breast cancers

乳腺癌
  • 文章类型: Journal Article
    乳腺癌是全球主要的公共卫生问题,是女性中最常见的癌症,也是癌症相关死亡的主要原因。最近的研究强调了非组蛋白甲基化在乳腺癌中的意义。调节活动,互动,本地化,和靶蛋白的稳定性。这种调节影响关键过程,如肿瘤发生,肿瘤生长,扩散,入侵,迁移,和免疫反应。这篇综述深入研究了负责非组蛋白甲基化的酶,如蛋白质精氨酸甲基转移酶(PRMT),赖氨酸甲基转移酶(KMT),和去甲基酶,并探讨了它们在乳腺癌中的作用。通过阐明非组蛋白甲基化的分子机制和功能后果,这篇综述旨在提供针对这些途径的新治疗策略的见解。还讨论了靶向非组蛋白甲基化以克服耐药性并增强乳腺癌治疗效果的治疗潜力。突出未来研究和临床应用的有希望的途径。
    Breast cancer is a major public health concern worldwide, being the most commonly diagnosed cancer among women and a leading cause of cancer-related deaths. Recent studies have highlighted the significance of non-histone methylation in breast cancer, which modulates the activity, interaction, localization, and stability of target proteins. This regulation affects critical processes such as oncogenesis, tumor growth, proliferation, invasion, migration, and immune responses. This review delves into the enzymes responsible for non-histone methylation, such as protein arginine methyltransferases (PRMTs), lysine methyltransferases (KMTs), and demethylases, and explores their roles in breast cancer. By elucidating the molecular mechanisms and functional consequences of non-histone methylation, this review aims to provide insights into novel therapeutic strategies targeting these pathways. The therapeutic potential of targeting non-histone methylation to overcome drug resistance and enhance treatment efficacy in breast cancer is also discussed, highlighting promising avenues for future research and clinical applications.
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  • 文章类型: Journal Article
    背景保乳手术具有显著的晚期乳腺癌治疗,提供良好的肿瘤学结果,增强美容效果,降低术后发病率,和更好的心理接受比乳房切除术。新辅助治疗的引入扩大了乳房保护手术的适用性,包括局部晚期肿瘤。肿瘤对新辅助化疗的反应是使用成像方式评估,如乳腺超声,乳腺磁共振成像(MRI),和正电子发射断层扫描/计算机断层扫描(PET/CT)。治疗反应的准确预测有助于手术和辅助治疗的计划。这项研究旨在比较MRI和PET/CT在预测乳腺癌患者对新辅助化疗的治疗反应方面的诊断准确性。方法这项回顾性研究是在巴林的三级护理中心进行的。共有138例局部晚期乳腺癌或人表皮生长因子受体2(HER2)阳性的患者,纳入了在2018年6月至2022年12月期间接受保乳手术的激素受体阴性癌.纳入标准集中在新辅助系统治疗后达到完全病理反应的患者,确保同质的研究人群。激素受体阳性早期乳腺癌或转移性肿瘤患者,不适合新辅助化疗,被排除在外。非应答者和部分应答者也从研究中排除。使用IBMSPSSv26.0(IBMCorp.,Armonk,美国)。评估了成像方式和组织病理学结果的反应率。使用kappa统计量计算组织学和成像模式之间的一致性。使用McNemar测试评估预测“无残留”疾病的诊断性能。所有测试都是双尾的,p值<0.05被认为具有统计学意义。结果本研究共纳入138例患者,其中73人(52.9%)有不完全反应或残留疾病,根据组织学报告,65(47.1%)完全缓解或无残留疾病。新辅助后MRI和组织学结果有轻微的一致性(Cohen’skappa0.172,p=0.010),新辅助后PET/CT与组织学结果基本一致(Cohen’skappa0.614,p=0.000)。PET/CT显示出较高的灵敏度为93.8%(p<0.001)和特异性为68.5%。尽管MRI更具体,PET/CT和MRI的阳性预测值相当.结论PET/CT具有较高的敏感性,可作为预测乳腺癌新辅助术后病理完全缓解的早期指标。然而,通过结合MRI和PET/CT作为诊断模式,可以优化残留疾病的预测。
    Background Breast-conserving surgeries have significantly advanced breast cancer treatment, offering favorable oncological outcomes, enhanced cosmetic results, reduced postoperative morbidity, and better psychological acceptance compared to mastectomy. The introduction of neoadjuvant therapy has expanded the applicability of breast conservation surgery to include locally advanced tumors. Tumor response to neoadjuvant chemotherapy is evaluated using imaging modalities such as breast ultrasound, breast magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT). Accurate prediction of therapeutic response facilitates the planning of surgical and adjuvant treatments. This study aims to compare the diagnostic accuracy of MRI and PET/CT in predicting treatment response to neoadjuvant chemotherapy in breast cancer patients. Methods This retrospective