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Nakhli R, Rich K, Zhang A, Darbandsari A, Shenasa E, Hadjifaradji A, Thiessen S, Milne K, Jones SJM, McAlpine JN, Nelson BH, Gilks CB, Farahani H, Bashashati A. VOLTA: an enVironment-aware cOntrastive ceLl represenTation leArning for histopathology. Nat Commun 2024; 15:3942. [PMID: 38729933 PMCID: PMC11087497 DOI: 10.1038/s41467-024-48062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
In clinical oncology, many diagnostic tasks rely on the identification of cells in histopathology images. While supervised machine learning techniques necessitate the need for labels, providing manual cell annotations is time-consuming. In this paper, we propose a self-supervised framework (enVironment-aware cOntrastive cell represenTation learning: VOLTA) for cell representation learning in histopathology images using a technique that accounts for the cell's mutual relationship with its environment. We subject our model to extensive experiments on data collected from multiple institutions comprising over 800,000 cells and six cancer types. To showcase the potential of our proposed framework, we apply VOLTA to ovarian and endometrial cancers and demonstrate that our cell representations can be utilized to identify the known histotypes of ovarian cancer and provide insights that link histopathology and molecular subtypes of endometrial cancer. Unlike supervised models, we provide a framework that can empower discoveries without any annotation data, even in situations where sample sizes are limited.
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Affiliation(s)
- Ramin Nakhli
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Katherine Rich
- Bioinformatics Graduate Program, University of British Columbia, Vancouver, Canada
| | - Allen Zhang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amirali Darbandsari
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Elahe Shenasa
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amir Hadjifaradji
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Sidney Thiessen
- Deeley Research Centre, BC Cancer Agency, Victoria, BC, Canada
| | - Katy Milne
- Deeley Research Centre, BC Cancer Agency, Victoria, BC, Canada
| | - Steven J M Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, Vancouver, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - Jessica N McAlpine
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Brad H Nelson
- Deeley Research Centre, BC Cancer Agency, Victoria, BC, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hossein Farahani
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Ali Bashashati
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, Vancouver, Canada.
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DiSipio T, Scholte C, Diaz A. Evaluation of online text-based information resources of gynaecological cancer symptoms. Cancer Med 2024; 13:e7167. [PMID: 38676385 PMCID: PMC11053368 DOI: 10.1002/cam4.7167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Gynaecological cancer symptoms are often vague and non-specific. Quality health information is central to timely cancer diagnosis and treatment. The aim of this study was to identify and evaluate the quality of online text-based patient information resources regarding gynaecological cancer symptoms. METHODS A targeted website search and Google search were conducted to identify health information resources published by the Australian government and non-government health organisations. Resources were classified by topic (gynaecological health, gynaecological cancers, cancer, general health); assessed for reading level (Simple Measure of Gobbledygook, SMOG) and difficulty (Flesch Reading Ease, FRE); understandability and actionability (Patient Education Materials Assessment Tool, PEMAT, 0-100), whereby higher scores indicate better understandability/actionability. Seven criteria were used to assess cultural inclusivity specific for Aboriginal and Torres Strait Islander people; resources which met 3-5 items were deemed to be moderately inclusive and 6+ items as inclusive. RESULTS A total of 109 resources were identified and 76% provided information on symptoms in the context of gynaecological cancers. The average readability was equivalent to a grade 10 reading level on the SMOG and classified as 'difficult to read' on the FRE. The mean PEMAT scores were 95% (range 58-100) for understandability and 13% (range 0-80) for actionability. Five resources were evaluated as being moderately culturally inclusive. No resource met all the benchmarks. CONCLUSIONS This study highlights the inadequate quality of online resources available on pre-diagnosis gynaecological cancer symptom information. Resources should be revised in line with the recommended standards for readability, understandability and actionability and to meet the needs of a culturally diverse population.
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Affiliation(s)
- Tracey DiSipio
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Cate Scholte
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Abbey Diaz
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
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Chen M, Wang P, Li Y, Jin Z, An Y, Zhang Y, Yuan W. Prediction of hematologic toxicity in luminal type breast cancer patients receiving neoadjuvant chemotherapy using CT L1 level skeletal muscle index. Sci Rep 2024; 14:8604. [PMID: 38615057 PMCID: PMC11016056 DOI: 10.1038/s41598-024-58433-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/29/2024] [Indexed: 04/15/2024] Open
Abstract
This study aims to explore the correlation between the CT-L1 and L3 body composition parameters and analyze the relationship between L1 body composition and hematologic toxicity in luminal-type breast cancer patients undergoing neoadjuvant chemotherapy. Data from 140 luminal-type breast cancer patients who underwent surgical treatment after neoadjuvant chemotherapy were analyzed retrospectively. Spearman analysis was used to assess the correlation between CT-L1 and CT-L3 body composition parameters pre-neoadjuvant chemotherapy. Additionally, univariate and multivariate logistic regression analyses were performed to identify factors influencing hematologic toxicity. CT-L1 body composition parameters were positively correlated with CT-L3 body composition parameters in 34 patients. Severe hematological toxicity occurred in 46 cases among the patient cohort. A skeletal muscle index (SMI) of < 32.91 cm2/m2, initial tumor size ≥ 3.335 cm, and a glucose-to-neutrophil ratio (GLR) ≥ 2.88 were identified as independent risk factors for severe hematologic toxicity during neoadjuvant chemotherapy in luminal-type breast cancer patients. The sample size in this study is small, and the predictive capacity of GLR in hematologic toxicity requires further research for comprehensive validation. CT-L1 analysis represents a viable alternative to CT-L3 analysis for body composition assessment. Patients with a low skeletal muscle index were more prone to experiencing severe hematologic toxicity during neoadjuvant chemotherapy.
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Affiliation(s)
- Min Chen
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Pinxiu Wang
- Department of Oncology, Shucheng People's Hospital, Lu'an, 231300, China
| | - Yanting Li
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Zhuanmei Jin
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Yu An
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Yanan Zhang
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Wenzhen Yuan
- The Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
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Le Tran N, Wang Y, Bilandzic M, Stephens A, Nie G. Podocalyxin promotes the formation of compact and chemoresistant cancer spheroids in high grade serous carcinoma. Sci Rep 2024; 14:7539. [PMID: 38553472 PMCID: PMC10980795 DOI: 10.1038/s41598-024-57053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
High grade serous carcinoma (HGSC) metastasises primarily intraperitoneally via cancer spheroids. Podocalyxin (PODXL), an anti-adhesive transmembrane protein, has been reported to promote cancer survival against chemotherapy, however its role in HGSC chemoresistance is unclear. This study investigated whether PODXL plays a role in promoting chemoresistance of HGSC spheroids. We first showed that PODXL was expressed variably in HGSC patient tissues (n = 17) as well as in ovarian cancer cell lines (n = 28) that are more likely categorised as HGSC. We next demonstrated that PODXL-knockout (KO) cells proliferated more slowly, formed less compact spheroids and were more fragile than control cells. Furthermore, when treated with carboplatin and examined for post-treatment recovery, PODXL-KO spheroids showed significantly poorer cell viability, lower number of live cells, and less Ki-67 staining than controls. A similar trend was also observed in ascites-derived primary HGSC cells (n = 6)-spheroids expressing lower PODXL formed looser spheroids, were more vulnerable to fragmentation and more sensitive to carboplatin than spheroids with higher PODXL. Our studies thus suggests that PODXL plays an important role in promoting the formation of compact/hardy HGSC spheroids which are more resilient to chemotherapy drugs; these characteristics may contribute to the chemoresistant nature of HGSC.
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Affiliation(s)
- Ngoc Le Tran
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia
| | - Yao Wang
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia
| | - Maree Bilandzic
- Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Andrew Stephens
- Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Guiying Nie
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia.
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Seib C, Harbeck E, Anderson D, Porter-Steele J, Nehill C, Sanmugarajah J, Perrin L, Shannon C, Cabraal N, Jennings B, Otton G, Adams C, Mellon A, Chambers S. Establishing the sensitivity and specificity of the gynaecological cancer distress screen. Psychooncology 2024; 33:e6328. [PMID: 38504431 DOI: 10.1002/pon.6328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/08/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Nuanced distress screening tools can help cancer care services manage specific cancer groups' concerns more efficiently. This study examines the sensitivity and specificity of a tool specifically for women with gynaecological cancers (called the Gynaecological Cancer Distress Screen or DT-Gyn). METHODS This paper presents cross-sectional data from individuals recently treated for gynaecological cancer recruited through Australian cancer care services, partner organisations, and support/advocacy services. Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT-Gyn against criterion measures for anxiety (GAD-7), depression (patient health questionnaire), and distress (IES-R and K10). RESULTS Overall, 373 individuals aged 19-91 provided complete data for the study. Using the recognised distress thermometer (DT) cut-off of 4, 47% of participants were classified as distressed, while a cut-off of 5 suggested that 40% had clinically relevant distress. The DT-Gyn showed good discriminant ability across all measures (IES-R: area under the curve (AUC) = 0.86, 95% CI = 0.82-0.90; GAD-7: AUC = 0.89, 95% CI = 0.85-0.93; K10: AUC = 0.88, 95% CI = 0.85-0.92; PHQ-9: AUC = 0.85, 95% CI = 0.81-0.89) and the Youden Index suggested an optimum DT cut-point of 5. CONCLUSIONS This study established the psychometric properties of the DT-Gyn, a tool designed to identify and manage the common sources of distress in women with gynaecological cancers. We suggest a DT cut point ≥5 is optimal in detecting 'clinically relevant' distress, anxiety, and depression in this population.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | - Emma Harbeck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Debra Anderson
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Janine Porter-Steele
- The Wesley Hospital Choices Cancer Support Centre (Choices), Wesley Hospital, Auchenflower, Queensland, Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
| | - Caroline Nehill
- Cancer Australia, Strawberry Hills, New South Wales, Australia
| | - Jasotha Sanmugarajah
- Gold Coast University Hospital, Southport, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Lewis Perrin
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Catherine Shannon
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Nimithri Cabraal
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Bronwyn Jennings
- Mater Hospital and Mater Cancer Care Centre, South Brisbane, Queensland, Australia
| | - Geoffrey Otton
- Lambton Women's Health, Lambton, New South Wales, Australia
| | | | - Anne Mellon
- Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
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Williams N, Griffin G, Wall M, Watson S, Warland J, Bradfield Z. Patient evaluation of gynaecological information provision and preferences. J Adv Nurs 2024; 80:1188-1200. [PMID: 37731325 DOI: 10.1111/jan.15866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
AIM To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. DESIGN A descriptive cross-sectional survey design was used. METHODS A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. RESULTS Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. CONCLUSION Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. IMPACT This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. REPORTING METHOD The STROBE reporting method was used in the preparation of the manuscript. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart Watson
- Women's Health, Genetics & Mental Health, King Edward Memorial Hospital, Subiaco, Australia
| | - Jane Warland
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
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Liu X, Wei Q, Yang C, Zhao H, Xu J, Mobet Y, Luo Q, Yang D, Zuo X, Chen N, Yang Y, Li L, Wang W, Yu J, Xu J, Liu T, Yi P. RNA m 5C modification upregulates E2F1 expression in a manner dependent on YBX1 phase separation and promotes tumor progression in ovarian cancer. Exp Mol Med 2024; 56:600-615. [PMID: 38424195 PMCID: PMC10984993 DOI: 10.1038/s12276-024-01184-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/01/2023] [Accepted: 12/26/2023] [Indexed: 03/02/2024] Open
Abstract
5-Methylcytosine (m5C) is a common RNA modification that modulates gene expression at the posttranscriptional level, but the crosstalk between m5C RNA modification and biomolecule condensation, as well as transcription factor-mediated transcriptional regulation, in ovarian cancer, is poorly understood. In this study, we revealed that the RNA methyltransferase NSUN2 facilitates mRNA m5C modification and forms a positive feedback regulatory loop with the transcription factor E2F1 in ovarian cancer. Specifically, NSUN2 promotes m5C modification of E2F1 mRNA and increases its stability, and E2F1 binds to the NSUN2 promoter, subsequently reciprocally activating NSUN2 transcription. The RNA binding protein YBX1 functions as the m5C reader and is involved in NSUN2-mediated E2F1 regulation. m5C modification promotes YBX1 phase separation, which upregulates E2F1 expression. In ovarian cancer, NSUN2 and YBX1 are amplified and upregulated, and higher expression of NSUN2 and YBX1 predicts a worse prognosis for ovarian cancer patients. Moreover, E2F1 transcriptionally regulates the expression of the oncogenes MYBL2 and RAD54L, driving ovarian cancer progression. Thus, our study delineates a NSUN2-E2F1-NSUN2 loop regulated by m5C modification in a manner dependent on YBX1 phase separation, and this previously unidentified pathway could be a promising target for ovarian cancer treatment.
