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Tang H, Lu Q, Feng S, Xiao Z, Wu W, Chen G, Deng L, Yu T, Wu J, Lin H, Ji B, Lin J, Zhang C, Li L, Liu T, Ouyang Y, Lei K, Chen J, Peng W, Qiu Z, Cai Q, Liang Q, Liu C, Li Y, Zhu L, Zhang Z, Liu X, Lin L, Zheng Z. Guidelines for the clinical application of the Xihuang pill for the prevention and treatment of breast hyperplasia diseases. PHARMACEUTICAL BIOLOGY 2024; 62:472-479. [PMID: 38769628 PMCID: PMC11110870 DOI: 10.1080/13880209.2024.2350233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
CONTEXT The Xihuang pill (XHP) is a traditional Chinese medicine formulation that has been historically used in the prevention and treatment of proliferative breast diseases. However, there is a lack of guidelines that offer recommendations for its clinical use. OBJECTIVE The task force from the Chinese Guangdong Pharmaceutical Association aims to develop evidence-based guidelines for XHP to prevent and treat proliferative breast diseases. METHODS We searched six Chinese and English electronic databases, including the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Wanfang Medical Database, PubMed, and Embase, up to November 1, 2022. Publications (case reports, clinical observation, clinical trials, reviews) on using XHP to treat proliferative breast diseases were manually searched. The search terms were Xihuang pill, hyperplasia of the mammary gland, breast lump, and mastalgia. The writing team developed recommendations based on the best available evidence. RESULTS Treatment should be customized based on syndrome identification. We recommend using XHP for the prevention and treatment of breast hyperplasia disease when a patient presents the following syndromes: concurrent blood stasis syndrome, concurrent phlegm-stasis syndrome, and concurrent liver fire syndrome. Safety indicators, including blood analysis and liver and kidney function monitoring, should be performed regularly during treatment. CONCLUSIONS Current clinical evidence suggests that XHP can be used as a standalone treatment or in conjunction with other medications to prevent and manage breast hyperplasia diseases. More randomized controlled studies are warranted to establish high-quality evidence of its use.
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Affiliation(s)
- Hongmei Tang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qin Lu
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiyin Feng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhiwei Xiao
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanyin Wu
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Gaofeng Chen
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Li Deng
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianqi Yu
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyan Wu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hua Lin
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Bo Ji
- Chinese PLA General Hospital of Southern Theater Command, Guangzhou, China
| | - Jietao Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chengguang Zhang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Liming Li
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tao Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong Ouyang
- Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China
| | - Kaijun Lei
- Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Jun Chen
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Weiwen Peng
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Zhenwen Qiu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qingqun Cai
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Liang
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Cuiling Liu
- Shenzhen Bao’an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Yuzhen Li
- The Eighth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lixia Zhu
- The Eighth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zexin Zhang
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xueting Liu
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lizhu Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhihua Zheng
- Guangdong Pharmaceutical Association, Guangzhou, China
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Wang L, Wei W, Cai M. A Review of the Risk Factors Associated with Endometrial Hyperplasia During Perimenopause. Int J Womens Health 2024; 16:1475-1482. [PMID: 39281324 PMCID: PMC11397258 DOI: 10.2147/ijwh.s481509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/02/2024] [Indexed: 09/18/2024] Open
Abstract
Background Endometrial hyperplasia, characterized by excessive growth leading to endometrial thickening, is commonly observed in the premenopausal period. Its prevalence in postmenopausal women is approximately 15%, peaking between ages 50 and 60. This condition often manifests as abnormal uterine bleeding and can progress to malignancy, with varying risks depending on the type of hyperplasia. Purpose This study aims to investigate the factors influencing endometrial thickness during the perimenopausal period and raise awareness among healthcare professionals about the importance of evaluating and caring for individuals with endometrial hyperplasia. Methods Studies examining the association between various factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, genetic factors, and endocrine-related proteins and the development of endometrial hyperplasia were reviewed. The literature search encompassed relevant databases, including PubMed, Scopus, and Web of Science. Results Research findings indicate significant associations between changes in gene expression of several factors and the development of endometrial hyperplasia. Notably, the risk of progression to cancer varies between non-atypical and atypical hyperplasia cases. Factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, Lynch syndrome, tamoxifen use, and alterations in gene expression of TNF-α, EGF, IGF-1, IGF-1R, and PTEN have been implicated in the pathogenesis of endometrial hyperplasia. Conclusion This study underscores the importance of understanding the factors influencing endometrial thickness during the perimenopausal period. It emphasizes the pivotal role of healthcare professionals in evaluating and caring for individuals with this condition.