study was conducted at a tertiary care center in Bahrain. A total of 138 patients with locally advanced breast cancer or human epidermal growth factor receptor-2 (HER2) positive, hormone receptor-negative cancers who underwent breast-conserving surgeries between June 2018 and December 2022 were included. The inclusion criteria focused on patients achieving a complete pathological response following neoadjuvant systemic therapy, ensuring a homogenous study population. Patients with hormone receptor-positive early breast cancers or metastatic tumors, ineligible for neoadjuvant chemotherapy, were excluded. Non-responders and partial responders were also excluded from the study. Statistical analysis was performed using IBM SPSS v26.0 (IBM Corp., Armonk, US). Response rates for the imaging modalities and histopathology results were assessed. Agreement between histology and imaging modalities was computed using kappa statistics. Diagnostic performance for predicting \"no residual\" disease was evaluated using the McNemar Test. All tests were two-tailed, with a p-value <0.05 considered statistically significant. Results The study included 138 patients, of whom 73 (52.9%) had an incomplete response or residual disease, while 65 (47.1%) had a complete response or no residual disease according to histology reports. There was slight agreement between post-neoadjuvant MRI and histology results (Cohen\'s kappa 0.172, p=0.010), while substantial agreement was observed between post-neoadjuvant PET/CT and histology results (Cohen\'s kappa 0.614, p=0.000). PET/CT demonstrated a higher sensitivity of 93.8% (p<0.001) and a specificity of 68.5%. Although MRI was more specific, the positive predictive value was comparable for both PET/CT and MRI. Conclusion PET/CT shows higher sensitivity and can serve as an early marker for predicting complete pathological response in post-neoadjuvant breast cancer patients. However, the prediction of residual disease is optimized by combining both MRI and PET/CT as diagnostic modalities.
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  • 文章类型: Journal Article
    目的:雌激素受体阳性(ER+)乳腺癌约占病例的80%,他莫昔芬是选择新辅助化疗。然而,很大比例的患者出现化学耐药性,妥协的恢复。临床证据表明,高血浆水平的低密度脂蛋白(LDL)可以促进癌症进展。本研究分析了LDL对初级血浆活性他莫昔芬代谢产物抗性获得的影响,4-羟基他莫昔芬(4OH-Tam)和4-羟基-N-去甲基-他莫昔芬(endoxifen),乳腺癌ER+细胞(MCF-7)。
    方法:两种抗性细胞变体,MCF-7Var-H和MCF-7Var-I,通过一种新的策略产生,并评估了它们的表型特征。通过MTT测定进行表型评估,细胞术,免疫荧光显微镜,酶谱和蛋白质表达分析。
    结果:MCF-7Var-H,仅由他莫昔芬代谢物产生,显示激素受体的关键下调,增强的迁移能力,金属蛋白酶9胞外介质排泄,和与天然MCF-7相反的间质形态,表明向三阴性乳腺癌(TNBC)表型的转变。相比之下,MCF-7Var-I在高LDL培养基中产生,仅显示ER的轻微上调和其他不太明显的代谢适应。结果表明转录因子核因子红系2相关因子2(Nrf2)在变体之间观察到的表型差异中的潜在作用。
    结论:在他莫昔芬代谢产物化学抗性获取过程中,高或低浓度的LDL会导致与化学抗性相关的不同细胞机制。可能涉及与Nrf2活性相关的新型适应性细胞应答。
    OBJECTIVE: Estrogen receptor-positive (ER+) breast cancer represents about 80% of cases, tamoxifen is the election neoadjuvant chemotherapy. However, a large percentage of patients develop chemoresistance, compromising recovery. Clinical evidence suggests that high plasmatic levels of low-density lipoproteins (LDL) could promote cancer progression. The present study analyzed the effect of LDL on the primary plasmatic active Tamoxifen\'s metabolites resistance acquisition, 4-hydroxytamoxifen (4OH-Tam) and 4-hydroxy-N-desmethyl-tamoxifen (endoxifen), in breast cancer ERα + cells (MCF-7).
