The progress of new therapies for solid tumors usually gradually transitions from late stage to early stage. Early treatment of Luminal breast cancer has entered the era of “endocrine therapy +”, with the strengthening of treatment duration and intensity, combined with targeted therapy and multi-gene detection, which still coexist with clinical parameters. For HER2-positive early breast cancer, neoadjuvant therapy has changed the treatment process, requiring exploration of precise strengthening and de-escalation of neoadjuvant therapy. “Neoadjuvant therapy changes adjuvant therapy, and early treatment affects recurrence treatment”.Although the early treatment of triple-negative breast cancer once showed a complicated state of “a hundred schools of thought contend”, today’s treatment strategy is far from focusing on the simple respond of those three negative markers. The core lies in precise diagnosis and classification for treatment! This article summarizes the progress of early breast cancer diagnosis and treatment, in order to provide valuable reference for clinicians' practical application.
ObjectiveTo understand the genetics associations between low-density lipoprotein receptor-related protein 5 (LRP5) gene polymorphisms and susceptibility of osteoporosis in patients with chronic obstructive pulmonary disease (COPD).MethodsThree hundred and seventy-nine patients with acute exacerbation of COPD were divided into groups of non osteoporosis and osteoporosis. Genomic DNA was extracted from all patients. UCSC genome browser and Haploview 4.2 software were used to screen tag single nucleotide polymorphisms (tagSNP) of LRP5 gene. The tagSNP was genotyped by Sequenom MassARRAY SNP detection method. Logistic regression were used to analysis the odds ratio (OR) values and confidence intervals (CI) of each SNP in different genetic models to assess the association between single nucleotide polymorphisms in LRP5 gene and osteoporosis in COPD patients.ResultsEight tagSNPs of LRP5 gene (rs312016 T/C, rs312017 C/T, rs312018 A/G, rs3736228 C/T, rs901823 T/C, rs589963 G/A, rs638051 A/G, rs671494 C/A) were selected for association analysis. Patients of rs901823 carrying C/C genotype had a higher risk of osteoporosis than those carrying T/T and C/T genotypes in COPD patients (in recessive mode, C/C vs. T/T+C/T, OR=9.42, 95%CI=2.01–44.29), P=0.000 431 8).ConclusionsThere is a significant association between rs901823 of LRP5 gene and osteoporosis in patients with COPD. Further studies are needed to discover the mechanism of LRP5 gene polymorphism in the pathogenesis of osteoporosis in COPD patients.
Objective To investigate the prevalence and predisposing factors of gastroesophageal reflux（GER）in patients with chronic obstructive pulmonary disease（COPD）and its impacts on the frequency of COPD exacerbations.Methods 50 patients with acute exacerbation of COPD were enrolled in the study.All patients filled a modified version of clinically validated standardized Mayo Clinic GER questionnaire.Pulmonary function tests（PFT），body mass index（BMI），serum albumin，and medications were recorded.The patients were divided in to GER group（13 patients with GER symptoms longer than one year and diagnosed GER by gastroscope） and non-GER group（37 patients without GER symptoms）.Results There were no significant differences in the BMI，serum albumin，use of inhaled steroids and theophylline between the two groups.Forced expiratory volume in one second as a percentage of the predicted value（FEV1%pred）（37% vs 38.3%，P=0.608.），residual volume % predicted（123.4 % vs 137.8%，P=0.222），and residual volume to total lung capacity（139.4% vs 141.5%，P=0.798） were not significantly different between the two groups.The number of COPD exacerbations per year was significantly higher in patients with GER compared to patients without GER（4.5 vs 1.3，P=0.006）.Conclusions The severity of airflow obstruction and the hyperinflation is unlikely to contribute to the development of GER.Patients with GER experience significantly more exacerbations per year when compared to patients without GER，suggesting more highlight warrant in treatment of GER in COPD patients.