Cancer occurrence

癌症发生
  • 文章类型: Journal Article
    高血压是癌症患者中最常见的合并症。因此,许多癌症患者在癌症诊断前或癌症治疗期间服用抗高血压药物。然而,降压药是否影响发病率,治疗功效,或者癌症的预后仍然没有答案。例如,肾素-血管紧张素和β-肾上腺素能信号可能不仅参与血压升高,而且参与细胞增殖,血管生成,和组织入侵。因此,这些途径的抑制可能对癌症的预防或治疗产生有益的影响。在这篇文章中,我们回顾了几项关于抗高血压药物和癌症的研究.特别是,我们关注临床试验的结果,以评估抗高血压药物的使用是否会影响未来的癌症风险和预后.不幸的是,结果有些不一致,证明抗高血压药物效果的证据仍然有限。我们指出,研究设计中的异质性使得难以阐明抗高血压药物与癌症之间的因果关系。我们还建议进行额外的实验研究,包括对来自癌症患者的诱导多能细胞的研究,癌细胞簇的单细胞分析,和使用人工智能电子健康记录系统的临床研究,可能有助于揭示抗高血压药物与癌症风险之间的精确关联。
    Hypertension is the most prevalent comorbidity in cancer patients. Consequently, many cancer patients are prescribed antihypertensive drugs before cancer diagnosis or during cancer treatment. However, whether antihypertensive drugs affect the incidence, treatment efficacy, or prognosis of cancer remains unanswered. For instance, renin-angiotensin and β-adrenergic signaling may be involved not only in blood pressure elevation but also in cell proliferation, angiogenesis, and tissue invasion. Therefore, the inhibition of these pathways may have beneficial effects on cancer prevention or treatment. In this article, we reviewed several studies regarding antihypertensive drugs and cancer. In particular, we focused on the results of clinical trials to evaluate whether the use of antihypertensive drugs affects future cancer risk and prognosis. Unfortunately, the results are somewhat inconsistent, and evidence demonstrating the effect of antihypertensive drugs remains limited. We indicate that the heterogeneity in the study designs makes it difficult to clarify the causal relationship between antihypertensive drugs and cancer. We also propose that additional experimental studies, including research with induced pluripotent cells derived from cancer patients, single-cell analyses of cancer cell clusters, and clinical studies using artificial intelligence electronic health record systems, might be helpful to reveal the precise association between antihypertensive drugs and cancer risk.
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  • 文章类型: Journal Article
    背景:癌症相关的发病率和死亡率在全球范围内迅速增加。然而,没有研究检查癌症作为单一因素对使用传统药物的影响,互补,和替代医学(T&CAM)。我们旨在使用韩国卫生小组(KHP)数据确定癌症发生对T和CAM利用率的影响。
    方法:我们分析了从2011年至2014年和2016年具有完整KHP数据的12,975名韩国成年参与者获得的纵向数据(49,380个观察值),并根据癌症诊断将其分为两组。小组多项logit模型用于评估参与者在门诊环境中是否使用T&CAM或传统医学或两者。此外,我们使用负二项回归模型来检验癌症对T&CAM门诊就诊次数的影响.
    结果:总计,癌症组中25.54%的研究参与者使用了T&CAM,高于非癌症组(18.37%,p<0.0001)。使用KHP数据的面板多项逻辑回归分析显示,癌症的发生与“同时使用韩国医学和传统医学”(Coef。=0.80,p=0.017)和\'不使用韩国药物而是使用传统医学\'(Coef。=0.85,p=0.008)比\'不使用韩国医学和传统医学。\'一组阴性二项回归显示,癌症对增加T&CAM门诊就诊次数具有显着影响(Coef。=0.11,p=0.040)。
    结论:我们的研究结果表明,个体内部的癌症发生导致同时使用常规药物和T&CAM。此外,在已经使用T&CAM的参与者中,癌症的发生显著增加了T&CAM门诊就诊的次数.还发现,最脆弱的人更经常使用T和CAM,例如医疗受益人和受教育程度低的人。
    BACKGROUND: Cancer-related incidence and mortality rates are rapidly increasing worldwide. However, no studies have examined the effect of cancer as a single factor on the use of traditional, complementary, and alternative medicine (T&CAM). We aimed to determine the effect of cancer occurrence on T&CAM utilization using Korea Health Panel (KHP) data.
    METHODS: We analyzed longitudinal data (49,380 observations) derived from 12,975 Korean adult participants with complete KHP data from 2011 to 2014 and 2016, and divided them into two groups based on cancer diagnosis. A panel multinomial logit model was used to assess whether the participants used T&CAM or conventional medicine or both in outpatient settings. Additionally, a negative binomial regression model was used to examine the effect of cancer on the number of outpatient visits for T&CAM.