    METHODS: Two resistant cellular variants, MCF-7Var-H and MCF-7Var-I, were generated by a novel strategy and their phenotype features were evaluated. Phenotypic assessment was performed by MTT assays, cytometry, immunofluorescence microscopy, zymography and protein expression analysis.
    RESULTS: MCF-7Var-H, generated only with tamoxifen metabolites, showed a critical down-regulation in hormone receptors, augmented migration capacity, metalloprotease 9 extracellular medium excretion, and a mesenchymal morphology in contrast with native MCF-7, suggesting the transition towards Triple-negative breast cancer (TNBC) phenotype. In contrast, MCF-7Var-I which was generated in a high LDL media, showed only a slight upregulation in ER and other less noticeable metabolic adaptations. Results suggest a potential role of transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) in phenotypic differences observed among variants.
    CONCLUSIONS: LDL high or low concentrations during Tamoxifen´s metabolites chemoresistance acquisition leads to different cellular mechanisms related to chemoresistance. A novel adaptative cellular response associated with Nrf2 activity could be implicated.
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  • 文章类型: Journal Article
    多基因面板可以分析易患乳腺癌(BC)的高和中/中等外显基因,提供识别受影响家庭中处于危险中的个人的机会。然而,考虑到不同致病变异的复杂性和相关的临床表现,需要一个多学科团队来有效管理BC.在这篇叙述性综述中介绍了多基因组中包含的致病变异的分类,以评估其在BC中的临床应用。讨论了每个类别的临床管理,重点是BC,包括关于BC患者的多学科和综合管理的现有证据。基因检测和咨询的整合需要在治疗策略和预防措施的定制决策,以及定义的多学科方法,考虑到该领域指导方针和研究的不断发展。
    Multigene panels can analyze high and moderate/intermediate penetrance genes that predispose to breast cancer (BC), providing an opportunity to identify at-risk individuals within affected families. However, considering the complexity of different pathogenic variants and correlated clinical manifestations, a multidisciplinary team is needed to effectively manage BC. A classification of pathogenic variants included in multigene panels was presented in this narrative review to evaluate their clinical utility in BC. Clinical management was discussed for each category and focused on BC, including available evidence regarding the multidisciplinary and integrated management of patients with BC. The integration of both genetic testing and counseling is required for customized decisions in therapeutic strategies and preventative initiatives, as well as for a defined multidisciplinary approach, considering the continuous evolution of guidelines and research in the field.
