于测试激素干预和管腔亚型特有的分子途径是有问题的。乳腺癌类器官被认为可以更好地保留肿瘤特征,但管腔亚型病例的长期生存是一个持续的挑战。我们的目标是使管腔乳腺癌的短期类器官适应遗传和药理学扰动的平行测试。方法我们从管腔肿瘤刮片中新鲜分离出患者来源的细胞,将类器官形式小型化为5微升重复,以增加通量,并设置14天的终点以最小化漂移。通过撤回β-雌二醇并添加4-羟基他莫昔芬,可以在这些零代器官中模拟治疗性激素靶向。我们还研究了萝卜硫烷作为亲电应力和具有抗癌特性的商业营养药物。通过两个互补sgRNA的慢病毒转导和Cas9稳定在类器官培养的第一周进行遗传测试下游机制。通过RT-qPCR或RNA测序测量转录变化,和器官表型通过连续明场成像定量,数字图像分割,和细胞倍增时间的回归模型。结果我们在从肿瘤擦伤中启动管腔乳腺癌类器官并将其维持至14天零传代终点方面取得了>50%的成功率。成功大多与临床参数无关,支持该方法的一般适用性。在终点时,零过器官中ESR1和PGR的丰度始终保持在患者变异性的范围内。然而,在接受测试的管腔内乳腺癌病例中,对激素戒断和阻断的反应性差异很大.将萝卜硫烷与NQO1(一种II期抗氧化反应基因和萝卜硫烷的下游效应子)的敲除结合也产生了广泛的类器官生长表型,包括用萝卜硫素抑制生长,NQO1基因敲除促进生长,和生长拮抗作用结合在一起。结论零代器官是一种快速且可扩展的方式,可以从患者来源的材料中询问管腔乳腺癌细胞的特性。这包括测试不同临床队列中的药物作用机制。未来的目标是将零代器官的患者间变异性与长期结果相关联。
    UNASSIGNED: Primary luminal breast cancer cells lose their identity rapidly in standard tissue culture, which is problematic for testing hormone interventions and molecular pathways specific to the luminal subtype. Breast cancer organoids are thought to retain tumor characteristics better, but long-term viability of luminal-subtype cases is a persistent challenge. Our goal was to adapt short-term organoids of luminal breast cancer for parallel testing of genetic and pharmacologic perturbations.
    UNASSIGNED: We freshly isolated patient-derived cells from luminal tumor scrapes, miniaturized the organoid format into 5 μl replicates for increased throughput, and set an endpoint of 14 days to minimize drift. Therapeutic hormone targeting was mimicked in these \"zero-passage\" organoids by withdrawing β-estradiol and adding 4-hydroxytamoxifen. We also examined sulforaphane as an electrophilic stress and commercial neutraceutical with reported anti-cancer properties. Downstream mechanisms were tested genetically by lentiviral transduction of two complementary sgRNAs and Cas9 stabilization for the first week of organoid culture. Transcriptional changes were measured by RT-qPCR or RNA sequencing, and organoid phenotypes were quantified by serial brightfield imaging, digital image segmentation, and regression modeling of cellular doubling times.
    UNASSIGNED: We achieved >50% success in initiating luminal breast cancer organoids from tumor scrapes and maintaining them to the 14-day zero-passage endpoint. Success was mostly independent of clinical parameters, supporting general applicability of the approach. Abundance of ESR1 and PGR in zero-passage organoids consistently remained within the range of patient variability at the endpoint. However, responsiveness to hormone withdrawal and blockade was highly variable among luminal breast cancer cases tested. Combining sulforaphane with knockout of NQO1 (a phase II antioxidant response gene and downstream effector of sulforaphane) also yielded a breadth of organoid growth phenotypes, including growth inhibition with sulforaphane, growth promotion with NQO1 knockout, and growth antagonism when combined.
    UNASSIGNED: Zero-passage organoids are a rapid and scalable way to interrogate properties of luminal breast cancer cells from patient-derived material. This includes testing drug mechanisms of action in different clinical cohorts. A future goal is to relate inter-patient variability of zero-passage organoids to long-term outcomes.
