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Orimoloye HT, Hu YH, Federman N, Ritz B, Arah OA, Li CY, Lee PC, Heck JE. Effects of hypertension and use of antihypertensive drugs in pregnancy on the risks of childhood cancers in Taiwan. Cancer Causes Control 2024:10.1007/s10552-024-01864-6. [PMID: 38557933 DOI: 10.1007/s10552-024-01864-6] [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: 07/26/2023] [Accepted: 02/10/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Childhood cancers are associated with high mortality and morbidity, and some maternal prescription drug use during pregnancy has been implicated in cancer risk. There are few studies on the effects of hypertension, preeclampsia, and the use of antihypertensives in pregnancy on children's cancer risks. OBJECTIVE This population-based cohort study analyzed the relationship between hypertension, preeclampsia, and antihypertensives taken during pregnancy and the risks of childhood cancers in the offspring. METHODS Data on all children born in Taiwan between 2004 and 2015 (N = 2,294,292) were obtained from the Maternal and Child Health Database. This registry was linked with the National Health Insurance Database and Cancer Registry to get the records of maternal use of diuretics or other antihypertensives in pregnancy and records of children with cancer diagnosed before 13 years. We used Cox proportional hazard modeling to estimate the influence of maternal health conditions and antihypertensive drug exposure on the risks of developing childhood cancers. RESULTS Offspring of mothers with hypertension (chronic or gestational) had a higher risk of acute lymphocytic lymphoma [hazard ratio (HR) = 1.87, 95% Confidence Interval (CI) 1.32 - 2.65] and non-Hodgkin's lymphoma (HR = 1.96, 95% CI 1.34 - 2.86). We estimated only a weak increased cancer risk in children whose mothers used diuretics (HR = 1.16, 95% CI 0.77 - 1.74) or used antihypertensives other than diuretics (HR = 1.15, 95% CI 0.86 - 1.54) before birth. CONCLUSIONS In this cohort study, children whose mothers had chronic and gestational hypertension had an increased risk of developing childhood cancer.
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Affiliation(s)
- Helen T Orimoloye
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Ya-Hui Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Noah Federman
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Statistics and Data Science, College of Letters and Science, University of California, Los Angeles, CA, USA
- Research Unit for Epidemiology, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Pei-Chen Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan.
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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2
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Monterroso PS, Li Z, Domingues AM, Sample JM, Marcotte EL. Racial and ethnic and socioeconomic disparities in childhood cancer incidence trends in the United States, 2000-2019. J Natl Cancer Inst 2023; 115:1576-1585. [PMID: 37531268 PMCID: PMC10699844 DOI: 10.1093/jnci/djad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Population-based surveillance of pediatric cancer incidence trends is critical to determine high-risk populations, drive hypothesis generation, and uncover etiologic heterogeneity. We provide a comprehensive update to the current understanding of pediatric cancer incidence trends by sex, race and ethnicity, and socioeconomic status (SES). METHODS The Surveillance, Epidemiology, and End Results 22 data (2000-2019) was used to summarize age-adjusted incidence rates for children and adolescents aged 0-19 years at diagnosis. The annual percentage change (APC) and 95% confidence interval (CI) were estimated to evaluate incidence trends by sex, race and ethnicity, and SES overall and for cancer subtypes. Tests of statistical significance were 2-sided. RESULTS Substantial variation was observed overall and for several histologic types in race and ethnicity- and SES-specific rates. Overall, we observed a statistically significant increase in incidence rates (APC = 0.8%, 95% CI = 0.6% to 1.1%). All race and ethnic groups saw an increase in incidence rates, with the largest occurring among non-Hispanic American Indian and Alaska Native children and adolescents (APC = 1.7%, 95% CI = 0.5% to 2.8%) and the smallest increase occurring among non-Hispanic White children and adolescents (APC = 0.7%, 95% CI = 0.5% to 1.0%). The lowest SES quintiles saw statistically significant increasing trends, while the highest quintile remained relatively stable (quintile 1 [Q1] APC = 1.6%, 95% CI = 0.6% to 2.6%; quintile 5 [Q5] APC = 0.3%, 95% CI = -0.1% to 0.7%). CONCLUSIONS Childhood cancer incidence is increasing overall and among every race and ethnic group. Variation by race and ethnicity and SES may enable hypothesis generation on drivers of disparities observed.
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Affiliation(s)
- Pablo S Monterroso
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Zhaoheng Li
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Allison M Domingues
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jeannette M Sample
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Erin L Marcotte
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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Wong EC, Lupo PJ, Desrosiers TA, Nichols HB, Smith SM, Poole C, Canfield M, Shumate C, Chambers TM, Schraw JM, Nembhard WN, Yazdy MM, Nestoridi E, Janitz AE, Olshan AF. Associations between birth defects with neural crest cell origins and pediatric embryonal tumors. Cancer 2023; 129:3595-3602. [PMID: 37432072 PMCID: PMC10615683 DOI: 10.1002/cncr.34952] [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: 04/25/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND There are few assessments evaluating associations between birth defects with neural crest cell developmental origins (BDNCOs) and embryonal tumors, which are characterized by undifferentiated cells having a molecular profile similar to neural crest cells. The effect of BDNCOs on embryonal tumors was estimated to explore potential shared etiologic pathways and genetic origins. METHODS With the use of a multistate, registry-linkage cohort study, BDNCO-embryonal tumor associations were evaluated by generating hazard ratios (HRs) and 95% confidence intervals (CIs) with Cox regression models. BDNCOs consisted of ear, face, and neck defects, Hirschsprung disease, and a selection of congenital heart defects. Embryonal tumors included neuroblastoma, nephroblastoma, and hepatoblastoma. Potential HR modification (HRM) was investigated by infant sex, maternal race/ethnicity, maternal age, and maternal education. RESULTS The risk of embryonal tumors among those with BDNCOs was 0.09% (co-occurring n = 105) compared to 0.03% (95% CI, 0.03%-0.04%) among those without a birth defect. Children with BDNCOs were 4.2 times (95% CI, 3.5-5.1 times) as likely to be diagnosed with an embryonal tumor compared to children born without a birth defect. BDNCOs were strongly associated with hepatoblastoma (HR, 16.1; 95% CI, 11.3-22.9), and the HRs for neuroblastoma (3.1; 95% CI, 2.3-4.2) and nephroblastoma (2.9; 95% CI, 1.9-4.4) were elevated. There was no notable HRM by the aforementioned factors. CONCLUSIONS Children with BDNCOs are more likely to develop embryonal tumors compared to children without a birth defect. Disruptions of shared developmental pathways may contribute to both phenotypes, which could inform future genomic assessments and cancer surveillance strategies of these conditions.
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Affiliation(s)
- Eugene C Wong
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Philip J Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Susan M Smith
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mark Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Charles Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Tiffany M Chambers
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jeremy M Schraw
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences and Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas, USA
| | - Mahsa M Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Eirini Nestoridi
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Farooqui Z, Johnston M, Schepers E, Brewer N, Hartman S, Jenkins T, Bondoc A, Pai A, Geller J, Tiao GM. Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050890. [PMID: 37238438 DOI: 10.3390/children10050890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Hepatoblastoma is the most common malignant liver tumor of childhood, with liver transplant and extended resection used as surgical treatments for locally advanced tumors. Although each approach has well-described post-operative complications, quality-of-life outcomes have not been described following the two interventions. Long-term pediatric survivors of hepatoblastoma who underwent conventional liver resection or liver transplantation at a single institution from January 2000-December 2013 were recruited to complete quality-of-life surveys. Survey responses for the Pediatric Quality of Life Generic Core 4.0 (PedsQL, n = 30 patient and n = 31 parent surveys) and Pediatric Quality of Life Cancer Module 3.0 (PedsQL-Cancer, n = 29 patient and n = 31 parent surveys) were collected from patients and parents. The mean total patient-reported PedsQL score was 73.7, and the parent-reported score was 73.9. There were no significant differences in scores on the PedsQL between patients who underwent resection compared to those who underwent transplantation (p > 0.05 for all comparisons). On the PedsQL-Cancer module, procedural anxiety scores were significantly lower for patients who underwent resection as compared to transplant (M = 33.47 points less, CI [-60.41, -6.53], p-value 0.017). This cross-sectional study demonstrates that quality of life outcomes are overall similar among patients receiving transplants and resections. Patients who received a resection reported worse procedural anxiety.
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Affiliation(s)
- Zishaan Farooqui
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Michael Johnston
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Emily Schepers
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Nathalie Brewer
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Stephen Hartman
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Todd Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Alexander Bondoc
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Ahna Pai
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - James Geller
- Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Gregory M Tiao
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
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Miao J, Chen Y, Liu X, Ye C, Zhou X, Yang Z, Gong Z, Chen L, Wang T. Maternal Body Mass Index, Gestational Weight Gain, and Risk of Cancer in Offspring: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15071601. [PMID: 37049442 PMCID: PMC10096488 DOI: 10.3390/nu15071601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Mounting evidence suggests that maternal obesity and gestational weight gain (GWG) may increase the risk of cancer in their offspring; however, results are inconsistent. The purpose of this research is to determine the association between maternal body mass index (BMI) and GWG and the risk of cancer in offspring through a systematic and comprehensive meta-analysis. Methods: A systematic literature search of several databases was conducted on 1 October 2022 to identify relevant studies. The quality of the included studies was evaluated using the Newcastle–Ottawa scale. The overall risk estimates were pooled using a random-effects meta-analysis. Results: Twenty-two studies with more than 8 million participants were included. An increased risk of total cancer was found in offspring whose mothers had a high GWG (odds ratio [OR]: 1.10; 95% CI: 1.01–1.19; p: 0.040) but not in offspring whose mothers had a low GWG (OR: 1.06; 95% CI: 0.96–1.17; p: 0.030), when compared with offspring whose mothers had a suitable GWG. In addition, no statistically significant association was found between maternal underweight (OR: 1.05; 95% CI: 0.97–1.13; p: 0.630), overweight/obesity (OR: 1.07; 95% CI: 0.99–1.16; p: 0.020), and risk of total cancer in offspring. Conclusions: Our study proposes evidence that maternal BMI and GWG may be associated with the risk of cancer in offspring, although statistical significance was found only for high GWG. Further well-designed research is required to clarify the potential relevance of maternal BMI and GWG on offspring cancer, especially for specific cancers.
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Affiliation(s)
- Junxiang Miao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Yan Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Xiaoling Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Changxiang Ye
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Xuan Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Ziqi Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Ziqiang Gong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
- Correspondence: (L.C.); (T.W.)
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China
- NHC Key Laboratory for Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410007, China
- Correspondence: (L.C.); (T.W.)
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6
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Albogami Y, Zhu Y, Wang X, Winterstein AG. Concordance of neonatal critical condition data between secondary databases: Florida and Texas birth certificate Linkage with medicaid analytic extract. BMC Med Res Methodol 2023; 23:47. [PMID: 36803103 PMCID: PMC9940322 DOI: 10.1186/s12874-023-01860-5] [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: 07/25/2022] [Accepted: 02/03/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Limited information is available about neonates' critical conditions data quality. The study aim was to measure the agreement regarding presence of neonatal critical conditions between Medicaid Analytic eXtract claims data and Birth Certificate (BC) records. METHODS Claims data files of neonates born between 1999-2010 and their mothers were linked to birth certificates in the states of Texas and Florida. In claims data, neonatal critical conditions were identified using medical encounter claims records within the first 30 days postpartum, while in birth certificates, the conditions were identified based on predetermined variables. We calculated the prevalence of cases within each data source that were identified by its comparator, in addition to calculating overall agreement and kappa statistics. RESULTS The sample included 558,224 and 981,120 neonates in Florida and Texas, respectively. Kappa values show poor agreement (< 20%) for all critical conditions except neonatal intensive care unit (NICU) admission, which showed moderate (> 50%) and substantial (> 60%) agreement in Florida and Texas, respectively. claims data resulted in higher prevalences and capture of a larger proportion of cases than the BC, except for assisted ventilation. CONCLUSIONS Claims data and BC showed low agreement on neonatal critical conditions except for NICU admission. Each data source identified cases most of which the comparator failed to capture, with higher prevalences estimated within claims data except for assisted ventilation.
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Affiliation(s)
- Yasser Albogami
- grid.15276.370000 0004 1936 8091Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida USA ,grid.56302.320000 0004 1773 5396Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yanmin Zhu
- grid.15276.370000 0004 1936 8091Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida USA
| | - Xi Wang
- grid.15276.370000 0004 1936 8091Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida USA
| | - Almut G Winterstein
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA. .,Center for Drug Evaluation and Safety, University of Florida College of Pharmacy, Gainesville, Florida, USA.
