tbuckley/cabot-search huggingface dataset:
Cervical malignant tumors with lymph node enlargement: A clinicopathologic analysis of 887 cases
Authors: 姜汉国, 唐慰萍, 曹军
Journal: BMJ (2005)

目的 探讨以淋巴结肿大为首发症状的颈部恶性肿瘤的临床病理特征.方法对1998年1月至2003年12月我院887例颈部恶性肿瘤患者的临床资料、组织学类型和转移癌的原发部位进行综合分析.结果 颈部淋巴结转移癌以51～60岁年龄组最多见(182/837,21.74%),男性明显多于女性.原发部位以鼻咽、肺、甲状腺、胃和食管多见(591/671,88.08%).组织学类型以鳞癌多见(407/671,60.66%),多发生于鼻咽、肺和食管(380/407,93.37%).淋巴瘤以非霍奇金淋巴瘤为主(184/216,85.19%).转移癌与淋巴瘤相比,在淋巴结的部位、大小、数量、质地、外观及病程、临床表现等方面均有差异.结论 广东地区颈部淋巴结转移癌患者的原发部位主要来源于鼻咽.某些特异性免疫组化抗体及CT、MRI和超声技术对诊断淋巴瘤和确定转移癌的原发部位具有重要意义。
Development and validation of a nomogram for predicting survival of advanced breast cancer patients in China.
Authors: Shaoyan Lin, Hongnan Mo, Yiqun Li, Xiuwen Guan, Yimeng Chen, Zijing Wang, Peng Yuan, Jiayu Wang, Yang Luo, Ying Fan, Ruigang Cai, Qiao Li, Shanshan Chen, Pin Zhang, Qing Li, Fei Ma, Binghe Xu
Journal: Journal of Clinical Oncology (2020)

e13064 Background: The prognosis of patients with advanced breast cancer (ABC) varied according to different prognostic factors. This study aimed to establish a nomogram to predict the overall survival (OS) of ABC patients in China. Methods: Data from the China National Cancer Center database that recorded 4039 patients diagnosed with breast cancer between 1987 and 2019 were extracted and a total of 2263 ABC patients with complete relevant information were included in this study, which were further randomized 3:1 and divided into training ( n = 1706) and validation ( n = 557) cohorts. The nomogram was built based on independent predictors identified by univariate and multivariate analyses. Harrell′s concordance index (C-index) and calibration plots were used to assessed the discriminatory and predictive capacities of the nomogram. Results: With a median OS of 45.4 months, the 2-year and 3-year OS rates of ABC patients were 75.2% and 60.2%, respectively. Univariate and multivariate analyses found that age, Eastern Cooperative Oncology Group (ECOG) performance status, T-stage, N-stage, tumor subtype, the presence of distant lymph node (DLN)/liver/brain metastasis, local therapy, efficacy of first-line therapy and metastatic-free interval (MFI) were significantly associated with OS (all P &lt; 0.05). These variables were incorporated into a nomogram to predict the 2-year and 3-year OS of ABC patients. The C-indexes of the nomogram were 0.700 (95% confidence interval [CI]: 0.683-0.717) and 0.686 (95% CI: 0.652-0.719) for the training and the validation sets, respectively. The calibration curves revealed satisfactory agreement between actual survival and nomogram prediction in both the internal and external validations. The nomogram was able to stratify patients into different risk groups. Conclusions: We developed and validated a nomogram that might serve as an efficient tool to provide individual prediction for ABC patients and guide the physicians to make personalized treatment decisions for individual ABC patients.
糖尿病肾病的药物治疗
Authors: 施雪枫
Journal: BMJ (2004)

糖尿病肾病(diabetic nephropathy, DN)是糖尿病重要的远期并发症和死亡原因,也是慢性肾功能衰竭的重要病因之一,中国的发病率也越来越高.DN的肾脏病理在不同阶段有各自的特点,而临床表现也随之发生变化,因此不同病程阶段的治疗策略应有所侧重。
丙型肝炎的抗病毒治疗
Authors: 肖江, 谢雯
Journal: BMJ (2006)