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Affiliation(s)
- Xiaoyi Liu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Qinglv Wei
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
- Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Chenyue Yang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Hongyan Zhao
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Jie Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Youchaou Mobet
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Qingya Luo
- Department of Pathology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Dan Yang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Xinzhao Zuo
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Ningxuan Chen
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Yu Yang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Li Li
- Department of Obstetrics and Gynecology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Wei Wang
- Institute of Life Sciences, Chongqing Medical University, Chongqing, 400016, China
| | - Jianhua Yu
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Jing Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Tao Liu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
| | - Ping Yi
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
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Breistig S, Thorkildsen KM, Werner HMJ, Nordgreen T, Sekse RJT. Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme. J Clin Nurs 2024; 33:1110-1121. [PMID: 37984464 DOI: 10.1111/jocn.16923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. METHODOLOGY This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. FINDINGS Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. CONCLUSION Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. IMPLICATIONS FOR PATIENT CARE Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. PATIENT OR PUBLIC CONTRIBUTION Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.
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Affiliation(s)
- Sigrund Breistig
- Centre of Diaconia and Professional Practice, VID Specialized University, Bergen, Norway
| | - Kari Marie Thorkildsen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Henrica Maria Johanna Werner
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW - School for Oncology and Reproduction, University of Maastricht, Maastricht, The Netherlands
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ragnhild Johanne Tveit Sekse
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
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Bhattacharyya T, Chakraborty S, Achari RB, Mallick I, Arunsingh M, Shenoy S, Harilal V, Phesao V, Maulik S, Manjunath NV, Mukherjee P, Sarkar N, Sinha A, Sarkar S, Vashistha B, Khanum H, Chatterjee S. Enhancing quality assurance in radiotherapy for gynaecological cancers: implementation of an on-demand peer review process. Br J Radiol 2024; 97:680-693. [PMID: 38401533 PMCID: PMC11027236 DOI: 10.1093/bjr/tqae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVES Ensuring high-quality radiotherapy requires peer-reviewing target volumes. The Royal College of Radiologists recommends peer review specifically for individual target volumes in cases of gynaecological cancers. This study presents the outcomes of implementing an on-demand peer review system for gynaecological cancers within our institute. METHODS The peer review process was planned for gynaecological cancer cases intended for curative radiotherapy. After junior clinical oncologists (COs) completed the segmentation, two senior COs specializing in gynaecological cancers conducted the peer review. All peer review outcomes were recorded prospectively. The audit process compliance, the proportion of patients requiring major and minor modifications in target volumes, the direction of changes, and the factors influencing these changes were reported. RESULTS A total of 230 patients were eligible, and out of these, 204 (88.3%) patients underwent at least one peer review. Among the patients, 108 required major modifications in their target volumes. P-charts revealed a stabilization in the need for major modifications at the end of three months, indicating that 38.2% and 28% of patients still required major modifications for the nodal and primary CTV, respectively. Multivariable analysis demonstrated that major modifications were associated with the use of extended field radiotherapy and radical radiation in non-cervical primary cases. CONCLUSIONS An on-demand peer review system was feasible and resulted in clinically meaningful, major modifications in the target volumes for 53% of patients. ADVANCES IN KNOWLEDGE Gynaecological cancers require ongoing peer review to ensure quality of care in radiotherapy. A flexible on-demand system not only ensures that patient treatment start is not delayed but also has an important educational role for junior trainees.
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Affiliation(s)
- Tapesh Bhattacharyya
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Santam Chakraborty
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Rimpa Basu Achari
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Indranil Mallick
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Moses Arunsingh
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Shashank Shenoy
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Vishnu Harilal
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Vezokhoto Phesao
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Shaurav Maulik
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | | | - Prattusha Mukherjee
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Nivedita Sarkar
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Avinaba Sinha
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Sebanti Sarkar
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Bhanu Vashistha
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Hashmath Khanum
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
| | - Sanjoy Chatterjee
- Depzartment of Radiation Oncology, Tata Medical Center, Kolkata, 14 MAR E-W, Kolkata, West Bengal, 700156, India
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10
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Jeong S, Yu H, Park SH, Woo D, Lee SJ, Chong GO, Han HS, Kim JC. Comparing deep learning and handcrafted radiomics to predict chemoradiotherapy response for locally advanced cervical cancer using pretreatment MRI. Sci Rep 2024; 14:1180. [PMID: 38216687 PMCID: PMC10786874 DOI: 10.1038/s41598-024-51742-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024] Open
Abstract
Concurrent chemoradiotherapy (CRT) is the standard treatment for locally advanced cervical cancer (LACC), but its responsiveness varies among patients. A reliable tool for predicting CRT responses is necessary for personalized cancer treatment. In this study, we constructed prediction models using handcrafted radiomics (HCR) and deep learning radiomics (DLR) based on pretreatment MRI data to predict CRT response in LACC. Furthermore, we investigated the potential improvement in prediction performance by incorporating clinical factors. A total of 252 LACC patients undergoing curative chemoradiotherapy are included. The patients are randomly divided into two independent groups for the training (167 patients) and test datasets (85 patients). Contrast-enhanced T1- and T2-weighted MR scans are obtained. For HCR analysis, 1890 imaging features are extracted and a support vector machine classifier with a five-fold cross-validation is trained on training dataset to predict CRT response and subsequently validated on test dataset. For DLR analysis, a 3-dimensional convolutional neural network was trained on training dataset and validated on test dataset. In conclusion, both HCR and DLR models could predict CRT responses in patients with LACC. The integration of clinical factors into radiomics prediction models tended to improve performance in HCR analysis. Our findings may contribute to the development of personalized treatment strategies for LACC patients.
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Affiliation(s)
- Sungmoon Jeong
- Department of Medical Informatics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Research Center for Artificial Intelligence in Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hosang Yu
- Research Center for Artificial Intelligence in Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Shin-Hyung Park
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
- Department of Radiation Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
- Cardiovascular Research Institute, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Dongwon Woo
- Research Center for Artificial Intelligence in Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Seoung-Jun Lee
- Department of Radiation Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Gun Oh Chong
- Department of Gynecology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Clinical Omics Research Center, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyung Soo Han
- Clinical Omics Research Center, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Physiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Chul Kim
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Radiation Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea
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11
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Zhang L, Cascio S, Mellors JW, Buckanovich RJ, Osmanbeyoglu HU. Single-cell analysis reveals the stromal dynamics and tumor-specific characteristics in the microenvironment of ovarian cancer. Commun Biol 2024; 7:20. [PMID: 38182756 PMCID: PMC10770164 DOI: 10.1038/s42003-023-05733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
High-grade serous ovarian carcinoma (HGSOC) is a heterogeneous disease, and a highstromal/desmoplastic tumor microenvironment (TME) is associated with a poor outcome. Stromal cell subtypes, including fibroblasts, myofibroblasts, and cancer-associated mesenchymal stem cells, establish a complex network of paracrine signaling pathways with tumor-infiltrating immune cells that drive effector cell tumor immune exclusion and inhibit the antitumor immune response. In this work, we integrate single-cell transcriptomics of the HGSOC TME from public and in-house datasets (n = 20) and stratify tumors based upon high vs. low stromal cell content. Although our cohort size is small, our analyses suggest a distinct transcriptomic landscape for immune and non-immune cells in high-stromal vs. low-stromal tumors. High-stromal tumors have a lower fraction of certain T cells, natural killer (NK) cells, and macrophages, and increased expression of CXCL12 in epithelial cancer cells and cancer-associated mesenchymal stem cells (CA-MSCs). Analysis of cell-cell communication indicate that epithelial cancer cells and CA-MSCs secrete CXCL12 that interacte with the CXCR4 receptor, which is overexpressed on NK and CD8+ T cells. Dual IHC staining show that tumor infiltrating CD8 T cells localize in proximity of CXCL12+ tumor area. Moreover, CXCL12 and/or CXCR4 antibodies confirm the immunosuppressive role of CXCL12-CXCR4 in high-stromal tumors.
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Affiliation(s)
- Linan Zhang
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15206, USA
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA
- Department of Applied Mathematics, School of Mathematics and Statistics, Ningbo University, Ningbo, Zhejiang, 315211, China
| | - Sandra Cascio
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA
- Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - John W Mellors
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Ronald J Buckanovich
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA
- Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
- Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
| | - Hatice Ulku Osmanbeyoglu
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15206, USA.
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.
- Department of Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, PA, 15219, USA.
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA.
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12
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Aggarwal A, Khalighi S, Babu D, Li H, Azarianpour-Esfahani S, Corredor G, Fu P, Mokhtari M, Pathak T, Thayer E, Modesitt S, Mahdi H, Avril S, Madabhushi A. Computational pathology identifies immune-mediated collagen disruption to predict clinical outcomes in gynecologic malignancies. Commun Med (Lond) 2024; 4:2. [PMID: 38172536 PMCID: PMC10764846 DOI: 10.1038/s43856-023-00428-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The role of immune cells in collagen degradation within the tumor microenvironment (TME) is unclear. Immune cells, particularly tumor-infiltrating lymphocytes (TILs), are known to alter the extracellular matrix, affecting cancer progression and patient survival. However, the quantitative evaluation of the immune modulatory impact on collagen architecture within the TME remains limited. METHODS We introduce CollaTIL, a computational pathology method that quantitatively characterizes the immune-collagen relationship within the TME of gynecologic cancers, including high-grade serous ovarian (HGSOC), cervical squamous cell carcinoma (CSCC), and endometrial carcinomas. CollaTIL aims to investigate immune modulatory impact on collagen architecture within the TME, aiming to uncover the interplay between the immune system and tumor progression. RESULTS We observe that an increased immune infiltrate is associated with chaotic collagen architecture and higher entropy, while immune sparse TME exhibits ordered collagen and lower entropy. Importantly, CollaTIL-associated features that stratify disease risk are linked with gene signatures corresponding to TCA-Cycle in CSCC, and amino acid metabolism, and macrophages in HGSOC. CONCLUSIONS CollaTIL uncovers a relationship between immune infiltration and collagen structure in the TME of gynecologic cancers. Integrating CollaTIL with genomic analysis offers promising opportunities for future therapeutic strategies and enhanced prognostic assessments in gynecologic oncology.
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Affiliation(s)
- Arpit Aggarwal
- Georgia Tech, Georgia, GA, USA
- Emory University, Georgia, GA, USA
| | | | - Deepak Babu
- Case Western Reserve University, Ohio, OH, USA
| | - Haojia Li
- Case Western Reserve University, Ohio, OH, USA
| | | | - Germán Corredor
- Emory University, Georgia, GA, USA
- Louis Stokes Cleveland Veterans Administration Medical Center, Ohio, OH, USA
| | - Pingfu Fu
- Case Western Reserve University, Ohio, OH, USA
| | | | | | | | | | - Haider Mahdi
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Anant Madabhushi
- Georgia Tech, Georgia, GA, USA.
- Emory University, Georgia, GA, USA.
- Atlanta Veterans Administration Medical Center, Georgia, GA, USA.
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13
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Xu K, Zheng X, Shi H, Ou J, Ding H. MAD2L2, a key regulator in ovarian cancer and promoting tumor progression. Sci Rep 2024; 14:130. [PMID: 38167649 PMCID: PMC10761867 DOI: 10.1038/s41598-023-50744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/24/2023] [Indexed: 01/05/2024] Open
Abstract
Ovarian cancer (OVCA), a prevalent gynecological malignancy, ranks as the fourth most common cancer among women. Mitotic Arrest Deficient 2 Like 2 (MAD2L2), a chromatin-binding protein and a component of DNA polymerase ζ, has been previously identified as an inhibitor of tumor growth in colorectal cancer. However, the roles of MAD2L2 in OVCA, including its expression, impact, and prognostic significance, remain unclear. We employed bioinformatics tools, Cox Regression analysis, and in vitro cell experiments to investigate its biological functions. Our findings reveal that MAD2L2 typically undergoes genomic alterations, such as amplifications and deep deletions. Moreover, we observed an overexpression of MAD2L2 mRNA in OVCA patients, correlating with reduced survival rates, particularly in those with Grade IV tumors. Furthermore, analysis of mRNA biofunctions indicated that MAD2L2 is predominantly localized in the organellar ribosome, engaging mainly in NADH dehydrogenase activity. This was deduced from the results of gene ontology enrichment analysis, which also identified its role as a structural constituent in mitochondrial translation elongation. These findings were corroborated by KEGG pathway analysis, further revealing MAD2L2's involvement in tumor metabolism and the cell death process. Notably, MAD2L2 protein expression showed significant associations with various immune cells, including CD4+T cells, CD8+T cells, B cells, natural killer cells, and Myeloid dendritic cells. Additionally, elevated levels of MAD2L2 were found to enhance cell proliferation and migration in OVCA cells. The upregulation of MAD2L2 also appears to inhibit the ferroptosis process, coinciding with increased mTOR signaling activity in these cells. Our study identifies MAD2L2 as a novel regulator in ovarian tumor progression and offers new insights for treating OVCA.
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Affiliation(s)
- Kejun Xu
- Gynaecology and Obstetrics Department, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, People's Republic of China
| | - Xiaojiao Zheng
- Gynaecology and Obstetrics Department, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, People's Republic of China
| | - Hongyan Shi
- Gynaecology and Obstetrics Department, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, People's Republic of China
| | - Jilan Ou
- Gynaecology and Obstetrics Department, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, People's Republic of China
| | - Huiqing Ding
- Gynaecology and Obstetrics Department, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, People's Republic of China.