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  • 文章类型: Journal Article
    肿瘤相关巨噬细胞(TAMs)是乳腺肿瘤微环境中的关键因素。CD163和CD206已用于TAM识别,但通过这些标记物鉴定的TAM的临床意义尚未得到彻底探索.本研究使用数字图像分析对CD163和CD206TAM进行了比较分析,重点关注它们与肿瘤浸润淋巴细胞(TIL)相关的空间分布和预后意义。两种类型的TAM之间有明显的临床病理和预后特征。CD163TAM与高级别肿瘤相关(p=0.006),而CD206TAM与淋巴结转移的发生率较高相关(p=0.033)。CD206TAM主要存在于基质中,基质CD206高(sCD206高)的病例多于肿瘤CD206高(tCD206高)(p=0.024)。关于预测,根据CD163的基质和肿瘤密度分层的患者显示出不同的无病生存期(DFS)。具体来说,sCD163低但tCD163高的DFS最差(卡方=10.853,p=0.013).此外,高sCD163与基质TILs的比值被认为是不良生存结局的独立预测因子(DFS:HR=3.477,p=0.018).与TIL的空间分布和相互作用增强了CD163TAM的预后价值,而CD206TAM在乳腺癌病例中似乎具有有限的预后效用。
    Tumor-associated macrophages (TAMs) is a key element in the breast tumor microenvironment. CD163 and CD206 have been utilized for TAM identification, but the clinical implications of TAMs identified by these markers have not been thoroughly explored. This study conducted a comparative analysis of CD163 and CD206 TAMs using digital image analysis, focusing on their spatial distribution and prognostic significance in relation to tumor-infiltrating lymphocytes (TILs). Distinct clinico-pathological and prognostic characteristics were noted between the two types of TAMs. CD163 TAMs were linked to high-grade tumors (p = 0.006), whereas CD206 TAMs were associated with a higher incidence of nodal metastasis (p = 0.033). CD206 TAMs were predominantly found in the stroma, with more cases being stromal CD206-high (sCD206-high) than tumoral CD206-high (tCD206-high) (p = 0.024). Regarding prognostication, patients stratified according to stromal and tumoral densities of CD163 showed different disease-free survival (DFS) time. Specifically, those that were sCD163-low but tCD163-high exhibited the poorest DFS (chi-square = 10.853, p = 0.013). Furthermore, a high sCD163-to-stromal-TILs ratio was identified as an independent predictor of unfavorable survival outcomes (DFS: HR = 3.477, p = 0.018). The spatial distribution and interactions with TILs enhanced the prognostic value of CD163 TAMs, while CD206 TAMs appeared to have limited prognostic utility in breast cancer cases.
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  • 文章类型: Journal Article
    乳腺癌(BC)是由由癌细胞和不断变化的肿瘤微环境(TME)组成的异质组织组成的实体瘤。TME包括,在其他非癌细胞类型中,影响癌组织免疫环境的免疫细胞。特别是,免疫细胞的串扰及其与癌细胞的相互作用会极大地影响BC的传播,免疫编辑,以及癌症治疗的结果。肿瘤浸润淋巴细胞(TIL),肿瘤相关巨噬细胞(TAMs),和骨髓来源的抑制细胞(MDSCs)代表了乳腺TME的主要免疫细胞群体,它们在癌症免疫逃逸和传播中具有重要作用。因此,在这篇文章中,我们回顾了TIL的特点,TAM,和BCs中的MDSCs。此外,我们强调了这些免疫细胞重塑免疫TME并导致乳腺癌转移的机制。
    Breast cancers (BCs) are solid tumors composed of heterogeneous tissues consisting of cancer cells and an ever-changing tumor microenvironment (TME). The TME includes, among other non-cancer cell types, immune cells influencing the immune context of cancer tissues. In particular, the cross talk of immune cells and their interactions with cancer cells dramatically influence BC dissemination, immunoediting, and the outcomes of cancer therapies. Tumor-infiltrating lymphocytes (TILs), tumor-associated macrophages (TAMs), and myeloid-derived suppressor cells (MDSCs) represent prominent immune cell populations of breast TMEs, and they have important roles in cancer immunoescape and dissemination. Therefore, in this article we review the features of TILs, TAMs, and MDSCs in BCs. Moreover, we highlight the mechanisms by which these immune cells remodel the immune TME and lead to breast cancer metastasis.