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  • 文章类型: Journal Article
    化疗传统上被用作乳腺癌的新辅助疗法,用于降低所有亚型的局部晚期疾病的分期。在佐剂设置中,基因组分析显示,相当比例的ER阳性/HER2阴性患者在辅助内分泌治疗的基础上,化疗并没有获益.在ER阳性/HER2阴性癌症中作为新辅助疗法的激素治疗的兴趣已经由它们在辅助设置中的成功所证明。此外,与其他乳腺癌亚型相比,细胞毒性化疗在ER阳性/HER2阴性疾病中在获得病理完全缓解方面效果较差.
    对ER阳性/HER2阴性乳腺癌的新辅助疗法和相关生物标志物进行综述。使用Medline调查。讨论的焦点是预测不太可能从化疗中获得额外益处并且具有从激素和其他靶向疗法中受益的最高概率的患者。
    新辅助化疗和激素治疗反应的预测性生物标志物有助于选择ER阳性/HER2阴性乳腺癌患者进行每种治疗。化疗仍然是许多需要新辅助治疗的患者的标准护理,但是其他新辅助疗法的使用越来越多。
    UNASSIGNED: Chemotherapy has been traditionally used as neo-adjuvant therapy in breast cancer for down-staging of locally advanced disease in all sub-types. In the adjuvant setting, genomic assays have shown that a significant proportion of ER positive/HER2 negative patients do not derive benefit from the addition of chemotherapy to adjuvant endocrine therapy. An interest in hormonal treatments as neo-adjuvant therapies in ER positive/HER2 negative cancers has been borne by their documented success in the adjuvant setting. Moreover, cytotoxic chemotherapy is less effective in ER positive/HER2 negative disease compared with other breast cancer subtypes in obtaining pathologic complete responses.
    UNASSIGNED: Neo-adjuvant therapies for ER positive/HER2 negative breast cancers and associated biomarkers are reviewed, using a Medline survey. A focus of discussion is the prediction of patients that are unlikely to derive extra benefit from chemotherapy and have the highest probabilities of benefiting from hormonal and other targeted therapies.
    UNASSIGNED: Predictive biomarkers of response to neo-adjuvant chemotherapy and hormonal therapies are instrumental for selecting ER positive/HER2 negative breast cancer patients for each treatment. Chemotherapy remains the standard of care for many of those patients requiring neo-adjuvant treatment, but other neo-adjuvant therapies are increasingly used.
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  • 文章类型: Journal Article
    背景:分子从血液进入大脑的主动转运受到受体的调节,运输商,和存在于血脑屏障(BBB)的内皮细胞腔表面的其他细胞表面蛋白。然而,由于难以以允许有效纯化这些相对低丰度的细胞表面蛋白的方式标记这些蛋白质,因此存在于BBB的腔内皮细胞表面上的蛋白质的蛋白质组学谱分析已被证明具有挑战性。
    方法:这里我们描述了一种新的基于灌注的标记工作流程:体内糖捕获。该工作流程依赖于通过灌注温和氧化剂对腔血管表面存在的聚糖的氧化,随后通过将其氧化的聚糖与酰肼珠共价连接来分离糖蛋白。分离的蛋白质的基于质谱的鉴定能够高置信度地鉴定大鼠和小鼠中的内皮细胞表面蛋白质。
    结果:使用开发的工作流程,从大鼠BBB中鉴定出347种蛋白质,在小鼠中鉴定出224种蛋白质,两个物种中总共有395种蛋白质。这些蛋白质包括许多具有转运蛋白活性的蛋白质(73种蛋白质),细胞粘附蛋白(47种蛋白质),和跨膜信号受体(31种蛋白质)。为了识别相对于整个大脑在血管中富集的蛋白质,我们建立了血管富集评分,并表明具有高血管富集评分的蛋白质参与血管发育功能,结合整合素,和细胞粘附。使用公开可用的单细胞RNAseq数据,我们表明,通过体内糖捕获鉴定的蛋白质更有可能在内皮细胞中被scRNAseq检测到,而不是在任何其他细胞类型中。此外,通过scRNAseq在内皮细胞中检测到的近50%的编码细胞表面蛋白的基因也通过体内糖捕获鉴定。
    结论:在这项工作中通过体内糖捕获鉴定的蛋白质代表了迄今为止在腔BBB表面上最完整和特异性的蛋白质谱分析。鉴定的蛋白质反映了抗体开发的可能靶标,以改善治疗性蛋白质进入大脑的穿越,并将有助于我们对BBB转运机制的进一步了解。
    BACKGROUND: The active transport of molecules into the brain from blood is regulated by receptors, transporters, and other cell surface proteins that are present on the luminal surface of endothelial cells at the blood-brain barrier (BBB). However, proteomic profiling of proteins present on the luminal endothelial cell surface of the BBB has proven challenging due to difficulty in labelling these proteins in a way that allows efficient purification of these relatively low abundance cell surface proteins.
