Qi-Jun Wu

Pre- and post-diagnosis dietary total antioxidant capacity and overall survival in patients with ovarian cancer: a prospective cohort study

The current study aims to investigate the association between dietary total antioxidant capacity (DTAC) and overall survival (OS) in patients with ovarian cancer (OC). A validated 111-item food frequency questionnaire was used to assess their pre- and post-diagnosis dietary intake. DTAC is represented by ferric-reducing ability of plasma (FRAP), total oxygen radical absorbance capacity (TORAC), hydrophilic oxygen radical absorbance capacity (HORAC), lipophilic oxygen radical absorbance capacity (LORAC), and total phenolics (TP). The OS was determined by both passive and active follow-up. A total of 531 patients with OC was involved in this study. High post-diagnosis FRAP (HR Increased pre- and post-diagnosis DTAC intake, and maintaining moderate or high DTAC intake after diagnosis, may be associated with enhanced OS in patients with OC.

Artificial Intelligence Performance in Image-Based Cancer Identification: Umbrella Review of Systematic Reviews

Background Artificial intelligence (AI) has the potential to transform cancer diagnosis, ultimately leading to better patient outcomes. Objective We performed an umbrella review to summarize and critically evaluate the evidence for the AI-based imaging diagnosis of cancers. Methods PubMed, Embase, Web of Science, Cochrane, and IEEE databases were searched for relevant systematic reviews from inception to June 19, 2024. Two independent investigators abstracted data and assessed the quality of evidence, using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. We further assessed the quality of evidence in each meta-analysis by applying the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Diagnostic performance data were synthesized narratively. Results In a comprehensive analysis of 158 included studies evaluating the performance of AI algorithms in noninvasive imaging diagnosis across 8 major human system cancers, the accuracy of the classifiers for central nervous system cancers varied widely (ranging from 48% to 100%). Similarities were observed in the diagnostic performance for cancers of the head and neck, respiratory system, digestive system, urinary system, female-related systems, skin, and other sites. Most meta-analyses demonstrated positive summary performance. For instance, 9 reviews meta-analyzed sensitivity and specificity for esophageal cancer, showing ranges of 90%-95% and 80%-93.8%, respectively. In the case of breast cancer detection, 8 reviews calculated the pooled sensitivity and specificity within the ranges of 75.4%-92% and 83%-90.6%, respectively. Four meta-analyses reported the ranges of sensitivity and specificity in ovarian cancer, and both were 75%-94%. Notably, in lung cancer, the pooled specificity was relatively low, primarily distributed between 65% and 80%. Furthermore, 80.4% (127/158) of the included studies were of high quality according to the JBI Critical Appraisal Checklist, with the remaining studies classified as medium quality. The GRADE assessment indicated that the overall quality of the evidence was moderate to low. Conclusions Although AI shows great potential for achieving accelerated, accurate, and more objective diagnoses of multiple cancers, there are still hurdles to overcome before its implementation in clinical settings. The present findings highlight that a concerted effort from the research community, clinicians, and policymakers is required to overcome existing hurdles and translate this potential into improved patient outcomes and health care delivery. Trial Registration PROSPERO CRD42022364278; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022364278

AI-Derived Blood Biomarkers for Ovarian Cancer Diagnosis: Systematic Review and Meta-Analysis