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  • 文章类型: Journal Article
    除了主要的皮下和内脏脂肪组织(AT),其他脂肪库分散在整个身体,并发现与近端器官如乳腺和前列腺周围的AT(分别为MAT和PPAT)密切相互作用。这些ATs在生理过程和诸如癌症的疾病期间对近端器官功能有影响。我们在这里强调了它们在组织组织和对外部刺激的反应方面的一些最鲜明的特征,并根据我们目前的知识讨论了肥胖如何影响它们。
    In addition to the major subcutaneous and visceral adipose tissues (AT), other adipose depots are dispersed throughout the body and are found in close interaction with proximal organs such as mammary and periprostatic AT (MAT and PPAT respectively). These ATs have an effect on proximal organ function during physiological processes and diseases such as cancer. We highlighted here some of their most distinctive features in terms of tissular organization and responses to external stimuli and discussed how obesity affects them based on our current knowledge.
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  • 文章类型: Retraction of Publication
    暂无摘要。
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  • 文章类型: Journal Article
    背景和目的:本研究旨在探讨NAC(新辅助化疗)后生物标志物的变化,并研究NAC后残留病(RD)患者的生物标志物表达作为预后因素的影响因素。材料和方法:我们回顾性评估104例浸润性乳腺癌患者,从2015年到2022年7月,他在釜山国立大学医院接受了NAC和手术。评估了生物标志物的表达,研究总生存期(OS)和无病生存期(DFS)。结果:NAC后,104例患者中有24例(23.1%)具有病理完全缓解(pCR)。我们发现,在41例患者(51.2%)中观察到至少一种生物标志物的变化,在80例RD患者中。在NAC后RD的患者中(n=80),20例患者(25.0%)出现亚型改变.任何类型的HER2状态的变化存在19(23.7%)患者。激素受体(HR)+/HER2+亚型与更好的无病生存期(DFS)(HR,0.13;95%CI,0.02-0.99;p=0.049)。p53的变化与更好的DFS相关,NAC后p53表达的阴性-阳性变化与DFS恶化相关(p<0.001)。p53的阴性到阳性变化是一个独立的,多变量分析中较差的DFS因素(HR,18.44;95%CI,1.86-182.97;p=0.013)。结论:NAC后的生物标志物变化和亚型变化并非罕见,这可能会影响手术后的进一步治疗策略。p53的表达变化可能具有预后作用。总的来说,我们建议,NAC后对生物标志物的重新评估可以提供预后作用,并且需要对进一步治疗做出最佳决定.
    Background and Objectives: This study aimed to explore biomarker change after NAC (neoadjuvant chemotherapy) and to investigate biomarker expression as a prognostic factor in patients with residual disease (RD) after NAC. Materials and Methods: We retrospectively evaluated 104 patients with invasive breast cancer, who underwent NAC and surgery at Pusan National University Hospital from 2015 to July 2022. The expression of the biomarker was assessed, and the overall survival (OS) and disease-free survival (DFS) were investigated. Results: After NAC, 24 patients (23.1%) out of 104 total patients had a pathological complete response (pCR). We found that changes in at least one biomarker were observed in 41 patients (51.2%), among 80 patients with RD. In patients with RD after NAC (n = 80), a subtype change was identified in 20 patients (25.0%). Any kind of change in the HER2 status was present 19 (23.7%) patients. The hormone receptor (HR)+/HER2+ subtype was significantly associated with better disease-free survival (DFS) (HR, 0.13; 95% CI, 0.02-0.99; p = 0.049). No change in p53 was associated with better DFS, and negative-to-positive change in p53 expression after NAC was correlated with worse DFS (p < 0.001). Negative-to-positive change in p53 was an independent, worse DFS factor in the multivariate analysis (HR,18.44; 95% CI, 1.86-182.97; p = 0.013). Conclusions: Biomarker change and subtype change after NAC were not infrequent, which can affect the further treatment strategy after surgery. The expression change of p53 might have a prognostic role. Overall, we suggest that the re-evaluation of biomarkers after NAC can provide a prognostic role and is needed for the best decision to be made on further treatment.