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Affiliation(s)
- Lianping Wang
- Nursing Department, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People's Republic of China
| | - Wengong Wei
- Department of Obstetrics and Gynecology, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People's Republic of China
| | - Meiling Cai
- Department of Obstetrics and Gynecology, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People's Republic of China
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Song X, Shen L, Contreras JM, Liu Z, Ma K, Ma B, Liu X, Wang DO. New potential selective estrogen receptor modulators in traditional Chinese medicine for treating menopausal syndrome. Phytother Res 2024. [PMID: 39120263 DOI: 10.1002/ptr.8289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/19/2024] [Accepted: 06/23/2024] [Indexed: 08/10/2024]
Abstract
Women go through several predictable conditions and symptoms during menopause that are caused by age, changes in sex hormone levels, and other factors. Conventional menopause hormone therapy has raised serious concerns about the increased risks of cancers, blood clots, depression, etc. Selective estrogen receptor modulators (SERMs) that can be both agonists and antagonists of estrogen receptors in a tissue-specific manner are being developed to reduce the health concerns associated with menopause hormone therapy. Here, we have searched the Chinese national traditional Chinese medicine (TCM) patent database to identify potential SERM-like compounds with reduced health risks. TCM has been widely used for treating complex symptoms associated with menopause syndrome and thus can be a particularly rich source for pharmaceutical alternatives with SERM properties. After extensive literature review and molecular simulation, we conclude that protopanaxatriol, paeoniflorin, astragalin, catalpol, and hyperoside among others may be particularly promising as SERM-like compounds in treating the menopausal syndrome. Compounds in TCM hold promise in yielding comparable outcomes to hormone therapy but with reduced associated risks, thus presenting promising avenues for their clinical applications.
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Affiliation(s)
- Xintong Song
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
| | - Lan Shen
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
| | | | - Zhiyuan Liu
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
| | - Kai Ma
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
| | - Biao Ma
- RIKEN Center for Computational Science, Kobe, Japan
| | - Xiaoling Liu
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
| | - Dan Ohtan Wang
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, China
- Biology Program, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Vitale SG, Angioni S, D'Alterio MN, Ronsini C, Saponara S, De Franciscis P, Riemma G. Risk of endometrial malignancy in women treated for breast cancer: the BLUSH prediction model - evidence from a comprehensive multicentric retrospective cohort study. Climacteric 2024:1-7. [PMID: 39023103 DOI: 10.1080/13697137.2024.2376189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/30/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE This study aimed to evaluate characteristics of endometrial surveillance in women treated for breast cancer to build a clinical prediction model. DESIGN A multicentric retrospective cohort study was conducted at two tertiary-care university hospitals from January 2020 to June 2023. Perimenopausal and postmenopausal women treated for breast cancer were categorized into two groups: patients with and without diagnosis of endometrial malignancy (endometrial carcinoma) or premalignancy (atypical endometrial hyperplasia). Characteristics of breast cancer and ultrasonographic and hysteroscopic examinations were compared. A prediction model for endometrial malignancy was built using logistic regression. Predictive accuracy was assessed using the receiver operating characteristic (ROC) curve and goodness of fit using the Hosmer-Lemeshow test. RESULTS One hundred and thirty-two (28 with