1.Prediction model establishment for complete resolution of sentinel lymph node metastasis after neoadjuvant chemotherapy in breast cancer
Qing PAN ; Yicong NIU ; Cheng CHEN ; Dachang MA ; Jun WU
Journal of Clinical Surgery 2025;33(8):846-851
Objective To explore the factors associated with complete resolution of sentinel lymph node metastasis(pCR)after neoadjuvant chemotherapy in breast cancer and to establish a predictive model.Methods The medical records of 136 female patients with breast cancer who received neoadjuvant chemotherapy in the First Hospital of Lanzhou University from January 2022 to February 2024 were retrospectively analyzed.According to the 80/20 rule,the patients were randomly divided into a training set(108 cases)and a validation set(28 cases).Based on the pathological examination results of axillary lymph node dissection(ALND)after neoadjuvant chemotherapy in breast cancer patients,they were classified into the sentinel lymph node pCR group and non-pCR group.Multivariate logistic regression analysis was used to screen the independent risk factors of sentinel lymph nodes failing to reach pCR.Build a nomogram prediction model based on the screened risk factors.By drawing the receiver operating characteristic(ROC)curve calculation curve,the area under ROC curve,sensitivity and specificity are used to evaluate the discrimination of the model.Results Among the 108 breast cancer patients,46 cases achieved pCR in the sentinel lymph nodes,accounting for 42.59%(46 cases/108 cases).In addition,33 cases(30.56%)achieved pCR in the primary tumor lesion.The non-pCR group showed a higher proportion of stage Ⅲ clinical staging,lymph node short-axis reduction of less than 50%before and after treatment,tumor maximum diameter reduction of less than 50%before and after treatment,lymph node type Ⅲ classification,and blood flow grade Ⅲ compared to the pCR group(P<0.05).Multivariate logistic regression analysis showed that Clinical staging(OR=3.593,95%CI:1.276-10.121),lymph node short-axis reduction of less than 50%before and after treatment(OR=4.272,95%CI:1.517-12.032),tumor maximum diameter reduction of less than 50%before and after treatment(OR=3.710,95%CI:1.317-10.449),lymph node type(OR=3.827,95%CI:1.359-10.779),and blood flow grade(OR=4.764,95%CI:1.691-13.418)were identified as risk factors for not achieving pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients(P<0.05).The sensitivity of the risk model for predicting non-achievement of pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in the training set of breast cancer patients was 0.826(95%CI:0.705-0.943),with a specificity of 0.826(95%CI:0.712-0.919)and an area under the ROC curve of 0.847(95%CI:0.738-0.952).In the validation set,the sensitivity for predicting non-achievement of pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients was 0.731(95%CI:0.608-0.904),with a specificity of 0.827(95%CI:0.713-0.941)and an area under the ROC curve of 0.834(95%CI:0.729-0.951).Conclusion Clinical staging,changes in lymph node short-axis before and after treatment,changes in tumor maximum diameter before and after treatment,lymph node type,and blood flow grade are associated with pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients.Constructing a predictive model can help evaluate the pCR status of sentinel lymph nodes after neoadjuvant chemotherapy.
2.Prediction model establishment for complete resolution of sentinel lymph node metastasis after neoadjuvant chemotherapy in breast cancer
Qing PAN ; Yicong NIU ; Cheng CHEN ; Dachang MA ; Jun WU
Journal of Clinical Surgery 2025;33(8):846-851
Objective To explore the factors associated with complete resolution of sentinel lymph node metastasis(pCR)after neoadjuvant chemotherapy in breast cancer and to establish a predictive model.Methods The medical records of 136 female patients with breast cancer who received neoadjuvant chemotherapy in the First Hospital of Lanzhou University from January 2022 to February 2024 were retrospectively analyzed.According to the 80/20 rule,the patients were randomly divided into a training set(108 cases)and a validation set(28 cases).Based on the pathological examination results of axillary lymph node dissection(ALND)after neoadjuvant chemotherapy in breast cancer patients,they were classified into the sentinel lymph node pCR group and non-pCR group.Multivariate logistic regression analysis was used to screen the independent risk factors of sentinel lymph nodes failing to reach pCR.Build a nomogram prediction model based on the screened risk factors.By drawing the receiver operating characteristic(ROC)curve calculation curve,the area under ROC curve,sensitivity and specificity are used to evaluate the discrimination of the model.Results Among the 