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7
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Hokken-Koelega ACS, van der Steen M, Boguszewski MCS, Cianfarani S, Dahlgren J, Horikawa R, Mericq V, Rapaport R, Alherbish A, Braslavsky D, Charmandari E, Chernausek SD, Cutfield WS, Dauber A, Deeb A, Goedegebuure WJ, Hofman PL, Isganatis E, Jorge AA, Kanaka-Gantenbein C, Kashimada K, Khadilkar V, Luo XP, Mathai S, Nakano Y, Yau M. International Consensus Guideline on Small for Gestational Age (SGA): Etiology and Management from Infancy to Early Adulthood. Endocr Rev 2023; 44:539-565. [PMID: 36635911 PMCID: PMC10166266 DOI: 10.1210/endrev/bnad002] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/31/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
This International Consensus Guideline was developed by experts in the field of SGA of 10 pediatric endocrine societies worldwide. A consensus meeting was held and 1300 articles formed the basis for discussions. All experts voted about the strengths of the recommendations. The guideline gives new and clinically relevant insights into the etiology of short stature after SGA birth, including novel knowledge about (epi)genetic causes. Besides, it presents long-term consequences of SGA birth and new treatment options, including treatment with gonadotropin-releasing hormone agonist (GnRHa) in addition to growth hormone (GH) treatment, and the metabolic and cardiovascular health of young adults born SGA after cessation of childhood-GH-treatment in comparison with appropriate control groups. To diagnose SGA, accurate anthropometry and use of national growth charts are recommended. Follow-up in early life is warranted and neurodevelopment evaluation in those at risk. Excessive postnatal weight gain should be avoided, as this is associated with an unfavorable cardio-metabolic health profile in adulthood. Children born SGA with persistent short stature < -2.5 SDS at age 2 years or < -2 SDS at age of 3-4 years, should be referred for diagnostic work-up. In case of dysmorphic features, major malformations, microcephaly, developmental delay, intellectual disability and/or signs of skeletal dysplasia, genetic testing should be considered. Treatment with 0.033-0.067 mg GH/kg/day is recommended in case of persistent short stature at age of 3-4 years. Adding GnRHa treatment could be considered when short adult height is expected at pubertal onset. All young adults born SGA require counseling to adopt a healthy lifestyle.
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Affiliation(s)
- Anita C S Hokken-Koelega
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Manouk van der Steen
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Stefano Cianfarani
- Department of Systems Medicine, University of Rome 'Tor Vergata', Children's Hospital, Rome, Italy.,Diabetology and Growth Disorders Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, the Sahlgrenska Academy, the University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Veronica Mericq
- Institute of Maternal and Child Research, faculty of Medicine, University of Chile
| | - Robert Rapaport
- Icahn School of Medicine, Division of Pediatric Endocrinology, Mount Sinai Kravis Children's Hospital, New York, NY, USA
| | | | - Debora Braslavsky
- Centro de Investigaciones Endocrinológicas "Dr. Cesar Bergadá" (CEDIE), División de Endocrinología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Steven D Chernausek
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Andrew Dauber
- Division of Endocrinology, Children's National Hospital, Washington, DC 20012, USA
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City and College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Wesley J Goedegebuure
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Alexander A Jorge
- Unidade de Endocrinologia Genética (LIM25) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Xiao-Ping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sarah Mathai
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Yuya Nakano
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Mabel Yau
- Icahn School of Medicine, Division of Pediatric Endocrinology, Mount Sinai Kravis Children's Hospital, New York, NY, USA
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8
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Fan L, Pan Q, Yang W, Koo SC, Tian C, Li L, Lu M, Brown A, Ju B, Easton J, Ranganathan S, Shin S, Bondoc A, Yang JJ, Yu J, Zhu L. A developmentally prometastatic niche to hepatoblastoma in neonatal liver mediated by the Cxcl1/Cxcr2 axis. Hepatology 2022; 76:1275-1290. [PMID: 35179799 PMCID: PMC9385889 DOI: 10.1002/hep.32412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS Hepatoblastoma (HB) is the most common pediatric liver cancer. Its predominant occurrence in very young children led us to investigate whether the neonatal liver provides a protumorigenic niche to HB development. APPROACH AND RESULTS HB development was compared between orthotopic transplantation models established in postnatal day 5 (P5) and 60 (P60) mice (P5Tx and P60Tx models). Single-cell RNA-sequencing (sc-RNAseq) was performed using tumor and liver tissues from both models and the top candidate cell types and genes identified are investigated for their roles in HB cell growth, migration, and survival. CONCLUSIONS We found that various HB cell lines including HepG2 cells were consistently and considerably more tumorigenic and metastatic in the P5Tx model than in the P60Tx models. Sc-RNAseq of the P5Tx and P60Tx HepG2 models revealed that the P5Tx tumor was more hypoxic and had a larger number of activated hepatic stellate cells (aHSCs) in the tumor-surrounding liver that express significantly higher levels of Cxcl1 than those from the P60Tx model. We found these differences were developmentally present in normal P5 and P60 liver. We showed that the Cxcl1/Cxcr2 axis mediated HB cell migration and was critical to HB cell survival under hypoxia. Treating HepG2 P60Tx model with recombinant CXCL1 protein induced intrahepatic and pulmonary metastasis and CXCR2 knockout (KO) in HepG2 cells abolished their metastatic potential in the P5Tx model. Lastly, we showed that in tumors from patients with metastatic HB, there was a similar larger population of aHSCs in the tumor-surrounding liver than in localized tumors, and tumor hypoxia was uniquely associated with prognosis of patients with HB among pediatric cancers. We demonstrated that the neonatal liver provides a prometastatic niche to HB development through the Cxcl1/Cxcr2 axis.
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Affiliation(s)
- Li Fan
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Qingfei Pan
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Wentao Yang
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Selene C. Koo
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Cheng Tian
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Liyuan Li
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Meifen Lu
- Veterinary Pathology Core, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Anthony Brown
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Bensheng Ju
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - John Easton
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Sarangarajan Ranganathan
- Department of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital, Cincinnati, Ohio, United States
| | - Soona Shin
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Alexander Bondoc
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Jun J. Yang
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Jiyang Yu
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
| | - Liqin Zhu
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
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9
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Nussbaumer G, Benesch M. Hepatoblastoma in molecularly defined, congenital diseases. Am J Med Genet A 2022; 188:2527-2535. [PMID: 35478319 PMCID: PMC9545988 DOI: 10.1002/ajmg.a.62767] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/21/2022] [Accepted: 04/09/2022] [Indexed: 01/24/2023]
Abstract
Beckwith-Wiedemann spectrum, Simpson-Golabi-Behmel syndrome, familial adenomatous polyposis and trisomy 18 are the most common congenital conditions associated with an increased incidence of hepatoblastoma (HB). In patients with these genetic disorders, screening protocols for HB are proposed that include periodic abdominal ultrasound and measurement of alpha-fetoprotein levels. Surveillance in these children may contribute to the early detection of HB and possibly improve their chances of overall survival. Therefore, physicians must be aware of the high HB incidence in children with certain predisposing genetic diseases.
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Affiliation(s)
- Gunther Nussbaumer
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
| | - Martin Benesch
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent MedicineMedical University of GrazGrazAustria
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10
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Marley AR, Domingues A, Ghosh T, Turcotte LM, Spector LG. Maternal BMI, Diabetes, and Gestational Weight Gain and Risk for Pediatric Cancer in Offspring: A Systematic Review and Meta-Analysis. JNCI Cancer Spectr 2022; 6:6537542. [PMID: 35603850 PMCID: PMC8982388 DOI: 10.1093/jncics/pkac020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Pediatric cancer incidence has steadily increased concurrent with rising adult obesity, but associations between maternal obesity and associated comorbidities and pediatric cancer risk remain understudied. We aimed to quantitatively characterize associations of pediatric cancer risk with maternal prepregnancy body mass index (BMI), gestational weight gain, and maternal diabetes. Methods We performed a comprehensive and systematic literature search in Ovid and EMBASE from their inception to March 15, 2021. Eligible studies reported risk estimates and sample sizes and provided sufficient description of outcome and exposure ascertainment. Random effects models were used to estimate pooled effects. Results Thirty-four studies were included in the analysis. Prepregnancy BMI was positively associated with leukemia risk in offspring (odds ratio [OR] per 5-unit BMI increase =1.07, 95% confidence intervals [CI] = 1.04 to 1.11; I2 = 0.0%). Any maternal diabetes was positively associated with acute lymphoblastic leukemia risk (OR = 1.46, 95% CI = 1.28 to 1.67; I2 = 0.0%), even after restricting to birthweight-adjusted analyses (OR = 1.74, 95% CI = 1.29 to 2.34; I2 = 0.0%), and inversely associated with risk of central nervous system tumors (OR = 0.73, 95% CI = 0.55 to 0.97; I2 = 0.0%). Pregestational diabetes (OR = 1.57, 95% CI = 1.11 to 2.24; I2 = 26.8%) and gestational diabetes (OR = 1.40, 95% CI = 1.12 to 1.75; I2 = 0.0%) were also positively associated with acute lymphoblastic leukemia risk. No statistically significant associations were observed for gestational weight gain. Conclusions Maternal obesity and diabetes may be etiologically linked to pediatric cancer, particularly leukemia and central nervous system tumors. Our findings support weight management and glycemic control as important components of maternal and offspring health. Further validation is warranted.
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Affiliation(s)
- Andrew R Marley
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Allison Domingues
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Taumoha Ghosh
- Division of Hematology/Oncology, Department of Pediatrics, University of Miami, Miami, FL, USA
| | - Lucie M Turcotte
- Division of Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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11
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Hjorth S, Hemmingsen CH, Bénévent J, Broe A, Pottegaard A, Mørch LS, Leinonen MK, Kjaer SK, Hargreave M, Nordeng H. Maternal Medication Use and Childhood Cancer in Offspring-Systematic Review and Considerations for Researchers. Am J Epidemiol 2021; 190:2487-2499. [PMID: 34017981 PMCID: PMC8561129 DOI: 10.1093/aje/kwab154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Cancer is an important cause of childhood mortality, yet the etiology is largely unknown. A combination of pre- and postnatal factors is thought to be implicated, including maternal medication use. We aimed to provide: 1) a systematic review of peer-reviewed publications on associations between maternal medication use and childhood cancer, with a focus on study design and methodology; and 2) suggestions for how to increase transparency, limit potential biases, and improve comparability in studies on maternal medication use and childhood cancer. We conducted a systematic search in the PubMed, Embase, Scopus, Cochrane, and Web of Science databases to June 8, 2020. Altogether, 112 studies were identified. The reviewed studies were heterogeneous in study design, exposure, and outcome classification. In 21 studies (19%), the outcome was any childhood cancer. Of the 91 papers that reported on specific types of cancer, 62% did not report the cancer classification system. The most frequently investigated medication groups were sex hormones (46 studies, excluding fertility medications), and antiinfectives (37 studies). Suggestions for strengthening future pharmacoepidemiologic studies on maternal medication use and childhood cancer relate to choice of cancer classification system, exposure windows, and methods for identification of, and control for, potential confounders.
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Affiliation(s)
- Sarah Hjorth
- Correspondence to Sarah Hjorth, PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Postboks 1068 Blindern 0316 Oslo, Norway (e-mail: )
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12
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Chen H, Duan F, Wang M, Zhu J, Zhang J, Cheng J, Li L, Li S, Li Y, Yang Z, Xia H, Niu H, He J. Polymorphisms in METTL3 gene and hepatoblastoma risk in Chinese children: A seven-center case-control study. Gene 2021; 800:145834. [PMID: 34274483 DOI: 10.1016/j.gene.2021.145834] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
Hepatoblastoma is the most common malignant liver cancer in childhood, yet its etiology remains unclear. As an m6A methylation modifier, methyltransferase like 3 (METTL3) has an active methyltransferase domain that functionally participates in various tumor occurrence and development. However, little is known about how METTL3 polymorphisms affect the occurrence of hepatoblastoma. Here, we attempted to investigate the associations between METTL3 gene polymorphisms and hepatoblastoma risk in a seven-center case-control study. We genotyped four METTL3 polymorphisms (rs1061026 T > G, rs1061027 C > A, rs1139130 A > G, rs1263801 G > C) by TaqMan technique in 313 cases and 1446 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the contributions of these four single nucleotide polymorphisms (SNPs) to hepatoblastoma susceptibility. In single genotype analysis, we detected no significant correlation between these four polymorphisms in METTL3 and hepatoblastoma risk. However, in the combined analysis, the presence of 2-4 risk genotypes of METTL3 was associated with an increased risk of hepatoblastoma compared with that of 0-1 risk genotypes (adjusted OR = 1.48, 95% CI = 1.03-2.12, P = 0.035). The stratified analysis further revealed that carriers of 2-4 risk genotypes are more susceptible to hepatoblastoma in the subgroups of subjects aged under 17 months (adjusted OR = 1.88, 95% CI = 1.12-3.16, P = 0.016) and females (adjusted OR = 1.79, 95% CI = 1.06-3.05, P = 0.031). Overall, our results revealed that none of these four SNPs could increase susceptibility to hepatoblastoma individually. Carriers with 2-4 risk genotypes in the combined analysis tend to increase the risk of hepatoblastoma.