    RESULTS: In total, 25.54% of the study participants in the cancer group used T&CAM, which was higher than that in the non-cancer group (18.37%, p < 0.0001). A panel multinomial logistic regression analysis using KHP data showed that cancer occurrence was significantly more likely to be associated with \'Using both Korean medicine and conventional medicine\' (Coef. = 0.80, p = 0.017) and \'Not using Korean medicine but using conventional medicine\' (Coef. = 0.85, p = 0.008) than \'Not using Korean medicine and conventional medicine.\' A panel negative binomial regression showed a significant effect of cancer on increasing the number of T&CAM outpatient visits (Coef. = 0.11, p = 0.040).
    CONCLUSIONS: Our findings showed that cancer occurrence within an individual led to the simultaneous use of conventional medicine and T&CAM. In addition, the occurrence of cancer significantly increased the number of T&CAM outpatient visits among participants already using T&CAM. It was also found that T&CAM has been utilized more often by the most vulnerable people, such as medical beneficiaries and those with a low level of education.
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  • 文章类型: Journal Article
    研究报道了关于肾素-血管紧张素-醛固酮系统(RAAS)抑制剂的使用与癌症发展之间的关联的矛盾结果。我们比较了使用RAAS抑制剂和其他抗高血压药物的患者之间的癌症发病率。这项回顾性观察性队列研究使用了来自韩国七家医院的数据,这些数据被转换为用于观察性医学结果伙伴关系通用数据模型。根据RAAS抑制剂的使用情况,在七家医院的数据库中,共有166,071名接受抗高血压治疗的患者分为两组。主要结果是癌症的发生。最终分析包括7家医院数据库中的166,071名患者;RAAS抑制剂组26,650(16%),其他抗高血压药物组139,421(84%)。整个队列的荟萃分析显示,RAAS抑制剂组的癌症发生率较低(9.90vs.每1000人年13.28;人力资源,0.81;95%置信区间[CI],0.75-0.88)。在倾向得分匹配后,RAAS抑制剂组的癌症发病率始终较低(9.90vs.每1000人年13.28;人力资源,0.86;95%CI,0.81-0.91)。与使用其他抗高血压药物的患者相比,使用RAAS抑制剂的患者显示出更低的癌症发生率。这些发现支持RAAS抑制剂的使用与癌症发生之间的关联。
    Studies have reported conflicting results on the association between the use of renin-angiotensin-aldosterone system (RAAS) inhibitors and cancer development. We compared the incidence of cancer between patients using RAAS inhibitors and other antihypertensive drugs. This retrospective observational cohort study used data from seven hospitals in Korea that were converted for use in the Observational Medical Outcomes Partnership Common Data Model. A total of 166,071 patients on antihypertensive therapy across the databases of the seven hospitals were divided into two groups according to the use of RAAS inhibitors. The primary outcome was the occurrence of cancer. A total of 166,071 patients across the databases of the seven hospitals was included in the final analysis; 26,650 (16%) were in the RAAS inhibitors group and 139,421 (84%) in the other antihypertensive drugs group. The meta-analysis of the whole cohort showed a lower incidence of cancer occurrence in the RAAS inhibitor group (9.90 vs. 13.28 per 1000 person years; HR, 0.81; 95% confidence interval [CI], 0.75-0.88). After propensity-score matching, the RAAS inhibitor group consistently showed a lower incidence of cancer (9.90 vs. 13.28 per 1000 person years; HR, 0.86; 95% CI, 0.81-0.91). The patients using RAAS inhibitors showed a lower incidence of cancer compared with those using other antihypertensive drugs. These findings support the association between the use of RAAS inhibitors and cancer occurrence.
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  • 文章类型: Journal Article
    背景:近年来,非小细胞肺癌(NSCLC)的治疗有了很大的改善。然而,无创性早期筛查癌变和进展不清楚。这项研究的目的是探讨外周血免疫细胞在未经治疗的NSCLC患者中的预测价值。
    方法:我们回顾性纳入了2016年2月至2019年8月在北京协和医院接受治疗的305例未经治疗的NSCLC患者和132例健康受试者。采用流式细胞术和血常规检测免疫细胞水平。
    结果:NSCLC患者的T淋巴细胞水平较低,NK细胞,CD8+T细胞,幼稚CD4+/CD4+,幼稚CD4+T细胞和更高水平的CD4+T细胞,记忆CD4+/CD4+T细胞,记忆CD4+T细胞,CD4+CD28+/CD4+T细胞,CD4+CD28+T细胞,CD8+CD28+/CD8+T细胞,CD8+HLA-DR+/CD8+T细胞,CD8+HLA-DR+T细胞T细胞,CD8+CD38+/CD8+T细胞,CD8+CD38+T细胞和CD4+/CD8+T细胞比对照组。癌症患者与健康个体的特定淋巴细胞亚型的百分比显着不同。例如,癌症患者的B细胞水平较低,CD4+T细胞,幼稚CD4+/CD4+T细胞,幼稚CD4+T细胞,CD4+CD28+T细胞,CD8+CD28+T细胞和更高水平的NK细胞,白细胞(WBC),单核细胞,中性粒细胞,嗜酸性粒细胞,嗜碱性粒细胞,单核细胞与淋巴细胞比率(MLR),中性粒细胞与淋巴细胞比率(NLR),嗜酸性粒细胞与淋巴细胞比率(ELR),嗜碱性粒细胞与淋巴细胞比率(BLR),和血小板与淋巴细胞比率(PLR)。
    结论:异常T细胞水平可作为非侵入性早期筛查NSCLC发生和进展的独立预测生物标志物。
    BACKGROUND: Treatment for non-small cell lung cancer (NSCLC) has greatly improved in recent years. However, noninvasive early screening for carcinogenesis and progression unclear. The aim of this study was to explore the predictive value of peripheral blood immune cells in untreated NSCLC patients.