108 breast cancer patients,46 cases achieved pCR in the sentinel lymph nodes,accounting for 42.59%(46 cases/108 cases).In addition,33 cases(30.56%)achieved pCR in the primary tumor lesion.The non-pCR group showed a higher proportion of stage Ⅲ clinical staging,lymph node short-axis reduction of less than 50%before and after treatment,tumor maximum diameter reduction of less than 50%before and after treatment,lymph node type Ⅲ classification,and blood flow grade Ⅲ compared to the pCR group(P<0.05).Multivariate logistic regression analysis showed that Clinical staging(OR=3.593,95%CI:1.276-10.121),lymph node short-axis reduction of less than 50%before and after treatment(OR=4.272,95%CI:1.517-12.032),tumor maximum diameter reduction of less than 50%before and after treatment(OR=3.710,95%CI:1.317-10.449),lymph node type(OR=3.827,95%CI:1.359-10.779),and blood flow grade(OR=4.764,95%CI:1.691-13.418)were identified as risk factors for not achieving pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients(P<0.05).The sensitivity of the risk model for predicting non-achievement of pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in the training set of breast cancer patients was 0.826(95%CI:0.705-0.943),with a specificity of 0.826(95%CI:0.712-0.919)and an area under the ROC curve of 0.847(95%CI:0.738-0.952).In the validation set,the sensitivity for predicting non-achievement of pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients was 0.731(95%CI:0.608-0.904),with a specificity of 0.827(95%CI:0.713-0.941)and an area under the ROC curve of 0.834(95%CI:0.729-0.951).Conclusion Clinical staging,changes in lymph node short-axis before and after treatment,changes in tumor maximum diameter before and after treatment,lymph node type,and blood flow grade are associated with pCR in the sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer patients.Constructing a predictive model can help evaluate the pCR status of sentinel lymph nodes after neoadjuvant chemotherapy.
3.Investigation and Analysis of Medication Information Labeling in 157 Package Inserts of Anticancer Drugs
Jing MA ; Yan WANG ; Bo LU ; Shouxiang TANG ; Lihua YUAN ; Xuemin ZHOU
China Pharmacy 2019;30(7):985-990
OBJECTIVE: To investigate and analyze medication information labeling in package inserts of anticancer drugs, and to provide reference for clinical rational use. METHODS: The package inserts of anticancer drugs were collected from drug catalogues of 3 Third Grade Class A hospitals in Nanjin. Common problems of drug package inserts (whether the main contents arweree contradictory or not and whether the contents were fully expressed, etc.), complete specific labeling items (detailed contents of “ADR” “contraindication” “precautions” and other items), detailed intravenous injection dispensing guidance (solvent selection, precautions during dispensing, etc.), package insert labeling difference of drugs with same general name and route of administration were evaluated according to Drug Package Inserts and Label Management Regulation,Regulations for Chemical Drugs and Biological Products for Treatment. RESULTS: A total of 157 package inserts for anticancer drugs were collected and divided into domestic drugs (80 pieces) and imported drugs (77 pieces) according to the source as well as also divided into oral preparation (44 pieces) and injection (113 pieces). The common problems of package inserts for anticancer drugs contained contradictory main contents, incomplete description, Chinese character errors, missing items and simple description of drug interactions, etc. Compared with domestic or oral anticancer drugs, the labeling rate of each item in the import or injection anticancer drug package inserts was higher, but specific labeling items such as prevention and treatment of vomiting (<20%) under “precautions” and interference of drugs on clinical tests (<40%) were lower. The labeling rate of serious ADR after large dose or long-term use was all less than 41% under the item of “drug overdose” (except for imported drugs). The labeling rate of intravenous dispensing guidance of imported anticancer drug injection package inserts about preparations was higher than that of domestic ones. There were differences in labeling items as “precautions” (30/56,53.57%), “pharmacological toxicology” (29/56,51.79%), “contraindication” (26/56,46.43%) among 56 groups of drug package inserts with same general name and route of administration. CONCLUSIONS: The labeling items for drug package inserts of anticancer drugs need to be further standardized and improved. It is recommended that the relevant departments force pharmaceutical manufacturers to regularly supplement the deficiencies in the package inserts to improve the safety of drug use in clinic.
