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Lung metastases in low-risk gestational trophoblastic neoplasia: a retrospective cohort study.

低危妊娠滋养细胞肿瘤肺转移: 一项回顾性队列研究。

  • 影响因子:2.02
  • DOI:10.1111/1471-0528.16036
  • 作者列表:"Frijstein MM","Lok C","van Trommel NE","Ten Kate-Booij MJ","Massuger L","van Werkhoven E","Short D","Aguiar X","Fisher RA","Kaur B","Sarwar N","Sebire NJ","Seckl MJ
  • 发表时间:2020-02-01
Abstract

OBJECTIVE:Presence of lung metastases in low-risk gestational trophoblastic neoplasia (GTN) is generally considered not to influence prognosis. However, in a recent study in the Netherlands, GTN patients with lung metastases had a higher recurrence rate and more disease-specific deaths compared with patients without metastases. The aim of the present study was to validate these findings in a different country. DESIGN:Historical cohort study. SETTING:Charing Cross Hospital, United Kingdom. POPULATION:A total of 1040 low-risk GTN patients treated with methotrexate (MTX) between 2002 and 2016 were identified: 65 with lung metastases (group 1) and 975 without metastases (group 2). METHODS:Baseline characteristics, MTX resistance, survival and recurrence rates were recorded and compared between both groups. MAIN OUTCOME MEASURES:MTX resistance, recurrence rate and survival. RESULTS:The occurrence of MTX resistance and median number of MTX courses to achieve remission was significantly higher in patients with lung metastases than patients without metastases (60% versus 38.9%, P = 0.001; and nine versus six courses, P < 0.001). All choriocarcinoma patients (n = 4) with lung metastases developed MTX resistance. The recurrence rate was also higher in group I (9.2% versus 2.7%; P = 0.012). Disease-specific survival was 100% in both groups. CONCLUSIONS:The presence of lung metastases at the start of MTX therapy is associated with increased incidence of MTX resistance and recurrence in low-risk GTN without affecting overall survival, which remains 100%. However, individuals with low-risk choriocarcinoma with lung metastases are likely to become resistant to MTX and primary multi-agent chemotherapy should be considered. TWEETABLE ABSTRACT:The presence of lung metastases appears to increase the risk of recurrence in low-risk GTN, but does not affect overall cure rates and survival.

摘要

目的: 低危妊娠滋养细胞肿瘤 (GTN) 肺转移通常不影响预后。然而,在荷兰最近的一项研究中,与没有转移的患者相比,GTN肺转移患者具有更高的复发率和更多的疾病特异性死亡。本研究的目的是在不同的国家验证这些发现。 设计: 历史队列研究。 单位: 英国查林十字医院。 人群: 2002 年至 1040 年间,共 2016 例接受甲氨蝶呤 (MTX) 治疗的低危GTN患者被确定为: 65 例肺转移 (组 1) 和 975 无转移 (组 2)。 方法: 记录并比较两组患者的基线特征、MTX耐药性、生存率和复发率。 主要观察指标: MTX耐药性、复发率和生存率。 结果: 肺转移患者MTX耐药的发生率和达到缓解的中位MTX疗程数显著高于无转移患者 (60% 比 38.9%,P = 0.001; 和 9 疗程对 6 疗程,P <0.001)。所有具有肺转移的绒毛膜癌患者 (n = 4) 均发生MTX抗性。I组的复发率也较高 (9.2% 比 2.7%; P = 0.012)。两组的疾病特异性生存率均为 100%。 结论: 在低危GTN中,MTX治疗开始时肺转移的存在与MTX耐药和复发的发生率增加相关,而不影响总生存期 (仍然是 100%)。然而,患有低危绒毛膜癌伴肺转移的个体可能对MTX产生耐药性,应考虑原发性多药化疗。 肺转移的存在似乎增加了低风险GTN的复发风险,但不影响总体治愈率和生存率。

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影响因子:6.93
发表时间:2020-01-15
DOI:10.1002/ijc.32532
作者列表:["Hata A","Nakajima T","Matsusaka K","Fukuyo M","Morimoto J","Yamamoto T","Sakairi Y","Rahmutulla B","Ota S","Wada H","Suzuki H","Matsubara H","Yoshino I","Kaneda A"]

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翻译标题与摘要 下载文献
影响因子:6.93
发表时间:2020-01-01
DOI:10.1002/ijc.32530
作者列表:["Zhang L","Yang Y","Chai L","Bu H","Yang Y","Huang H","Ran J","Zhu Y","Li L","Chen F","Li W"]

METHODS::The role of Fyn-related kinase (FRK) in malignant tumors remains controversial. Our study investigated the function of FRK in lung cancer. Immunohistochemistry staining and generating a knockout of FRK by CRISPR/Cas9 in H1299 (FRK-KO-H1299) cells were strategies used to explore the role of FRK. Immunohistochemistry staining indicated that FRK expression was elevated in 223 lung cancer tissues compared to 26 distant normal lung tissues. FRK contributed to poor survival status in lung cancer patients and acted as a predictor for poor prognosis of lung cancer. Knockout of FRK by CRISPR/Cas9 markedly inhibited proliferation, invasion, colony formation and epithelial-mesenchymal transition (EMT) process in the lung cancer cell line H1299. Further exploration indicated that FRK-KO damaged the stemness phenotype of H1299 by inhibiting CD44 and CD133 expression. Seahorse detection and a U-13 C flux assay revealed that FRK-KO induced metabolism reprogramming by inhibiting the Warburg effect and changing the energy type in H1299 cells. Epidermal growth factor stimulation recovered the expression of FRK and biological functions, metabolic reprogramming and stemness phenotype of H1299 cells. FRK plays an oncogenic role in lung cancer cells via a novel regulation mechanism of enhancing the stemness of H1299 cells by inducing metabolism reprogramming, which finally promotes EMT and metastasis. Our study also indicates that FRK could be used as a potential therapeutic target for drug development.

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肺肿瘤方向

肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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