    METHODS: We retrospectively enrolled 305 untreated NSCLC patients and 132 healthy participants from February 2016 to August 2019 in Peking Union Medical College Hospital. Immune cell levels were determined by flow cytometry and routine blood tests.
    RESULTS: NSCLC patients had lower levels of T lymphocytes, NK cells, CD8+ T cells, naïve CD4+/CD4+, naïve CD4+ T cells and higher levels of CD4+ T cells, memory CD4+/CD4+ T cells, memory CD4+ T cells, CD4+CD28+/CD4+ T cells, CD4+CD28+ T cells, CD8+CD28+/CD8+ T cells, CD8+HLA-DR+/CD8+ T cells, CD8+HLA-DR+ T cells T cells, CD8+CD38+/CD8+ T cells, CD8+CD38+ T cells and CD4+/CD8+ T cells than those in controls. The percentages of specific lymphocyte subtypes were significantly different in cancer patients versus healthy individuals. For instance, cancer patients had lower levels of B cells, CD4+ T cells, naïve CD4+/CD4+ T cells, naïve CD4+ T cells, CD4+CD28+ T cells, CD8+CD28+ T cells and higher levels of NK cells, white blood cells (WBC), monocytes, neutrophils, eosinophils, basophils, monocytes to lymphocyte ratio (MLR), neutrophils to lymphocyte ratio (NLR), eosinophil to lymphocyte ratio (ELR), basophil to lymphocyte ratio (BLR), and blood platelet to lymphocyte ratio (PLR).
    CONCLUSIONS: Abnormal T cell levels can be used as an independent predictive biomarker for noninvasive early screening in NSCLC occurrence and progression.
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  • 文章类型: Journal Article
    Cancer among patients with systemic sclerosis (SSc) would appear to be more prevalent than in the general population. Pathophysiological hypotheses are multiple, involving intertwined factors such as immune system antitumoral response, oxygen species dysregulation, and immunosuppressive treatments. We aimed to identify SSc patients with cancer monitored at our center, describing their clinical and immunological characteristics, such as cancer-specific outcomes. We focused in particular on the temporal relationships between cancer onset and SSc diagnosis. A retrospective study was conducted on SSc patients from Montpellier University Hospital from 2003 to 2018. Clinical characteristics and outcomes of each SSc patient with cancer were recorded. Fifty-five patients with SSc and at least one cancer was included (median age 56 years (47-66)), with a median follow-up time of 11 years (4-15). Sixty-four metachronous malignancies were identified (12 patients had two cancers). Among them, early-onset cancer occurrences (±5 years from SSc diagnosis) included 23 cancers (39% breast cancers, 13% lung cancers, and 13% gastro-intestinal tract cancers). Twenty-two cancers occurred 10 years (±5 years) after SSc diagnosis (14% breast cancers, 23% gastrointestinal (GI) tract cancers, and 18% lung cancers). Patients without any of the two autoantibodies (anti-centromere (ACA) and anti-topoisomerase (ATA-scl70) antibodies) were more prevalent in the early-onset cancer subgroup (14 vs. 6, p = 0.02). This study brought to light two peaks of cancer occurrence in SSc patients. Early-onset cancers were associated with SSc with a specific immunological signature. Late-onset cancers might be the consequence of a subtle interplay between repeated target organ inflammation, immunosuppressant use, mesenchymal cell dysfunction and subsequent genetic alterations.