premalignancy or malignancy and 104 without malignancy) women were analyzed. A nomogram was produced for prediction model development utilizing the presence and duration in months of abnormal uterine (BL)eeding, ultrasound (US) vascular pattern and echogenicity and (H)ysteroscopic appearance of endometrium (BLUSH) as determined by logistic regression. Sensitivity and specificity were 79.17% and 95.19%, respectively, with an area under ROC curve of 0.965, indicating good accuracy. Good goodness of fit and prediction stability were indicated by the calibration curve and Hosmer-Lemeshow test (χ2 = 26.36; p = 0.999). CONCLUSIONS Breast cancer survivors undergoing endometrial surveillance might benefit from a potentially useful prediction model based on hysteroscopic appearance, ultrasonographic uniformity of endometrium, Doppler flow and presence of abnormal uterine bleeding.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Stefano Angioni
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Maurizio Nicola D'Alterio
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Carlo Ronsini
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Stefania Saponara
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Pasquale De Franciscis
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gaetano Riemma
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
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He Z, Xing L, He M, Sun Y, Xu J, Zhuang H, Guo R, Chen H, Wu K, Dong Q, Yin G, Zhang J, Yu S, Wang X, Zhao R, Qin D. Best acupuncture method for mammary gland hyperplasia: Evaluation of randomized controlled trials and Bayesian network meta-analysis. Heliyon 2024; 10:e28831. [PMID: 38638998 PMCID: PMC11024574 DOI: 10.1016/j.heliyon.2024.e28831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
Objective To evaluate the effectiveness of different acupuncture treatments for mammary gland hyperplasia (MGH) using a network meta-analysis. Methods Several databases were searched without language restrictions from 2000 to February 2023, including PubMed, Embase, Web of Science, Cochrane Library, China Science and Technology Journal Database, China Biology Medicine Database, Wanfang Database, China National Knowledge Infrastructure Database, and other professional websites and gray literature. Inclusion criteria were adult women diagnosed with MGH; intervention measures included acupuncture and related therapies; the control group was treated with simple drugs; and the research type was a randomized controlled trial (RCT). The primary outcomes were treatment effectiveness and estradiol and progesterone levels. Secondary outcomes were breast lump size and visual analog scale (VAS) score of breast pain. Exclusion criteria were studies unrelated to MGH, incorrect study populations, control measures or interventions, incomplete data, non-RCTs, case reports, and animal experiments. Cochrane tools were used to assess the risk of bias. The R software (x64 version 4.2.1), Review Manager 5.3 software and STATA 16.0 software were used for data analysis. Results Following a rigorous screening process, data extraction, and quality assessment, 48 eligible RCTs encompassing 4,500 patients with MGH and 16 interventions were included. The results indicated that acupuncture, alone or in combination with traditional Chinese or Western medicine, had better therapeutic effects than conventional therapy. In terms of effectiveness, warm needle acupuncture was the best choice (94.6%). Bloodletting pricking was the most effective method (85.7%) for lowering progesterone levels. Bloodletting pricking was the most effective method (98.3%) for lowering estradiol levels. Manual acupuncture combined with traditional Chinese medicine was the most effective (74.5%) treatment to improve the size of the breast lump. Warm needle acupuncture was the most effective (69.8%) in improving the VAS score. Conclusion Acupuncture therapy was more effective in treating MGH than drug therapy alone, and warm needle acupuncture and bloodletting pricking were the two best options. However, larger sample sizes and high-quality RCTs are required.