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Affiliation(s)
- Huitong Chen
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Fei Duan
- Department of Pediatric General Surgery, Hebei Children's Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei, China
| | - Mi Wang
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Jinhong Zhu
- Department of Clinical Laboratory, Biobank, Harbin Medical University Cancer Hospital, Harbin 150040, Heilongjiang, China
| | - Jiao Zhang
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jiwen Cheng
- Department of Pediatric Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China
| | - Li Li
- Kunming Key Laboratory of Children Infection and Immunity, Yunnan Key Laboratory of Children's Major Disease Research, Yunnan Institute of Pediatrics Research, Yunnan Medical Center for Pediatric Diseases, Kunming Children's Hospital, Kunming 650228, Yunnan, China
| | - Suhong Li
- Department of Pathology, Children Hospital and Women Health Center of Shanxi, Taiyuan 030013, Shannxi, China
| | - Yong Li
- Department of Pediatric Surgery, Hunan Children's Hospital, Changsha 410004, Hunan, China
| | - Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Huimin Xia
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Huizhong Niu
- Department of Pediatric General Surgery, Hebei Children's Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei, China.
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China.
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13
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Hu H, Zhang W, Zhi T, Li J, Wen Y, Li F, Mei Y, Huang D. Genotypic Characteristics of Hepatoblastoma as Detected by Next Generation Sequencing and Their Correlation With Clinical Efficacy. Front Oncol 2021; 11:628531. [PMID: 34426785 PMCID: PMC8379014 DOI: 10.3389/fonc.2021.628531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/20/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hepatoblastoma (HB) is the most common malignant embryonic liver tumor type in children under 3 years of age. In the present study, the next generation sequencing (NGS) method was used to detect the genotype characteristics of HB and summarize the correlation between the common mutation genotypes noted in this disease and the clinical treatment and prognosis. The results may aid clinical prognosis and the successful application of targeted drugs. METHODS Initially, DNA was extracted from tumor tissue specimens and peripheral blood derived from 19 pediatric patients with HB. Subsequently, DNA panel and NGS methods were used to detect tumor diagnosis and the expression levels of treatment-associated genes, followed by the summary of genotype characteristics. In addition, in order to further assess the application of immunotherapy in HB, immunohistochemical detection of programmed cell death 1 ligand 1 (PDL1) was performed in combination with tumor mutation burden (TMB) and DNA mismatch repair status analysis. Furthermore, the clinical treatment effect and prognosis of the pediatric patients were statistically analyzed according to the characteristics of the genotype. Overall prognosis and prognostic analyses in different groups were performed by Kaplan-Meier and log-rank tests, respectively. Finally, expression validation and diagnostic analysis of commonly reported genes were performed in the GSE75271 dataset, which was obtained from the Gene Expression Omnibus (GEO) database. RESULTS In the present study, certain mutated genes, including nuclear factor erythroid 2-related factor 2 (NFE2L2), catenin β1 (CTNNB1), MYCN, tumor protein p53, axis inhibition protein 1 (AXIN1) and adenomatous polyposis coli (APC) were associated with the pathogenesis of HB. During TMB and DNA mismatch repair status analyses, pediatric patients had a low TMB. All of them did not present with microsatellite instability. The immunohistochemical results indicated lower expression levels of PDL1 in HB. The complete remission (CR) rate of pediatric patients in the gene abnormality group was lower than that of the non-reported disease-associated gene abnormality group. The 2-year overall survival rate and disease-free survival rate of 19 pediatric patients with HB were 72.1% and 42.4%, respectively. Receiver operating characteristic (ROC) analysis demonstrated that CTNNB1, NFE2L2, AXIN1, APC, MYCN and insulin growth factor 2 (IGF2) may be potential biomarkers that could be used for the diagnosis of HB. CONCLUSION The genotype changes in HB were more common and the CR rate of the pediatric patients with an altered genotype was lower than that of pediatric patients without an altered genotype. In addition, pediatric patients with HB exhibited lower TMB compared with adult patients. Moreover, the data indicated that CTNNB1, NFE2L2, AXIN1, APC, MYCN and IGF2 may be potential biomarkers that can be used for the diagnosis of HB.
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14
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Abbas AA, Samkari AM, Almehdar AS. Hepatoblastoma: Review of Pathology, Diagnosis and Modern Treatment Strategies. CURRENT CANCER THERAPY REVIEWS 2020. [DOI: 10.2174/1573394716666200206103826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hepatoblastoma (HB) is the most common primary malignant hepatic tumor of childhood
and, occurring predominantly in the first two years of life. Approximately 100 cases are diagnosed
every year in the United States of America. The management of HB has changed markedly
over the last three decades. Alfa feto protein (AFP) and beta human chorionic gonadotrophin (beta
HCG) are the main tumor markers and are markers for diagnosis and follow up. International collaborative
efforts have led to the implementation of the Pre - Treatment Extent of the Disease PRETEXT
staging system consensus classification to assess upfront resectability. Complete surgical
resection plays a key role in successful management. Overall, outcomes have greatly improved over
the past decades mainly because of advances in chemotherapy (CTR) agents and administration
protocols, newer surgical approaches and liver transplantation (LT). Targeted medications towards
the newly discovered β-catenin and Wnt genetic pathways in tumor cells may soon become an option
for treatment. The current disease free survival (DFS) rates are approaching 85%. For the 25%
of patients with metastasis at presentation, the overall survival (OS) remains poor. A more individualized
approach to treating the heterogeneous spectrum of HB may become the basis of successful
treatment in complex cases. Newer medications and surgical techniques are being exploited.
Here we present a comprehensive review of the recent advances in the management of HB. A wide
literature search was made using internet search engines such as PubMed and Google scholar. More
than 100 articles were reviewed and the information extrapolated was arranged to produce this
review.
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Affiliation(s)
- Adil A. Abbas
- Pediatric Hematology/Oncology Section, College of Medicine, Princess Nourah Oncology Centre, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Alaa M.N. Samkari
- Department of Laboratory Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abeer S. Almehdar
- Department of Medical Imaging, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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15
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Lupo PJ, Spector LG. Cancer Progress and Priorities: Childhood Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1081-1094. [DOI: 10.1158/1055-9965.epi-19-0941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/18/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
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16
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Hadžić N, Cho SJ, Finegold MJ. Hepatoblastoma surveillance in infants born with very low birth weight: Has the time come? J Pediatr 2020; 216:248-249. [PMID: 31606153 DOI: 10.1016/j.jpeds.2019.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 09/10/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Nedim Hadžić
- Paediatric Service for Hepatology, Gastroenterology and Nutrition, King's College Hospital, London, United Kingdom
| | - Soo-Jin Cho
- Department of Pathology, University of California San Francisco, San Francisco, California
| | - Milton J Finegold
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
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17
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Yang Z, Deng Y, Zhang K, Bai Y, Zhu J, Zhang J, Xin Y, Li L, He J, Wang W. LIN28B gene polymorphisms modify hepatoblastoma susceptibility in Chinese children. J Cancer 2020; 11:3512-3518. [PMID: 32284747 PMCID: PMC7150445 DOI: 10.7150/jca.42798] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/02/2020] [Indexed: 02/07/2023] Open
Abstract
Hepatoblastoma is one of the malignant liver tumors in children. However, genetic mechanisms underpinning the initiation of hepatoblastoma remain largely unclear. The previous study showed that lin-28 homolog B (LIN28B) might play a role in the development of hepatoblastoma. To detect the association between LIN28B gene polymorphisms and hepatoblastoma risk in Chinese children, we conducted a five-center case-control study of 275 hepatoblastoma patients and 1018 cancer-free controls. Four potentially functional polymorphisms were genotyped using the Taqman method. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of the associations. We found that the rs314276 C>A polymorphism (AA vs. CC: adjusted OR=2.05, 95% CI=1.36-3.10, P=0.0006; AA vs. CA/CC: adjusted OR=2.11, 95% CI=1.43-3.12, P=0.0002) and rs9404590 T>G (GG vs. TT: adjusted OR=1.89, 95% CI=1.20-3.00, P=0.007; GG vs. TT/TG: adjusted OR=1.87, 95% CI=1.20-2.92, P=0.006) were associated with increased hepatoblastoma risk. Combination analysis of risk genotypes showed that patients with four risk genotypes had a higher chance of developing hepatoblastoma than carriers of 1 to 3 risk genotypes. Stratification analysis showed the significant association between the rs314276 AA genotype and hepatoblastoma risk in both age and sex groups, as well as clinical stages III+IV cases. The rs9404590 GG genotype was associated with hepatoblastoma risk in participants' ≥17 months, in females, and for those with clinical stages III+IV disease. Furthermore, four risk genotypes confer higher hepatoblastoma susceptibility in both age and sex groups, as well as groups with clinical stages III+IV disease. Genotype-based gene expression analysis confirmed that the rs9404590 T>G polymorphism was significantly associated with altered LIN28B gene expression. We further validated our findings using false-positive probability analysis. This finding suggested that LIN28B gene polymorphisms may be associated with an increased predisposition to hepatoblastoma.
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Affiliation(s)
- Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Yuyao Deng
- Department of Clinical Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China
| | - Keren Zhang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Yuzuo Bai
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Jinhong Zhu
- Department of Clinical Laboratory, Biobank, Harbin Medical University Cancer Hospital, Harbin 150040, Heilongjiang, China
| | - Jiao Zhang
- Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yijuan Xin
- Clinical Laboratory Medicine Center of PLA, Xijing Hospital, Air Force Medical University, Xi'an 710032, Shaanxi, China
| | - Li Li
- Kunming Key Laboratory of Children Infection and Immunity, Yunnan Key Laboratory of Children's Major Disease Research, Yunnan Institute of Pediatrics Research, Yunnan Medical Center for Pediatric Diseases, Kunming Children's Hospital, Kunming 650228, Yunnan, China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
- ✉ Corresponding authors: Weilin Wang, Department of Pediatric Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning, China. E-mail: ; or Jing He, Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou 510623, Guangdong, China. E-mail: or
| | - Weilin Wang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
- ✉ Corresponding authors: Weilin Wang, Department of Pediatric Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning, China. E-mail: ; or Jing He, Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou 510623, Guangdong, China. E-mail: or
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18
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Li L, Zhuo Z, Yang Z, Zhu J, He X, Yang Z, Zhang J, Xin Y, He J, Zhang T. HMGA2 Polymorphisms and Hepatoblastoma Susceptibility: A Five-Center Case-Control Study. Pharmgenomics Pers Med 2020; 13:51-57. [PMID: 32104047 PMCID: PMC7023882 DOI: 10.2147/pgpm.s241100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatoblastoma is a rare disease. Its etiology remains obscure. No epidemiological reports have assessed the relationship of High Mobility Group A2 (HMGA2) single nucleotide polymorphisms (SNPs) with hepatoblastoma risk. This case-control study leads as a pioneer to explore whether HMGA2 SNPs (rs6581658 A>G, rs8756 A>C, rs968697 T>C) could impact hepatoblastoma risk. METHODS We acquired samples from 275 hepatoblastoma cases and 1018 controls who visited one of five independent hospitals located in the different regions of China. The genotyping of HMGA2 SNPs was implemented using the PCR-based TaqMan method, and the risk estimates were quantified by odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS In the main analysis, we identified that rs968697 T>C polymorphism was significantly related to hepatoblastoma risk in the additive model (adjusted OR=0.73, 95% CI=0.54-0.98, P=0.035). Notably, participants carrying 2-3 favorable genotypes had reduced hepatoblastoma risk (adjusted OR=0.71, 95% CI=0.52-0.96, P=0.028) in contrast to those carrying 0-1 favorable genotypes. Furthermore, stratification analysis revealed a significant correlation between rs968697 TC/CC and hepatoblastoma risk for males and clinical stage I+II. The existence of 2-3 protective genotypes was correlated with decreased hepatoblastoma susceptibility in children ≥17 months old, males, and clinical stage I+II cases, when compared to 0-1 protective genotype. CONCLUSION To summarize, these results indicated that the HMGA2 gene SNPs exert a weak influence on hepatoblastoma susceptibility. Further validation of the current conclusion with a larger sample size covering multi-ethnic groups is warranted.
