Jun Yan

MGAT4A/Galectin9‐Driven N‐Glycosylation Aberration as a Promoting Mechanism for Poor Prognosis of Endometrial Cancer with TP53 Mutation

AbstractEmerging evidence recognizes aberrant glycosylation as the malignant characteristics of cancer cells, but little is known about glycogenes’ roles in endometrial carcinoma (EC), especially the most aggressive subtype carrying TP53 mutations. Using unsupervised hierarchical clustering, an 11‐glycogene cluster is identified to distinguish an EC subtype associated with frequent TP53 mutation and worse prognosis. Among them, MGAT4A (alpha‐1,3‐mannosyl‐glycoprotein 4‐β‐N‐acetylglucosaminyltransferase A) emerges as the most consistently overexpressed glycogene, contributing to EC aggressiveness. In the presence of galectin‐9, MGAT4A increases EC cell proliferation and invasion via promoting glucose metabolism. N‐glycoproteomics further revealed GLUT1, a glucose transporter, as a glycoprotein modified by MGAT4A. Binding of galectin‐9 to the MGAT4A‐branched N‐glycan on GLUT1 enhances its cell membrane distribution, leading to glucose uptake increase. In addition, oncogenic mutations of TP53 gene in EC cells upregulate MGAT4A expression by disrupting the regulatory oversight exerted by wild‐type p53 on tumor‐suppressive miRNAs, including miR‐34a and miR‐449a/b. The findings highlight a new molecular mechanism involving MGAT4A‐regulated N‐glycosylation on the key regulator of glucose metabolism in p53 mutants‐driven EC aggressiveness, which may provide a strategic avenue to combat advanced EC.

Illness perception and intimate relationships in patients with cervical cancer: the mediating role of dyadic coping

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients. A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke-Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory. The mean score for intimate relationships was 107.78 (SD = 23.99, range 30-154). Pearson's correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR. The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

Development and Psychometric Testing of a Low Extremity Lymphedema Risk Management Behaviours Questionnaire for Patients With Gynecologic Cancer

ABSTRACT Background Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason. Aims To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer. Design This was a methodological study. Methods Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N  = 158) and confirmatory factor analysis (CFA; subsample 2, N  = 231) were performed separately to determine the multi‐dimensional structure of the questionnaire. Known‐group validity, internal consistency reliability, and test–retest reliability were also evaluated. Results A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four‐factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known‐group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable. Conclusions The 18‐item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer. Implications for the Profession and/or Patient Care The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness. Reporting Method This manuscript followed the STROBE guidelines. Patient or Public Contribution Patients with gynecologic cancer participated in this study and provided the data through the survey.

The impact of illness perception on marital quality among patients with cervical cancer and their husbands: based on actor-partner interdependence mediation model.

To describe the illness perception, dyadic coping, and marital quality of cervical cancer patient-husband dyads. In addition, we explore the direct effects of illness perception on marital quality, and whether dyadic coping acts as a mediator in this process. A cross-sectional design was employed. The Revised Illness Perception Questionnaire for Cervical Cancer, the Dyadic Coping Inventory, and the Marital Adjustment Test were used to assess illness perception, dyadic coping, and marital quality. Dyadic analysis was conducted by constructing the actor‒partner interdependence mediation model. A total of 175 dyads of postoperative cervical cancer patients and their husbands completed the questionnaires. The dyads reported suboptimal scores for both marital quality and dyadic coping. For direct effects of illness perception on marital quality, our model indicated that the positive illness perception of patients and negative illness perception of husbands can negatively impact their own marital quality. With respect to the indirect effects of dyadic coping acting as a mediator, both positive illness perception and negative illness perception of husbands can impact their own marital quality through their own dyadic coping and can also impact patients' marital quality through patients' dyadic coping. This study highlights that the level of marital quality and dyadic coping in dyads need to be improved, demonstrates the significance of illness perception for influencing dyads' marital quality and reveals the underlying mediating mechanism of dyadic coping. This study provides guidance for illness perception-based dyadic interventions to improve marital quality among cervical cancer patients and husbands.