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14
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Akinjiyan FA, Ibitoye Z, Zhao P, Shriver LP, Patti GJ, Longmore GD, Fuh KC. DDR2-regulated arginase activity in ovarian cancer-associated fibroblasts promotes collagen production and tumor progression. Oncogene 2024; 43:189-201. [PMID: 37996700 PMCID: PMC10786713 DOI: 10.1038/s41388-023-02884-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/21/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Ovarian cancer has poor survival outcomes particularly for advanced stage, metastatic disease. Metastasis is promoted by interactions of stromal cells, such as cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME), with tumor cells. CAFs play a key role in tumor progression by remodeling the TME and extracellular matrix (ECM) to result in a more permissive environment for tumor progression. It has been shown that fibroblasts, in particular myofibroblasts, utilize metabolism to support ECM remodeling. However, the intricate mechanisms by which CAFs support collagen production and tumor progression are poorly understood. In this study, we show that the fibrillar collagen receptor, Discoidin Domain Receptor 2 (DDR2), promotes collagen production in human and mouse omental CAFs through arginase activity. CAFs with high DDR2 or arginase promote tumor colonization in the omentum. In addition, DDR2-depleted CAFs had decreased ornithine levels leading to decreased collagen production and polyamine levels compared to WT control CAFs. Tumor cell invasion was decreased in the presence CAF conditioned media (CM) depleted of DDR2 or arginase-1, and this invasion defect was rescued in the presence of CM from DDR2-depleted CAFs that constitutively overexpressed arginase-1. Similarly, the addition of exogenous polyamines to CM from DDR2-depleted CAFs led to increased tumor cell invasion. We detected SNAI1 protein at the promoter region of the arginase-1 gene, and DDR2-depleted CAFs had decreased levels of SNAI1 protein at the arginase-1 promoter region. Furthermore, high stromal arginase-1 expression correlated with poor survival in ovarian cancer patients. These findings highlight how DDR2 regulates collagen production by CAFs in the tumor microenvironment by controlling the transcription of arginase-1, and CAFs are a major source of arginase activity and L-arginine metabolites in ovarian cancer models.
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Affiliation(s)
- Favour A Akinjiyan
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Reproductive Health Sciences, Washington University, St Louis, MO, 63110, USA
- ICCE Institute, Washington University, St Louis, MO, 63110, USA
- Department of Medicine (Oncology), Washington University, St. Louis, MO, 63110, USA
| | - Zainab Ibitoye
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Reproductive Health Sciences, Washington University, St Louis, MO, 63110, USA
- ICCE Institute, Washington University, St Louis, MO, 63110, USA
- Department of Medicine (Oncology), Washington University, St. Louis, MO, 63110, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Leah P Shriver
- Department of Medicine (Oncology), Washington University, St. Louis, MO, 63110, USA
- Department of Chemistry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Metabolomics and Isotope Tracing, Washington University, St. Louis, MO, 63130, USA
| | - Gary J Patti
- Department of Medicine (Oncology), Washington University, St. Louis, MO, 63110, USA
- Department of Chemistry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Metabolomics and Isotope Tracing, Washington University, St. Louis, MO, 63130, USA
| | - Gregory D Longmore
- ICCE Institute, Washington University, St Louis, MO, 63110, USA
- Department of Medicine (Oncology), Washington University, St. Louis, MO, 63110, USA
| | - Katherine C Fuh
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Center for Reproductive Health Sciences, Washington University, St Louis, MO, 63110, USA.
- Department of Obstetrics and Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA, 94143, USA.
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15
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Ghosh R, Mukherjee KK, Mandal R, Maji T, Lahiri D, Mazumder S, Dutta B, Ghosh D, Chakrabarti J. Efficacy and Safety of Oral Metronomic Chemotherapy in Recurrent Refractory Advanced Gynaecological Cancer: An Experience From the Regional Cancer Centre of Eastern India. Cureus 2024; 16:e53232. [PMID: 38425585 PMCID: PMC10902727 DOI: 10.7759/cureus.53232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION The outcome of recurrent/metastatic gynaecological malignancy has drastically improved with the introduction of poly(ADP-ribose) polymerase inhibitors and immunotherapy, but the use of these drugs in routine practice is complicated due to access barriers and their high cost in developing countries. The purpose of this study is to present the clinical response, outcome and safety of oral metronomic chemotherapy (OMCT) in resource-limited, financially constrained populations. METHODS This is a retrospective study on patients with advanced gynaecological cancer treated at Chittaranjan National Cancer Institute, Kolkata, India, from 2021 to 2023. The patients were treated with one of these two regimens: a split-dose course of cyclophosphamide (50 mg orally once daily for 21 days) and capecitabine (500 mg twice daily continuous) or a fixed-dose combination (capecitabine 1800 mg and cyclophosphamide 80 mg orally for 14 days in every 21 days) until disease progression or unacceptable toxicities occurred. All data was captured from the hospital's medical records until June 2023. Toxicity data was reported per the Common Terminology Criteria for Adverse Events (CTCAE) v5.1, and progression-free survival (PFS) was estimated using Kaplan-Meier methods. RESULTS Among 34 screened patients, 10 were excluded due to noncompliance. This study analysed 24 patients with a median age at diagnosis of 56 years (IQ range 44-75). Sixteen (67%) patients were at stage IV disease with an Eastern Cooperative Oncology Group (ECOG) performance status of 3. Ovarian and cervical cancers were 80% and 20%, respectively; among them, 16 (67%) patients were platinum-refractory. Forty-two per cent of patients received three lines of chemotherapy before OMCT. A split course versus fixed dose was given to 67% versus 33% of the population; the best responses per the Response Evaluation Criteria in Solid Tumours v1.1 were complete response in 12%, partial response in 67% and stable disease in 21%. The most common toxicities were grade I anaemia (54%), grade I chemotherapy-induced nausea and vomiting (46%), grade I fatigue (42%) and grade I neutropenia (21%). Twenty-five per cent of patients were offered next-line systemic therapy after progression. The entire cohort had a median PFS of nine months (95%, CI: 5.2-12.7). Cox regression analysis identified a median PFS of 12 months (95%, CI: 6.2-17.7) among platinum-refractory groups. CONCLUSION OMCT was a well-tolerated, affordable regimen with durable clinical response and survival outcome (median PFS of nine months) in recurrent, refractory advanced gynaecological cancer and can be offered to patients at resource-limited centres.
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Affiliation(s)
- Ranti Ghosh
- Radiation Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
| | | | - Ranajit Mandal
- Gynecologic Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
| | - Tapas Maji
- Radiation Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
| | - Debarshi Lahiri
- Radiation Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
| | - Suparna Mazumder
- Radiodiagnosis, Chittaranjan National Cancer Institute, Kolkata, IND
| | - Bodhisattwa Dutta
- Radiation Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
| | - Debjit Ghosh
- Radiation Oncology, Chittaranjan National Cancer Institute, Kolkata, IND
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16
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Rocha Martins P, Luciano Pereira Morais K, de Lima Galdino NA, Jacauna A, Paula SOC, Magalhães WCS, Zuccherato LW, Campos LS, Salles PGO, Gollob KJ. Linking tumor immune infiltrate and systemic immune mediators to treatment response and prognosis in advanced cervical cancer. Sci Rep 2023; 13:22634. [PMID: 38114557 PMCID: PMC10730812 DOI: 10.1038/s41598-023-49441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
Cervical cancer (CC) poses a significant burden on individuals in developing regions, exhibiting heterogeneous responses to standard chemoradiation therapy, and contributing to substantial mortality rates. Unraveling host immune dynamics holds promise for innovative therapies and discovery of clinically relevant biomarkers. We studied prospectively locally advanced CC patients pre-treatment, stratifying them as responders (R) or non-responders (NR). R patients had increased tumor-infiltrating lymphocytes (TILs), while NR patients showed elevated PD-1 scores, CD8+ and PD-L2+ TILs, and PD-L1 immune reactivity. NR patients exhibited higher systemic soluble mediators correlating with TIL immune markers. R patients demonstrated functional polarization of CD4 T cells (Th1, Th2, Th17, and Treg), while CD8+ T cells and CD68+ macrophages predominated in the NR group. Receiver operating characteristic analysis identified potential CC response predictors, including PD-L1-immunoreactive (IR) area, PD-L2, CD8, FGF-basic, IL-7, IL-8, IL-12p40, IL-15, and TNF-alpha. Dysfunctional TILs and imbalanced immune mediators contribute to therapeutic insufficiency, shedding light on local and systemic immune interplay. Our study informs immunological signatures for treatment prediction and CC prognosis.
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Affiliation(s)
- Patrícia Rocha Martins
- Pathology Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Instituto Mário Penna, Belo Horizonte, MG, Brazil
| | - Kátia Luciano Pereira Morais
- Translational Immuno-Oncology Lab, Education and Research Institute, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Center for Research in Immuno-Oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Nayane Alves de Lima Galdino
- Translational Immuno-Oncology Lab, Education and Research Institute, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Center for Research in Immuno-Oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Adriana Jacauna
- Pathology Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Wagner C S Magalhães
- Instituto Mário Penna, Belo Horizonte, MG, Brazil
- CCATES - Centro Colaborador do SUS: Avaliação de Tecnologias e Excelencia em Saude, UFMG, Belo Horizonte, Brazil
- Pontificia Universidade Catolica de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana W Zuccherato
- Instituto Mário Penna, Belo Horizonte, MG, Brazil
- Department of Biochemistry and Immunology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Kenneth J Gollob
- Instituto Mário Penna, Belo Horizonte, MG, Brazil.
- Translational Immuno-Oncology Lab, Education and Research Institute, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Center for Research in Immuno-Oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Center for Research in Immuno-Oncology (CRIO), Translational Immuno-Oncology Laboratory, Hospital Israelita Albert Einstein, Av. Albert Einstein, São Paulo, SP, 62705652-900, Brazil.
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17
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Li B, Li X, Ma M, Wang Q, Shi J, Wu C. Analysis of long non-coding RNAs associated with disulfidptosis for prognostic signature and immunotherapy response in uterine corpus endometrial carcinoma. Sci Rep 2023; 13:22220. [PMID: 38097686 PMCID: PMC10721879 DOI: 10.1038/s41598-023-49750-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
Disulfidptosis, the demise of cells caused by the abnormal breakdown of disulfide bonds and actin in the cytoprotein backbone, has attracted attention in studies concerning disulfide-related cell death and its potential implications in cancer treatment. This study utilized bioinformatics to detect disulfidptosis associated lncRNA prognostic markers (DALPMs) with Uterine Corpus Endometrial Carcinoma (UCEC)-related to investigate the correlation between these indicators and the tumor immune microenvironment. The RNA sequencing data and somatic mutation information of patients with UCEC were obtained from the Cancer Genome Atlas (TCGA) database. Patients were randomly divided into Train and Test groups. The findings revealed a potential prognostic model comprising 14 DALPMs. Both univariate and multivariate Cox analyses demonstrated that the model-derived risk score functioned as a standalone prognostic indicator for patients. Significant disparities in survival outcomes were observed between the high- and low-risk groups as defined by the model. Differences in tumor mutational burden (TMB), tumor immune dysfunction and exclusion (TIDE), and tumor microenvironment (TME) stromal cells between patients of the high- and low-risk groups were also observed. The forecast model comprising long non-coding RNAs (lncRNAs) associated with disulfidptosis can effectively anticipate patients' prognoses.
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Affiliation(s)
- Bohan Li
- Department of Gynecology and Oncology, Inner Mongolia Medical University, Affiliated Cancer Hospital, 42 Zhaowuda Road, Saihan District, Hohhot, 010000, Inner Mongolia, China
| | - Xiaoling Li
- Department of General Surgery, Inner Mongolia Medical University, Affiliated Cancer Hospital, 42 Zhaowuda Road, Saihan District, Hohhot, 010000, Inner Mongolia, China
| | - Mudan Ma
- Department of Gynecology and Oncology, Inner Mongolia Medical University, Affiliated Cancer Hospital, 42 Zhaowuda Road, Saihan District, Hohhot, 010000, Inner Mongolia, China
| | - Qing Wang
- Department of Gynaecology and Obstetrics, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, No. 10, East Section of Fengcheng Third Road, Weiyang District, Xi'an, 710018, Shaanxi, China
| | - Jie Shi
- Department of Gynecology and Oncology, Inner Mongolia Medical University, Affiliated Cancer Hospital, 42 Zhaowuda Road, Saihan District, Hohhot, 010000, Inner Mongolia, China.
| | - Chao Wu
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Huanhu West Road, Hexi District, Tianjin, 300060, China.