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Affiliation(s)
- Li Li
- Kunming Key Laboratory of Children's Infection and Immunity, Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Institute of Pediatrics Research, Kunming Children’s Hospital, Kunming, Yunnan, 650228, People’s Republic of China
| | - Zhenjian Zhuo
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou510623, Guangdong, People’s Republic of China
| | - Zhen Yang
- Kunming Key Laboratory of Children's Infection and Immunity, Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Institute of Pediatrics Research, Kunming Children’s Hospital, Kunming, Yunnan, 650228, People’s Republic of China
- Department of Oncology, Kunming Children’s Hospital, Kunming650228, Yunnan, People’s Republic of China
| | - Jinhong Zhu
- Department of Clinical Laboratory, Biobank, Harbin Medical University Cancer Hospital, Harbin150040, Heilongjiang, People’s Republic of China
| | - Xiaoli He
- Kunming Key Laboratory of Children's Infection and Immunity, Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Institute of Pediatrics Research, Kunming Children’s Hospital, Kunming, Yunnan, 650228, People’s Republic of China
| | - Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang110004, Liaoning, People’s Republic of China
| | - Jiao Zhang
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People’s Republic of China
| | - Yijuan Xin
- Clinical Laboratory Medicine Center of PLA, Xijing Hospital, Air Force Medical University, Xi’an710032, Shaanxi, People’s Republic of China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou510623, Guangdong, People’s Republic of China
- Jing He Department of Pediatric, Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou510623, Guangdong, People’s Republic of ChinaTel/Fax +86 2038076560 Email
| | - Tiesong Zhang
- Kunming Key Laboratory of Children's Infection and Immunity, Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Institute of Pediatrics Research, Kunming Children’s Hospital, Kunming, Yunnan, 650228, People’s Republic of China
- Correspondence: Tiesong Zhang Kunming Key Laboratory of Children's Infection and Immunity, Yunnan Key Laboratory of Children’s Major Disease Research, Yunnan Institute of Pediatrics Research, Kunming Children’s Hospital, 288 Qianxing Road, Kunming650228, Yunnan, People’s Republic of ChinaTel/Fax +86 –8713169969 Email
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19
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Cancer Risk in Children and Young Adults (Offspring) Born after Medically Assisted Reproduction: A Systematic Review and Meta-Analysis. J 2019. [DOI: 10.3390/j2040028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many studies have investigated the relationship between medically assisted reproduction (MAR) and health outcomes, particularly cancer, in the offspring. This meta-analysis investigated the association between MAR and childhood cancer. Data sources were PubMed, Scopus, and Web of Science up until June 2018. From the selected studies, we extracted the cancer risk estimates of the exposure of interest (MAR, assisted reproductive technology—ART, and in fitro fertilization—IVF). We conducted the meta-analysis using a random effects model. The outcomes of interest were childhood cancers, classified according to the international classification of childhood cancer (ICCC-3). In our meta-analysis (18 cohort and 15 case-control studies) the overall cancer risk was significantly increased in children conceived by MAR, ART, or IVF. MAR and ART significantly increased the risk for hematological tumors, hepatic tumors, and sarcomas (odds ratio (OR) 1.54; 95% CI 1.18–2.02 and OR 1.92; 95% CI 1.34–2.74, respectively). MAR increased acute myeloid leukemia risk (OR 1.41; 95% CI 1.02–1.95) and ART increased neural cancer risk (OR 1.21; 95% CI 1.01–1.46). Our results suggest an increased risk of cancer in children conceived by MAR. Further studies are needed to investigate the impact of fertility treatments, parental subfertility status, and their association on health outcomes in the offspring.
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The Emerging Roles of Cancer Stem Cells and Wnt/Beta-Catenin Signaling in Hepatoblastoma. Cancers (Basel) 2019; 11:cancers11101406. [PMID: 31547062 PMCID: PMC6826653 DOI: 10.3390/cancers11101406] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatoblastoma (HB) is the most common form of primary liver malignancy found in pediatric populations. HB is considered to be clonal and arises from hepatoblasts, or embryonic liver progenitor cells. These less differentiated tumor-initiating progenitor cells, or cancer stem cells (CSCs), may contribute to tumor recurrence and resistance to therapies, and have high metastatic abilities. Phenotypic heterogeneity, undesired genetic and epigenetic alterations, and dysregulated signaling pathways provide CSCs with a survival advantage over current therapies. The molecular and cellular basis of HB and the mechanism of CSC induction are not fully understood. The Wnt/beta-catenin pathway is one of the major developmental pathways and is believed to play an important role in the pathogenesis of HB and CSC formation. This review summarizes the cellular and molecular characteristics of HB with a specific emphasis on CSCs and Wnt/beta-catenin signaling.
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21
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Williams CL, Bunch KJ, Murphy MFG, Stiller CA, Botting BJ, Wallace WH, Davies MC, Sutcliffe AG. Cancer risk in children born after donor ART. Hum Reprod 2019; 33:140-146. [PMID: 29106578 DOI: 10.1093/humrep/dex333] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/17/2017] [Indexed: 01/11/2023] Open
Abstract
STUDY QUESTION Do children born after donor ART have an increased risk of developing childhood cancer in comparison to the general population? SUMMARY ANSWER This study showed no overall increased risk of childhood cancer in individuals born after donor ART. WHAT IS KNOWN ALREADY Most large population-based studies have shown no increase in overall childhood cancer incidence after non-donor ART; however, other studies have suggested small increased risks in specific cancer types, including haematological cancers. Cancer risk specifically in children born after donor ART has not been investigated to date. STUDY DESIGN, SIZE, DURATION This retrospective cohort study utilized record linkage to determine the outcome status of all children born in Great Britain (1992-2008) after donor ART. The cohort included 12 137 members who contributed 95 389 person-years of follow-up (average follow-up 7.86 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Records of all children born in Great Britain (England, Wales, Scotland) after all forms of donor ART (1992-2008) were linked to the UK National Registry of Childhood Tumours (NRCT) to determine the number who subsequently developed cancer by 15 years of age, by the end of 2008. Rates of overall and type specific cancer (selected a priori) were compared with age, sex and calendar year standardized population-based rates, stratifying for potential mediating/moderating factors including sex, age at diagnosis, birth weight, multiple births, maternal previous live births, assisted conception type and fresh/ cryopreserved cycles. MAIN RESULTS AND THE ROLE OF CHANCE In our cohort of 12 137 children born after donor ART (52% male, 55% singleton births), no overall increased risk of cancer was identified. There were 12 cancers detected compared to 14.4 expected (standardized incidence ratio (SIR) 0.83; 95% CI 0.43-1.45; P = 0.50). A small, significant increased risk of hepatoblastoma was found, but the numbers and absolute risks were small (<5 cases observed; SIR 10.28; 95% CI 1.25-37.14; P < 0.05). This increased hepatoblastoma risk was associated with low birthweight. LIMITATIONS REASONS FOR CAUTION Although this study includes a large number of children born after donor ART, the rarity of specific diagnostic subgroups of childhood cancer results in few cases and therefore wide CIs for such outcomes. As this is an observational study, it is not possible to adjust for all potential confounders; we have instead used stratification to explore potential moderating and mediating factors, where data were available. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to investigate cancer risk in children born after donor ART. Although based on small numbers, results are reassuring for families and clinicians. The small but significant increased risk of hepatoblastoma detected was associated with low birthweight, a known risk factor for this tumour type. It should be emphasized that the absolute risks are very small. However, on-going investigation with a longer follow-up is needed. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by Cancer Research UK (C36038/A12535) and the National Institute for Health Research (405526) and supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London. The work of the Childhood Cancer Research Group (CCRG) was supported by the charity CHILDREN with CANCER UK, the National Cancer Intelligence Network, the Scottish Government and the Department of Health for England and Wales. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- C L Williams
- University College London, Great Ormond Street Institute of Child Health, London WC1 1EH, UK
| | - K J Bunch
- National Perinatal Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK
| | - M F G Murphy
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford OX3 9DU, UK
| | - C A Stiller
- National Cancer Registration and Analysis Service, Oxford OX4 2GX, UK
| | - B J Botting
- University College London, Great Ormond Street Institute of Child Health, London WC1 1EH, UK
| | - W H Wallace
- Paediatric Oncology Department, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh EH9 1LF, UK
| | - M C Davies
- Reproductive Medicine Unit, Institute for Women's Health, University College London Hospitals, London NW1 2BU, UK
| | - A G Sutcliffe
- University College London, Great Ormond Street Institute of Child Health, London WC1 1EH, UK
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22
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Wang T, Chen L, Yang T, Wang L, Zhao L, Zhang S, Ye Z, Chen L, Zheng Z, Qin J. Cancer risk among children conceived by fertility treatment. Int J Cancer 2019; 144:3001-3013. [PMID: 30548591 PMCID: PMC6590158 DOI: 10.1002/ijc.32062] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 12/03/2018] [Indexed: 12/31/2022]
Abstract
Prior studies on the association between fertility treatment and childhood cancer risk have generated inconsistent results. We performed a systematic review and meta-analysis of observation studies to summarize the evidence regarding the relation of fertility treatment with childhood cancer risk. A systematic literature search of several databases was conducted through April 2018 to identify relevant studies. The outcomes of interest included overall cancer, haematological malignancies, neural tumours, other solid tumours, and eight specific cancers. The overall risk estimates and corresponding 95% confidence intervals (CIs) were pooled using random-effects meta-analysis. Sixteen cohort and thirteen case-control studies were included. Results showed that children conceived by fertility treatment had significantly higher risk for developing overall cancer (relative risk [RR]: 1.16, 95% CI: 1.01, 1.32), haematological malignancies (RR: 1.39, 95% CI: 1.21, 1.60) and other solid tumours (RR: 1.57, 95% CI: 1.14, 2.16). For specific cancers, fertility treatment was associated with a significantly increased risk of leukaemia (RR: 1.31, 95% CI: 1.09, 1.57) and hepatic tumours (RR: 2.26, 95% CI: 1.32, 3.85). Sensitivity analysis validated evidence of the robustness of the findings. The results may demonstrate a possible association between fertility treatment and an increased risk of cancer among the offspring. However, the findings cannot say whether this increased risk is due to the subfertility itself or to the fertility treatment. Further research is needed to address the underlying mechanisms.
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Affiliation(s)
- Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lesan Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lijuan Zhao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Ziwei Ye
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Letao Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Zan Zheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
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Yang T, Li J, Wen Y, Tan T, Yang J, Pan J, Hu C, Yao Y, Zhang J, Xin Y, Li S, Xia H, He J, Zou Y. LINC00673 rs11655237 C>T Polymorphism Impacts Hepatoblastoma Susceptibility in Chinese Children. Front Genet 2019; 10:506. [PMID: 31178901 PMCID: PMC6544040 DOI: 10.3389/fgene.2019.00506] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/07/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatoblastoma (HB) is the most common hepatic malignancy in children, accounting for approximately 80% of all childhood liver tumors. Previous genome-wide association studies (GWASs) have found that the LINC00673 rs11655237 C>T polymorphism is associated with the risk of several different adult cancers. However, the association between this polymorphism and HB susceptibility remains unclear. METHODS We analyzed the association between the LINC00673 rs11655237 C>T polymorphism and HB susceptibility in a hospital-based study of Chinese children. We enrolled 213 HB patients and 958 healthy controls with genotypes determined by TaqMan, and the strength of the association of interest was determined by calculating odds ratios (ORs) and 95% confidence intervals (CIs). FINDINGS We found a significant association between the LINC00673 rs11655237 C>T polymorphism and HB risk (CT/TT compared with CC: adjusted OR = 1.40, 95% CI = 1.04-1.88, p = 0.029). Furthermore, stratified analysis indicated that rs11655237 T allele carriers in the following subgroups were more likely to develop HB: children older than 17 months, males, and those with tumors of clinical stages III + IV. INTERPRETATION In conclusion, we confirmed that the LINC00673 rs11655237 C>T polymorphism may be associated with HB susceptibility. Prospective studies with larger sample sizes and patients of different ethnicities are needed to validate our findings.