Background Emerging evidence underscores the potential application of artificial intelligence (AI) in discovering noninvasive blood biomarkers. However, the diagnostic value of AI-derived blood biomarkers for ovarian cancer (OC) remains inconsistent. Objective We aimed to evaluate the research quality and the validity of AI-based blood biomarkers in OC diagnosis. Methods A systematic search was performed in the MEDLINE, Embase, IEEE Xplore, PubMed, Web of Science, and the Cochrane Library databases. Studies examining the diagnostic accuracy of AI in discovering OC blood biomarkers were identified. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies–AI tool. Pooled sensitivity, specificity, and area under the curve (AUC) were estimated using a bivariate model for the diagnostic meta-analysis. Results A total of 40 studies were ultimately included. Most (n=31, 78%) included studies were evaluated as low risk of bias. Overall, the pooled sensitivity, specificity, and AUC were 85% (95% CI 83%-87%), 91% (95% CI 90%-92%), and 0.95 (95% CI 0.92-0.96), respectively. For contingency tables with the highest accuracy, the pooled sensitivity, specificity, and AUC were 95% (95% CI 90%-97%), 97% (95% CI 95%-98%), and 0.99 (95% CI 0.98-1.00), respectively. Stratification by AI algorithms revealed higher sensitivity and specificity in studies using machine learning (sensitivity=85% and specificity=92%) compared to those using deep learning (sensitivity=77% and specificity=85%). In addition, studies using serum reported substantially higher sensitivity (94%) and specificity (96%) than those using plasma (sensitivity=83% and specificity=91%). Stratification by external validation demonstrated significantly higher specificity in studies with external validation (specificity=94%) compared to those without external validation (specificity=89%), while the reverse was observed for sensitivity (74% vs 90%). No publication bias was detected in this meta-analysis. Conclusions AI algorithms demonstrate satisfactory performance in the diagnosis of OC using blood biomarkers and are anticipated to become an effective diagnostic modality in the future, potentially avoiding unnecessary surgeries. Future research is warranted to incorporate external validation into AI diagnostic models, as well as to prioritize the adoption of deep learning methodologies. Trial Registration PROSPERO CRD42023481232; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023481232

Inadequate consumption of dietary fatty acids is a risk factor for ovarian cancer: evidence from the prostate, lung, colorectal, and ovarian cancer screening trial

Currently, there is controversy surrounding the association between dietary fatty acids (FAs) and ovarian cancer (OC) risk. We aimed to elucidate the aforementioned topic using data from a large cohort. Women participating in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial were included in this study. The dietary information of participants was collected through the diet history questionnaire. Multivariable Cox proportional hazards regression models incorporating restricted cubic splines were constructed to explore the association between dietary FAs intake and the incidence of OC. Among 50,614 participants in the present study, a total of 277 cases of ovarian cancer were diagnosed. The median follow-up time was 9.44 years. Non-significant association between total FAs intake and risk of OC was observed (non-linear P = 0.060). Compared to the median of total FAs intake, hazard ratios were 1.68 (95% CI: 1.10-2.58) and 1.45 (95% CI: 1.05-1.99) for the 5th percentile and 10th percentile, respectively, while consuming more than the median failed to show significant findings. Similar results were found in the analyses of different types (saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids) and sources (animals and plants) of dietary FAs. Inadequate consumption of various types and sources of dietary FAs might be associated with an increased risk of OC.

Association of pre- and post-diagnosis dietary total antioxidant capacity (TAC) and composite dietary antioxidant index (CDAI) with overall survival in patients with ovarian cancer: a prospective cohort study

Abstract Background The evidence on the relationship of dietary antioxidant nutrients with the survival of ovarian cancer (OC) remains scarce. Objective This study aimed to investigate these associations in a prospective cohort of Chinese patients with OC. Methods In this prospective cohort study, patients with epithelial OC completed a food frequency questionnaire at diagnosis and 12 months post-diagnosis, and were followed from 2015 to 2023. Dietary total antioxidant capacity (TAC) and composite dietary antioxidant index (CDAI) were calculated based on specific antioxidant nutrients. We examined the associations of pre-diagnosis, post-diagnosis, and changes from pre-diagnosis to post-diagnosis in TAC, CDAI, and representative antioxidant nutrients with overall survival (OS) among patients with OC. Multivariable Cox proportional-hazards models were applied to calculate the hazard ratios (HR) and 95% confidence intervals (CI). Dose–response relationships were evaluated by restricted cubic splines. Results Among the total 560 patients with OC, there were 211 (37.68%) deaths during a median follow-up of 44.40 (interquartile range: 26.97–61.37) months. High pre-diagnosis TAC (HR = 0.58; 95% CI 0.38–0.8) and vitamin C intake (HRT3 vs. T1 = 0.36; 95% CI 0.21–0.61), and post-diagnosis TAC (HR = 0.57; 95% CI 0.37–0.8), CDAI (HR = 0.57; 95% CI 0.33–0.9), and β-carotene intake (HRT3 vs. T1 = 0.55; 95% CI 0.32–0.97) were significantly associated with improved OS. Compared to patients with constantly low pre- and post-diagnosis TAC and CDAI, those with consistently higher TAC (HRMedium-Medium vs. Low-Low = 0.53; 95% CI 0.29–0.97; HRHigh-High vs. Low-Low = 0.40; 95% CI 0.16–0.94) and CDAI (HRHigh-High vs. Low-Low = 0.33; 95% CI 0.12–0.88) experienced better OS. Conclusion High pre- and post-diagnosis TAC, and post-diagnosis CDAI were associated with improved OC survival, suggesting that consistent high-intake of antioxidant-rich food may be beneficial for the prognosis of OC.