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18
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Dimas A, Margioula-Siarkou C, Politi A, Sotiriadis A, Papanikolaou A, Dinas K, Petousis S. The expression and possible role of corticotropin-releasing hormone family peptides and their corresponding receptors in gynaecological malignancies and premalignant conditions: a systematic review. Prz Menopauzalny 2023; 22:227-235. [PMID: 38239406 PMCID: PMC10793609 DOI: 10.5114/pm.2023.133878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/26/2023] [Indexed: 01/22/2024]
Abstract
The aim of this systematic review is to investigate the impact of corticotropin-releasing hormone (CRH) family peptides and their corresponding receptors on human physiology and disease onset, with a specific focus on gynaecological malignancies such as breast, endometrial, ovarian, vulvar, and cervical cancer. A comprehensive systematic review of 3 medical databases was conducted by 2 independent reviewers. We reviewed studies that explored the expression and role of CRH peptides in various aspects of cancer biology, in the context of breast, endometrial, ovarian, vulvar, and cervical cancer. Our findings reveal that CRH family peptides and their receptors, CRHR1 and CRHR2, are expressed in diverse gynaecological tissues, including cancer cells. Notably, we observed differential expression patterns among different gynaecological cancer types and stages, indicating potential associations with tumour aggressiveness and patient prognosis. Furthermore, CRH peptides were found to exert significant influences on critical cellular processes, such as cell proliferation, migration, invasion, and immune response, in gynaecological cancers. These findings highlight the multifaceted roles of CRH family peptides in gynaecological malignancies and emphasize the need for further research in this field. Therefore, understanding the mechanisms underlying the involvement of CRH family peptides in tumourigenesis may open new avenues for targeted therapeutic strategies in gynaecological malignancies.
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Affiliation(s)
- Angelos Dimas
- 2 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Anastasia Politi
- 1 Dermatology Department, “Andreas Syggros” Hospital for Skin Diseases, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Sotiriadis
- 2 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexios Papanikolaou
- 2 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Dinas
- 2 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stamatios Petousis
- 2 Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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19
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Tian M, Wang X, Sun J, Lin W, Chen L, Liu S, Wu X, Shi L, Xu P, Cai X, Wang X. Author Correction: IRF3 prevents colorectal tumorigenesis via inhibiting the nuclear translocation of β-catenin. Nat Commun 2023; 14:7862. [PMID: 38030635 PMCID: PMC10687087 DOI: 10.1038/s41467-023-43761-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Affiliation(s)
- Miao Tian
- Institute of Immunology and Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Xiumei Wang
- Institute of Immunology and Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Jihong Sun
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016, Hangzhou, China
| | - Wenlong Lin
- Institute of Immunology and Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Lumin Chen
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016, Hangzhou, China
| | - Shengduo Liu
- The MOE Key Laboratory of Biosystems Homeostasis & Protection and Innovation Center for Cell Signaling Network, Life Sciences Institute, Zhejiang University, 310058, Hangzhou, China
| | - Ximei Wu
- Department of Pharmacology, School of Medicine, Zhejiang University, 310058, Hangzhou, Zhejiang, China
| | - Liyun Shi
- Department of Immunology and Medical Microbiology, Nanjing University of Chinese Medicine, 210046, Nanjing, China
| | - Pinglong Xu
- The MOE Key Laboratory of Biosystems Homeostasis & Protection and Innovation Center for Cell Signaling Network, Life Sciences Institute, Zhejiang University, 310058, Hangzhou, China
| | - Xiujun Cai
- Department of General Surgery, Innovation Center for Minimally Invasive Techniques and Devices, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016, Hangzhou, China.
| | - Xiaojian Wang
- Institute of Immunology and Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, 310003, Hangzhou, China.
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20
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Mysona DP, Purohit S, Richardson KP, Suhner J, Brzezinska B, Rungruang B, Hopkins D, Bearden G, Higgins R, Johnson M, Bin Satter K, McIndoe R, Ghamande S. Ovarian recurrence risk assessment using machine learning, clinical information, and serum protein levels to predict survival in high grade ovarian cancer. Sci Rep 2023; 13:20933. [PMID: 38016985 PMCID: PMC10684567 DOI: 10.1038/s41598-023-47983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
In ovarian cancer, there is no current method to accurately predict recurrence after a complete response to chemotherapy. Here, we develop a machine learning risk score using serum proteomics for the prediction of early recurrence of ovarian cancer after initial treatment. The developed risk score was validated in an independent cohort with serum collected prospectively during the remission period. In the discovery cohort, patients scored as low-risk had a median time to recurrence (TTR) that was not reached at 10 years compared to 10.5 months (HR 4.66, p < 0.001) in high-risk patients. In the validation cohort, low-risk patients had a median TTR which was not reached compared to 4.7 months in high-risk patients (HR 4.67, p = 0.009). In advanced-stage patients with a CA125 < 10, low-risk patients had a median TTR of 68 months compared to 6 months in high-risk patients (HR 2.91, p = 0.02). The developed risk score was capable of distinguishing the duration of remission in ovarian cancer patients. This score may help guide maintenance therapy and develop innovative treatments in patients at risk at high-risk of recurrence.
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Affiliation(s)
- David P Mysona
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
| | - Sharad Purohit
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
- Department of Undergraduate Health Professionals, College of Allied Health Sciences, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Katherine P Richardson
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Jessa Suhner
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Bogna Brzezinska
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Bunja Rungruang
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Diane Hopkins
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Gregory Bearden
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Robert Higgins
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Marian Johnson
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Khaled Bin Satter
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Richard McIndoe
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Sharad Ghamande
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
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21
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Kluz-Barłowska M, Kluz T, Paja W, Sarzyński J, Łączyńska-Madera M, Odrzywolski A, Król P, Cebulski J, Depciuch J. FT-Raman data analyzed by multivariate and machine learning as a new methods for detection spectroscopy marker of platinum-resistant women suffering from ovarian cancer. Sci Rep 2023; 13:20772. [PMID: 38008780 PMCID: PMC10679116 DOI: 10.1038/s41598-023-48169-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/22/2023] [Indexed: 11/28/2023] Open
Abstract
The phenomenon of platinum resistance is a very serious problem in the treatment of ovarian cancer. Unfortunately, no molecular, genetic marker that could be used in assigning women suffering from ovarian cancer to the platinum-resistant or platinum-sensitive group has been discovered so far. Therefore, in this study, for the first time, we used FT-Raman spectroscopy to determine chemical differences and chemical markers presented in serum, which could be used to differentiate platinum-resistant and platinum-sensitive women. The result obtained showed that in the serum collected from platinum-resistant women, a significant increase of chemical compounds was observed in comparison with the serum collected from platinum-sensitive woman. Moreover, a decrease in the ratio between amides vibrations and shifts of peaks, respectively, corresponding to C-C/C-N stretching vibrations from proteins, amide III, amide II, C = O and CH lipids vibrations suggested that in these compounds, structural changes occurred. The Principal Component Analysis (PCA) showed that using FT-Raman range, where the above-mentioned functional groups were present, it was possible to differentiate the serum collected from both analyzed groups. Moreover, C5.0 decision tree clearly showed that Raman shifts at 1224 cm-1 and 2713 cm-1 could be used as a marker of platinum resistance. Importantly, machine learning methods showed that the accuracy, sensitivity and specificity of the FT-Raman spectroscopy were from 95 to 100%.
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Affiliation(s)
- Marta Kluz-Barłowska
- Department of Pathology, Fryderyk Chopin University Hospital, F. Szopena 2, 35-055, Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Fryderyk Chopin University Hospital, F.Szopena 2, 35-055, Rzeszow, Poland
- Institute of Medical Sciences, Medical College of Rzeszow University, Kopisto 2a, 35-959, Rzeszow, Poland
| | - Wiesław Paja
- Institute of Computer Science, College of Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | - Jaromir Sarzyński
- Institute of Computer Science, College of Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | - Monika Łączyńska-Madera
- Department of Gynecology, Gynecology Oncology and Obstetrics, Fryderyk Chopin University Hospital, F.Szopena 2, 35-055, Rzeszow, Poland
| | - Adrian Odrzywolski
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, 20-093, Lublin, Poland
| | - Paweł Król
- College of Medical Sciences, Institute of Physical Culture Studies, University of Rzeszow, 35-959, Rzeszów, Poland
| | - Józef Cebulski
- Institute of Physics, College of Natural Sciences, University of Rzeszow, 35959, Rzeszow, Poland
| | - Joanna Depciuch
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, 20-093, Lublin, Poland.
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Krakow, Poland.
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22
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Wu RR, Zhou YM, Xie XY, Chen JY, Quan KR, Wei YT, Xia XY, Chen WJ. Delta radiomics analysis for prediction of intermediary- and high-risk factors for patients with locally advanced cervical cancer receiving neoadjuvant therapy. Sci Rep 2023; 13:19409. [PMID: 37938596 PMCID: PMC10632513 DOI: 10.1038/s41598-023-46621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023] Open
Abstract
This study aimed to assess the feasibility of using magnetic resonance imaging (MRI)-based Delta radiomics characteristics extrapolated from the Ax LAVA + C series to identify intermediary- and high-risk factors in patients with cervical cancer undergoing surgery following neoadjuvant chemoradiotherapy. A total of 157 patients were divided into two groups: those without any intermediary- or high-risk factors and those with one intermediary-risk factor (negative group; n = 75). Those with any high-risk factor or more than one intermediary-risk factor (positive group; n = 82). Radiomics characteristics were extracted using Ax-LAVA + C MRI sequences. The data was divided into training (n = 126) and test (n = 31) sets in an 8:2 ratio. The training set data features were selected using the Mann-Whitney U test and the Least Absolute Shrinkage and Selection Operator (LASSO) test. The best radiomics features were then analyzed to build a preoperative predictive radiomics model for predicting intermediary- and high-risk factors in cervical cancer. Three models-the clinical model, the radiomics model, and the combined clinic and radiomics model-were developed in this study utilizing the random forest Algorithm. The receiver operating characteristic (ROC) curve, decision curve analysis (DCA), accuracy, sensitivity, and specificity were used to assess the predictive efficacy and clinical benefits of each model. Three models were developed in this study to predict intermediary- and high-risk variables associated with postoperative pathology for patients who underwent surgery after receiving neoadjuvant radiation. In the training and test sets, the AUC values assessed using the clinical model, radiomics model, and combined clinical and radiomics models were 0.76 and 0.70, 0.88 and 0.86, and 0.91 and 0.89, respectively. The use of machine learning algorithms to analyze Delta Ax LAVA + C MRI radiomics features can aid in the prediction of intermediary- and high-risk factors in patients with cervical cancer receiving neoadjuvant therapy.
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Affiliation(s)
- Rong-Rong Wu
- Department of Radiation Oncology, Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Yi-Min Zhou
- School of Nuclear Science and Technology, University of South China, Hengyang, China
| | - Xing-Yun Xie
- Department of Radiation Oncology, Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Jin-Yang Chen
- College of Computer and Cyber Security, Fujian Normal University, Fuzhou, China
| | - Ke-Run Quan
- Department of Radiation Oncology, Xiangtan City Central Hospital Xiangtan, Hengyang, China
| | - Yu-Ting Wei
- Department of Radiation Oncology, Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Xiao-Yi Xia
- Department of Radiation Oncology, Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Wen-Juan Chen
- Department of Radiation Oncology, Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
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23
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Niemira M, Erol A, Bielska A, Zeller A, Skwarska A, Chwialkowska K, Kuzmicki M, Szamatowicz J, Reszec J, Knapp P, Moniuszko M, Kretowski A. Identification of serum miR-1246 and miR-150-5p as novel diagnostic biomarkers for high-grade serous ovarian cancer. Sci Rep 2023; 13:19287. [PMID: 37935712 PMCID: PMC10630404 DOI: 10.1038/s41598-023-45317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is one of the leading cancers in women, with high-grade serous ovarian cancer (HGSOC) being the most common and lethal subtype of this disease. A vast majority of HGSOC are diagnosed at the late stage of the disease when the treatment and total recovery chances are low. Thus, there is an urgent need for novel, more sensitive and specific methods for early and routine HGSOC clinical diagnosis. In this study, we performed miRNA expression profiling using the NanoString miRNA assay in 34 serum samples from patients with HGSOC and 36 healthy women. We identified 13 miRNAs that were differentially expressed (DE). For additional exploration of expression patterns correlated with HGSOC, we performed weighted gene co-expression network analysis (WGCNA). As a result, we showed that the module most correlated with tumour size, nodule and metastasis contained 8 DE miRNAs. The panel including miR-1246 and miR-150-5p was identified as a signature that could discriminate HGSOC patients with AUCs of 0.98 and 1 for the training and test sets, respectively. Furthermore, the above two-miRNA panel had an AUC = 0.946 in the verification cohorts of RT-qPCR data and an AUC = 0.895 using external data from the GEO public database. Thus, the model we developed has the potential to markedly improve the diagnosis of ovarian cancer.