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Affiliation(s)
- Tianyou Yang
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiahao Li
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yang Wen
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tianbao Tan
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiliang Yang
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jing Pan
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chao Hu
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yuxiao Yao
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiao Zhang
- Department of Pediatric Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yijuan Xin
- Clinical Laboratory Medicine Center of PLA, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Suhong Li
- Department of Pathology, Children Hospital and Women Health Center of Shanxi, Taiyuan, China
| | - Huimin Xia
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Jing He, ;
| | - Yan Zou
- Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- Yan Zou, ;
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Xie L, Onysko J, Morrison H. Childhood cancer incidence in Canada: demographic and geographic variation of temporal trends (1992-2010). HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018. [PMID: 29537768 DOI: 10.24095/hpcdp.38.3.01] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Surveillance of childhood cancer incidence trends can inform etiologic research, policy and programs. This study presents the first population-based report on demographic and geographic variations in incidence trends of detailed pediatric diagnostic groups in Canada. METHODS The Canadian Cancer Registry data were used to calculate annual age-standardized incidence rates (ASIRs) from 1992 to 2010 among children less than 15 years of age by sex, age and region for the 12 main diagnostic groups and selected subgroups of the International Classification of Childhood Cancer (ICCC), 3rd edition. Temporal trends were examined by annual percent changes (APCs) using Joinpoint regression. RESULTS The ASIRs of childhood cancer among males increased by 0.5% (95% confidence interval (CI) = 0.2-0.9) annually from 1992 to 2010, whereas incidence among females increased by 3.2% (CI = 0.4-6.2) annually since 2004 after an initial stabilization. The largest overall increase was observed in children aged 1-4 years (APC = 0.9%, CI = 0.4-1.3). By region, the overall rates increased the most in Ontario from 2006 to 2010 (APC = 5.9%, CI = 1.9-10.1), and increased non-significantly in the other regions from 1992 to 2010. Average annual ASIRs for all cancers combined from 2006 to 2010 were lower in the Prairies (149.4 per million) and higher in Ontario (170.1 per million). The ASIRs increased for leukemias, melanoma, carcinoma, thyroid cancer, ependymomas and hepatoblastoma for all ages, and neuroblastoma in 1-4 year olds. Astrocytoma decreased in 10-14 year olds (APC = -2.1%, CI = -3.7 to -0.5), and among males (APC = -2.4%, CI = -4.6 to -0.2) and females (APC = -3.7%, CI = -5.8 to -1.6) in Ontario over the study period. CONCLUSION Increasing incidence trends for all cancers and selected malignancies are consistent with those reported in other developed countries, and may reflect the changes in demographics and etiological exposures, and artefacts of changes in cancer coding, diagnosis and reporting. Significant decreasing trend for astrocytoma in late childhood was observed for the first time.
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Affiliation(s)
- Lin Xie
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Jay Onysko
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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25
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Advancing Parental Age and Risk of Solid Tumors in Children: A Case-Control Study in Peru. JOURNAL OF ONCOLOGY 2018; 2018:3924635. [PMID: 30018640 PMCID: PMC6029448 DOI: 10.1155/2018/3924635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/06/2018] [Accepted: 05/20/2018] [Indexed: 11/17/2022]
Abstract
Background The causes of childhood cancer are not well known, but the advanced age of the parents has been suggested as a risk factor for childhood cancer in several observational studies. In this study, we examine a possible link between parental age and childhood solid tumors. Methods We conducted a hospital-based case-control study (310 cases and 620 controls, matched by age and gender) at Rebagliati Hospital, Lima, Peru. Odd ratio was used to compare categories of advancing maternal and paternal age with and without adjusting for possible confounding factors were calculated. Results The risk of childhood retinoblastoma was significantly higher among children of mothers aged> 35 years (adjusted OR 1.21; 95% CI, 1.09-6.08) and fathers aged> 35 years (OR 1.17; 1.01-16.33). A significant trend with increasing mother's age (p = 0.037) and father's age (p = 0.005) was found. There were more risks to development of non-Hodgkin's lymphoma (p = 0.047) and gonadal germ cell tumors (p = 0.04) for advanced paternal age. There was a strong protective effect of increasing parity on risk of solid tumors in children (p=0.0015). Conclusion Our results suggest that advanced parental age is associated with the risk for the development of retinoblastoma. Advanced paternal age increases the risk of non-Hodgkin lymphoma and gonadal germ cell tumor. The higher the order of birth of the children, the less the chance of developing any neoplasm.
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26
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Molina L, Bell D, Tao J, Preziosi M, Pradhan-Sundd T, Singh S, Poddar M, Luo J, Ranganathan S, Chikina M, Monga SP. Hepatocyte-Derived Lipocalin 2 Is a Potential Serum Biomarker Reflecting Tumor Burden in Hepatoblastoma. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 188:1895-1909. [PMID: 29920228 DOI: 10.1016/j.ajpath.2018.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 12/24/2022]
Abstract
Hepatoblastoma (HB) is the most common pediatric liver malignant tumor. Previously, we reported co-activation of β-catenin and Yes-associated protein-1 (YAP1) in 80% of HB. Hepatic co-expression of active β-catenin and YAP1 via sleeping beauty transposon/transposase and hydrodynamic tail vein injection led to HB development in mice. Here, we identify lipocalin 2 (Lcn2) as a target of β-catenin and YAP1 in HB and show that serum Lcn2 values positively correlated with tumor burden. Lcn2 was strongly expressed in HB tumor cells in our mouse model. A tissue array of 62 HB cases showed highest LCN2 expression in embryonal and lowest in fetal, blastemal, and small cell undifferentiated forms of HB. Knockdown of LCN2 in HB cells had no effect on cell proliferation but reduced NF-κB reporter activity. Next, liver-specific Lcn2 knockout (KO) mice were generated. No difference in tumor burden was observed between Lcn2 KO mice and wild-type littermate controls after sleeping beauty transposon/transposase and hydrodynamic tail vein injection delivery of active YAP1 and β-catenin, although Lcn2 KO mice with HB lacked any serum Lcn2 elevation, demonstrating that transformed hepatocytes are the source of serum Lcn2. More blastemal areas and inflammation were observed within HB in Lcn2 KO compared with wild-type tumors. In conclusion, Lcn2 expressed in hepatocytes appears to be dispensable for the pathogenesis of HB. However, transformed hepatocytes secrete serum Lcn2, making Lcn2 a valuable biomarker for HB.
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Affiliation(s)
- Laura Molina
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Danielle Bell
- Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Hematology-Oncology, Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Junyan Tao
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Morgan Preziosi
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tirthadipa Pradhan-Sundd
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sucha Singh
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Minakshi Poddar
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jianhua Luo
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarangarajan Ranganathan
- Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Pediatric Pathology, Department of Pathology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria Chikina
- Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Satdarshan P Monga
- Division of Experimental Pathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Liver Research Center, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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27
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Kehm RD, Spector LG, Poynter JN, Vock DM, Osypuk TL. Socioeconomic Status and Childhood Cancer Incidence: A Population-Based Multilevel Analysis. Am J Epidemiol 2018; 187:982-991. [PMID: 29036606 DOI: 10.1093/aje/kwx322] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/18/2017] [Indexed: 12/19/2022] Open
Abstract
The etiology of childhood cancers remains largely unknown, especially regarding environmental and behavioral risk factors. Unpacking the association between socioeconomic status (SES) and incidence may offer insight into such etiology. We tested associations between SES and childhood cancer incidence in a population-based case-cohort study (source cohort: Minnesota birth registry, 1989-2014). Cases, ages 0-14 years, were linked from the Minnesota Cancer Surveillance System to birth records through probabilistic record linkage. Controls were 4:1 frequency matched on birth year (2,947 cases and 11,907 controls). We tested associations of individual-level (maternal education) and neighborhood-level (census tract composite index) SES using logistic mixed models. In crude models, maternal education was positively associated with incidence of acute lymphoblastic leukemia (odds ratio (OR) = 1.10, 95% confidence interval (CI): 1.02, 1.19), central nervous system tumors (OR = 1.12, 95% CI: 1.04, 1.21), and neuroblastoma (OR = 1.15, 95% CI: 1.02, 1.30). Adjustment for established risk factors-including race/ethnicity, maternal age, and birth weight-substantially attenuated these positive associations. Similar patterns were observed for neighborhood-level SES. Conversely, higher maternal education was inversely associated with hepatoblastoma incidence (adjusted OR = 0.70, 95% CI: 0.51, 0.98). Overall, beyond the social patterning of established demographic and pregnancy-related exposures, SES is not strongly associated with childhood cancer incidence.
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Affiliation(s)
- Rebecca D Kehm
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Logan G Spector
- University of Minnesota, Division of Epidemiology and Clinical Research, Department of Pediatrics, Minneapolis, Minnesota
| | - Jenny N Poynter
- University of Minnesota, Division of Epidemiology and Clinical Research, Department of Pediatrics, Minneapolis, Minnesota
| | - David M Vock
- University of Minnesota School of Public Health, Division of Biostatistics, Minneapolis, Minnesota
| | - Theresa L Osypuk
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota
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28
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Fu H, Zhang J, Pan T, Ai S, Tang L, Wang F. miR‑378a enhances the sensitivity of liver cancer to sorafenib by targeting VEGFR, PDGFRβ and c‑Raf. Mol Med Rep 2018; 17:4581-4588. [PMID: 29328399 DOI: 10.3892/mmr.2018.8390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 09/12/2017] [Indexed: 11/05/2022] Open
Abstract
Liver cancer is a globally prevalent cancer with poor prognosis. The present study investigated the link between microRNA-378a (miR‑378a) expression and the sensitivity of hepatocellular carcinoma (HCC) and hepatoblastoma (HB) cancers to sorafenib therapy. miR‑378a expression was determined in liver tissue samples from healthy candidates and patients with liver cancer using the reverse transcription‑quantitative polymerase chain reaction. The antitumor effects of miR‑378a alone and in combination with sorafenib were investigated in the HB cell line HepG2 and the HCC cell line SMMC‑7721 with methyl thiazoyl tetrazolium, colony formation, flow cytometry and Transwell migration assays. The underlying mechanisms were investigated using western blot analysis. miR‑378a expression was decreased in tissue samples from patients with liver cancer. HCC and HB cell line proliferation and invasion ability was inhibited by miR‑378a. The combination of miR‑378a and sorafenib provided the greatest inhibition. Western blot indicated that mitogen activated protein kinase signaling pathway proteins, vascular endothelial growth factor receptor, platelet derived growth factor receptor β, Raf‑1 proto‑oncogene, serine/threonine kinase and matrix metallopeptidase 2 were regulated by miR‑378a alone and to a greater extent when combined with sorafenib. Results suggest that miR‑378a can inhibit liver cancer cell growth and enhance the sensitivity of liver cancer cells to sorafenib‑based chemotherapies.
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Affiliation(s)
- Hongxia Fu
- Department of Clinical Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Jicai Zhang
- Department of Clinical Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Tongshan Pan
- Department of Pediatrics, Danjiangkou First Hospital, Danjiangkou, Hubei 442700, P.R. China
| | - Shuying Ai
- Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Li Tang
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Fengqin Wang
- Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
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Xie X, Zhu H, Zhang J, Wang M, Zhu L, Guo Z, Shen W, Wang D. Solamargine inhibits the migration and invasion of HepG2 cells by blocking epithelial-to-mesenchymal transition. Oncol Lett 2017; 14:447-452. [PMID: 28693190 DOI: 10.3892/ol.2017.6147] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/30/2017] [Indexed: 02/03/2023] Open
Abstract
Solamargine (SM), a steroidal alkaloid glycoside purified from the Chinese traditional herb Solanum incanum, is known to possess various biological activities. However, only a few previous studies have reported the anti-metastatic activity of SM. In the present study, the inhibitory effects of SM on metastatic action were investigated in human HepG2 cells. The proliferation effects of SM on the HepG2 cells was evaluated by MTT and colony formation assays. Wound-healing and Transwell assays were performed to examine the migration and invasion effects on SM-treated HepG2 cells. The epithelial-to-mesenchymal transition (EMT)-associated markers (E-cadherin, Vimentin and N-cadherin) were detected by western blotting analysis. In the present study, MTT and colony formation assays indicated that SM suppressed HepG2 cell viability in a dose-dependent manner. The wound-healing and Transwell assays revealed that the migration and invasion activities were significantly inhibited following exposure to SM. EMT has been demonstrated to be essential for promoting migration and invasion in tumor cells and has often been characterized with a loss of epithelial markers (E-cadherin) and an increase of mesenchymal markers (Vimentin and N-cadherin). In the western blotting analysis, the expression level of E-cadherin was significantly upregulated compared with that in the control group, whereas the expression levels of N-cadherin and Vimentin were downregulated. Thus, it was suggested that the underlying mechanism of SM inhibits migration and invasion in HepG2 cells and is associated with suppression of EMT.