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Affiliation(s)
- Zhe He
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Liwei Xing
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Ming He
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Yuhuan Sun
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Jinlong Xu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Haina Zhuang
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Rui Guo
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Hongxi Chen
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Kenan Wu
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Qinzuo Dong
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Guochen Yin
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Junbao Zhang
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Shun Yu
- The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Xiaoyan Wang
- Department of Acupuncture and Moxibustion, Yuxi Traditional Chinese Medicine Hospital, 53 North Nie er Road, 653100, Yuxi, China
| | - Rong Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, No. 1076 Yuhua Road, Chenggong District, 650500, Kunming, China
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Dannehl D, von Au A, Engler T, Volmer LL, Gutsfeld R, Englisch JF, Hahn M, Hawighorst-Knapstein S, Chaudhuri A, Bauer A, Wallwiener M, Taran FA, Wallwiener D, Brucker SY, Wallwiener S, Hartkopf AD, Dijkstra TMH. Implementation and Evaluation of a Breast Cancer Disease Model Using Real-World Claims Data in Germany from 2010 to 2020. Cancers (Basel) 2024; 16:1490. [PMID: 38672572 PMCID: PMC11049278 DOI: 10.3390/cancers16081490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Breast cancer is the leading cause of cancer-related mortality among women in Germany and worldwide. This retrospective claims data analysis utilizing data from AOK Baden-Wuerttemberg, a major statutory German health insurance provider, aimed to construct and assess a real-world data breast cancer disease model. The study included 27,869 female breast cancer patients and 55,738 age-matched controls, analyzing data from 2010 to 2020. Three distinct breast cancer stages were analyzed: Stage A (early breast cancer without lymph node involvement), Stage B (early breast cancer with lymph node involvement), and Stage C (primary distant metastatic breast cancer). Tumor subtypes were estimated based on the prescription of antihormonal or HER2-targeted therapy. The study established that 77.9% of patients had HR+ breast cancer and 9.8% HER2+; HR+/HER2- was the most common subtype (70.9%). Overall survival (OS) analysis demonstrated significantly lower survival rates for stages B and C than for controls, with 5-year OS rates ranging from 79.3% for stage B to 35.4% for stage C. OS rates were further stratified by tumor subtype and stage, revealing varying prognoses. Distant recurrence-free survival (DRFS) analysis showed higher recurrence rates in stage B than in stage A, with HR-/HER2- displaying the worst DRFS. This study, the first to model breast cancer subtypes, stages, and outcomes using German claims data, provides valuable insights into real-world breast cancer epidemiology and demonstrates that this breast cancer disease model has the potential to be representative of treatment outcomes.
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Affiliation(s)
- Dominik Dannehl
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Alexandra von Au
- Department of Gynecology and Obstetrics, Heidelberg University, 69120 Heidelberg, Germany;
| | - Tobias Engler
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Léa Louise Volmer
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Raphael Gutsfeld
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Johannes Felix Englisch
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Markus Hahn
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | | | - Ariane Chaudhuri
- AOK Baden-Wuerttemberg, 70188 Stuttgart, Germany; (S.H.-K.); (A.C.)
| | - Armin Bauer
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | | | - Florin-Andrei Taran
- Department of Gynecology and Obstetrics, Freiburg University, 79106 Freiburg im Breisgau, Germany;
| | - Diethelm Wallwiener
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Sara Yvonne Brucker
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Stephanie Wallwiener
- Department of Obstetrics and Perinatal Medicine, Halle University, 06120 Halle, Germany;
| | - Andreas Daniel Hartkopf
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
| | - Tjeerd Maarten Hein Dijkstra
- Department of Women’s Health, Tübingen University, 72076 Tübingen, Germany; (T.E.); (R.G.); (J.F.E.); (M.H.); (A.B.); (D.W.); (S.Y.B.); (A.D.H.); (T.M.H.D.)
- Institute for Translational Bioinformatics, University Hospital Tübingen, 72076 Tübingen, Germany
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Pleasant V. Gynecologic Care of Black Breast Cancer Survivors. CURRENT BREAST CANCER REPORTS 2024; 16:84-97. [PMID: 38725438 PMCID: PMC11081127 DOI: 10.1007/s12609-024-00527-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 05/12/2024]
Abstract
Purpose of Review Black patients suffer from breast cancer-related racial health disparities, which could have implications on their gynecologic care. This review explores considerations in the gynecologic care of Black breast cancer survivors. Recent Findings Black people have a higher risk of leiomyoma and endometrial cancer, which could confound bleeding patterns such as in the setting of tamoxifen use. As Black people are more likely to have early-onset breast cancer, this may have implications on long-term bone and heart health. Black patients may be more likely to have menopausal symptoms at baseline and as a result of breast cancer treatment. Furthermore, Black patients are less likely to utilize assisted reproductive technology and genetic testing services. Summary It is important for healthcare providers to be well-versed in the intersections of breast cancer and gynecologic care. Black breast cancer survivors may have unique considerations for which practitioners should be knowledgeable.