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Affiliation(s)
- Magdalena Niemira
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland.
| | - Anna Erol
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Agnieszka Bielska
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Anna Zeller
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Anna Skwarska
- Cancer Center, Department of Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karolina Chwialkowska
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Mariusz Kuzmicki
- Department of Gynecology and Gynecological Oncology, Medical University of Bialystok, Bialystok, Poland
| | - Jacek Szamatowicz
- Department of Gynecology and Gynecological Oncology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Reszec
- Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland
| | - Pawel Knapp
- University Oncology Centre, University Clinical Hospital in Bialystok, Bialystok, Poland
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Adam Kretowski
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
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24
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Mejia Peña C, Skipper TA, Hsu J, Schechter I, Ghosh D, Dawson MR. Metronomic and single high-dose paclitaxel treatments produce distinct heterogenous chemoresistant cancer cell populations. Sci Rep 2023; 13:19232. [PMID: 37932310 PMCID: PMC10628134 DOI: 10.1038/s41598-023-46055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/27/2023] [Indexed: 11/08/2023] Open
Abstract
More than 75% of epithelial ovarian cancer (EOC) patients experience disease recurrence after initial treatment, highlighting our incomplete understanding of how chemoresistant populations evolve over the course of EOC progression post chemotherapy treatment. Here, we show how two paclitaxel (PTX) treatment methods- a single high dose and a weekly metronomic dose for four weeks, generate unique chemoresistant populations. Using mechanically relevant alginate microspheres and a combination of transcript profiling and heterogeneity analyses, we found that these PTX-treatment regimens produce distinct and resilient subpopulations that differ in metabolic reprogramming signatures, acquisition of resistance to PTX and anoikis, and the enrichment for cancer stem cells (CSCs) and polyploid giant cancer cells (PGCCs) with the ability to replenish bulk populations. We investigated the longevity of these metabolic reprogramming events using untargeted metabolomics and found that metabolites associated with stemness and therapy-induced senescence were uniquely abundant in populations enriched for CSCs and PGCCs. Predictive network analysis revealed that antioxidative mechanisms were likely to be differentially active dependent on both time and exposure to PTX. Our results illustrate how current standard chemotherapies contribute to the development of chemoresistant EOC subpopulations by either selecting for intrinsically resistant subpopulations or promoting the evolution of resistance mechanisms. Additionally, our work describes the unique phenotypic signatures in each of these distinct resistant subpopulations and thus highlights potential vulnerabilities that can be exploited for more effective treatment.
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Affiliation(s)
- Carolina Mejia Peña
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, 02912, USA
| | - Thomas A Skipper
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, 02912, USA
| | - Jeffrey Hsu
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, 02912, USA
| | - Ilexa Schechter
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, 02912, USA
| | - Deepraj Ghosh
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, 02912, USA
| | - Michelle R Dawson
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, 02912, USA.
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, 02912, USA.
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25
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Mogi K, Koya Y, Yoshihara M, Sugiyama M, Miki R, Miyamoto E, Fujimoto H, Kitami K, Iyoshi S, Tano S, Uno K, Tamauchi S, Yokoi A, Shimizu Y, Ikeda Y, Yoshikawa N, Niimi K, Yamakita Y, Tomita H, Shibata K, Nawa A, Tomoda Y, Kajiyama H. 9-oxo-ODAs suppresses the proliferation of human cervical cancer cells through the inhibition of CDKs and HPV oncoproteins. Sci Rep 2023; 13:19208. [PMID: 37932321 PMCID: PMC10628276 DOI: 10.1038/s41598-023-44365-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Mucosal human papillomavirus (HPV) subtypes 16 and 18 are causative agents of cervical cancer, a leading cause of cancer-related deaths among women worldwide. In Japan, eggplant calyx is a folk remedy used to treat common warts. 9-oxo-(10E,12E)-octadecadienoic acid, isolated from eggplant calyx, may have antitumor effects. This study investigated the antitumor effects of 9-oxo-(10E, 12Z)-octadecadienoic acid and 9-oxo-(10E,12E)-octadecadienoic acid (9-oxo-ODAs) on human cervical cancer cells. 9-oxo-ODAs suppressed the proliferation of human cervical cancer cell lines (HeLa, and SiHa) in a concentration-dependent manner (IC50 = 25-50 µM). FCM analysis revealed that 9-oxo-ODAs induced apoptosis. Transcriptome, proteomics, and enrichment analyses revealed that treatment with 9-oxo-ODAs significantly altered the cell cycle and p53 pathways and decreased cyclin-dependent kinase 1 (CDK1) protein expression. Real-time PCR analysis demonstrated that 9-oxo-ODAs reduced CDK1 mRNA expression in a concentration-dependent manner. In vitro, 9-oxo-ODAs reduced the HPV oncoprotein expression. In ex vivo human cervical cancer tissues, 9-oxo-ODAs decreased CDK1 expression and increased cleaved caspase 3, an apoptosis marker. Further, 9-oxo-ODAs showed the potential to suppressed metastatic formation and growth of cervical cancer in vivo. These findings suggest that 9-oxo-ODAs induce cell cycle arrest and apoptosis in HPV-positive human cervical cancer cells, and this process involves CDK1. Consequently, 9-oxo-ODAs may be potential therapeutic agents for cervical cancer.
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Affiliation(s)
- Kazumasa Mogi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshihiro Koya
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan.
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan.
| | - Mai Sugiyama
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Rika Miki
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Emiri Miyamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Hiroki Fujimoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Kazuhisa Kitami
- Department of Obstetrics and Gynecology, Kitazato University, Kanagawa, Japan
| | - Shohei Iyoshi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Spemann Graduate School of Biology and Medicine, University of Freiburg, Breisgau, Germany
- Institute for Advanced Research, Nagoya University, Nagoya, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Kaname Uno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Satoshi Tamauchi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Akira Yokoi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Institute for Advanced Research, Nagoya University, Nagoya, Aichi, Japan
| | - Yusuke Shimizu
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshiki Ikeda
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshihiko Yamakita
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Bantane Hospital, Fujita Health University, Nagoya, Aichi, Japan
| | - Akihiro Nawa
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | | | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
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Wolf B, Weydandt L, Dornhöfer N, Hiller GGR, Höhn AK, Nel I, Jain RK, Horn LC, Aktas B. Desmoplasia in cervical cancer is associated with a more aggressive tumor phenotype. Sci Rep 2023; 13:18946. [PMID: 37919378 PMCID: PMC10622496 DOI: 10.1038/s41598-023-46340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
In cancer of the uterine cervix, the role of desmoplasia, i.e., peritumoral stromal remodeling characterized by fibroblast activation and increased extracellular matrix deposition, is not established. We conducted a retrospective cohort study based on data from 438 patients who had undergone surgical treatment for cervical cancer as part of the prospective Leipzig Mesometrial Resection study between 1999 and 2021. Using non-parametric tests, Kaplan-Meier plotting, and Cox regression modeling, we calculated the prognostic impact of desmoplasia and its association with other risk factors. Desmoplasia was present in 80.6% of cases and was associated with a higher frequency of lymphovascular space involvement (76.5 vs. 56.5%, p < 0.001) and venous infiltration (14.4 vs. 2.4%, p < 0.001). Lymph node metastasis (23.0 vs. 11.8%, p < 0.05) and parametrial involvement (47.3 vs. 17.6%, p < 0.0001) were also more common in patients with desmoplasia. The presence of desmoplasia was associated with inferior overall (80.2% vs. 94.5% hazard ratio [HR] 3.8 [95% CI 1.4-10.4], p = 0.002) and recurrence-free survival (75.3% vs. 87.3%, HR 2.3 [95% CI 1.2-4.6], p = 0.008). In addition, desmoplasia was associated with significantly less peritumoral inflammation (rho - 0.43, p < 0.0001). In summary, we link desmoplasia to a more aggressive phenotype of cervical cancer, reduced peritumoral inflammation, and inferior survival.
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Affiliation(s)
- Benjamin Wolf
- Department of Gynecology, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA.
- Harvard Medical School, Boston, USA.
| | - Laura Weydandt
- Department of Gynecology, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Nadja Dornhöfer
- Department of Gynecology, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | | | - Anne Kathrin Höhn
- Institute for Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Ivonne Nel
- Department of Gynecology, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Rakesh K Jain
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | | | - Bahriye Aktas
- Department of Gynecology, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
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27
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Hashimoto K, Kumagai T, Nomura K, Miyagawa Y, Tago S, Takasaki K, Takahashi Y, Nishida H, Ichinose T, Hirano M, Hiraike H, Wada-Hiraike O, Sasajima Y, Kim SH, Nagasaka K. Validation of an on-chip p16 ink4a/Ki-67 dual immunostaining cervical cytology system using microfluidic device technology. Sci Rep 2023; 13:17052. [PMID: 37816765 PMCID: PMC10564753 DOI: 10.1038/s41598-023-44273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
More specific screening systems for cervical cancer may become necessary as the human papillomavirus (HPV) vaccine becomes more widespread. Although p16/Ki-67 dual-staining cytology has several advantages, it requires advanced diagnostic skills. Here, we developed an automated on-chip immunostaining method using a microfluidic device. An electroactive microwell array (EMA) microfluidic device with patterned thin-film electrodes at the bottom of each microwell was used for single-cell capture by dielectrophoresis. Immunostaining and dual staining for p16/Ki-67 were performed on diagnosed liquid cytology samples using the EMA device. The numbers of p16/Ki-67 dual-stained cells captured by the EMA device were determined and compared among the cervical intraepithelial neoplasia (CIN) lesion samples. Seven normal, fifteen CIN grade 3, and seven CIN grade 2 samples were examined. The percentage of dual-positive cells was 18.6% in the CIN grade 2 samples and 23.6% in the CIN grade 3 samples. The percentages of dual-positive staining increased significantly as the severity of the cervical lesions increased. p16/Ki67 dual immunostaining using the EMA device is as sensitive as the conventional method of confirming the histopathological diagnosis of cervical samples. This system enables a quantified parallel analysis at the individual cell level.
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Affiliation(s)
- Kei Hashimoto
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Tomoo Kumagai
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Kyosuke Nomura
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Yuko Miyagawa
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Saori Tago
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - Kazuki Takasaki
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Yuko Takahashi
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Haruka Nishida
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Takayuki Ichinose
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Mana Hirano
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Haruko Hiraike
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Osamu Wada-Hiraike
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Sasajima
- Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
| | - Soo Hyeon Kim
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - Kazunori Nagasaka
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8605, Japan.
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28
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Pleunis N, Pouwer AFW, Oonk MHM, van Doorn HC, Tjiong MY, van der Velden J, Zijlmans H, van Poelgeest MIE, van Dorst EB, Slangen BFM, Verhoef LCG, Pijnenborg JMA, de Hullu JA. Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study. Br J Cancer 2023; 129:956-964. [PMID: 37507545 PMCID: PMC10491599 DOI: 10.1038/s41416-023-02373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. METHODS A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N-) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. RESULTS Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N- and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence. CONCLUSIONS The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.
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Affiliation(s)
- Noortje Pleunis
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands.
- Department of Obstetrics and Gynaecology, Rijnstate Hospital, Arnhem, the Netherlands.
| | - Anne-Floor W Pouwer
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maaike H M Oonk
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Helena C van Doorn
- Department of Gynaecological Oncology, ErasmusMC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Ming Y Tjiong
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Jacobus van der Velden
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Henry Zijlmans
- Department of Gynaecological Oncology, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | | | - Eleonora B van Dorst
- Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Brigitte F M Slangen
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center, GROW-School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - Lia C G Verhoef
- Department of Radiotherapy, Radboud University Medical Center and Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joanne A de Hullu
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands
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29
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Su N, Yang Y, Liu Z, Gao L, Dai Q, Li J, Wang H, Jiang Y. Validation of the diagnostic efficacy of O-RADS in adnexal masses. Sci Rep 2023; 13:15667. [PMID: 37735610 PMCID: PMC10514283 DOI: 10.1038/s41598-023-42836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023] Open
Abstract
The aim of this study was to validate the performance of the Ovarian-Adnexal Reporting and Data Systems (O-RADS) series models proposed by the American College of Radiology (ACR) in the preoperative diagnosis of adnexal masses (AMs). Two experienced sonologists examined 218 patients with AMs and gave the assessment results after the examination. Pathological findings were used as a reference standard. Of the 218 lesions, 166 were benign and 52 were malignant. Based on the receiver operating characteristic (ROC) curve, we defined a malignant lesion as O-RADS > 3 (i.e., lesions in O-RADS categories 4 and 5 were malignant). The area under the curve (AUC) of O-RADS (v2022) was 0.970 (95% CI 0.938-0.988), which wasn't statistically significantly different from the O-RADS (v1) combined Simple Rules Risk (SRR) assessment model with the largest AUC of 0.976 (95% CI 0.946-0.992) (p = 0.1534), but was significantly higher than the O-RADS (v1) (AUC = 0.959, p = 0.0133) and subjective assessment (AUC = 0.918, p = 0.0255). The O-RADS series models have good diagnostic performance for AMs. Where, O-RADS (v2022) has higher accuracy and specificity than O-RADS (v1). The accuracy and specificity of O-RADS (v1), however, can be further improved when combined with SRR assessment.
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Affiliation(s)
- Na Su
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Ya Yang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Zhenzhen Liu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Luying Gao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Qing Dai
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Jianchu Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Hongyan Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
| | - Yuxin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
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30
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Mir BA, Ahmad A, Farooq N, Priya MV, Siddiqui AH, Asif M, Manzoor R, Ishqi HM, Alomar SY, Rahaman PF. Increased expression of HPV-E7 oncoprotein correlates with a reduced level of pRb proteins via high viral load in cervical cancer. Sci Rep 2023; 13:15075. [PMID: 37699974 PMCID: PMC10497568 DOI: 10.1038/s41598-023-42022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023] Open
Abstract
Human Papillomavirus (HPV) is the most common cause of sexually transmitted diseases and causes a wide range of pathologies including cervical carcinoma. Integration of the HR-HPV DNA into the host genome plays a crucial role in cervical carcinoma. An alteration of the pRb pathways by the E7 proteins is one of the mechanisms that's account for the transforming capacity of high-risk papillomavirus. For the proper understanding of the underline mechanism of the progression of the disease, the present study investigate the correlation of concentration of host pRb protein, viral E7 oncoprotein and viral load in early and advanced stages of cervical carcinoma. It was found that the viral load in early stages (stage I and II) was less (log10 transformed mean value 2.6 and 3.0) compared to advanced stages (stage III and IV) (Log10 transformed value 5.0 and 5.8) having high expression of HPV E7 onco-protein and reduced level of pRb protein, signifying the role of viral load and expression level of E7 oncoprotein in the progression of cervical cancer.