据流行病学统计资料,丙型肝炎病毒(HCV)携带者已超过世界总人口3%以上[1],患者易转变为慢性感染过程,部分人最终导致肝硬化,甚至肝细胞癌[2].因此,丙型肝炎(丙肝)抗病毒治疗具有重要的临床意义。
Clinical observation of prolapse and hemorrhoids plus anterior rectal wall repair in the treatment of outlet obstructive constipation caused by rectocele with internal prolapse
Authors: Ya-feng Sun
Journal: BMJ (2013)

To explore the clinical efficacies of surgical procedures for prolapse and hemorrhoids (PPH) plus anterior rectal wall repair in the treatment of outlet obstructive constipation caused by rectocele with internal prolapse. Postoperative complications and treatment effects of 162 cases with outlet obstructive constipation caused by rectocele with internal prolapse undergoing PPH plus anterior rectal wall repair were observed. The cure rate was 100% at week 2 post-operation. No rectocele or rectal mucosa prolapse signs were found within 41 months after defecography in 110 cases. The follow-up period was 17-41 months for 114 cases. Four cases recurred with mild clinical symptoms. The combined approach has high efficacies and low recurrence rates in the treatment of outlet obstructive constipation caused by rectocele accompanied with internal prolapse.


Key words: 
Outlet obstructive constipation; Surgical procedures
Aprepitant in weekly cisplatin with radiation in head and neck cancer: Is it required?
Authors: Hollis D'souza, Vanita Noronha, Vijay Maruti Patil, Amit Joshi, Nandini Sharrel Menon, Kumar Prabhash
Journal: Journal of Clinical Oncology (2020)

e24122 Background: Weekly cisplatin below 50 mg/m2 has lower emetogenic potential than 100 mg/m2 3weekly regimen. There is limited data on the utility of Aprepitant with weekly cisplatin used in radiation in head and neck squamous cell cancer (HNSCC). Methods: We conducted a phase 3 randomized trial in locally advanced HNSCC patients who were treated with definitive chemoradiation either with cisplatin or cisplatin-nimotuzumab. 5HT3 inhibitor and steroids +/- aprepitant were used as antiemetic prophylaxis as per physician discretion. The current analysis is focussed on studying the impact of aprepitant on nausea and vomiting. Fischer’s exact test was used to compare the chemotherapy induced nausea vomiting (CINV) rates between aprepitant and non-aprepitant groups. Binary logistic regression analysis was used to calculate the odds of CINV with the use of aprepitant. Results: Data on CINV is available for 524/536 patients. Nausea was present in 251 (47.9%) patients while vomiting was seen in 155 (29.6%) patients. Aprepitant, 5HT3 antagonist and dexamethasone were administered to 265 (50.86%), while 256 received 5HT3 antagonist and dexamethasone. Among patients receiving aprepitant, nausea was present in 112 (42.3%), while there was no nausea in 153 (57.7%) patients (p = 0.011). Vomiting with aprepitant was seen in 71 (26.8%) patients while 194 (73.2%) had no vomiting (p = 0.151). Adjusted odds ratio for use of aprepitant containing antiemetic prophylaxis in prevention of CINV were 1.585 (1.116-2.249;p = 0.010) and 1.328 (0.904-1.951;p = 0.149) as depicted in the table. Conclusions: Use of aprepitant significantly decreases nausea and is needed for weekly cisplatin regimens used in radiation in head and neck cancers. [Table: see text]
Long-term effect of intensive lifestyle intervention on cardiovascular risk factors in patients with diabetes in real-world clinical practice: a 5-year longitudinal study
Authors: Hamdy Osama, Mottalib Adham, Morsi Amr, El-Sayed Nuha, Goebel-Fabbri Ann, Arathuzik Gillian, Shahar Jacqueline, Kirpitch Amanda, Zrebiec John, 黄融, 范竹萍
Journal: BMJ (2017)

目的
我们评估了在临床中持续减重与增重对心血管危险因素的长期影响。


方法
我们在Why WAIT计划（为期12周的强化生活方式干预）中评估了129例肥胖的糖尿病患者，1年后我们将入组人群分为A组（减重<7%）（47.3%）和B组（减重≥7%）（52.7%），之后我们进行了5年的跟踪随访。