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  • 文章类型: Journal Article
    与普通人群相比,患有肾脏疾病和糖尿病的患者患癌症的风险更高。这项研究的目的是评估透析患者,糖尿病与透析开始后患癌症的风险之间的关联。
    包括2008年至2015年在法国普瓦图-夏朗特地区开始透析的所有患者。他们的基线特征是从法国肾脏流行病学和信息网络中提取的,并使用INSHARE平台开发的程序与Poitou-Charentes普通癌症登记处的癌症发生相关数据相关联。糖尿病与癌症风险之间的关联是使用Fine&Gray模型评估的,该模型考虑了竞争的死亡风险。
    在纳入的1634名患者中,591(36.2%)患有糖尿病,91(5.6%)患者发生癌症(n=24之前或透析开始时,透析开始后n=67)。透析糖尿病患者开始透析后发生癌症的风险低于无糖尿病患者(SHR=0.54;95CI:0.32-0.91)。此外,与普通人群相比,没有糖尿病的透析患者患癌症的风险更高,但不是糖尿病患者。
    在没有糖尿病的透析患者中,Poitou-Charentes地区患癌症的风险高于糖尿病患者。
    The risk of cancer is higher in patients with renal diseases and diabetes compared with the general population. The aim of this study was to assess in dialyzed patients, the association between diabetes and the risk to develop a cancer after dialysis start.
    All patients who started dialysis in the French region of Poitou-Charentes between 2008 and 2015 were included. Their baseline characteristics were extracted from the French Renal Epidemiology and Information Network and were linked to data relative to cancer occurrence from the Poitou-Charentes General Cancer Registry using a procedure developed by the INSHARE platform. The association between diabetes and the risk of cancer was assessed using the Fine & Gray model that takes into account the competing risk of death.
    Among the 1634 patients included, 591 (36.2 %) had diabetes and 91 (5.6 %) patients developed a cancer (n = 24 before or at dialysis start, and n = 67 after dialysis start). The risk to develop a cancer after dialysis initiation was lower in dialyzed patients with diabetes than without diabetes (SHR = 0.54; 95 %CI: 0.32-0.91). Moreover, compared with the general population, the cancer risk was higher in dialyzed patients without diabetes, but not in those with diabetes.
    The risk of developing a cancer in the region of Poitou-Charentes is higher in dialyzed patients without diabetes than with diabetes.
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  • 文章类型: Journal Article
    为了鉴定肿瘤发生的特征基因,模式识别方法用于分析基因甲基化(ME)数据,该数据仅包括正常和癌症样本,并且收集自TCGA(癌症基因组图谱)数据库.这里,我们分析了六种类型癌症的DNA甲基化谱,并通过相关性组合选择了每种癌症的ME特征基因,学生的t检验和弹性网。支持向量机建模,对于训练集,ME签名基因的准确性可高达98%,对于独立测试集,可高达97%,训练集的识别准确率达到97%以上,测试集的识别准确率达到98%以上。然后,获得了多种癌症中出现的共同特征基因和共同通路.对这些标记基因的功能分析表明,鉴定的标记与肿瘤发生有直接关系,对于理解癌症的发病机制和早期治疗非常重要。
    In order to identify the signature genes of tumorigenesis, the pattern-recognition method was used to analyze the gene methylation (ME) data which included only normal and cancer samples and was collected from the TCGA (The Cancer Genome Atlas) database. Here, we analyzed the DNA methylation profiles of the six types of cancer and the ME signature genes for each cancer were selected by means of a combination of correlation, student\'s t-test and Elastic Net. Modeling by support vector machine, the accuracy of ME signature genes can be as high as 98 % for training set and as high as 97 % for the independent test set, the recognition accuracy of stage I is more than 97 % for training set and more than 98 % for test set. Then, the common signature genes and common pathways emerging in multiple cancers were obtained. A functional analysis of these signature genes indicates that the identified signatures have direct relationship with tumorigenesis and is very important for understanding the pathogenesis of cancer and the early therapy.
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  • 文章类型: Journal Article
    DNA nuclease/helicase 2 (DNA2), a multi-functional protein protecting the high fidelity of genomic transmission, plays critical roles in DNA replication and repair processes. In the maturation of Okazaki fragments, DNA2 acts synergistically with other enzymes to cleave the DNA-RNA primer flaps via different pathways. DNA2 is also involved in the stability of mitochondrial DNA and the maintenance of telomeres. Moreover, DNA2 potentially participates in controlling the cell cycle by repairing the DNA replication faults at main checkpoints. In addition, previous evidences demonstrated that DNA2 also functions in the repair process of DNA damages, such as base excision repair (BER). Currently, large studies revealed the structures and functions of DNA2 in prokaryotes and unicellular eukaryotes, such as bacteria and yeast. However, the studies that highlighted the functions of human DNA2 (hDNA2) and the relationships with other multifunctional proteins are still elusive, and more precise investigations are immensely needed. Therefore, this review mainly encompasses the key functions of DNA2 in human cells with various aspects, especially focusing on the genome integrity, and also generalizes the recent insights to the mechanisms related to the occurrence of cancer and other diseases potentially linked to the mutations in DNA2.
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