Pre- and post-polyphenol intake and ovarian cancer survival: evidence from a prospective cohort study

Although (poly)phenols have shown potential in anti-cancer activities, their impact on improving ovarian cancer (OC) survival remains unknown. Therefore, we aim to first investigate the association between dietary polyphenol intake and OC survival, providing valuable insights into potential interventions. The prospective cohort recruited 560 patients with OC to assess the associations of polyphenol intake, not only pre- and post-diagnosis but also the change from pre- to post-diagnosis with OC survival. Dietary intakes of total (poly)phenols and their five classes (flavonoids, phenolic acids, lignans, stilbenes, and other polyphenols) were assessed using a validated 111-item food frequency questionnaire. Overall survival (OS) was tracked through active follow-up and medical records until February 16th, 2023. Cox proportional hazard regression models were applied to calculate the hazard ratios (HR) and 95% confidence intervals (CI). During a median follow-up of 44.4 months, 211 all-cause deaths were identified. We observed significant associations between higher polyphenol intake with lower risk of mortality among patients with OC ((HR Dietary (poly)phenols, as well as its five classes, have an inverse association with OC survival.

Proteomics for Biomarker Discovery in Gynecological Cancers: A Systematic Review

The present study aims to summarize the current biomarker landscape in gynecological cancers (GCs) and incorporate bioinformatics analysis to highlight specific biological processes. The literature was retrieved from PubMed, Web of Science, Embase, Scopus, Ovid Medline, and Cochrane Library. The final search was conducted on December 7, 2022. Prospective registration was completed with the PROSPERO with registration number CRD42023477145. This systematic review covered proteomic research on biomarkers for cervical, endometrial, and ovarian cancers. The PANTHER classification system was used to classify the shortlisted candidate biomarkers (CBs), and the STRING database was utilized to visualize protein-protein interaction networks. A total of 23 articles were included in this systematic review. Consistently regulated CBs in the GCs include collagen alpha-2(I) chain, collagen alpha-1(III) chain, collagen alpha-2(V) chain, calreticulin, protein disulfide-isomerase A3, heat shock protein family A (Hsp70) member 5, prolyl 4-hydroxylase, beta polypeptide, fibrinogen alpha chain, fibrinogen gamma chain, apolipoprotein B-100, apolipoprotein C-IV, and apolipoprotein M. In conclusion, collagens, fibrinogens, chaperones, and apolipoproteins were revealed to be replicated in GCs and to be regulated consistently. These CBs contribute to GC etiology and physiology by participating in collagen fibril organization, blood coagulation, protein folding in endoplasmic reticulum, and lipid transporter activity.