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Affiliation(s)
- Versha Pleasant
- University of Michigan Hospital, Mott Children & Women’s Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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8
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Tian Z, Zhao M, Sui X, Li X, Qin L, Chen ZJ, Zhao S, Zhao H. Associations between vaginal microbiota and endometrial polypoid lesions in women of reproductive age: a cross-sectional study. Reprod Biomed Online 2024; 48:103602. [PMID: 38101145 DOI: 10.1016/j.rbmo.2023.103602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/04/2023] [Accepted: 10/03/2023] [Indexed: 12/17/2023]
Abstract
RESEARCH QUESTION What are the different characteristics of vaginal microbial composition between patients with endometrial polypoid lesions and controls? DESIGN This cohort study compared the pre-operative microbial compositions of vaginal samples in a cohort of 703 women with endometrial polypoid lesions [293 and 410 women diagnosed and not diagnosed with polyps pathologically (polyps group and not-polyps group, respectively] and 703 women in the control group. Bacterial abundance, diversity, differential taxa and microbial network structure were assessed using 16S rRNA gene sequencing. Predictive algorithms were used to determine the functional pathways of vaginal microbiota within the cohort. RESULTS The control group exhibited higher relative abundance of Lactobacillus crispatus in comparison with the polypoid lesions group (P = 0.0427). Beta diversity of vaginal microbiota differed significantly between the groups (P < 0.05). Comparing the polyps group with the not-polyps group, Leptotrichia spp. and Cutibacterium spp. were more abundant in the polyps group, and Fannyhessea spp., Acinetobacter spp. and Achromobacter spp. were more abundant in the not-polyps group. The control group exhibited higher abundance of Bifidobacterium spp., Achromobacter spp. and Escherichia/Shigella spp. (false discovery rate < 0.05). Furthermore, the polyps group and not-polyps group displayed more complex co-occurrence networks compared with the control group. CONCLUSIONS The results of this study provide compelling evidence supporting associations between vaginal microbiota and endometrial polypoid lesions, highlighting the potential relationship between a well-balanced vaginal microbial ecosystem and a healthy intrauterine environment.
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Affiliation(s)
- Zhaomei Tian
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Maoning Zhao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Xinlei Sui
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Xiao Li
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Lang Qin
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Zi-Jiang Chen
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China; Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, Shandong, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China; Centre for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shigang Zhao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China; Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, Shandong, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Han Zhao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China; Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, Shandong, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China.
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9
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Khamis AA, Ali EMM, Salim EI, El-Moneim MAA. Synergistic effects of bee venom, hesperidin, and piperine with tamoxifen on apoptotic and angiogenesis biomarker molecules against xerographic MCF-7 injected rats. Sci Rep 2024; 14:1510. [PMID: 38233443 PMCID: PMC10794414 DOI: 10.1038/s41598-023-50729-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/23/2023] [Indexed: 01/19/2024] Open
Abstract
Breast cancer ranks as the second leading most significant of mortality for women. Studies have demonstrated the potential benefits of natural compounds in cancer treatment and prevention, either in isolation or in conjunction with chemotherapy. In order to improve Tamoxifen's therapeutic efficacy in in-vivo studies, our research sought to determine the effects of hesperidin, piperine, and bee venom as natural compounds, as well as their combination effect with or without Tamoxifen. First, 132 female albino rats were equally divided into six groups and five subgroups, and breast cancer was induced in the selected groups by xenografting of MCF7 cells. Second, the effect of single and best ratio combinations treatment from previous in vitro studies were selected. Next, tumorous mammary glands were collected for apoptotic and antiapoptotic biomarkers and cell cycle analysis. Single or combined natural products with or without Tamoxifen revealed a significant up-regulation in apoptotic genes Bax and Casp3 and a downregulation of antiapoptotic and angiogenesis genes Bcl-2 and VEGF genes. We found that cell cycle arrest in the G0/G1 phase was exclusively caused by Tamoxifen and/ or hesperidin. However, the cell cycle arrest in the G2/M phase is a result of the combination of piperine and bee venom, with or without Tamoxifen by using the flow cytometric technique. Our research concludes that bee venom, hesperidin, and piperine can synergistically enhance to increase Tamoxifen's efficiency in the management of breast cancer.