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Affiliation(s)
- Xiaodong Xie
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, Jiangsu 210000, P.R. China
| | - Haitao Zhu
- Department of Radiology, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Jia Zhang
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, Jiangsu 210000, P.R. China
| | - Meiqin Wang
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, Jiangsu 210000, P.R. China
| | - Li Zhu
- Department of Radiology, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Zhen Guo
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, Jiangsu 210000, P.R. China
| | - Wenrong Shen
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, Jiangsu 210000, P.R. China
| | - Dongqing Wang
- Department of Radiology, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
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30
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Reigstad MM, Oldereid NB, Omland AK, Storeng R. Literature review on cancer risk in children born after fertility treatment suggests increased risk of haematological cancers. Acta Paediatr 2017; 106:698-709. [PMID: 28128867 DOI: 10.1111/apa.13755] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 12/21/2016] [Accepted: 01/23/2017] [Indexed: 12/28/2022]
Abstract
Medically assisted fertility treatment, including assisted reproductive technology (ART), is increasingly being used and the subsequent child health outcomes are of interest. Some studies have suggested an elevated risk of somatic morbidity, while others have reported an elevated cancer risk. This review summarises the literature on fertility treatments and childhood cancer, based on 23 cohort and case-control studies. CONCLUSION The findings varied, but reassuring results on overall childhood cancer and fertility treatment were observed. However, some studies suggested an elevated risk of haematological cancers. More large population-based studies are needed, and the growing population of ART children should be monitored.
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Affiliation(s)
- Marte M. Reigstad
- Norwegian National Advisory Unit on Women's Health; Oslo University Hospital; Rikshospitalet HF; Oslo Norway
| | - Nan B. Oldereid
- Section for Reproductive Medicine; Division of Gynecology and Obstetrics; Oslo University Hospital Rikshospitalet; Oslo Norway
| | - Anne K. Omland
- Section for Reproductive Medicine; Division of Gynecology and Obstetrics; Oslo University Hospital Rikshospitalet; Oslo Norway
| | - Ritsa Storeng
- Norwegian National Advisory Unit on Women's Health; Oslo University Hospital; Rikshospitalet HF; Oslo Norway
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31
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Lerner-Geva L, Boyko V, Ehrlich S, Mashiach S, Hourvitz A, Haas J, Margalioth E, Levran D, Calderon I, Orvieto R, Ellenbogen A, Meyerovitch J, Ron-El R, Farhi A. Possible risk for cancer among children born following assisted reproductive technology in Israel. Pediatr Blood Cancer 2017; 64. [PMID: 27748017 DOI: 10.1002/pbc.26292] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/28/2016] [Accepted: 08/30/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Among children conceived by assisted reproductive technology (ART), increased risk of adverse birth outcomes has been observed, including multiple births, preterm births, and congenital malformations. Regarding cancer among ART-conceived children, findings are discrepant. METHODS This is a historical cohort of 9,042 ART-conceived children and 211,763 spontaneously conceived (SC) children born from 1997 through 2004. The median duration of follow-up was 10.6 years (interquartile range 9.0-12.3) in the ART group and 9.3 years (interquartile range 8.0-10.6) in the SC group. The cohort database was linked with the Israel National Cancer Registry updated until December 31, 2011 using each child's personal identification number. RESULTS Twenty-one cases of cancer were identified in the ART group (2.2 per 10,000 person-years), as compared to 361 cancer cases in the SC group (1.8 per 10,000 person-years). The relative risk (RR) for overall cancer in the ART group compared to the SC group adjusted for maternal characteristics was 1.18 (95% confidence interval [CI] 0.80-1.75). ART children had a significantly increased risk for specific cancers, although based on small number of cases, including two cases of retinoblastoma (RR 6.18, 95% CI 1.22-31.2), as well as four cases of renal tumors (RR 3.25, 95% CI 1.67-6.32). CONCLUSION A statistically significant increased risk for two pediatric cancers was found. However, for overall types of cancer the risk estimate was elevated but not statistically significant. Further studies with larger sample size and longer follow-up time are warranted in order to either confirm or refute these findings.
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Affiliation(s)
- Liat Lerner-Geva
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research Ltd., Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Valentina Boyko
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research Ltd., Tel Hashomer, Israel
| | - Shelley Ehrlich
- Division of Biostatistics and Epidemiology, Department of Environmental Health, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Shlomo Mashiach
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Medical Center, IVF Unit, Tel Aviv, Israel
| | - Ariel Hourvitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sheba Medical Center, IVF Unit, Tel Aviv, Israel
| | - Jigal Haas
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sheba Medical Center, IVF Unit, Tel Aviv, Israel
| | | | - David Levran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Wolfson Medical Center, IVF Unit, Tel Aviv, Israel
| | - Ilan Calderon
- Bnai-Zion Medical Center, IVF Unit, Tel Aviv, Israel
| | - Raoul Orvieto
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sheba Medical Center, IVF Unit, Tel Aviv, Israel.,Barzilai Medical Center, IVF Unit, Tel Aviv, Israel
| | | | - Joseph Meyerovitch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Raphael Ron-El
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assaf-Harofeh Medical Center, IVF Unit, Tel Aviv, Israel
| | - Adel Farhi
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research Ltd., Tel Hashomer, Israel
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32
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Bell D, Ranganathan S, Tao J, Monga SP. Novel Advances in Understanding of Molecular Pathogenesis of Hepatoblastoma: A Wnt/β-Catenin Perspective. Gene Expr 2017; 17:141-154. [PMID: 27938502 PMCID: PMC5311458 DOI: 10.3727/105221616x693639] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatoblastoma is the most common pediatric liver malignancy, typically striking children within the first 3 years of their young lives. While advances in chemotherapy and newer surgical techniques have improved survival in patients with localized disease, unfortunately, for the 25% of patients with metastasis, the overall survival remains poor. These tumors, which are thought to arise from hepatic progenitors or hepatoblasts, hence the name hepatoblastoma, can be categorized by histological subtyping based on their level of cell differentiation. Genomic and histological analysis of human tumor samples has shown exon-3 deletions or missense mutations in gene coding for β-catenin, a downstream effector of the Wnt signaling pathway, in up to 90% of hepatoblastoma cases. The current article will review key aberrations in molecular pathways that are implicated in various subtypes of hepatoblastoma with an emphasis on Wnt signaling. It will also discuss cooperation among components of pathways such as β-catenin and Yes-associated protein in cancer development. Understanding the complex network of molecular signaling in oncogenesis will undoubtedly aid in the discovery of new therapeutics to help combat hepatoblastoma.
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Duffy KA, Deardorff MA, Kalish JM. The utility of alpha-fetoprotein screening in Beckwith-Wiedemann syndrome. Am J Med Genet A 2017; 173:581-584. [PMID: 28160403 DOI: 10.1002/ajmg.a.38068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/11/2016] [Indexed: 01/10/2023]
Abstract
Beckwith-Wiedemann syndrome (BWS) is one of the most common cancer predisposition disorders. As a result, BWS patients receive tumor screening as part of their clinical management. Until recently, this screening has been employed uniformly across all genetic and epigenetic causes of BWS, including the utilization of ultrasonography to detect abdominal tumors and alpha-fetoprotein (AFP) to detect hepatoblastoma. The advancements in our understanding of the genetics and epigenetics leading to BWS has evolved over time, and has led to the development of genotype/phenotype correlations. As tumor risk appears to correlate with genetic and epigenetic causes of BWS, several groups have proposed alterations to tumor screening protocols based on the etiology of BWS, with the elimination of AFP as a screening measure and the elimination of all screening measures in BWS patients with loss of methylation at the KCNQ1OT1:TSS-DMR 2 (IC2). There are many challenges to this suggestion, as IC2 patients may have additional factors that contribute to risk of hepatoblastoma including fetal growth patterns, relationship with assisted reproductive technologies, and the regulation of the IC2 locus. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Kelly A Duffy
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Matthew A Deardorff
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer M Kalish
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Abstract
Although rare, hepatoblastoma is the most common pediatric liver tumor. Complete resection is a critical component for cure; however, most patients will have tumors that are not resected at diagnosis. For these patients, administration of neoadjuvant chemotherapy renders tumors resectable in most patients. For patients whose tumors remain unresectable after chemotherapy, liver transplantation is indicated (in the absence of active unresectable metastatic disease). In patients whose tumors remain unresectable after conventional chemotherapy, interventional techniques may serve as a promising option to reduce tumor size, decrease systemic toxicity, decrease need for liver transplantation, and increase feasibility of tumor resection.
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Affiliation(s)
- Angela D Trobaugh-Lotrario
- Department of Pediatric Hematology and Oncology, Providence Sacred Heart Children's Hospital, Spokane, WA
| | - Rebecka L Meyers
- Primary Children's Hospital, University of Utah, Salt Lake City, UT
| | | | - James H Feusner
- Children's Hospital & Research Center Oakland, Oakland, CA, USA
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35
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Contreras ZA, Ritz B, Virk J, Cockburn M, Heck JE. Maternal pre-pregnancy and gestational diabetes, obesity, gestational weight gain, and risk of cancer in young children: a population-based study in California. Cancer Causes Control 2016; 27:1273-85. [PMID: 27613707 PMCID: PMC5066566 DOI: 10.1007/s10552-016-0807-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/30/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE We aimed to examine the influence of pre-pregnancy diabetes, pre-pregnancy body mass index (BMI), gestational diabetes, and gestational weight gain on childhood cancer risk in offspring. METHODS We identified cancer cases (n = 11,149) younger than age 6 years at diagnosis from the California Cancer Registry registered between 1988 and 2013. Controls (n = 270,147) were randomly sampled from California birth records, and frequency matched by year of birth to all childhood cancers during the study period. Exposure and covariate information were extracted from birth records. Unconditional logistic regression models were generated to assess the importance of pre-pregnancy diabetes, pre-pregnancy BMI, gestational diabetes, and gestational weight gain on childhood cancer risk. RESULTS We observed increased risks of acute lymphoblastic leukemia and Wilms' tumor in children of mothers with pre-pregnancy diabetes [odds ratio (OR) 95 % confidence interval (CI) 1.37 (1.11, 1.69); OR (95 % CI) 1.45 (0.97, 2.18), respectively]. When born to mothers who were overweight prior to pregnancy (BMI 25-<30), children were at increased risk of leukemia [OR (95 % CI) 1.27 (1.01, 1.59)]. Insufficient gestational weight gain increased the risk of acute myeloid leukemia [OR (95 % CI) 1.50 (0.92, 2.42)] while excessive gestational weight gain increased the risk of astrocytomas [OR (95 % CI) 1.56 (0.97, 2.50)]. No associations were found between gestational diabetes and childhood cancer risk in offspring. CONCLUSIONS We estimated elevated risks of several childhood cancers in the offspring of mothers who had diabetes and were overweight prior to pregnancy, as well as mothers who gained insufficient or excessive weight. Since few studies have focused on these factors in relation to childhood cancer, replication of our findings in future studies is warranted.
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Affiliation(s)
- Zuelma A Contreras
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jasveer Virk
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, USC/Keck School of Medicine, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
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Trobaugh-Lotrario AD, Meyers RL, Tiao GM, Feusner JH. Pediatric liver transplantation for hepatoblastoma. Transl Gastroenterol Hepatol 2016; 1:44. [PMID: 28138611 DOI: 10.21037/tgh.2016.04.01] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/16/2016] [Indexed: 01/03/2023] Open
Abstract
Hepatoblastoma is the most common pediatric liver tumor and is usually diagnosed before five years of age. Treatment consists of a combination of chemotherapy and surgery, with the goal being attainment of complete local control by surgical resection and eradication of any extrahepatic disease. Neoadjuvant chemotherapy is utilized and is often beneficial in rendering tumors resectable; however, prolonged chemotherapy administration attempting to render tumors resectable by conventional resection should be avoided. For patients whose tumors are too extensive to be conventionally resected, liver transplantation can be curative and remains the treatment of choice for eligible patients otherwise incurable by conventional resection.
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Affiliation(s)
- Angela D Trobaugh-Lotrario
- Department of Pediatric Hematology/Oncology, Providence Sacred Heart Children's Hospital, Spokane, WA, USA
| | - Rebecka L Meyers
- Department of Pediatric Surgery, Primary Children's Medical Center, Salt Lake City, UT, USA
| | - Greg M Tiao
- Department of Pediatric Surgery, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - James H Feusner
- Department of Pediatric Hematology/Oncology, Children's Hospital & Research Center Oakland, Oakland, CA, USA
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37
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Reigstad MM, Larsen IK, Myklebust TÅ, Robsahm TE, Oldereid NB, Brinton LA, Storeng R. Risk of Cancer in Children Conceived by Assisted Reproductive Technology. Pediatrics 2016; 137:e20152061. [PMID: 26908669 PMCID: PMC5178823 DOI: 10.1542/peds.2015-2061] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE An increasing number of children are born after assisted reproductive technology (ART), and monitoring their long-term health effects is of interest. This study compares cancer risk in children conceived by ART to that in children conceived without. METHODS The Medical Birth Registry of Norway contains individual information on all children born in Norway (including information of ART conceptions). All children born between 1984 and 2011 constituted the study cohort, and cancer data were obtained from the Cancer Registry of Norway. Follow-up started at date of birth and ended on the date of the first cancer diagnosis, death, emigration, or December 31, 2011. A Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer risk between children conceived by ART and those not. Cancer risk was also assessed separately for all childhood cancer types. RESULTS The study cohort comprised 1 628 658 children, of which 25 782 were conceived by ART. Of the total 4554 cancers, 51 occurred in ART-conceived children. Risk of overall cancer was not significantly elevated (HR 1.21; 95% CI 0.90-1.63). However, increased risk of leukemia was observed for children conceived by ART compared with those who were not (HR 1.67; 95% CI 1.02-2.73). Elevated risk of Hodgkin's lymphoma was also found for ART-conceived children (HR 3.63; 95% CI 1.12-11.72), although this was based on small numbers. CONCLUSIONS This population-based cohort study found elevated risks of leukemia and Hodgkin's lymphoma in children conceived by ART.