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Affiliation(s)
- Bilal Ahmad Mir
- Zoology Section, School of Sciences, Maulana Azad National Urdu University, Hyderabad, India
| | - Arif Ahmad
- Zoology Section, School of Sciences, Maulana Azad National Urdu University, Hyderabad, India
| | - Nighat Farooq
- Zoology Section, School of Sciences, Maulana Azad National Urdu University, Hyderabad, India
| | - M Vishnu Priya
- Department of Radiation Oncology, MNJ Cancer Hospital, Hyderabad, India
| | - A H Siddiqui
- School of Medical Sciences, University of Hyderabad, Hyderabad, India
| | - M Asif
- Zoology Section, School of Sciences, Maulana Azad National Urdu University, Hyderabad, India
| | - Rouquia Manzoor
- Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar, J&K, India
| | - Hassan Mubarak Ishqi
- Department of Surgery and Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Suliman Y Alomar
- Department of Zoology, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia.
| | - P F Rahaman
- Zoology Section, School of Sciences, Maulana Azad National Urdu University, Hyderabad, India.
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31
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Segedin B, Kobav M, Zobec Logar HB. The Use of 3D Printing Technology in Gynaecological Brachytherapy-A Narrative Review. Cancers (Basel) 2023; 15:4165. [PMID: 37627193 PMCID: PMC10452889 DOI: 10.3390/cancers15164165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Radiation therapy, including image-guided adaptive brachytherapy based on magnetic resonance imaging, is the standard of care in locally advanced cervical and vaginal cancer and part of the treatment in other primary and recurrent gynaecological tumours. Tumour control probability increases with dose and brachytherapy is the optimal technique to increase the dose to the target volume while maintaining dose constraints to organs at risk. The use of interstitial needles is now one of the quality indicators for cervical cancer brachytherapy and needles should optimally be used in ≥60% of patients. Commercially available applicators sometimes cannot be used because of anatomical barriers or do not allow adequate target volume coverage due to tumour size or topography. Over the last five to ten years, 3D printing has been increasingly used for manufacturing of customised applicators in brachytherapy, with gynaecological tumours being the most common indication. We present the rationale, techniques and current clinical evidence for the use of 3D-printed applicators in gynaecological brachytherapy.
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Affiliation(s)
- Barbara Segedin
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Manja Kobav
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
| | - Helena Barbara Zobec Logar
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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32
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Yurchenko AA, Fresneau B, Borghese B, Rajabi F, Tata Z, Genestie C, Sarasin A, Nikolaev SI. Early-onset gynecological tumors in DNA repair-deficient xeroderma pigmentosum group C patients: a case series. Commun Med (Lond) 2023; 3:109. [PMID: 37567969 PMCID: PMC10421935 DOI: 10.1038/s43856-023-00341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a group of rare hereditary disorders with highly increased risk of skin tumors due to defective DNA repair. Recently we reported 34-fold increased risk of internal tumors in XP patients in comparison with general population. The molecular data and clinical practice on the internal tumors treatment in XP patients is limited and scarcely represented in the medical literature. In this work, we describe young patients with constitutive biallelic deactivation of the XPC gene developing gynecological tumors with somatic DICER1 mutations. METHODS Whole genome sequencing was used to analyze in detail somatic mutational landscape and driver events of these rare tumors. RESULTS We describe five early-onset gynecological tumors in four xeroderma pigmentosum group C (XP-C) young patients (11 to 19 years old) including vaginal embryonal rhabdomyosarcomas in monozygotic twin sisters, juvenile granulosa-cell tumor of the ovary and poorly differentiated stage IA Sertoli-Leydig cell tumor in 19-years old patient, and FIGO stage IC1 tumor of ovary in 13-years old patient. XP-C ovarian tumors harbor 4.4 times more single base substitutions than sporadic tissue-matched cancers and demonstrate XP-C specific mutation signature with strong transcriptional bias indicating inability of the cells to repair bulky DNA lesions of unknown etiology. A special mode of treatment was applied to avoid usage of chemotherapy which is toxic for XP patients. CONCLUSIONS XP-C status should be accounted for prevention and specific treatment of gynecological tumors in young DNA repair-deficient XP patients.
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Affiliation(s)
- Andrey A Yurchenko
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - Brice Fresneau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
| | - Bruno Borghese
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France
- Université de Paris Cité, Paris, France
- Institut du Cancer Paris CARPEM, AP-HP, APHP Centre, Department of Gynecological Surgery, Hôpital Cochin, Paris, France
| | - Fatemeh Rajabi
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - Zora Tata
- Liberal Endocrinologist, Algiers, Algeria
| | | | - Alain Sarasin
- CNRS UMR9019 Genome Integrity and Cancers, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sergey I Nikolaev
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France.
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33
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Alp Dal N, Gümüşsoy S, Ertem G. Analysis of awareness of gynaecological cancers İn women using social media. PSYCHOL HEALTH MED 2023; 28:2720-2727. [PMID: 34724843 DOI: 10.1080/13548506.2021.1996616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to use social media to investigate the relationship between the demographic, obstetric and gynaecological characteristics and the awareness of gynaecological cancer among women. The data were collected between 1st March and May 2018 using an internet-baseline survey/surveymonkey/google form. The sample was consisted of 1227 women who were literate, active social media users and had volunteered to participate in the study via social media. The GCAS scores of women who were in the age range 20-24 years, primary school graduates, no social security, were not pregnant, had a miscarriage, did not examine their external genital organs, had not entered the menopause and who did not use any family planning methods, were lower than the other women. The GCA of the women was found to be high.
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Affiliation(s)
- Nursel Alp Dal
- School of Health Sciences, Munzur University, Tunceli, Turkey
| | - Süreyya Gümüşsoy
- Izmir Atatürk Health Care Vocational School, Ege University, İzmir, Turey
| | - Gül Ertem
- Faculty of Nursing, Ege University, Izmir, Turkey
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34
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Williams P, Murchie P, Cruickshank ME, Bond CM, Burton CD. What influences GPs' use of pelvic examination? A qualitative investigation in primary care. Br J Gen Pract 2023; 73:e528-e536. [PMID: 37068965 PMCID: PMC10131233 DOI: 10.3399/bjgp.2022.0363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Omission of pelvic examination (PE) has been associated with diagnostic delay in women diagnosed with gynaecological cancer. However, PEs are often not carried out by GPs. AIM To determine the perceptions of GPs about the role of PEs, the barriers to and facilitators of PEs, and GPs' experience of PEs in practice. DESIGN AND SETTING Qualitative semi-structured interview study conducted in one health board in Scotland (mixed urban and rural) with an approximate population of 500 000. METHOD Interviews were conducted face-to-face or by telephone between March and June 2019. Framework analysis used the COM-B behaviour change model concepts of capability, opportunity, and motivation. RESULTS Data was compatible with all three domains of the COM-B framework. Capability related to training in and maintenance of skills. These went beyond carrying out the examination to interpreting it reliably. Opportunity related to the clinical environment and the provision of chaperones for intimate examination. Interviewees described a range of motivations towards or against PEs that were unrelated to either capability or opportunity. These all related to providing high-quality care, but this was defined in different ways: 'doing what is best for the individual', 'doctors examine', and 'GPs as pragmatists'. CONCLUSION GPs' reasons for carrying out, or not carrying out, PEs in women with symptoms potentially indicating cancer are complex. The COM-B framework provides a way of understanding this complexity. Interventions to increase the use of PEs, and critics of its non-use, need to consider these multiple factors.
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Affiliation(s)
- Pauline Williams
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen
| | - Peter Murchie
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen
| | - Maggie E Cruickshank
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen
| | - Christine M Bond
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen
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Xue B, Wang X. Predictive value of PET metabolic parameters for occult lymph node metastases in PET/CT defined node-negative patients with advanced epithelial ovarian cancer. Sci Rep 2023; 13:9439. [PMID: 37296189 PMCID: PMC10256759 DOI: 10.1038/s41598-023-36640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/07/2023] [Indexed: 06/12/2023] Open
Abstract
Accurate lymph node metastasis (LNM) prediction is crucial for patients with advanced epithelial ovarian cancer (AEOC) since it guides the decisions about lymphadenectomy. Previous studies have shown that occult lymph node metastasis (OLNM) is common in AEOC. The objective of our study is to quantitatively assess the probability of occult lymph node metastasis defined by 18F-Fluorodeoxyglucose PET/CT in AEOC and explore relationship between OLNM and PET metabolic parameters. The patients with pathologically confirmed AEOC who underwent PET/CT for preoperative staging at our institute were reviewed. Univariate and multivariate analysis were performed to evaluate the predictive value of PET/CT-related metabolic parameters for OLNM. The result of our study showed metastatic TLG index had a better diagnostic performance than other PET/CT-related metabolic parameters. Two variables were independently and significantly associated with OLNM in multivariate analysis: metastatic TLG index and primary tumor location. The logistic model combining metastatic TLG index, primary tumor location, and CA125 might be a promising tool to effectively predict the individualized possibility of OLNM for AEOC patients.
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Affiliation(s)
- Bing Xue
- Department of Nuclear Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China
| | - Xihai Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
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Dio CD, Azenkoud I, Trezza A, Lentini E, D’Augè TG, Cuccu I, Bartolomeo GD, Firulli I, Canicchio A, Sgamba L, Muzii L. Early-stage cervical cancer treatment - what's new? Prz Menopauzalny 2023; 22:87-92. [PMID: 37674927 PMCID: PMC10477763 DOI: 10.5114/pm.2023.127774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/27/2023] [Indexed: 09/08/2023]
Abstract
The gold standard of treatment for patients with early-stage cervical cancer is radical hysterectomy, in agreement with the entire scientific community. During the last decade, growing evidence has supported the minimally invasive approach. Several studies have suggested that the minimally invasive approach could improve surgical and perioperative outcomes. Because of these findings, ESCO/ESTRO/ESP guidelines state that a "minimally invasive approach is favoured" in comparison with open surgery, as a grade B recommendation. Because of the lack of a grade A recommendation, this randomized Laparoscopic Approach to Cervical Cancer trial evaluated open vs. minimally invasive approach in the early stage. It demonstrated an increase in mortality among patients treated with minimally invasive surgery, revolutionizing current thinking on the primary surgical approach to early cervical cancer. The aim of this study is to analyse which is the best treatment for early cervical cancer and which approach is the most effective at the moment. Further studies are needed to state with certainty the appropriateness of the treatments offered to patients with early cervical cancer.
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Affiliation(s)
- Camilla Di Dio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilham Azenkoud
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Angelo Trezza
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Emanuele Lentini
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Tullio Golia D’Augè
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilaria Cuccu
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giorgia Di Bartolomeo
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ilaria Firulli
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Andrea Canicchio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovica Sgamba
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Møller NB, Boonen DS, Feldner ES, Hao Q, Larsen M, Lænkholm AV, Borg Å, Kvist A, Törngren T, Jensen UB, Boonen SE, Thomassen M, Terkelsen T. Validation of the BOADICEA model for predicting the likelihood of carrying pathogenic variants in eight breast and ovarian cancer susceptibility genes. Sci Rep 2023; 13:8536. [PMID: 37237042 PMCID: PMC10220031 DOI: 10.1038/s41598-023-35755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/23/2023] [Indexed: 05/28/2023] Open
Abstract
BOADICEA is a comprehensive risk prediction model for breast and/or ovarian cancer (BC/OC) and for carrying pathogenic variants (PVs) in cancer susceptibility genes. In addition to BRCA1 and BRCA2, BOADICEA version 6 includes PALB2, CHEK2, ATM, BARD1, RAD51C and RAD51D. To validate its predictions for these genes, we conducted a retrospective study including 2033 individuals counselled at clinical genetics departments in Denmark. All counselees underwent comprehensive genetic testing by next generation sequencing on suspicion of hereditary susceptibility to BC/OC. Likelihoods of PVs were predicted from information about diagnosis, family history and tumour pathology. Calibration was examined using the observed-to-expected ratio (O/E) and discrimination using the area under the receiver operating characteristics curve (AUC). The O/E was 1.11 (95% CI 0.97-1.26) for all genes combined. At sub-categories of predicted likelihood, the model performed well with limited misestimation at the extremes of predicted likelihood. Discrimination was acceptable with an AUC of 0.70 (95% CI 0.66-0.74), although discrimination was better for BRCA1 and BRCA2 than for the other genes in the model. This suggests that BOADICEA remains a valid decision-making aid for determining which individuals to offer comprehensive genetic testing for hereditary susceptibility to BC/OC despite suboptimal calibration for individual genes in this population.