    METHODS: Here we describe a novel perfusion-based labelling workflow: in vivo glycocapture. This workflow relies on the oxidation of glycans present on the luminal vessel surface via perfusion of a mild oxidizing agent, followed by subsequent isolation of glycoproteins by covalent linkage of their oxidized glycans to hydrazide beads. Mass spectrometry-based identification of the isolated proteins enables high-confidence identification of endothelial cell surface proteins in rats and mice.
    RESULTS: Using the developed workflow, 347 proteins were identified from the BBB in rat and 224 proteins in mouse, for a total of 395 proteins in both species combined. These proteins included many proteins with transporter activity (73 proteins), cell adhesion proteins (47 proteins), and transmembrane signal receptors (31 proteins). To identify proteins that are enriched in vessels relative to the entire brain, we established a vessel-enrichment score and showed that proteins with a high vessel-enrichment score are involved in vascular development functions, binding to integrins, and cell adhesion. Using publicly-available single-cell RNAseq data, we show that the proteins identified by in vivo glycocapture were more likely to be detected by scRNAseq in endothelial cells than in any other cell type. Furthermore, nearly 50% of the genes encoding cell-surface proteins that were detected by scRNAseq in endothelial cells were also identified by in vivo glycocapture.
    CONCLUSIONS: The proteins identified by in vivo glycocapture in this work represent the most complete and specific profiling of proteins on the luminal BBB surface to date. The identified proteins reflect possible targets for the development of antibodies to improve the crossing of therapeutic proteins into the brain and will contribute to our further understanding of BBB transport mechanisms.
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  • 文章类型: Journal Article
    基因表达谱通过识别四种分子亚型重塑了我们对乳腺癌的理解:(1)管腔A,(2)管腔B,(3)人表皮生长因子受体2(HER2)富集,和(4)基底样,在发病率上有关键的差异,对治疗的反应,疾病进展,生存,和成像功能。管腔肿瘤是最常见的(60%-70%),以雌激素受体(ER)表达为特征。管腔A肿瘤在所有亚型中预后最好,而管腔B肿瘤患者的总体生存期和无病生存期明显较短.区分这些肿瘤很重要,因为腔B肿瘤需要更积极的治疗。两者通常表现为不规则肿块,在乳房X线照相术中没有相关的钙化;然而,管腔B肿瘤在诊断时更常表现为腋窝受累。HER2富集肿瘤的特征在于HER2癌基因的过表达和低至不存在的ER表达。HER2+疾病预后不良,但是抗HER2治疗的发展大大改善了HER2+乳腺癌女性的预后.HER2+肿瘤最常表现为伴有多形性钙化的针状肿块或仅表现为钙化。基底样癌(占所有浸润性乳腺癌的15%)在“三阴性”癌症中占主导地位,缺乏ER,孕激素受体(PR),和HER2表达。基底样癌通常是高级别,在诊断时很大,复发率高。尽管成像通常显示不规则肿块,边缘不明确或有毛刺,一些局限性的基底样肿瘤可能被误认为是良性病变。纳入生物标志物数据(组织学分级,ER/PR/HER2状态,和多基因检测)进入经典的解剖肿瘤,节点,转移(TNM)分期可以更好地指导这种异质性疾病的临床治疗。
    Gene expression profiling has reshaped our understanding of breast cancer by identifying four molecular subtypes: (1) luminal A, (2) luminal B, (3) human epidermal growth factor receptor 2 (HER2)-enriched, and (4) basal-like, which have critical differences in incidence, response to treatment, disease progression, survival, and imaging features. Luminal tumors are most common (60%-70%), characterized by estrogen receptor (ER) expression. Luminal A tumors have the best prognosis of all subtypes, whereas patients with luminal B tumors have significantly shorter overall and disease-free survival. Distinguishing between these tumors is important because luminal B tumors require more aggressive treatment. Both commonly present as irregular masses without associated calcifications at mammography; however, luminal B tumors more commonly demonstrate axillary involvement at diagnosis. HER2-enriched tumors are characterized by overexpression of the HER2 oncogene and low-to-absent ER expression. HER2+ disease carries a poor prognosis, but the development of anti-HER2 therapies has greatly improved outcomes for women with HER2+ breast cancer. HER2+ tumors most commonly present as spiculated masses with pleomorphic calcifications or as calcifications alone. Basal-like cancers (15% of all invasive breast cancers) predominate among \"triple negative\" cancers, which lack ER, progesterone receptor (PR), and HER2 expression. Basal-like cancers are frequently high-grade, large at diagnosis, with high rates of recurrence. Although imaging commonly reveals irregular masses with ill-defined or spiculated margins, some circumscribed basal-like tumors can be mistaken for benign lesions. Incorporating biomarker data (histologic grade, ER/PR/HER2 status, and multigene assays) into classic anatomic tumor, node, metastasis (TNM) staging can better inform clinical management of this heterogeneous disease.