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Affiliation(s)
- Marte Myhre Reigstad
- Norwegian National Advisory Unit on Women's Health and Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; and
| | - Inger Kristin Larsen
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; and
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; and
| | - Trude Eid Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; and
| | - Nan Birgitte Oldereid
- Section for Reproductive Medicine, Department of Gynecology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Louise A. Brinton
- Division of Cancer Epidemiology & Genetics, Hormonal and Reproductive Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Ritsa Storeng
- Norwegian National Advisory Unit on Women’s Health and
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38
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Heck JE, Omidakhsh N, Azary S, Ritz B, von Ehrenstein OS, Bunin GR, Ganguly A. A case-control study of sporadic retinoblastoma in relation to maternal health conditions and reproductive factors: a report from the Children's Oncology group. BMC Cancer 2015; 15:735. [PMID: 26481585 PMCID: PMC4615328 DOI: 10.1186/s12885-015-1773-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 10/10/2015] [Indexed: 01/08/2023] Open
Abstract
Background The early age at retinoblastoma occurrence, the most common eye malignancy in childhood, suggests that perinatal factors may contribute to its etiology. Methods In a large multicenter study of non-familial retinoblastoma, we conducted structured interviews with the parents of 280 cases and 146 controls to elicit information on health during the perinatal period. We used unconditional logistic regression to assess associations between retinoblastoma and parental fertility treatment, birth control use in the year prior to pregnancy, maternal health conditions and the use of prescription medications during pregnancy, and whether mothers breastfed the index child. Results Bilateral retinoblastoma was related to maternal underweight (body mass index <18.5) prior to pregnancy [Odds Ratio (OR) = 4.5, 95 % confidence interval (CI) 1.0, 20]. With regards to unilateral retinoblastoma, we observed a negative association with the use of condoms in the year prior to pregnancy (OR = 0.4, CI 0.2, 0.9), and a trend towards a positive association with maternal diabetes (OR = 2.2, CI 0.8, 6.6). Conclusions Results from our study suggest a role for several maternal health and reproductive factors. Given that there are few epidemiologic studies of retinoblastoma, our results require replication in studies which utilize medical record review. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1773-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E Young Dr, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E Young Dr, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Saeedeh Azary
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E Young Dr, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E Young Dr, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, 650 Charles E Young Dr, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Greta R Bunin
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, 3535 Market Street, Room 1472, Philadelphia, PA, 19104, USA.
| | - Arupa Ganguly
- Department of Genetics, University of Pennsylvania, USA415 Anatomy Chemistry Building, 3620 Hamilton Walk, Philadelphia, PA, 19104, USA.
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Tulla M, Berthold F, Graf N, Rutkowski S, von Schweinitz D, Spix C, Kaatsch P. Incidence, Trends, and Survival of Children With Embryonal Tumors. Pediatrics 2015; 136:e623-32. [PMID: 26304823 DOI: 10.1542/peds.2015-0224] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Central nervous system (CNS) and non-CNS embryonal tumors occur principally in children and are rarely seen in adults. The incidence rates for rare entities such as atypical teratoid/rhabdoid tumors (AT/RT) or primitive neuroectodermal tumors in the CNS are rarely published. Incidence rates for certain subgroups, such as hepatoblastomas, have been increasing in some countries. METHODS Data of 8337 embryonal tumors, registered in children (0-14 years) between 1991 and 2012 (for AT/RT 2000-2012) in the population-based German Childhood Cancer Registry with complete national coverage were analyzed for incidence rates, time trends, and survival. RESULTS For most entities, the incidence rates were the highest for children <1 year. An important exception was medulloblastomas, which occurred mainly in 1- to 9-year-olds. Neuroblastomas and ganglioneuroblastomas as well as Wilms tumors (nephroblastomas) had the highest age standardized incidence rates (13.7 and 9.4 per million, respectively). A statistically significant increasing trend for hepatoblastomas (annual average percent change 4.6%) was detected. The survival probabilities varied between the diagnostic groups: primitive neuroectodermal tumors and AT/RT had the lowest and retinoblastomas the highest. The survival was dependent on the age at diagnosis, the most extreme examples being neuroblastomas, for which the survival probability declined steeply for children ≥1 year and medulloblastomas, for which the highest survival was seen for 10- to 14-year-olds. CONCLUSIONS This study presents a comprehensive overview of pediatric embryonal tumors from a well-established, complete nationwide cancer registry. Significant increasing trend for hepatoblastomas was detected for the first time in Europe.
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Affiliation(s)
- M Tulla
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany;
| | - F Berthold
- Children's Hospital, Department of Pediatric Oncology and Hematology and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - N Graf
- Department of Pediatric Hematology and Oncology, University of Saarland, Homburg/Saar, Germany
| | - S Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and
| | - D von Schweinitz
- Department of Pediatric Surgery, University of Munich, Munich, Germany
| | - C Spix
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - P Kaatsch
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
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Hyrapetian M, Loucaides EM, Sutcliffe AG. Health and disease in children born after assistive reproductive therapies (ART. J Reprod Immunol 2015; 106:21-6. [PMID: 25438931 DOI: 10.1016/j.jri.2014.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 07/15/2014] [Accepted: 08/04/2014] [Indexed: 01/20/2023]
Abstract
In vitro fertilisation (IVF) and other assisted reproductive therapies (ART) offer hope to subfertile couples worldwide. At least 5 million ART children have been born to date. Their health is an issue that is increasingly relevant: first, to those children and young adults themselves; second, to couples considering fertility treatment; and third, to the general population as ART has progressed from experimental treatment to routine practice. Many concerns about the potential risks to these children have been voiced with varying degrees of supportive evidence. This article summarises some key long-term data. Current evidence suggests that ART does increase risk of: higher order pregnancy (with its inherent pre- and perinatal risks); prematurity and low birth weight; congenital malformations in particular of the male urogenital system; imprinting disorders. Reassuringly, evidence points away from an increased overall cancer risk or differences in neurodevelopmental outcomes. Many unknowns remain, including future fertility and cardiovascular risks and risk of cerebral palsy.
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Affiliation(s)
- Mariyum Hyrapetian
- The Whittington Hospital, Whittington NHS Trust, Magdala Avenue, N19 5NF London, United Kingdom
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41
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Bahnassy AA, Fawzy M, El-Wakil M, Zekri ARN, Abdel-Sayed A, Sheta M. Aberrant expression of cancer stem cell markers (CD44, CD90, and CD133) contributes to disease progression and reduced survival in hepatoblastoma patients: 4-year survival data. Transl Res 2015; 165:396-406. [PMID: 25168019 DOI: 10.1016/j.trsl.2014.07.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 07/03/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
Abstract
Hepatoblastoma (HB) is an embryonal tumor of the liver in children. Prognosis and response to treatment in HB are highly variable. Cancer stem cells (CSCs) constitute a population of cells, which contribute to the development and progression of many tumors. However, their role in HB is not well defined yet. We assessed the prognostic and predictive values of some CSC markers in HB patients. Protein and messenger RNA expressions of the CSC markers CD133, CD90, and CD44 were assessed in 43 HB patients and 20 normal hepatic tissues using immunohistochemistry and quantitative real-time polymerase chain reaction. The expression levels of these markers were correlated to standard prognostic factors, patients' response to treatment, overall survival (OS), and disease-free survival (DFS). CD44, CD90, and CD133 proteins were detected in 48.8%, 32.6%, and 48.8% compared with 46.5%, 41.7%, and 58.1% RNA, respectively (concordance, 77.8%-96%). None of the normal tissue samples was positive for any of the markers. Significant correlations were reported between α-fetoprotein and both CD44 and CD133 (P = 0.02) as well as between tumor types CD90 and CD133 (P = 0.009). Reduced OS correlated with CD44, CD90, and CD133 expressions (P < 0.001), advanced stage (P < 0.001), response to treatment (P < 0.001), and total excision of the tumor. Reduced DFS correlated with CD44 and CD133 expressions (P < 0.001) only. In conclusion, CD133, CD44, and CD90 could be used as prognostic and predictive markers in HB. High expression of these markers is significantly associated with poor response to treatment and reduced survival. Moreover, complete surgical resection and systemic chemotherapy are essential to achieve good response and prolonged survival, especially in early stage patients.
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Affiliation(s)
- Abeer A Bahnassy
- Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Mohamed Fawzy
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohamed El-Wakil
- Clinical Oncology Department, Faculty of Medicine, Beni-Suef University, Cairo, Egypt
| | - Abdel-Rahman N Zekri
- Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmed Abdel-Sayed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Marwa Sheta
- Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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42
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Kettner LO, Henriksen TB, Bay B, Ramlau-Hansen CH, Kesmodel US. Assisted reproductive technology and somatic morbidity in childhood: a systematic review. Fertil Steril 2015; 103:707-19. [PMID: 25624193 DOI: 10.1016/j.fertnstert.2014.12.095] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/21/2014] [Accepted: 12/04/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess whether children conceived by assisted reproductive technology are at increased risk of somatic morbidity in childhood compared with spontaneously conceived children. DESIGN Systematic review. SETTING None. PATIENT(S) Children conceived by assisted reproductive technology and reference groups of spontaneously conceived children or children from the background population. INTERVENTION(S) Medline/Pubmed, Embase, and the Cochrane Library were searched as well as reference lists of the retrieved relevant studies. Only cohort studies and case-control studies were included. All studies were scored using the Newcastle-Ottawa scale to assess study quality and the risk of bias in the individual studies. MAIN OUTCOME MEASURE(S) Postneonatal somatic diseases, health care use, chronic illnesses (unspecified), surgery, use of medication, and mortality. RESULT(S) Thirty-eight studies were included. Results indicated that children conceived by assisted reproductive technology may be at increased risk of unspecified infectious and parasitic diseases, asthma, genitourinary diseases, epilepsy or convulsions, and longer hospitalizations. However, several results in individual studies were not statistically significant and some inconsistency existed between study results. No differences between groups were found regarding hospital admission, outpatient visits, or use of medication. Results regarding mortality, unspecified cancer, pneumonia, allergy, respiratory, and gastrointestinal diseases were contradictory. When considering only the 13 studies allocated the highest score on the Newcastle-Ottawa scale, similar results were found. CONCLUSION(S) Children conceived by assisted reproductive technology may be at increased risk of somatic morbidity in childhood compared with spontaneously conceived children, although some inconsistency exists between study results.
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Affiliation(s)
- Laura Ozer Kettner
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark.
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Bjørn Bay
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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43
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Turcotte LM, Georgieff MK, Ross JA, Feusner JH, Tomlinson GE, Malogolowkin MH, Krailo MD, Miller N, Fonstad R, Spector LG. Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: a report from the Children's Oncology Group. Pediatr Blood Cancer 2014; 61:2018-23. [PMID: 25044669 PMCID: PMC4287257 DOI: 10.1002/pbc.25128] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/07/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. PROCEDURE Incident hepatoblastoma cases who were born <2,500 g (N = 60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N = 51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. RESULTS Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. CONCLUSIONS This study presents the largest case series of hepatoblastoma in <2,500 g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology.