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Affiliation(s)
- Nanna Bæk Møller
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgårdsvej 21, 8200, Aarhus N, Denmark
| | - Desirée Sofie Boonen
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark
| | - Elisabeth Simone Feldner
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark
| | - Qin Hao
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark
| | - Martin Larsen
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark
| | - Anne-Vibeke Lænkholm
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - Åke Borg
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anders Kvist
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Therese Törngren
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgårdsvej 21, 8200, Aarhus N, Denmark
| | - Susanne Eriksen Boonen
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark.
| | - Thorkild Terkelsen
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgårdsvej 21, 8200, Aarhus N, Denmark.
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Vardar O, Serçekus P. Experiences of Muslim women living with gynaecological cancer and family caregivers. Int J Palliat Nurs 2023; 29:225-234. [PMID: 37224095 DOI: 10.12968/ijpn.2023.29.5.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Cancer has a large impact on the life of the diagnosed person and also their caregivers, who are typically family members. The impact of cancer on a Muslim woman and her caregivers has not been well researched because of cultural and social constraits. AIMS The aim of this study was to explorel the experiences of Muslim women with gynaecological cancers and their family caregivers. METHODS A descriptive phenomenological approach was adopted. A convenience sample was used in the research. FINDINGS The study findings were grouped into four major themes: the initial reaction to a cancer diagnosis from women and their caregivers, difficulties the patient and caregiver experienced (physiological, psychological, social and sexual), coping with cancer and expectations that caregivers and patients have of the institution and the health personnel. It was determined that during this disease and treatment, both the patients and caregivers faced difficulties, which can be categorised as physiological, psychological, social and sexual. Muslim women with gynaecological cancer frequently used coping behaviours, such as worshiping and believing that illness and healing come from God during the illness process. CONCLUSIONS Patients and their family caregivers lived through various difficulties. Healthcare professionals need to consider the expectations of patients with gynecological cancer, alongside those of their family caregivers. Nurses can help Muslim patients and their families cope with the problems they experience by being aware of the positive coping methods of Muslim cancer patients and their caregivers. Nurses should consider individuals' religious beliefs and cultural differences while giving care.
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Nowosielski K, Pałka A. Couples' sexual health after gynaecological cancer diagnosis - an unexplored area for further research. Contemp Oncol (Pozn) 2023; 27:47-56. [PMID: 37266338 PMCID: PMC10230241 DOI: 10.5114/wo.2023.127308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/18/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction The aim of the study was to assess the sexual inhibitory tone, body image, self-concept, and sexual performance in couples after gynaecological cancer treatment, and to identify areas for further prospective studies. Material and methods Thirty gynaecological cancer survivors with a heterosexual partner were assessed during a semi-structural sexual interview. Sexual excitation/sexual inhibition scales were used to evaluate proneness to sexual stimuli, whereas a body exposure during sexual activity questionnaire was used to assess body avoidance during sex. Self-concept in cancer survivors was evaluated by a sexual self-scheme scale. The differences in sexual needs, satisfaction, and sexual activity were comped between women and their partners. Results In survivors and their partners the sexual inhibitory tone was higher than the excitatory tone - 3.91 and 2.45 vs. 2.97 and 2.31, respectively. Most women were schematic-positive and co-schematic - 46.7% and 40.0%, respectively. The decrease in importance of sex was higher in women compared to their partners (D change -0.88 and -0.22, respectively). The frequency of satisfying sex decreased after treatment in women but increased in their partners - D change: -1.04 and +2.94, respectively. Satisfaction with sexual life and quality of relationship improved or did not change after cancer diagnosis in women. None of the sexual response elements were changed by the cancer diagnosis in partners. Conclusions In cancer survivors with a sexual partner, both people should be carefully counselled because there are some important differences in perception of sexual needs within the couple. Avoiding body exposure during sex and differences in proneness to sexual stimuli should be explored in further studies.
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Affiliation(s)
- Krzysztof Nowosielski
- Address for correspondence Krzysztof Nowosielski, MD, prof. SUM Department of Gynecology, Obstetricsand Gynecological Oncology University Clinical Center Chair of Gynecology and Obstetrics Medical University of Silesiaul. Medykow 1440754 Katowice, Poland e-mail:
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40
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Meng Y, Shang M, Cai T, Wang X, Wang Q, Yang R, Zhao D, Qu Y. Incidence and risk factors of intimate partner violence among patients with gynaecological cancer in China. Nurs Open 2023. [PMID: 37098088 DOI: 10.1002/nop2.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/17/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023] Open
Abstract
AIM The aim of this study is to examine the incidence and risk factors for intimate partner violence (IPV) among patients with gynaecological cancer. DESIGN A cross-sectional study design was employed. METHODS Patients with gynaecological cancer were recruited from a tertiary hospital in Shandong, China. Eligible patients completed a survey including questions regarding their demographic and cancer-related characteristics, IPV experience and dyadic coping. RESULTS A total of 429 patients were surveyed, 31% of them reported previous experiences with IPV, and negotiation was the most common type reported. The following variables were associated with IPV: a husband, wife and child/children family structure; a husband, wife, child/children and parent-in-law family structure; an annual household income ≥¥50,000 ($7207); and a similar or greater income earned by the patient than by her partner. PATIENT OR PUBLIC CONTRIBUTION IPV in patients with gynaecological cancer is investigated in this study.
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Affiliation(s)
- Yingtao Meng
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Meimei Shang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Tingting Cai
- School of Nursing, Fudan University, Shanghai, China
| | - Xingli Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Qian Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Rong Yang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Di Zhao
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Yuxin Qu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
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Kotnik U, Maver A, Peterlin B, Lovrecic L. Assessment of pathogenic variation in gynecologic cancer genes in a national cohort. Sci Rep 2023; 13:5307. [PMID: 37002323 PMCID: PMC10066348 DOI: 10.1038/s41598-023-32397-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Population-based estimates of pathogenic variation burden in gynecologic cancer predisposition genes are a prerequisite for the development of effective precision public health strategies. This study aims to reveal the burden of pathogenic variants in a comprehensive set of clinically relevant breast, ovarian, and endometrial cancer genes in a large population-based study. We performed a rigorous manual classification procedure to identify pathogenic variants in a panel of 17 gynecologic cancer predisposition genes in a cohort of 7091 individuals, representing 0.35% of the general population. The population burden of pathogenic variants in hereditary gynecologic cancer-related genes in our study was 2.14%. Pathogenic variants in genes ATM, BRCA1, and CDH1 are significantly enriched and the burden of pathogenic variants in CHEK2 is decreased in our population compared to the control population. We have identified a high burden of pathogenic variants in several gynecologic cancer-related genes in the Slovenian population, most importantly in the BRCA1 gene.
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Affiliation(s)
- Urška Kotnik
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - Aleš Maver
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luca Lovrecic
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Tharin Z, Richard C, Derangère V, Ilie A, Arnould L, Ghiringhelli F, Boidot R, Ladoire S. PIK3CA and PIK3R1 tumor mutational landscape in a pan-cancer patient cohort and its association with pathway activation and treatment efficacy. Sci Rep 2023; 13:4467. [PMID: 36934165 PMCID: PMC10024711 DOI: 10.1038/s41598-023-31593-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 03/14/2023] [Indexed: 03/20/2023] Open
Abstract
There is little data concerning the implications of PIK3CA mutations outside of the known hotspots described in ER+/HER2- metastatic breast cancer (mBC). Similarly, PIK3R1 mutations could also lead to activation of PI3K pathway, but are poorly described. We determined the incidence and type of all somatic PIK3CA and PIK3R1 mutations by whole exome sequencing (WES) in a pan-cancer cohort of 1200 patients. Activation of the PI3K pathway was studied using phospho-AKT immunohistochemistry. Associations between PIK3CA/PIK3R1 mutations and response to chemotherapy were studied in mBC cases. We found 141 patients (11.8%) with a PIK3CA and/or PIK3R1 mutation across 20 different cancer types. The main cancer subtype was mBC (45.4%). Eighty-four mutations (62.2%) occurred in the three described hotspots; 51 mutations occurred outside of these hotspots. In total, 78.4% were considered activating or probably activating. Among PIK3R1 mutations, 20% were loss of function mutations, leading to a constitutional activation of the pathway. Phospho-AKT quantification in tumor samples was in favor of activation of the PI3K pathway in the majority of mutated tumors, regardless of mutation type. In ER+/HER2- mBC, first line chemotherapy efficacy was similar for PIK3CA-mutated and PIK3CA-WT tumors, whereas in triple negative mBC, chemotherapy appeared to be more effective in PIK3CA-WT tumors. In this large, real-life pan-cancer patient cohort, our results indicate that PIK3CA/PIK3R1 mutations are widely spread, and plead in favour of evaluating the efficacy of PI3K inhibitors outside of ER+/HER2- mBC and outside of hotspot mutations.
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Affiliation(s)
- Zoé Tharin
- Department of Medical Oncology, Centre Georges François Leclerc-UNICANCER, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Corentin Richard
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Valentin Derangère
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- Centre de Recherche INSERM LNC-UMR1231, Dijon, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, France
| | - Alis Ilie
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France
- Centre de Recherche INSERM LNC-UMR1231, Dijon, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, France
| | - Laurent Arnould
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - François Ghiringhelli
- Department of Medical Oncology, Centre Georges François Leclerc-UNICANCER, 1 Rue du Professeur Marion, 21000, Dijon, France
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- Centre de Recherche INSERM LNC-UMR1231, Dijon, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, France
| | - Romain Boidot
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
- ICMUB UMR CNRS 6302, Dijon, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc-UNICANCER, 1 Rue du Professeur Marion, 21000, Dijon, France.
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France.
- University of Burgundy-Franche Comté, Dijon, France.
- Centre de Recherche INSERM LNC-UMR1231, Dijon, France.
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, France.
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Zhang Q, Li N, Deng L, Jiang X, Zhang Y, Lee LTO, Zhang H. ACSL1-induced ferroptosis and platinum resistance in ovarian cancer by increasing FSP1 N-myristylation and stability. Cell Death Discov 2023; 9:83. [PMID: 36882396 PMCID: PMC9992462 DOI: 10.1038/s41420-023-01385-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Reprogramming of lipid metabolism, which modulates energy utilization and cell signaling, maintains cell survival and promotes cancer metastasis in cancer cells. Ferroptosis is a type of cell necrosis caused by an overload of lipid oxidation, which has been demonstrated to be involved in cancer cell metastasis. However, the mechanism by which fatty acid metabolism regulates the anti-ferroptosis signaling pathways is not fully understood. The formation of ovarian cancer spheroids helps to counteract the hostile microenvironment of the peritoneal cavity with low oxygen, shortage of nutrients, and subjected to platinum therapy. Previously, we demonstrated that Acyl-CoA synthetase long-chain family member 1 (ACSL1) promotes cell survival and peritoneal metastases in ovarian cancer, but the mechanism is still not well elucidated. In this study, we demonstrate that the formation of spheroids and under exposure to platinum chemotherapy increased the levels of anti-ferroptosis proteins as well as ACSL1. Inhibition of ferroptosis can enhance spheroid formation and vice versa. Genetic manipulation of ACSL1 expression showed that ACSL1 reduced the level of lipid oxidation and increased the resistance to cell ferroptosis. Mechanistically, ACSL1 increased the N-myristoylation of ferroptosis suppressor 1 (FSP1), resulting in the inhibition of its degradation and translocation to the cell membrane. The increase in myristoylated FSP1 functionally counteracted oxidative stress-induced cell ferroptosis. Clinical data also suggested that ACSL1 protein was positively correlated with FSP1 and negatively correlated with the ferroptosis markers 4-HNE and PTGS2. In conclusion, this study demonstrated that ACSL1 enhances antioxidant capacity and increases ferroptosis resistance by modulating the myristoylation of FSP1.
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Affiliation(s)
- Qingyu Zhang
- Laboratory of Obstetrics and Gynecology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
| | - Ning Li
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023, China.,Department of Hematology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Limei Deng
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023, China
| | - Xingmei Jiang
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yuming Zhang
- Department of Hematology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Leo Tsz On Lee
- Cancer Centre, Faculty of Health Sciences, University of Macau, Taipa, Macau, China. .,Ministry of Education Frontiers Science Center for Precision Oncology, University of Macau, Macau, China.
| | - Haitao Zhang
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023, China. .,Peptide and Protein Research and Application Key Laboratory of Guangdong Medical University, Zhanjiang, Guangdong, 524023, China. .,Department of Biochemistry and Molecular Biology, Guangdong Medical University, Zhanjiang, Guangdong, 524023, China.