Association between pre-diagnosis and post-diagnosis Alternate Mediterranean Diet and ovarian cancer survival: evidence from a prospective cohort study

There is currently a lack of comprehensive evidence regarding the correlation between Alternate Mediterranean Diet (AMED) and the survival of patients with ovarian cancer (OC). This prospective cohort study first assessed the association of AMED, not only pre-diagnosis and post-diagnosis but also the change from pre-diagnosis to post-diagnosis with OC survival. A total of 560 OC patients were included in the study, and their dietary intake was assessed using a reliable 111-item food frequency questionnaire. The overall survival (OS) of the patients was monitored through active follow-up and review of medical records until February 16th, 2023. Cox proportional hazard regression models were utilized to compute the hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs). Out of the total 560 patients with OC, 211 (37.68%) succumbed during a median follow-up period of 44.40 months (interquartile range: 26.97-61.37). Comparative analysis indicated a significant association between the highest tertiles of pre-diagnosis (HR = 0.59; 95% CI 0.38-0.90; P High pre-diagnosis and post-diagnosis AMED was associated with an improved OS in patients with OC, suggesting that maintaining a consistently high intake of AMED could potentially benefit the prognosis of OC.

Proteomic characterization of epithelial ovarian cancer delineates molecular signatures and therapeutic targets in distinct histological subtypes

AbstractClear cell carcinoma (CCC), endometrioid carcinoma (EC), and serous carcinoma (SC) are the major histological subtypes of epithelial ovarian cancer (EOC), whose differences in carcinogenesis are still unclear. Here, we undertake comprehensive proteomic profiling of 80 CCC, 79 EC, 80 SC, and 30 control samples. Our analysis reveals the prognostic or diagnostic value of dysregulated proteins and phosphorylation sites in important pathways. Moreover, protein co-expression network not only provides comprehensive view of biological features of each histological subtype, but also indicates potential prognostic biomarkers and progression landmarks. Notably, EOC have strong inter-tumor heterogeneity, with significantly different clinical characteristics, proteomic patterns and signaling pathway disorders in CCC, EC, and SC. Finally, we infer MPP7 protein as potential therapeutic target for SC, whose biological functions are confirmed in SC cells. Our proteomic cohort provides valuable resources for understanding molecular mechanisms and developing treatment strategies of distinct histological subtypes.

Cruciferous vegetable consumption and multiple health outcomes: an umbrella review of 41 systematic reviews and meta-analyses of 303 observational studies

Epidemiological studies evaluating the associations between the consumption of cruciferous vegetables (CV) and diverse health outcomes have generated inconsistent findings.

Urinary concentrations of phthalate metabolites and the survival of high-grade serous ovarian cancer with advanced stage

Phthalates have been reported to increase the risk of various hormone-dependent cancers. However, there is still a lack of evidence regarding the association between phthalates and overall survival (OS) in advanced high-grade serous ovarian cancer (HGSOC). This study investigated the relationship between urinary phthalate metabolites and OS in patients with HGSOC using a nested case-control study within the Ovarian Cancer Follow-Up Study. We matched 159 deceased patients with HGSOC to 159 survivors by age at diagnosis, body mass index, and sampling date. Spot urine samples were analyzed for ten phthalate metabolites and five classes of phthalate molar sums via mass spectrometry. Conditional logistic regression models were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs), comparing the highest tertile with the lowest. We found that the highest tertiles of mono-2-ethyl-5-oxohexyl phthalates and monoethyl phthalates were associated with poorer OS, with ORs (95%CIs) being 4.24 (1.46, 12.32) and 3.28 (1.16, 9.22), respectively. Additionally, the highest tertiles of the sum of di(2-ethylhexyl) phthalate metabolites, the sum of high-molar-weight phthalate metabolites, and the sum of 10 phthalate metabolites, were associated with worse OS, with ORs (95%CIs) were 18.4 (4.14, 81.87), 9.28 (2.87, 30.08), and 5.94 (2.00, 17.64), respectively. Our study suggests that exposure to high levels of phthalates may be associated with poorer OS in patients with advanced HGSOC, particularly exposure to di(2-ethylhexyl) phthalates. Since it is widely used in personal care products, avoiding the use of these products may improve the OS of patients with HGSOC.

Associations Between Pre- and Post-Diagnosis Dietary Inflammatory Patterns and Ovarian Cancer Survival: Results From the Ovarian Cancer Follow-Up Study

Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse. The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS). This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles. Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022. OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive. Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HR Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival.