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Affiliation(s)
- Lucie M. Turcotte
- Division of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota,Correspondence to: Lucie M. Turcotte, MD, MPH, Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, 420 Delaware St SE, MMC 484, Minneapolis, MN 55455.
| | | | - Julie A. Ross
- Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, Minnesota,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - James H. Feusner
- Children's Hospital & Research Center Oakland, Oakland, California
| | | | - Marcio H. Malogolowkin
- Division of Hematology/Oncology/Bone Marrow Transplant, Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Mark D. Krailo
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Nicole Miller
- Division of Neonatology, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Fonstad
- Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, Minnesota
| | - Logan G. Spector
- Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, Minnesota
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44
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Hargreave M, Jensen A, Nielsen TSS, Colov EP, Andersen KK, Pinborg A, Kjaer SK. Maternal use of fertility drugs and risk of cancer in children--a nationwide population-based cohort study in Denmark. Int J Cancer 2014; 136:1931-9. [PMID: 25257918 DOI: 10.1002/ijc.29235] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/10/2014] [Accepted: 09/15/2014] [Indexed: 11/05/2022]
Abstract
Large population-based studies are needed to examine the effect of maternal use of fertility drugs on the risk of cancer in children, while taking into account the effect of the underlying infertility. A cohort of 123,322 children born in Denmark between 1964 and 2006 to 68,255 women who had been evaluated for infertility was established. We used a case-cohort design and calculated hazard ratios (HRs) for cancer in childhood (0-19 years) and in young adulthood (20-29 years) associated with maternal use of six groups of fertility drugs (clomiphene, gonadotropins [i.e., human menopausal gonadotropins and follicle-stimulating hormone], gonadotropin-releasing hormone analogs, human chorionic gonadotropins, progesterone and other fertility drugs). We found no statistically significant association between maternal use of fertility drugs and risk for overall cancer in childhood or young adulthood. However, with regard to specific cancers in childhood, our results showed that maternal use of progesterone before childbirth markedly increased the risks of their offspring for acute lymphocytic leukemia (any use: HR, 4.95; 95% CI, 1.69-14.54; ≥ three cycles of use: HR, 9.96; 95% CI, 2.63-37.77) and for sympathetic nervous system tumors (any use: HR, 5.79; 95% CI, 1.23-27.24; ≥ three cycles of use: HR, 8.51; 95% CI, 1.72-42.19). These findings show that maternal use of progesterone may increase the risk for specific cancers in the offspring. Additional large epidemiological studies are urgently needed to confirm our finding.
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Affiliation(s)
- Marie Hargreave
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
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45
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Spyridakis I, Kepertis C, Lampropoulos V, Mouravas V, Filippopoulos A. Embryonal/Fetal subtype hepatoblastoma: a case report. J Clin Diagn Res 2014; 8:ND01-2. [PMID: 25386480 DOI: 10.7860/jcdr/2014/6643.4823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 04/16/2014] [Indexed: 11/24/2022]
Abstract
Hepatoblastoma is the most common primary liver tumor of childhood and after neuroblastoma and nephroblastoma the third most common abdominal neoplasm in this age group. Hepatoblastoma is an embryonal tumor classified by histology as epithelial (including pure fetal subtype, mixed embryonal/fetal subtype, macrotrabecular subtype and small cell undifferentiated subtype), mixed epithelial and mesenchymal type (with teratoid and non-teratoid features) and hepatoblastoma not otherwise specified. We present a case of a five-months old girl with embryonal/fetal subtype hepatoblastoma. The clinical presentation was asymptomatic abdominal mass. Ultrasound and MRI scan demonstrated a solid hepatic tumor. She presented thrombocytosis and serum alpha-fetoprotein was increased. A left lobe hepatectomy was performed and the pathological examination revealed complete excision of a mixed embryonalfetal subtype hepatoblastoma.
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Affiliation(s)
- I Spyridakis
- Assistant Professor, Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Ring Road Efkarpia-Thessaloniki - Greece
| | - C Kepertis
- Paediatric Surgeon, Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Ring Road Efkarpia-Thessaloniki - Greece
| | - V Lampropoulos
- Paediatric Surgeon, Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Ring Road Efkarpia-Thessaloniki - Greece
| | - V Mouravas
- Paediatric Surgeon, Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Ring Road Efkarpia-Thessaloniki - Greece
| | - A Filippopoulos
- Assistant Professor, Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Ring Road Efkarpia-Thessaloniki - Greece
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46
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Sundh KJ, Henningsen AKA, Källen K, Bergh C, Romundstad LB, Gissler M, Pinborg A, Skjaerven R, Tiitinen A, Vassard D, Lannering B, Wennerholm UB. Cancer in children and young adults born after assisted reproductive technology: a Nordic cohort study from the Committee of Nordic ART and Safety (CoNARTaS). Hum Reprod 2014; 29:2050-7. [PMID: 24990274 DOI: 10.1093/humrep/deu143] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
STUDY QUESTION Do children and young adults born after assisted reproductive technology (ART) have an increased risk of cancer? SUMMARY ANSWER Children born after ART showed no overall increase in the rate of cancer when compared with children born as a result of spontaneous conception. WHAT IS KNOWN ALREADY Children born after ART have more adverse perinatal outcomes, i.e. preterm births, low birthweights and birth defects. Previous studies have shown divergent results regarding the risk of cancer among children born after ART. STUDY DESIGN, SIZE, DURATION A retrospective Nordic population-based cohort study was performed, comprising all children born after ART in Sweden, Denmark, Finland and Norway between 1982 and 2007. The mean (±standard deviation) follow-up time was 9.5 (4.8) years. PARTICIPANTS/MATERIALS, SETTING, METHODS Children born after ART (n = 91 796) were compared with a control group of children born after spontaneous conception. This control group was almost 4-fold the size of the ART group (n = 358 419) and matched for parity, year of birth and country. Data on perinatal outcomes and cancer were obtained from the National Medical Birth Registries, the Cancer Registries, the Patient Registries and the Cause of Death Registries. The cancer diagnoses were divided into 12 main groups. Hazard ratios (HRs) and adjusted HR were calculated. Adjustments were carried out for country, maternal age, parity, sex, gestational age and birth defects. MAIN RESULTS AND THE ROLE OF CHANCE There was no significant increase in overall cancer rates among children born after ART when compared with children born after spontaneous conception (adjusted HR 1.08; 95% CI 0.91-1.27). Cancer, of any form, was found among 181 children born after ART (2.0/1000 children, 21.0/100 000 person-years) compared with 638 children born after spontaneous conception (1.8/1000 children, 18.8/100 000 person-years). Leukaemia was the most common type of cancer (n = 278, 0.62/1000 children) but no significantly increased incidence was found among children born after ART. An increased risk was observed for 2 of 12 cancer groups. They were central nervous system tumours (adjusted HR 1.44; 95% CI 1.01-2.05) and malignant epithelial neoplasms (adjusted HR 2.03; 95% CI 1.06-3.89); the absolute risks were 0.46/1000 and 0.15/1000 children, respectively, corresponding to an absolute increased risk of 0.14/1000 and 0.08/1000 children, respectively. LIMITATIONS, REASONS FOR CAUTION As this is an observational study, the main limitation is the fact that it is not possible to adjust for all potential confounders. We were not able to control for confounders such as socio-economic status and perinatal factors, such as Apgar score, which other studies have suggested affect cancer rates. WIDER IMPLICATIONS OF THE FINDINGS The results of this large population-based cohort study are in agreement with most previously published studies. The main findings are reassuring for couples undergoing ART, children born after ART and clinicians working with ART. STUDY FUNDING/COMPETING INTERESTS No conflict of interest was reported. The study was supported by grants from The European Society for Human Reproduction and Embryology (ESHRE), Sahlgrenska University Hospital, Gothenburg, Sweden, the University of Copenhagen, Denmark, the Danish Agency of Science, Technology and Innovation and the Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
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Affiliation(s)
- Karin Jerhamre Sundh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, SE-416 85 Gothenburg, Sweden
| | | | - Karin Källen
- Department of Reproduction Epidemiology, Tornblad Institute, Institution of Clinical Sciences, Lund University, Lund, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Sweden Academy, University of Gothenburg, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Liv Bente Romundstad
- Department of Obstetrics and Gynaecology, Fertility Clinic, St Olavs University Hospital, Trondheim, Norway Department of Public Health, NTNU, Trondheim, Norway
| | - Mika Gissler
- THL, National Institute for Health and Welfare, Helsinki, Finland Nordic School of Public Health, Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
| | - Rolv Skjaerven
- Department of Global Public Health, University of Bergen, Bergen, Norway Medical Birth Registry of Norway, National Institute of Public Health, Bergen, Norway
| | - Aila Tiitinen
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Ditte Vassard
- Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Birgitta Lannering
- Department of Clinical Sciences, Paedriatic Oncology, University of Gothenburg, Gothenburg, Sweden
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, SE-416 85 Gothenburg, Sweden
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Hackl C, Schlitt HJ, Kirchner GI, Knoppke B, Loss M. Liver transplantation for malignancy: Current treatment strategies and future perspectives. World J Gastroenterol 2014; 20:5331-5344. [PMID: 24833863 PMCID: PMC4017048 DOI: 10.3748/wjg.v20.i18.5331] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/31/2013] [Accepted: 02/27/2014] [Indexed: 02/06/2023] Open
Abstract
In 1967, Starzl et al performed the first successful liver transplantation for a patient diagnosed with hepatoblastoma. In the following, liver transplantation was considered ideal for complete tumor resection and potential cure from primary hepatic malignancies. Several reports of liver transplantation for primary and metastatic liver cancer however showed disappointing results and the strategy was soon dismissed. In 1996, Mazzaferro et al introduced the Milan criteria, offering liver transplantation to patients diagnosed with limited hepatocellular carcinoma. Since then, liver transplantation for malignant disease is an ongoing subject of preclinical and clinical research. In this context, several aspects must be considered: (1) Given the shortage of deceased-donor organs, long-term overall and disease free survival should be comparable with results obtained in patients transplanted for non-malignant disease; (2) In this regard, living-donor liver transplantation may in selected patients help to solve the ethical dilemma of optimal individual patient treatment vs organ allocation justice; and (3) Ongoing research focusing on perioperative therapy and anti-proliferative immunosuppressive regimens may further reduce tumor recurrence in patients transplanted for malignant disease and thus improve overall survival. The present review gives an overview of current indications and future perspectives of liver transplantation for malignant disease.
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48
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Fawzy M, Bahnassy A, El-Wakil M, Abdel-Sayed A. Hepatoblastoma Survival and the Prognostic Role of Cancer Stem Cell Markers. INTERNATIONAL JOURNAL OF CANCER THERAPY AND ONCOLOGY 2014. [DOI: 10.14319/ijcto.0201.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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49
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Allan BJ, Wang B, Davis JS, Parikh PP, Perez EA, Neville HL, Sola JE. A review of 218 pediatric cases of hepatocellular carcinoma. J Pediatr Surg 2014; 49:166-71; discussion 171. [PMID: 24439603 DOI: 10.1016/j.jpedsurg.2013.09.050] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 09/30/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE This study evaluates the incidence trends and clinical outcomes of children with hepatocellular carcinoma (HCC) and assesses factors predictive of patient survival. METHODS The Surveillance, Epidemiology, and End Results registry was queried from 1973 to 2009 for all patients between ages 0 and 19 with primary HCC. Demographics, tumor histology, surgical intervention, and patient survival were collected. RESULTS Overall, 218 patients were identified. The annual age-adjusted incidence was 0.05 cases per 100,000 in 2009. Fibrolamellar subtype tumors were exclusive to children >5years old and exhibited greater survival compared to non-fibrolamellar subtype (57% vs. 28%, respectively, p=0.002). Tumor extirpation for patients with resectable disease significantly improved overall survival at 5years compared to no surgery (60% vs. 0%, respectively, p<0.0001). Overall 5-, 10- and 20-year survival for the entire cohort was 24%, 23%, and 8%, respectively. Independent prognostic factors of lower mortality according to multivariate analysis were surgical resection (hazard ratio (HR)=0.18), non-Hispanic ethnicity (HR=0.52), and local disease at presentation (HR=0.46). CONCLUSION Over the past four decades, the incidence of HCC has remained relatively stable. Children of Hispanic ethnicity have high mortality rates. However, HCC resection for curative intent significantly improves outcomes.
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Affiliation(s)
- Bassan J Allan
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Bo Wang
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - James S Davis
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Punam P Parikh
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Eduardo A Perez
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Holly L Neville
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan E Sola
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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50
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M Turcotte L, G Spector L. What do we know about the etiology of hepatoblastoma? Hepat Oncol 2013; 1:7-10. [PMID: 30190935 DOI: 10.2217/hep.13.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Lucie M Turcotte
- Division of Pediatric Hematology/Oncology, University of Minnesota, 420 Delaware Street SE, MMC 484, Minneapolis, MN 55455, USA.,Division of Pediatric Hematology/Oncology, University of Minnesota, 420 Delaware Street SE, MMC 484, Minneapolis, MN 55455, USA
| | - Logan G Spector
- Division of Pediatric Epidemiology & Clinical Research, University of Minnesota, 420 Delaware Street SE, MMC 422, Minneapolis, MN 55455, USA.,Division of Pediatric Epidemiology & Clinical Research, University of Minnesota, 420 Delaware Street SE, MMC 422, Minneapolis, MN 55455, USA
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