Qiuji Wu

Prevalence of breast cancer in ovarian cancer patients and its impact on patient survival: An analysis of the surveillance, epidemiology, and end results data

Background: Patients with high-grade serous ovarian carcinoma (HGSOC) often have a personal and/or family history of breast cancers. However, the clinical association and underlying molecular interaction between breast cancer and HGSOC is not well understood. In this study, the clinical characteristics and outcomes of HGSOC patients with or without breast cancer were compared. Methods: Eligible patient information was extracted from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier and Cox proportional hazards regression models were used to determine survival outcomes and prognostic factors. Results: A total of 3065 HGSOC (ICD-O-3 code 8461/3) patients were identified from 1975 to 2020, among whom 239 (9.56%) had co-existing breast cancers. HGSOC with breast cancers tended to have more stage I-II ovarian cancer (20.92% vs 13.79%), less metastatic diseases (25.1% vs 32.13%) and had a higher probability of undergoing surgery (94.1% vs 87.9%). The overall survival of HGSOC patients with breast cancer was better than that of patients without breast cancer (HR = 0.77, 95% CI 0.65 to 0.91; P = 0.0015). Further, patients who developed ovarian cancer before breast cancer had better overall survival than those who developed breast cancer before or simultaneously with ovarian cancer (HR = 0.35, 95% CI 0.23 to 0.52; P < 0.001). Conclusion: HGSOC combined with breast cancer is a common phenomenon. HGSOC patients with breast cancer, especially those diagnosed with ovarian cancer before breast cancer have a better prognosis. Further validation is warranted and more genetic and mechanistical study is needed.

Clinicopathological characteristics and prognosis of cervical adenocarcinoma across diverse histological subtypes

Objective: To investigate the clinical features and prognostic implications of different subtypes of cervical adenocarcinoma. Methods: We examined 13,353 adenocarcinoma (AC) cases from the SEER database to identify distinct clinical characteristics and prognostic factors among various histological subtypes. Using the WHO classification and International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) codes, we categorized patients and assessed overall survival (OS) and cancer-specific survival (CSS) via Kaplan-Meier and Cox regression analyses. A nomogram was constructed to predict patient survival across subtypes. Results: Patients with non-usual type show a significantly poorer prognosis. Our analysis revealed that serous carcinoma patients had the most adverse outcomes (OS: hazard ratio (HR) = 2.69, 95% confidence interval (CI): 2.23-3.23, P < 0.001; CSS: HR = 1.78, 95% CI: 1.34-2.36, P < 0.001), while villous adenocarcinoma patients had the most favorable (OS: HR = 0.43, 95% CI: 0.29-0.65, P < 0.001; CSS: HR = 0.32, 95% CI: 0.17-0.60, P < 0.001), compared to the usual type. Multivariable Cox regression identified age, marital status, race, tumor grade, FIGO stage, and treatment as independent prognostic factors. In patients with serous carcinoma, advanced FIGO stage was a risk factor (stage IV vs stage I: HR = 4.06, 95% CI: 1.35-12.22, P = 0.013), and surgery was a protective factor (HR = 0.22, 95% CI: 0.10-0.49, P < 0.001). We also created a prognostic model incorporating diverse histological subtypes, internally validated for high predictive accuracy and discrimination via the receiver operating characteristic (ROC) curve and calibration plots. Conclusion: Clinical characteristics and prognostic features in cervical adenocarcinoma vary significantly by histological subtype, with serous carcinoma being associated with the worst outcomes.

TPP1 is associated with risk of advanced precursors and cervical cancer survival

It is unclear how telomere-binding protein TPP1 interacts with human telomerase reverse transcriptase (hTERT) and influences cervical cancer development and progression. This study included all eligible 156 cervical cancers diagnosed during 2003–2008 and followed up through 2014, 102 cervical intraepithelial neoplasia (CIN) patients, and 16 participants with normal cervix identified at the same period. Correlation of expression of TPP1 and hTERT in these lesions was assessed using Kappa statistics. TPP1 was knocked down by siRNA in three cervical cancer cell lines. We assessed mRNA expression using quantitative real-time polymerase chain reaction and protein expression using tissue microarray-based immunohistochemical staining. We further analyzed the impact of TPP1 expression on the overall survival of cervical cancer patients by calculating the hazard ratio (HR) with 95% confidence intervals (CIs) using the multivariable-adjusted Cox regression model. Compared to the normal cervix, high TPP1expression was significantly associated with CIN 3 and cervical cancers (P<0.001 for both). Expressions of TPP1 and hTERT were highly correlated in CIN 3 (Kappa statistics = 0.50, P = 0.005), squamous cell carcinoma (Kappa statistics = 0.22, P = 0.011), and adenocarcinoma/adenosquamous carcinoma (Kappa statistics = 0.77, P = 0.001). Mechanistically, knockdown of TPP1 inhibited the expression of hTERT in both mRNA and protein levels. High expression of TPP1 (HR = 2.61, 95% CI 1.23–5.51) and co-high expression of TPP1 and hTERT (HR = 2.38, 95% CI 1.28–4.43) were independently associated with worse survival in cervical cancer patients. TPP1 and hTERT expression was correlated and high expression of TPP1 was associated with high risk of CIN 3 and cervical cancer and could predict a worse survival in cervical cancer.