Association between plasma perfluoroalkyl substances and high-grade serous ovarian cancer overall survival: A nested case-control study

Although evidence suggests that perfluoroalkyl and polyfluoroalkyl substances (PFASs) are positively correlated to several disease risks, no studies have proven if plasma PFASs are related to ovarian cancer survival. To explore the association between plasma PFASs and high-grade serous ovarian cancer (HGSOC) overall survival (OS) in the population who did not smoke. We conducted a nested case-control study within the Ovarian Cancer Follow-Up Study, matching 159 dead patients and 159 survival ones based on body mass index, sample date, and age at diagnosis. Nine plasma PFASs were extracted by solid phase extraction and measured using a liquid chromatography system coupled with tandem mass spectrometry. Baseline plasma concentrations of perfluorinated carboxylic acids (PFCAs) [perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroheptanoic acid (PFHpA)] and perfluorinated sulfonic acids (PFSAs) [perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS)] were calculated. Odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were calculated via conditional logistic regression models. To elucidate the combined effects, Bayesian kernel machine (BKMR), and regression quantile g-computation (QGC) models were utilized. In full-adjusted model, significant differences were observed between HGSOC survival and perfluorobutane sulfonic acid, PFHpA, PFHxS, PFOS, PFCA, and PFSA. ORs and 95 %CIs were 2.74 (1.41-5.31), 1.97 (1.03-3.76), 2.13 (1.15-3.95), 2.28 (1.16-4.47), 3.74 (1.78-7.85), and 2.56 (1.31-5.01), respectively for the highest tertile compared with the lowest tertile. The QGC and BKMR models indicated that elevated concentrations of PFAS mixtures were associated with poor OS in HGSOC. Both individual and mixed plasma PFASs may relate to poor OS of HGSOC. Further research is necessary to establish causality, and it is recommended to reinforce environmental risk mitigation strategies to minimize PFAS exposure.

Dietary protein intake and PM2.5 on ovarian cancer survival: A prospective cohort study

Evolving evidence suggests both protein consumption and particulate matter less than 2.5 micrometers (PM The objective of this study was to explore the association of dietary protein, PM A prospective cohort study was carried out, which encompassed 658 newly diagnosed OC patients (18-79 years) residing in China. Dietary protein intakes were collected through a food frequency questionnaire examination, including total protein and protein from diverse sources. Average residential PM During a median follow-up of 37.60 months, 123 deaths were documented. As for all-cause mortality, the multivariate-adjusted HRs (95 % CIs) in the highest vs. the lowest tertile were 0.57 (0.35-0.93), 0.60 (0.36-0.99), and 0.58 (0.37-0.90) for intakes of fish, egg, as well as fruit/vegetable protein, respectively (all P for trend < 0.05). A positive association between PM This study provides evidence linking the potential interactions between dietary fish, egg, and fruit/vegetable protein intake and PM

Particulate matter and their interaction of physical activity on ovarian cancer survival: A prospective cohort study

Insufficient data exists regarding the trade-off between the survival benefits of exercise in patients with ovarian cancer (OC) and the potential risks associated with increased particulate matter (PM) exposure during physical activity (PA). This study included 822 individuals newly diagnosed with OC. The total PA and subtypes (occupational [OPA], traffic [TPA], household [HPA], leisure-time [LTPA]) were assessed for the year preceding diagnosis using the Physical Activity Questionnaire of the China Kadoorie Biobank. The residential average PM concentrations 1-year before the date of OC diagnosis were assessed by random forest models at a 1 km × 1 km resolution. The comprehensive exposure to three types of PM was evaluated using a PM score (PMS). In addition, we further examined interaction of PMS with different types of PA on OC survival. Cox proportional hazard models were employed to determine hazard ratios (HRs) and their corresponding 95 % confidence intervals (CIs). Through a median follow-up of 44.95 months, 373 deaths were documented. The highest tertile of the total PA (HR = 0.68, 95 %CI = 0.53, 0.87), TPA (HR = 0.66, 95 %CI = 0.47, 0.95), HPA (HR = 0.41, 95 %CI = 0.25, 0.67), and LTPA (HR = 0.02, 95 %CI = 0.01, 0.05) showed improved overall survival (OS) compared with the lowest tertile, OPA decreased OS (HR = 1.50, 95 %CI = 1.17, 1.92). Additionally, a 34 % reduction in OC survival was observed with each standard deviation rise in PMS (95 %CI = 1.10, 1.63). Notably, OPA intensified PMS-related OS reductions, while total PA, HPA, and LTPA attenuated this association. We revealed that joint exposure to comprehensive PM was significantly linked to decreased OS of patients with OC, particularly for those primarily engaged in OPA. However, the long-term benefits of total PA, HPA, and LTPA may ameliorate the adverse effects of comprehensive PM exposure during PA.