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  • 文章类型: Journal Article
    背景:乳腺癌(BC)仍然是一个重大的医疗保健挑战,和治疗方法继续发展。其中,新辅助内分泌治疗(NET)日益受到重视,特别是绝经后,激素受体阳性,HER2阴性(HR+/HER2-)BC患者。尽管如此,在确定从网络中受益的患者方面存在显著差距。这项研究的目的是评估马吉方程(ME)是否可以作为对NET反应的预测因子。
    方法:这项回顾性研究包括接受NET治疗后接受根治性手术的侵袭性BC成年患者。社会人口统计学评估,临床,并进行了肿瘤相关变量。分析ME1、ME2、ME3和ME平均值以探索它们对NET反应的预测作用。采用受试者工作特征(ROC)曲线,以及最佳截止点的确定。使用Logistic回归模型来确定病理反应的最重要预测因子。
    结果:在75名女性参与者中,平均年龄是69.4岁,大多数为绝经后(n=72,96%),ECOG-PS为0/1(n=63,84%)。大多数患者被分类为管腔A(n=41,54.7%)。ME3成为一个有希望的预测指标,当阈值≤19.97时,AUC为0.734,灵敏度为90.62%,特异性为57.50%。在单变量分析中,临床分期(p=0.002),分子亚型(p=0.001),和ME3(连续=0.001,原始3层:p=0.013,新2层:<0.001)类别与病理反应显着相关。在多变量模型中,临床分期和新的2层ME3(<20vs.≥20)作为显著变量。
    结论:ME3<20的患者出现病理反应的可能性更高,为OncotypeDX提供具有成本效益的替代工具。等待具有前瞻性设计的更大的未来研究来证实我们的发现。
    BACKGROUND: Breast cancer (BC) remains a significant health care challenge, and treatment approaches continue to evolve. Among these, neoadjuvant endocrine therapy (NET) has gained prominence, particularly for postmenopausal, hormone-receptor positive, HER2-negative (HR+/HER2-) BC patients. Despite this, a significant gap exists in identifying patients who stand to benefit from NET. The objective of this study was to assess whether Magee equations (MEs) could serve as predictors of response to NET.
    METHODS: This retrospective study included adult patients with invasive BC who underwent NET followed by curative surgery. Assessment of sociodemographic, clinical, and tumor-related variables was conducted. The ME1, ME2, ME3, and ME mean were analyzed to explore their predictive role for NET response. Receiver operating characteristic (ROC) curves were employed, along with the determination of optimal cutoff points. Logistic regression models were utilized to identify the most significant predictors of pathological response.
    RESULTS: Among the 75 female participants, the mean age was 69.4 years, with the majority being postmenopausal (n = 72, 96%) and having an ECOG-PS of 0/1 (n = 63, 84%). Most patients were classified as luminal A (n = 41, 54.7%). ME3 emerged as a promising predictor, boasting an AUC of 0.734, with sensitivity of 90.62% and specificity of 57.50% when the threshold was ≤ 19.97. In univariate analysis, clinical staging (p = 0.002), molecular subtype (p = 0.001), and ME3 (continuous = 0.001, original 3-tier: p = 0.013, new 2-tier: <0.001) categories exhibited significant associations with pathological response. In the multivariate model, clinical staging and new 2-tier ME3 (<20 vs. ≥20) were included as significant variables.
    CONCLUSIONS: Patients with ME3 < 20 have a higher likelihood of presenting a pathological response, offering a cost-effective alternative tool to Oncotype DX. Larger future studies with a prospective design are awaited to confirm our findings.
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