结果
整个入组人群在12周时减重23.8磅（-9.7%），5年后减重16.2磅（-6.4%）（P<0.001），其中A组减重8.4磅（-3.5%）、B组减重23.1磅（-9.0%）。A组糖化血红蛋白在12周时由（7.5±1.3）%下降到（6.7±0.9）%，1年后上升到（7.7±1.4）%，5年后上升到（8.0±1.9）%。B组糖化血红蛋白在12周时由（7.4±1.2）%下降到（6.4±0.9）%，1年上升至（6.8±1.2）%，5年后上升为（7.3±1.5）%。尽管体重有所反弹，A组的低密度脂蛋白胆固醇和高密度脂蛋白胆固醇仍是有所改善的，但是血清甘油三酯升高，血压无明显变化。5年内B组的血脂谱仍有所改善，18个月内血压显著降低。


结论
糖尿病患者减重维持5年，预计1年时体重可以下降7%以上。糖化血红蛋白和甘油三酯随着体重的恢复而升高，而其他的血脂谱则保持不变。持续的体重下降与糖化血红蛋白显著降低达5年和血压降低达18个月相关。
C5aR correlated with the dissemination capacity of circulating tumor cells in hepatocellular carcinoma by targeting INHBA-p-smad2/3-EMT/MMPs axis.
Authors: Qian Dai, Jie Zhu, Minna Shen, Huiqin Jiang, Baishen Pan, Jian Zhou, Jia Fan, Xinrong Yang, Wei Guo
Journal: Journal of Clinical Oncology (2020)

e16649 Background: Circulating tumor cells (CTCs) play important role in tumor dissemination and is an independent survival predictor in Hepatocellular carcinoma (HCC) patients. The aim of this study was to investigate C5a/C5aR, an important axis in complement pathway, which causes the difference capacity of the dissemination of CTCs between HCC patients. The influence of C5a/C5aR axis on recurrence and HCC cell functions was also explored. Methods: Expression microarray analysis was carried out to identify key molecule that cause the difference of CTC enumeration. Clinical significance of the key gene C5aR was evaluated by immunohistochemistry in 187 resectable HCC patients with CTC detection from March 2011 to October 2014. The function of C5a/C5aR axis to enhance the dissemination capacity of CTCs was confirmed first in HCC cell line and than validated in a mouse model. CTCs isolated from the animal circulation were identified by immunostaining for human EpCAM and nuclear counterstaining of red blood cell-lysed blood. Results: Analysis of 187 HCC patients undergoing curative resection showed that C5aR high expression patients were prone to developing vascular invasion, suffering higher AFP level as well as higher percentage of recurrence and death. Further, C5aR expression was also positive correlated with CTC number in HCC patients. In vitro, we observed that cell migration, invasive, proliferation, anti-apoptosis ability and EMT could be greatly inhibited after C5aR knockdown. Opposite results could be observed when C5aR is overexpressed. Further exploration indicated that C5a/C5aR axis could upregulate the expression of INHBA/Activin, and induce phosphorylation of smad2/3 which maintains the mesenchymal phenotype in HCC. Inhibition of the C5a/C5aR signal pathway could decrease circulating capacities of tumor cells and inhibit their colonization to distal organs such as lung in mouse model. Conclusions: Our research elucidated a new C5a/C5aR targeted INHBA-p-smad2/3-EMT/MMP axis to regulate the dissemination of CTC in HCC patients. And these molecules could be novel therapeutic targets for inhibiting the metastasis of tumor cell in the futures.
Preliminary application of self-made acuductor of CT-guided aspiration biopsy for solitary pulmonary nodules
Authors: Yi-hong Zhang, Yong-jie Li, Qiu-feng Yu
Journal: BMJ (2011)

Sixty-four patients with solitary pulmonary nodules were included in this study. The diameter of pulmonary nodules was equal or less than 3.0 cm and no contact with the adjacent pleura. They were divided into study group( with acuductor locating method)and conventional group (with conventional method). The results showed that the one-time success rates were 97％ (31/32)in study group and 72％(23/32) in conventional group, the diagnostic accuracy were 94％ ( 30/32 ) and 88 ％ ( 28/32 ), respectively,while the successful puncture time were( 13. 5 ±4. 9)min and( 18. 7 ±5. 7) min, respectively. In study group,the complication rate was 9％ (3/32), while 28％ ( 9/32 ) in conventional group. There were statistical differences between the two groups. CT-guided aspriation biopsy for solitary pulmonary nodules with self-made acuductor can obviously improve one-time success rate and reduce the complication rate and operative time.