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Sun Y, Ma Y, Li Q, Ge J. Supportive care needs of women with gynaecological cancer: A systematic review and synthesis of qualitative studies. J Adv Nurs 2023. [PMID: 36811244 DOI: 10.1111/jan.15614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/23/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
AIMS To synthesize existing qualitative research evidence on the supportive care needs of women with gynaecological cancer. DESIGN Qualitative systematic review. DATA SOURCES A comprehensive literature search was performed using nine databases (PubMed, Web of Science, PsycINFO, CINAHL, Embase, CBM, CNKI, VIP and WanFang) without restrictions regarding publication date; qualitative studies published in English or Chinese were included. Initial search in December 2021 and updated in October 2022. REVIEW METHODS This study was conducted according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of all included papers. Finally, we adopted a thematic synthesis method, synthesized the main findings, and constructed themes. RESULTS Eleven studies published between 2010 and 2021 were included in the review. Based on the thematic synthesis method, 10 descriptive themes were generated and five analytical themes were derived: psychological support, information support, social support, disease-specific symptom management and form of care. Women with gynaecological cancer expressed a desire for psychological support from empathetic healthcare professionals; information support included access to adequate and appropriate information, as well as communication and involvement; social support highlighted women's desire for peer support, family-related support and financial support; disease-specific symptom management described women's desire for support in coping with reproduction/sexual issues and form of care highlighted the need for continuity of care and holistic care. CONCLUSION The supportive care needs of women with gynaecological cancer are multidimensional and complex. The future care practice should take women's needs as a starting point and provide ongoing holistic and individualized support. Healthcare providers' understanding and support of these needs are critical to improving women's clinical outcomes and quality of care. IMPACT The present findings can help further develop supportive care programmes and make nursing interventions more targeted and effective. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yue Sun
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanling Ma
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, China
| | - Qiaoran Li
- School of Nursing, China Medical University, Shenyang, China.,Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingling Ge
- Department of Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
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Jun SH, Toosi H, Mold J, Engblom C, Chen X, O'Flanagan C, Hagemann-Jensen M, Sandberg R, Aparicio S, Hartman J, Roth A, Lagergren J. Reconstructing clonal tree for phylo-phenotypic characterization of cancer using single-cell transcriptomics. Nat Commun 2023; 14:982. [PMID: 36813776 PMCID: PMC9946941 DOI: 10.1038/s41467-023-36202-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/20/2023] [Indexed: 02/24/2023] Open
Abstract
Functional characterization of the cancer clones can shed light on the evolutionary mechanisms driving cancer's proliferation and relapse mechanisms. Single-cell RNA sequencing data provide grounds for understanding the functional state of cancer as a whole; however, much research remains to identify and reconstruct clonal relationships toward characterizing the changes in functions of individual clones. We present PhylEx that integrates bulk genomics data with co-occurrences of mutations from single-cell RNA sequencing data to reconstruct high-fidelity clonal trees. We evaluate PhylEx on synthetic and well-characterized high-grade serous ovarian cancer cell line datasets. PhylEx outperforms the state-of-the-art methods both when comparing capacity for clonal tree reconstruction and for identifying clones. We analyze high-grade serous ovarian cancer and breast cancer data to show that PhylEx exploits clonal expression profiles beyond what is possible with expression-based clustering methods and clear the way for accurate inference of clonal trees and robust phylo-phenotypic analysis of cancer.
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Affiliation(s)
- Seong-Hwan Jun
- SciLifeLab, School of EECS, KTH Royal Institute of Technology, Stockholm, Sweden.,Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Hosein Toosi
- SciLifeLab, School of EECS, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Jeff Mold
- Department of Cell and Molecular Biology, Karolinska Institutet, Solna, Sweden
| | - Camilla Engblom
- Department of Cell and Molecular Biology, Karolinska Institutet, Solna, Sweden
| | - Xinsong Chen
- Department of Oncology and Pathology, Karolinska Institutet, Solna, Sweden
| | - Ciara O'Flanagan
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | | | - Rickard Sandberg
- Department of Cell and Molecular Biology, Karolinska Institutet, Solna, Sweden
| | - Samuel Aparicio
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Johan Hartman
- Department of Oncology and Pathology, Karolinska Institutet, Solna, Sweden.,Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Stockholm, Sweden
| | - Andrew Roth
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada. .,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada. .,Department of Computer Science, University of British Columbia, Vancouver, Canada.
| | - Jens Lagergren
- SciLifeLab, School of EECS, KTH Royal Institute of Technology, Stockholm, Sweden.
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Oxley S, Kalra A, Sideris M, Itzkowitz N, Evans O, Atakpa EC, Brentnall AR, Dworschak N, Gaba F, Gabe R, Sundar S, Wood N, Nicum S, Taylor A, Dobbs S, McCluggage WG, Nordin A, Legood R, Kehoe S, Ghaem-Maghami S, Manchanda R. Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK. Cancers (Basel) 2023; 15:cancers15041273. [PMID: 36831615 PMCID: PMC9953843 DOI: 10.3390/cancers15041273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services. METHODS An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022. RESULTS In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity. CONCLUSION COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.
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Affiliation(s)
- Samuel Oxley
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Ashwin Kalra
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Michail Sideris
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Nicole Itzkowitz
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Olivia Evans
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Emma Christine Atakpa
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Adam R. Brentnall
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Nina Dworschak
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Faiza Gaba
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Rhian Gabe
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Sudha Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nick Wood
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK
| | - Shibani Nicum
- Institute of Cancer Research, University College London, London WC1E 6DD, UK
| | | | - Stephen Dobbs
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK
| | - W. Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | - Andy Nordin
- East Kent Gynaecological Oncology Centre, Queen Elizabeth the Queen Mother Hospital, Margate CT9 4AN, UK
| | - Rosa Legood
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Sean Kehoe
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Sadaf Ghaem-Maghami
- Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK
| | - Ranjit Manchanda
- Wolfson Institute of Population Health, Cancer Research UK, Barts Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK
- Department of Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India
- Correspondence:
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Wang Y, Zhang H, Wang T, Yao L, Zhang G, Liu X, Yang G, Yuan L. Deep learning for the ovarian lesion localization and discrimination between borderline and malignant ovarian tumors based on routine MR imaging. Sci Rep 2023; 13:2770. [PMID: 36797331 DOI: 10.1038/s41598-023-29814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
To establish a deep learning (DL) model in differentiating borderline ovarian tumor (BOT) from epithelial ovarian cancer (EOC) on conventional MR imaging. We retrospectively enrolled 201 patients of 102 pathologically proven BOTs and 99 EOCs at OB/GYN hospital Fudan University, between January 2015 and December 2017. All imaging data were reviewed on picture archiving and communication systems (PACS) server. Both T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) MR images were used for lesion area determination. We trained a U-net++ model with deep supervision to segment the lesion area on MR images. Then, the segmented regions were fed into a classification model based on DL network to categorize ovarian masses automatically. For ovarian lesion segmentation, the mean dice similarity coefficient (DSC) of the trained U-net++ model in the testing dataset achieved 0.73 [Formula: see text] 0.25, 0.76 [Formula: see text] 0.18, and 0.60 [Formula: see text] 0.24 in the sagittal T2WI, coronal T2WI, and axial T1WI images, respectively. The DL model by combined T2WI computerized network could differentiate BOT from EOC with a significantly higher AUC of 0.87, an accuracy of 83.7%, a sensitivity of 75.0% and a specificity of 87.5%. In comparison, the AUC yielded by radiologist was only 0.75, with an accuracy of 75.5%, a sensitivity of 96.0% and specificity of 54.2% (P < 0.001).The trained DL network model derived from routine MR imaging could help to distinguish BOT from EOC with a high accuracy, which was superior to radiologists' assessment.
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Yoder AK, Lakomy DS, Wu J, Andring LM, Fellman B, Colbert LE, Jhingran A, Klopp AH, Soliman P, Peterson SK, Lin LL. Impact of Treatment Modality on Quality of Life Among Uterine Cancer Survivors. Clin Oncol (R Coll Radiol) 2023; 35:e215-e226. [PMID: 36494250 PMCID: PMC9904419 DOI: 10.1016/j.clon.2022.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
AIMS Our understanding of the impact of adjuvant therapy on longitudinal quality of life (QoL) following surgery for patients with uterine cancer is limited. The purpose of this study was to compare QoL in patients who have undergone surgery with or without radiation therapy for uterine cancer. MATERIALS AND METHODS This was a cross-sectional cohort study that examined women treated for uterine cancer at MD Anderson Cancer Center from 2006 to 2017. Participants included those who underwent hysterectomy/bilateral salphingo-oophorectomy alone, with brachytherapy or external beam radiation therapy (EBRT). A non-cancer cohort of women who underwent a hysterectomy/bilateral salphingo-oophorectomy for benign indications was also identified (non-CA). To compare QoL we used the Functional Assessment of Cancer Therapy - Endometrial survey (FACT-En), a validated survey used to assess QoL. The survey has five subscales: physical, social, emotional, functional and an endometrial cancer-specific subscale. Cohorts were compared using ANOVA tests. RESULTS In total, 309 women responded to the questionnaire (hysterectomy/bilateral salphingo-oophorectomy 64, brachytherapy 77, EBRT 96, non-CA 72). The median time from surgery to survey completion was 6.7 years. The mean total FACT-En score for the entire cohort was 144 [standard deviation 22]. Overall QoL was different between cohorts, with the EBRT cohort reporting the lowest QoL (mean 139.4 [21.6]) and the brachytherapy cohort the highest (150.6 [18.2], P = 0.006). Among patients who had undergone cancer treatment, the EBRT cohort reported the worst endometrial-specific QoL (53.5 [8.6]), while again the brachytherapy group reported the highest score (57.5 [6.1], P = 0.007). CONCLUSIONS QoL differences in women who have undergone different treatments for uterine cancer may persist years after treatment. In women with endometrial cancer who require adjuvant therapy, brachytherapy does not appear to have any long-term detriments on QoL.
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Affiliation(s)
- A K Yoder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D S Lakomy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Dartmouth College Geisel School of Medicine, Hanover, NH, USA
| | - J Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Texas School of Public Health, Houston, TX, USA
| | - L M Andring
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - B Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L E Colbert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A H Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Soliman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L L Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Zhou L, Hong J, Henricson M, Qin R, Dai Y, Enskär K, Stenmarker M, Browall M. Factors associated with posttraumatic growth among spouses of women diagnosed with gynaecological cancer: A cross-sectional study. Nurs Open 2023; 10:630-640. [PMID: 36040057 PMCID: PMC9834501 DOI: 10.1002/nop2.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of this study was to explore the factors that are associated with posttraumatic growth among spouses of women diagnosed with gynaecological cancer. DESIGN A cross-sectional descriptive study. METHODS A convenience sample of 312 spouses of women diagnosed with gynaecological cancer was recruited from two comprehensive hospitals in China, from March 2018 to March 2020. Demographic characteristics, cancer-related characteristics, posttraumatic growth, perceived social support and coping were assessed using self-reported questionnaires. Descriptive statistics and multiple linear regression analysis were performed. The methods were guided by the STROBE checklist. RESULTS The mean score of posttraumatic growth was 46.7 (standard deviation = 16.7). The associated factors of posttraumatic growth were spouses' age, perceived social support, problem-focused coping, dysfunctional coping (e.g. denial) and cancer treatment received by partners, which accounted for 34% of total posttraumatic growth score. PATIENT OR PUBLIC CONTRIBUTION All participants contributed to the conducting of this study by completing self-reported questionnaires.
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Affiliation(s)
- Lihua Zhou
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China
| | - Maria Henricson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Rumeng Qin
- Department of Nursing, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Dai
- Department of General Surgery (Third Ward), Suzhou Hospital of Anhui Medical University, Suzhou, China
| | - Karin Enskär
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Margaretha Stenmarker
- Department of Paediatrics, Institute of Clinical Sciences, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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50
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Berg HF, Engerud H, Myrvold M, Lien HE, Hjelmeland ME, Halle MK, Woie K, Hoivik EA, Haldorsen IS, Vintermyr O, Trovik J, Krakstad C. Mismatch repair markers in preoperative and operative endometrial cancer samples; expression concordance and prognostic value. Br J Cancer 2023; 128:647-655. [PMID: 36482191 PMCID: PMC9938259 DOI: 10.1038/s41416-022-02063-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The endometrial cancer mismatch repair (MMR) deficient subgroup is defined by loss of MSH6, MSH2, PMS2 or MLH1. We compare MMR status in paired preoperative and operative samples and investigate the prognostic impact of differential MMR protein expression levels. METHODS Tumour lesions from 1058 endometrial cancer patients were immunohistochemically stained for MSH6, MSH2, PMS2 and MLH1. MMR protein expression was evaluated as loss or intact to determine MMR status, or by staining index to evaluate the prognostic potential of differential expression. Gene expression data from a local (n = 235) and the TCGA (n = 524) endometrial cancer cohorts was used for validation. RESULTS We identified a substantial agreement in MMR status between paired curettage and hysterectomy samples. Individual high expression of all four MMR markers associated with non-endometrioid subtype, and high MSH6 or MSH2 strongly associated with several aggressive disease characteristics including high tumour grade and FIGO stage, and for MSH6, with lymph node metastasis. In multivariate Cox analysis, MSH6 remained an independent prognostic marker, also within the endometrioid low-grade subgroup (P < 0.001). CONCLUSION We demonstrate that in addition to determine MMR status, MMR protein expression levels, particularly MSH6, may add prognostic information in endometrial cancer.
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Affiliation(s)
- Hege F Berg
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Hilde Engerud
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Madeleine Myrvold
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Hilde E Lien
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Marta Espevold Hjelmeland
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Mari K Halle
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Kathrine Woie
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Erling A Hoivik
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Section of Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Ingfrid S Haldorsen
- Section of Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Olav Vintermyr
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
- Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jone Trovik
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Camilla Krakstad
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway.
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
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