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Affiliation(s)
- Abeer A Khamis
- Biochemistry Division, Chemistry Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt.
| | - Ehab M M Ali
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
- Chemistry Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Elsayed I Salim
- Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Mohamed A Abd El-Moneim
- Biochemistry Department, Faculty of Dentistry, Sinai University, Al-Arish, North Sinai, Egypt
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10
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Sorouri K, Lynce F, Feltmate CM, Davis MR, Muto MG, Konstantinopoulos PA, Stover EH, Kurian AW, Hill SJ, Partridge AH, Tolaney SM, Garber JE, Bychkovsky BL. Endometrial Cancer Risk Among Germline BRCA1/ 2 Pathogenic Variant Carriers: Review of Our Current Understanding and Next Steps. JCO Precis Oncol 2023; 7:e2300290. [PMID: 38061009 PMCID: PMC10715772 DOI: 10.1200/po.23.00290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/02/2023] [Accepted: 09/14/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE To review the literature exploring endometrial cancer (EC) risk among surgical candidates with germline BRCA1/2 pathogenic variants (PVs) to guide decisions around risk-reducing (rr) hysterectomy in this population. DESIGN A comprehensive review was conducted of the current literature that influences clinical practice and informs expert consensus. We present our understanding of EC risk among BRCA1/2 PV carriers, the risk-modifying factors specific to this patient population, and the available research technology that may guide clinical practice in the future. Limitations of the existing literature are outlined. RESULTS Patients with BRCA1/2 PVs, those with a personal history of tamoxifen use, those who desire long-term hormone replacement therapy, and/or have an elevated BMI are at higher risk of EC, primarily endometrioid EC and/or uterine papillary serous carcinoma, and may benefit from rr-hysterectomy. Although prescriptive clinical guidelines specific to BRCA1/2 PV carriers could inform decisions around rr-hysterectomy, limitations of the current literature prevent more definitive guidance at this time. A large population-based study of a contemporary cohort of BRCA1/2 PV carriers with lifetime follow-up compared with cancer-gene negative controls would advance this topic and facilitate care decisions. CONCLUSION This review validates a potential role for rr-hysterectomy to address EC risk among surgical candidates with BRCA1/2 PVs. Evidence-based clinical guidelines for rr-hysterectomy in BRCA1/2 PV carriers are essential to ensure equitable access to this preventive measure, supporting insurance coverage for patients with either BRCA1 or BRCA2 PVs to pursue rr-hysterectomy. Overall, this review highlights the complexity of EC risk in BRCA1/2 PV carriers and offers a comprehensive framework to shared decision making to inform rr-hysterectomy for BRCA1/2 PV carriers.
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Affiliation(s)
- Kimia Sorouri
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Filipa Lynce
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Colleen M. Feltmate
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA
| | - Michelle R. Davis
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA
| | - Michael G. Muto
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA
| | - Panagiotis A. Konstantinopoulos
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Elizabeth H. Stover
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Sarah J. Hill
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Ann H. Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Sara M. Tolaney
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Judy E. Garber
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
- Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
| | - Brittany L. Bychkovsky
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
- Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
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11
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Pleasant V, Pearlman MD. Does tamoxifen use increase the risk of endometrial cancer in premenopausal patients? OBG MANAGEMENT 2023; 35:17-21. [PMID: 38919701 PMCID: PMC11197877 DOI: 10.12788/obgm.0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
In a large, nationwide retrospective longitudinal cohort study that examined the occurrence of endometrial cancer and other uterine pathology in patients using tamoxifen for treatment of invasive breast cancer compared with breast cancer patients not receiving tamoxifen, the authors found a 3.77-fold increased risk of endometrial cancer in premenopausal patients using tamoxifen. These data conflict with multiple previously published randomized controlled trials that demonstrated an increased risk of endometrial cancer in the postmenopausal population (but not in premenopausal patients). The experts suggest that a study design issue in the recent study may explain these disparate findings.