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  • 文章类型: Journal Article
    乳腺癌是威胁女性健康的最常见癌症之一。我们之前的研究发现水飞蓟宾诱导MCF-7和MDA-MB-231人乳腺癌细胞死亡。我们注意到水飞蓟宾诱导的细胞损伤伴随着形态学变化,包括增加的细胞纵横比(细胞长度/宽度)和减少的细胞面积。此外,在用水飞蓟宾处理的细胞中,细胞骨架也被破坏。YAP/TAZ,与细胞外压力相互作用的机械信号传感器,细胞粘附面积和细胞骨架,也与细胞存活密切相关,扩散和迁移。因此,YAP/TAZ参与水飞蓟宾在乳腺癌细胞中的细胞毒性引起了我们的兴趣。令人兴奋的是,我们发现水飞蓟宾在MCF-7和MDA-MB-231细胞中抑制YAP/TAZ的核转位,并降低YAP/TAZ靶基因的mRNA表达,ACVR1、MnSOD和ANKRD。更重要的是,YAP1基因的表达与乳腺癌患者的生存率呈负相关。分子对接分析揭示了水飞蓟宾与YAP途径中的蛋白质结合的高概率。DARTS和CETSA结果证实了水飞蓟宾对YAP和LATS的结合能力。通过添加维替泊芬抑制YAP途径,YAP/TAZ-TEAD抑制剂,或通过转染靶向YAP或TAZ的si-RNA进一步增强水飞蓟宾诱导的细胞损伤。在通过沉默LATS1/2或过表达YAPS127/397A增强YAP活性的同时,YAP的一种活跃形式,减弱水飞蓟宾诱导的细胞损伤。这些发现表明,YAP/TAZ途径的抑制有助于乳腺癌中水飞蓟宾的细胞毒性,YAP/TAZ靶向癌症治疗的启示。
    Breast cancer is one of the most common cancers threatening women\'s health. Our previous study found that silibinin induced the death of MCF-7 and MDA-MB-231 human breast cancer cells. We noticed that silibinin-induced cell damage was accompanied by morphological changes, including the increased cell aspect ratio (cell length/width) and decreased cell area. Besides, the cytoskeleton is also destroyed in cells treated with silibinin. YAP/TAZ, a mechanical signal sensor interacted with extracellular pressure, cell adhesion area and cytoskeleton, is also closely associated with cell survival, proliferation and migration. Thus, the involvement of YAP/TAZ in the cytotoxicity of silibinin in breast cancer cells has attracted our interests. Excitingly, we find that silibinin inhibits the nuclear translocation of YAP/TAZ in MCF-7 and MDA-MB-231 cells, and reduces the mRNA expressions of YAP/TAZ target genes, ACVR1, MnSOD and ANKRD. More importantly, expression of YAP1 gene is negatively correlated with the survival of the patients with breast cancers. Molecular docking analysis reveals high probabilities for binding of silibinin to the proteins in the YAP pathways. DARTS and CETSA results confirm the binding abilities of silibinin to YAP and LATS. Inhibiting YAP pathway either by addition of verteporfin, an inhibitor of YAP/TAZ-TEAD, or by transfection of si-RNAs targeting YAP or TAZ further enhances silibinin-induced cell damage. While enhancing YAP activity by silencing LATS1/2 or overexpressing YAPS127/397A, an active form of YAP, attenuates silibinin-induced cell damage. These findings demonstrate that inhibition of the YAP/TAZ pathway contributes to cytotoxicity of silibinin in breast cancers, shedding lights on YAP/TAZ-targeted cancer therapies.
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