4.The expression of miR-199a-3p in breast cancer and its effect
Dachang MA ; Cheng CHEN ; Duoming WU ; Honglei WANG ; Li WU
China Oncology 2016;26(6):481-486
Background and purpose:Multiple microRNAs (miRNAs) are abnormally expressed in breast cancer and play an important role in the regulation of breast cancer. miRNAs may be a new target for the treatment of breast cancer. This study aimed to investigate the expression of miR-199a-3p in breast cancer and the effect of miR-199a-3p on proliferation and apoptosis of breast cancer.Methods:Real-time PCR was used to test the expression of miR-199a-3p in breast cancer tissues, normal breast tissues, breast cancer cells and normal breast cells. Overexpression (or silencing the expression) of miR-199a-3p was conducted by transfecting MDA-MB-231 with miR-199a-3p mimics (or inhibitors). The proliferation of MDA-MB-231 was detected by MTT method. The apoptosis of MDA-MB-231 was investigated by Hoechst staining and caspase-3 activity assay kit.Results:Compared to corresponding non-tumor breast tissues (or normal breast cell HBL-100), lower levels of miR-199a-3p were expressed in breast cancer tissues or breast cancer cells. Overexpression of miR-199a-3p induced by miR-199a-3p mimic inhibited the proliferation and promoted the apoptosis of MDA-MB-231, while silencing the expression of miR-199a-3p induced by miR-199a-3p in-hibitor increased the proliferation and suppressed the apoptosis of MDA-MB-231.Conclusion:The expression of miR-199a-3p is lower in breast cancer, which shows its tumor suppression effect by regulating the proliferation and apoptosis of breast cancer cells.
5.Identification of proteins interacting with the circadian clock protein PER1 in tumors using bacterial two-hybrid system technique.
Yu ZHANG ; Youlin YAO ; Siyuan JIANG ; Yilu LU ; Yunqiang LIU ; Dachang TAO ; Sizhong ZHANG ; Yongxin MA
Chinese Journal of Medical Genetics 2015;32(2):192-197
OBJECTIVETo identify protein-protein interaction partners of PER1 (period circadian protein homolog 1), key component of the molecular oscillation system of the circadian rhythm in tumors using bacterial two-hybrid system technique.
METHODSHuman cervical carcinoma cell Hela library was adopted. Recombinant bait plasmid pBT-PER1 and pTRG cDNA plasmid library were cotransformed into the two-hybrid system reporter strain cultured in a special selective medium. Target clones were screened. After isolating the positive clones, the target clones were sequenced and analyzed.
RESULTSFourteen protein coding genes were identified, 4 of which were found to contain whole coding regions of genes, which included optic atrophy 3 protein (OPA3) associated with mitochondrial dynamics and homo sapiens cutA divalent cation tolerance homolog of E. coli (CUTA) associated with copper metabolism. There were also cellular events related proteins and proteins which are involved in biochemical reaction and signal transduction-related proteins.
CONCLUSIONIdentification of potential interacting proteins with PER1 in tumors may provide us new insights into the functions of the circadian clock protein PER1 during tumorigenesis.
Base Sequence ; Cell Line, Tumor ; Escherichia coli ; genetics ; metabolism ; Humans ; Molecular Sequence Data ; Neoplasms ; genetics ; metabolism ; Period Circadian Proteins ; genetics ; metabolism ; Protein Binding ; Proteins ; genetics ; metabolism ; Two-Hybrid System Techniques
6.The A-204C Polymorphism in CYP7A1 Gene Affects Its Promoter Activity
Yujuan CHEN ; Sizhong ZHANG ; Cuiying XIAO ; Dachang TAO ; Guoping HE ; Yingcheng WANG ; Yunqiang LIU ; Yongxin MA
Chinese Journal of Biochemistry and Molecular Biology 2006;22(6):450-453
cholesterol 7α-hydroxylase gene ( CYP7A 1 ) plays a key role in the catabolism of cholesterol into bile acids. To investigate whether the A-204C polymorphism in CYP7A1 gene affects the gene expression,using luciferase as the reporter gene, four recombinants were constructed by inserting forward or reverse sequence with A or C allele at the polymorphism site into the promoter-less vector pGL3-basic. The constructs were then transfected into four cell lines and the luciferase activity of each expression vector was examined by dual luciferase reporter gene assay system. The results showed that activities of the forward sequence of both genotypes were higher than that of reverse sequence. Promoter activity of the recombinants with A allele was about one third lower than that with C allele. According to the analysis with TRANSFAC database, there may exist a Zic3 binding site when there is the C allele at -204. Our study indicates that the A-204 C polymorphism in CYP7A1 promoter region decreases its promoter activity and thus represses the gene expression, possibly due to the lack of a potential Zic3 binding site.

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