Association between pre- and post-diagnosis healthy eating index 2020 and ovarian cancer survival: evidence from a prospective cohort study

Adherence to the healthy eating index-2020 before and after diagnosis is associated with better overall survival in patients with ovarian cancer.

SH3RF2 contributes to cisplatin resistance in ovarian cancer cells by promoting RBPMS degradation

AbstractPlatinum-based chemotherapy remains one of the major choices for treatment of ovarian cancer (OC). However, primary or acquired drug resistance severely impairs their efficiency, thereby causing chemotherapy failure and poor prognosis. SH3 domain containing ring finger 2 (SH3RF2) has been linked to the development of cancer. Here we find higher levels of SH3RF2 in the tumor tissues from cisplatin-resistant OC patients when compared to those from cisplatin-sensitive patients. Similarly, cisplatin-resistant OC cells also express higher levels of SH3RF2 than normal OC cells. Through in vitro and in vivo loss-of-function experiments, SH3RF2 is identified as a driver of cisplatin resistance, as evidenced by increases in cisplatin-induced cell apoptosis and DNA damage and decreases in cell proliferation induced by SH3RF2 depletion. Mechanistically, SH3RF2 can directly bind to the RNA-binding protein mRNA processing factor (RBPMS). RBPMS has been reported as an inhibitor of cisplatin resistance in OC. As a E3 ligase, SH3RF2 promotes the K48-linked ubiquitination of RBPMS to increase its proteasomal degradation and activator protein 1 (AP-1) transactivation. Impairments in RBPMS function reverse the inhibitory effect of SH3RF2 depletion on cisplatin resistance. Collectively, the SH3RF2-RBPMS-AP-1 axis is an important regulator in cisplatin resistance and inhibition of SH3RF2 may be a potential target in preventing cisplatin resistance.

Nutrients-Rich Food Index Scores and the Overall Survival of Ovarian Cancer Patients: Results from the Ovarian Cancer Follow-Up Study, a Prospective Cohort Study

Background: The nutrients-rich food (NRF) index provides a score of diet quality. Although high diet quality is associated with survival of ovarian cancer (OC), the associations between NRF index scores and OC survival remain unevaluated. Methods: The prospective cohort study enrolled 703 women with newly diagnosed epithelial OC to assess the correlations between NRF index scores and overall survival (OS) in OC patients. Dietary consumption was evaluated through a food frequency questionnaire and diet quality was calculated based on NRF index scores, including three limited nutrients and six (NRF6.3), nine (NRF9.3), or eleven (NRF11.3) benefit nutrients. All-cause deaths were ascertained through medical records combined with active follow-up. Immunohistochemistry (IHC) analyses were conducted to evaluate the expression of IHC indicators (including Estrogen Receptor, Progesterone Receptor, p53, Vimentin, and Wilms’ tumor 1), which were identified by two independent pathologists. The Cox proportional hazards regression models were applied for estimating the hazard ratios (HRs) and 95% confidence intervals (CIs). Moreover, we performed the penalized cubic splines model to assess the curvilinear associations of NRF index scores with OC survival. Results: During the median follow-up of 37.17 (interquartile: 24.73–50.17) months, 130 deaths were documented. Compared to the lowest tertiles, the highest tertile of index scores [NRF9.3 (HR = 0.63, 95% CI = 0.41–0.95), NRF6.3 (HR = 0.59, 95% CI = 0.39–0.89), and NRF11.3 (HR = 0.57, 95% CI = 0.38–0.87)] were correlated to better OS, showing an obvious linear trend (all p trend &lt; 0.05). Interestingly, the curvilinear association between the NRF6.3 index score and OC survival was also observed (p non-linear &lt; 0.05). Subgroup analyses, stratified by clinical, demographic, and IHC features, showed similar risk associations as the unstratified results. Furthermore, there were significant multiplicative interactions between NRF index scores and Progestogen Receptors as well as Wilms’ tumor 1 expressions (all p interaction &lt; 0.05). Conclusions: Higher NRF index scores were associated with an improved OS in OC patients.