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Affiliation(s)
- Versha Pleasant
- Center for Cancer Genetics and Breast Health, University of Michigan Health System, Ann Arbor
| | - Mark D Pearlman
- Center for Cancer Genetics and Breast Health, University of Michigan Health System, Ann Arbor
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12
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Kim D, Oh J, Seok JH, Lee HS, Jeon S, Yoon CI. Risk of Secondary Cancer after Adjuvant Tamoxifen Treatment for Ductal Carcinoma In Situ: A Nationwide Cohort Study in South Korea. Diagnostics (Basel) 2023; 13:diagnostics13040792. [PMID: 36832280 PMCID: PMC9954831 DOI: 10.3390/diagnostics13040792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/05/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Endocrine therapy is the mainstay treatment for hormone receptor-positive ductal carcinoma in situ. The aim of this study was to examine the long-term secondary malignancy risk of tamoxifen therapy. The data of patients diagnosed with breast cancer between January 2007 and December 2015 were retrieved from the database of the Health Insurance Review and Assessment Service of South Korea. The International Classification of Diseases, 10th revision, was used to track all-site cancers. Age at the time of surgery, chronic disease status, and type of surgery were considered covariates in the propensity score matching analysis. The median follow-up duration was 89 months. Forty-one patients in the tamoxifen group and nine in the control group developed endometrial cancer. The Cox regression hazard ratio model showed that tamoxifen therapy was the only significant predictor of the development of endometrial cancer (hazard ratio, 2.791; 95% confidence interval, 1.355-5.747; p = 0.0054). No other type of cancer was associated with long-term tamoxifen use. In consonance with the established knowledge, the real-world data in this study demonstrated that tamoxifen therapy is related to an increased incidence of endometrial cancer.
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Affiliation(s)
- Dooreh Kim
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Chang Ik Yoon
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence: ; Tel.: +82-2-2258-6109
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13
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Cui Y, Ren W, Du X, Yang L, Tan B. Research Progress of Multiple Primary Malignancies Associated With Esophageal Cancer. Cancer Control 2023; 30:10732748231176641. [PMID: 37212379 PMCID: PMC10214099 DOI: 10.1177/10732748231176641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 04/07/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023] Open
Abstract
With the improvement in survival of patients with tumors, and continuous advancement of diagnostic technology and treatment modalities, instances of multiple primary malignancies (MPMs) are becoming an increasingly common phenomenon. The occurrence of esophageal-relevant MPMs increases the difficulty of diagnosis and treatment, and the overall prognosis is poor. Esophageal cancer related-MPMs tend to occur in areas such as the head, neck, stomach, and lungs. "Field cancerization" is one theoretical basis for the disease, and chemoradiotherapy, environmental life factors, and gene polymorphism are etiological factors. However, the influence of new therapeutic methods on MPM is still unclear, and the relationship between gene polymorphism and MPMs related to esophageal cancer needs further elucidation. Additionally, there is a lack of unified standards for diagnosis and treatment. Therefore, this study aimed to review the causes, clinical features, and prognostic factors of MPMs related to esophageal cancer.
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Affiliation(s)
- Yu Cui
- Department of Oncology, Affiliated Hospital of North Sichuan
Medical College, Nanchong City, Sichuan Province, China
| | - Wenxia Ren
- Department of Oncology, Affiliated Hospital of North Sichuan
Medical College, Nanchong City, Sichuan Province, China
| | - Xue Du
- Department of Oncology, Affiliated Hospital of North Sichuan
Medical College, Nanchong City, Sichuan Province, China
| | - Lu Yang
- Department of Oncology, Affiliated Hospital of North Sichuan
Medical College, Nanchong City, Sichuan Province, China
| | - Bangxian Tan
- Department of Oncology, Affiliated Hospital of North Sichuan
Medical College, Nanchong City, Sichuan Province, China
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