Key words: 
CT-guided puncture;  Coin lesion, pulmonary
Tumor antigen expression and survival of patients with previously treated advanced non-small cell lung cancer (NSCLC) receiving viagenpumatucel-L (HS-110) plus nivolumab.
Authors: Daniel Morgensztern, Saiama Naheed Waqar, Lyudmila Bazhenova, Lori McDermott, Jeff Hutchins, David H Taylor, Fred L Robinson, Alexa K Dowdell, Brian Piening, Wael A. Harb, Nathan A. Pennell, Roger B. Cohen
Journal: Journal of Clinical Oncology (2020)

9546 Background: Viagenpumatucel-L (HS-110) is an allogeneic cellular vaccine derived from a human lung adenocarcinoma cell line transfected with gp96-Ig fusion protein. Gp96-Ig functions as an antigen chaperone for dendritic cell activation and direct CD8+T cell expansion via cross presentation. DURGA is a multi-cohort study evaluating HS-110 plus anti-PD-1 mAbs in patients (pts) with advanced NSCLC. We report on Cohort A, which enrolled previously-treated pts who had not received an anti-PD(L)1 prior to study entry. Methods: Primary objectives were safety and objective response rate (ORR). Overall Survival (OS) was a secondary endpoint. Pts received 1 X 10 7 HS-110 cells intradermally every week for 18 wks and nivolumab until tumor progression. To determine cancer testis antigen (CTA) overexpression from baseline pt tumor samples, hybrid-capture RNA-seq libraries were prepared from macrodissected formalin fixed paraffin embedded tumor tissue and sequenced on an Illumina NovaSeq 6000. Gene-level transcripts were quantified using the Salmon software package. Results: 47 pts were enrolled into Cohort A. ORR and clinical benefit rate (CR + PR + SD) were 21% and 43%, respectively, with a 17.2 month median duration of response. Median OS was 28.7 months (mos), with a median follow up of 15.7 mos. One and 2-year survival were 57% and 36%, respectively. A prespecified exploratory analysis of CTA expression level in baseline pt tumor tissue was performed. 50% of pts shared at least 8 of the 39 total antigens overexpressed by HS110. Although there was no difference in ORR between these groups, mOS was higher in pts with tumors that shared ≥ 8 antigens with HS-110 (not reached (NR) [95%CI: 10.3 mos, NR] vs 6.7 mos [95%CI: 1.4 mos, NR]), p = 0.028. Pts whose tumors expressed the ZNF492 antigen also had improved OS (NR [95%CI: 11.6 mos, NR] vs 7.2 mos [95%CI: 1.6 mos, NR]), p = 0.03. All pts experienced at least one adverse event (AE), and the most common AEs were fatigue (28%), arthralgia (19%) and cough (17%). There were 2 grade 5 AEs not related to treatment. Conclusions: The combination of HS-110 and nivolumab appears safe and well tolerated. OS was improved in pts whose tumors express ≥ 8 shared antigens with HS110, as well as in those who specifically expressed ZNF492. Further exploration of antigen expression as a predictor for treatment outcome with HS110 plus nivolumab is ongoing. Clinical trial information: NCT02439450 .
Accurate prediction of somatic variants using deep learning model.
Authors: Peng Zhang, Kai Wang, Ming Yao, Aodi Wang, Lijuan Chen, Angen Liu, Xiaoliang Shi, Shiyue Zhang
Journal: Journal of Clinical Oncology (2020)