Adherence to Sulfur Microbial Diet and Ovarian Cancer Survival: Evidence from a Prospective Cohort Study

ScopeThe study aims to investigate the role of the sulfur microbial diet in the survival of ovarian cancer (OC).Methods and resultsA prospective cohort study is conducted with 703 patients diagnosed with OC between 2015 and 2020. Diet information is collected using a validated food frequency questionnaire. Deaths are ascertained up to March 31, 2021, via the death registry linkage. During the follow‐up period (median: 37.2 months, interquartile range: 24.7–50.2 months), 130 deaths are observed. A higher sulfur microbial diet score is significantly associated with an increased risk of all‐cause mortality among OC patients (tertile 3 vs tertile 1: HR = 1.93, 95% CI = 1.11–3.35). Each 1‐standard deviation increment in the sulfur microbial diet score increases the all‐cause mortality risk by 33% (95% CI = 1.04–1.71). Stratified analysis shows that significant associations are found in OC patients diagnosed over 50 years of age, with body mass index ≥24  kg m−2, who changed their diet after diagnosis, or without residual lesions.ConclusionsAdherence to the sulfur microbial diet, characterized by high intakes of red meats and processed meats, and low intakes of fruits, vegetables, and whole grains, is associated with poor survival in OC patients.

Association of pre-diagnosis specific color groups of fruit and vegetable intake with ovarian cancer survival: results from the ovarian cancer follow-up study (OOPS)

Pre-diagnosis fruit and vegetable intake from various color groups, especially the green and red/purple ones, may improve OC survival.

Diet quality and survival after ovarian cancer: results from an ovarian cancer follow-up study (OOPS)

Owing to the limited studies and controversial evidence, the connection between diet quality and survival of patients with ovarian cancer (OC) has been indistinct. Our findings indicate that high CHEI was associated with an improved OS for patients with OC.

PM2.5 exposure and its interaction of oxidative balance score on ovarian cancer survival: A prospective cohort study

Recent evidence advises particles with a diameter of 2.5 µm or less (PM

Purine Intake and All-Cause Mortality in Ovarian Cancer: Results from a Prospective Cohort Study

Background: Current biological evidence suggests that purine involvement in purine metabolism may contribute to the development and progression of ovarian cancer (OC), but the epidemiological association is currently unknown. Methods: A total of 703 newly diagnosed patients with OC aged 18–79 years were included in this prospective cohort study. Utilizing a verified food-frequency questionnaire, the participants’ dietary consumption was gathered. Using medical records and ongoing follow-up, the deaths up until 31 March 2021 were determined. To assess the hazard ratios (HRs) and 95% confidence intervals (CIs) of purine intake with OC mortality, Cox proportional-hazard models were utilized. Results: During the median follow-up of 31 months (interquartile: 20–47 months), 130 deaths occurred. We observed an improved survival for the highest tercile of total purine intake compared with the lowest tercile (HR = 0.39, 95% CI = 0.19–0.80; p trend &lt; 0.05), and this protective association was mainly attributed to xanthine intake (HR = 0.52, 95% CI = 0.29–0.94, p trend &lt; 0.05). Additionally, we observed a curving relationship in which OC mortality decreased with total purine intake, and the magnitude of the decrease was negatively correlated with intake (p non-linear &lt; 0.05). Significant inverse associations were also observed in subgroup analyses and sensitivity analyses according to demographic and clinical characteristics. Moreover, we observed that xanthine intake and hypoxanthine intake had a multiplicative interaction with ER and PR expression (p &lt; 0.05), respectively. Conclusion: A high total purine and xanthine intake was linked to a lower risk of OC mortality. Further clarification of these findings is warranted.