e13659 Background: Efficient and accurate identification of somatic variant is important for understanding the formation, progression, and treatment of cancer. It is necessary to conduct manual review by Integrative Genomic Viewer (IGV) in traditional variant calling process. However, the traditional manual is heavy workload when evaluating tumor with a high variant burden. In this study, a new convolutional neural network (CNN) method was created to train models for somatic mutation identification, which was suitable for Panel sequencing platform with different tumor purities. Methods: A total of 1000 tumor samples from next generation sequencing (NGS)-based genetic testing by a College of American Pathologists (CAP) accredited and Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. Through variant calling program, like GATK, the candidate mutation locations were identified and standardized by manual confirmation. For each candidate mutation location, reads of both tumor and control tissue were extracted. A 2-dimensional feature matrix M of size (2k+1) * 32 in each candidate base was created. The rows of 2k+1 represented the length of candidate region, and the 32 columns included the reads coverage frequency, mapping quality messages, and genome local scores of different tumor and control tissues. CNN model, which includes nine convolutional layers structured by Temporal Convolutional Networks (TCN) but with a different structure to adapt to the proposed input matrix, was used for training. The training data set including manually validated sequence data was used as benchmark test, and optimized by Stochastic Gradient Descent (SGD) optimizer with a learning rate of 0.01 was used for training. Results: The validation data set included 15 mixed samples which were composed of different proportions of known cell lines and real mixed blood samples. The pooled DNA contained 2,359 somatic variants, with expected variant allele frequencies ranged from 3% to 97% in each pool. The overall sensitivity and positive predictive value (PPV) of single nucleotide variants (SNVs) were 99.3% and 99.8%, respectively. Conclusions: A novel and sensitive computational tool for somatic variation detection in DNA Panel sequencing was developed. Our result showed that the deep learning CNN model could call variant in Panel sequencing data.
The impact of census-tract socioeconomic status on survival in stage III colon cancer.
Authors: Amina Dhahri, Jori Lee Kaplan, Shana Ntiri, Iman Imanirad, Seth Felder, Sean Patrick Dineen, Julian Sanchez, Sophie Dessureault, Estrella M. Carballido, Benjamin Powers
Journal: Journal of Clinical Oncology (2020)

7032 Background: Socioeconomic status (SES) has been associated with worse outcomes in stage III colon cancer. However, these studies have used large geographic areas (zip codes or counties) as a proxy for SES which may bias results. To overcome this challenge, we used a national database with census-tract level SES to assess the impact on cancer-specific (CSS) and overall survival (OS). Methods: Using the SEER Census-Tract Dataset from 2004-2015, we identified 8 th edition AJCC stage III colon adenocarcinoma patients who underwent curative-intent surgery and initiated adjuvant chemotherapy. The predictor variable was census-tract level SES, consisting of 7 variables such as income, housing, and education. SES was analyzed as quartiles. Statistical analysis included chi square tests for association and Kaplan-Meier and Cox regression for survival analysis. Results: We identified 27,222 patients who met inclusion criteria. Lower SES was associated with younger age, Black or Hispanic race/ethnicity, Medicaid or uninsured status, higher T stage, &lt;12 lymph nodes examined and lower grade tumors. Median CSS was not reached; the 25 th percentile CSS time was 54 months for the lowest SES (LSES) quartile and 80 months for the highest (HSES). Median OS was 113 months for LSES and not reached for HSES. The 5-year CSS rate was 72.4% for the LSES quartile compared to 78.9% in the HSES (p&lt;0.001). The 5-year OS rate was 66.5% for LSES and 74.6% in the HSES (p&lt;0.001). After adjusting for potential confounders (age, sex, race, insurance, pathologic T and N stage and grade), LSES was associated with increased cancer-specific death relative to the HSES (HR 1.22; 95% CI [1.114-1.327]) Conclusions: This is the first study to evaluate CSS and OS in a national cohort of stage III colon cancer patients using a granular, standardized measure of SES. Despite receipt of guideline-based treatment, low SES remained a predictor of increased cancer-specific mortality. These data suggest that investigating treatment barriers beyond adjuvant therapy is needed to address colon cancer survival disparities. [Table: see text]
Whole genome SNP arrays for best practice for detection of diagnostic, prognostic and therapy related copy number changes and copy neutral-loss of heterozygosity across solid tumors and hematologic malignancies.
Authors: Patrick Alan Lennon, Gordana Raca, Min Fang, Daynna Wolff, Marilyn M. Li, Anwar M. Iqbal, Brynn Levy, Stuart Schwartz, Adrian M. Dubuc
Journal: Journal of Clinical Oncology (2020)

e15575 Background: High resolution single nucleotide polymorphism (SNP) chromosomal microarrays (CMA) detect copy number changes and copy neutral-loss of heterozygosity (CN-LOH) across the entire genome, currently providing the best assessment for these types of genomic variants. Chromosomal microarrays are first tier tests utilized in the postnatal detection of microdeletions, microduplications and uniparental disomy/regions of homozygosity in constitutional disorders involving congenital abnormalities, developmental delay and intellectual disability. Methods: In the oncology setting, aberrations detected may be diagnostic, prognostic, and therapeutic. Because CMA assesses the entire genome and can readily detect aberrations as small as a single exon to as large as a whole chromosome, this is an important clinical tool to bridge the gap between low resolution of metaphase chromosome analysis and PCR-based short read sequencing-based assays. Results: No single genomic technique (metaphase chromosome analysis, FISH, CMA or Next Generation Sequencing, including large targeted gene panels) has the ability to detect all relevant information. Therefore, CMA should be considered an important clinical tool for solid and liquid tumors. Across a wide variety of solid tumors, whole genome assessment (including oncogene amplification, tumor suppressor loss, and copy number burden) leads not only to possible therapy targets but also to opportunities for participation in active clinical trials. Recently, the Cancer Genomics Consortium has published evidenced-based reviews on the clinical utility of CMA for copy number and CN-LOH assessment in a variety of hematologic malignancies, and similar papers in solid tumors are in review. Recognizing the growing evidence for CMA, the American Medical Association (AMA) CPT editorial board recently created a new Tier 1 test for cytogenomic arrays in neoplasia, and Centers for Medicare and Medicaid Services (CMS) approved crosswalking the price of the new code to the well-established constitutional cytogenomic array CPT code. Conclusions: For this presentation, examples of diagnostic, prognostic, and therapeutic utility and inclusion in clinical trials across many hematologic and solid tumor neoplasms will be presented to demonstrate the efficacy, cost effectiveness and sensitivity of whole genome assessment of copy number and copy neutral loss of heterozygosity
Video conference intervention for distance caregivers (DCGs) of patients with cancer: Improving psychological outcomes.
Authors: Sara L Douglas, Polly Mazanec, Amy R Lipson, Eric Blackstone, Kim Day, David Lawrence Bajor, Smitha S. Krishnamurthi
Journal: Journal of Clinical Oncology (2020)

12123 Background: Family caregivers are increasingly involved in providing care and support for patients with cancer. Approximately 20% of caregivers live &gt; 1 hour away from the patient and are considered DCGs. DCGs report higher distress and anxiety than local caregivers—often due to lack of first hand information and a high degree of uncertainty regarding the patient’s condition. Methods: This RCT was conducted at a large, urban comprehensive cancer center. Patients of all cancer types were eligible if they had monthly oncologist appointments and were receiving treatment. DCGs were randomized to one of three arms. Arm 1 received 4 monthly videoconference coaching sessions with a nurse practitioner or social worker focused upon information and support, participated in patient’s appointments with the oncologist via videoconference over the 4 month study period, and had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other 2 components of Arm 1. Arm 3 received access to the DCG website only. Primary variables of interest were DCG distress and anxiety. DCGs completed online surveys prior to randomization and at the completion of the intervention period. PROMIS Anxiety and the NCCN distress thermometer were used. Results: Between November, 2016 and October, 2019, 441 patient-dyads were enrolled. Mean DCG age was 47 years; 71% were female, 65% Caucasian, 63% were the child of the patient and 81% were employed. Mean patient age was 65 years, 60% were female, 30% had GI cancer and 18% had hematologic cancer. For patients with solid tumor cancers, 59% were Stage IV. RMANOVA was used to examine the change in anxiety t-scores over time by arms of the intervention, controlling for DCG age, race, and gender. There was a significant anxiety by group interaction (p = .03) with Arm 1 being the only group that showed a significant reduction in anxiety over time (21.2% improved, ES = .57). Distress followed a similar pattern with a significant distress by group interaction (p = .02) with Arm 1 demonstrating the greatest improvement in distress over time (54.3%). Conclusions: These data suggest that the use of a coaching videoconference intervention made significant and clinically meaningful differences in anxiety and distress for these important members of the family caregiving team. Clinical trial information: NCT02666183 .