Infertility and ovarian cancer risk: Evidence from nine prospective cohort studies

AbstractEpidemiological studies have investigated the relationship between infertility and the risk of ovarian cancer (OC); however, the results have been inconsistent. We therefore conducted the first meta‐analysis to update and quantify the aforementioned association based on prospective cohort studies. Studies were identified by searching PubMed, EMBASE and Web of Science databases up to January 8, 2020. We extracted data from the studies and performed quality assessments. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random‐effects model. Publication bias, and subgroup, meta‐regression and sensitivity analyses were also conducted. Nine prospective cohort studies with a total of 10 383 OC cases and 6 278 830 participants were included in the present study. The summary RR of the association between infertility and the risk of OC was 1.51 (95% CI: 1.35‐1.69), with low heterogeneity. Positive associations were observed in most subgroup analyses stratified by predefined factors, including region, duration of follow‐up, study quality, causes of infertility, invasiveness of OC, infertility treatment status and adjustment of potential confounding parameters. No significant publication bias was detected. Our findings suggest that infertility in women were associated with an increased risk of OC.

Relationship between different forms of dietary choline and ovarian cancer survival: findings from the ovarian cancer follow-up study, a prospective cohort study

Higher levels of pre-diagnosis fat-soluble choline intake was associated with better overall survival of ovarian cancer, and this association was more attributed to phosphatidylcholine.

Pre-diagnosis fiber : carbohydrate intake ratio and mortality of ovarian cancer: results from a prospective cohort study

The association between the ratio of fiber to carbohydrate (F : C-R) and cancer mortality is not currently well-known.

Pre-diagnosis meat intake and cooking method and ovarian cancer survival: results from the Ovarian Cancer Follow-Up Study (OOPS)

The relationships between pre-diagnosis meat intake and ovarian cancer survival were limited and controversial. To date, no study has taken account of cooking methods. Thus, we aimed to firstly clarify these associations based on the Ovarian Cancer Follow-Up Study.

Exposure to bisphenol analogues and advanced high-grade serous ovarian cancer survival: An integrative study combining epidemiology and mechanism exploration

The reproductive toxicity and potential carcinogenicity of bisphenol analogs (BPs) has drawn attention, but their role in ovarian cancer prognosis remains unclear. We aimed to explore the association between BPs and advanced high-grade serous ovarian cancer (HGSOC) survival. In the nested case-control study, 318 patients were included. Conditional logistic regression models estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Joint effects were assessed using quantile g-computation and Bayesian kernel machine regression. Targets were obtained from ChEMBL, Swiss Target Predict, STITCH, CTD, OMIM, and Gene-Cards databases, followed by pathway enrichment, molecular docking, and dynamic simulation analyses to explore potential interactions. Exposure to high BPS concentration was associated with worse advanced HGSOC survival (OR = 2.18, 95% CI: 1.01 - 4.71) when compared the highest tertile with the lowest. A dose-response relationship was also discovered between BPS (per SD increment) and decreased advanced HGSOC survival (OR = 1.36, 95% CI: 1.01 - 1.83). Core targets mainly enriched the tumorigenesis, hormone regulation, and cellular adaptation signaling pathways. EGFR and ESR1 exhibited the strongest binding affinities with BPS. High urinary BPs concentrations were associated with worse advanced HGSOC survival, potentially via interactions with EGFR and ESR1 influencing progression.