北方地区汉族人核苷酸剪切修复基因mRNA的表达与头颈鳞癌发病风险的初步研究

目的:探讨我国北方汉族人核苷酸剪切修复(Nucleotide excision repair,NER)基因mRNA的表达水平与头颈鳞癌发病风险的相关性,为头颈鳞癌的诊断提供新的生物学标志物。方法:收集205例头颈鳞癌患者和176例健康对照,均为我国北方地区汉族人。通过实时定量聚合酶链反应实验检测研究对象外周血淋巴细胞中的5个核心核苷酸剪切修复基因mRNA的相对表达情况。对病例和对照之间一般特征的分布差异进行卡方检验,通过Wilcoxon秩和检验计算不同基因的mRNA表达水平的差异。采用logistic回归计算优势比(OR值)及95%置信区间(95%CI)。此外,通过ROC曲线评价NER基因模型的诊断价值。结果:病例组DDB1的mRNA表达低于对照组(P=0.075)。在logistic回归分析中,矫正年龄、性别、吸烟状况和饮酒因素后,DDB1的mRNA相对表达水平与SCCHN患病风险关系的ORs,在第二、第三和第四四分位数水平中分别为1.90(95%CI,1.02-3.54)、1.54(95%CI,0.82-2.87)和1.88(95%CI,1.00-3.52),分布与其mRNA的高表达水平相比。此外,DDB1(Ptrend=0.036)的蛋白表达水平降低与SCCHN风险增加之间也存在剂量反应关系)。ROC曲线提示DDB1表达水平与性别结合的效应模型中AUC显著改善(P=0.046)。结论:我国北方汉族DDB1的mRNA相对表达的降低与SCCHN患病风险的增加显著相关。     

西北地区汉族人核苷酸剪切修复蛋白的表达与头颈鳞癌发病风险的相关性研究

目的:初步探讨西北地区汉族人核苷酸剪切修复蛋白表达水平与头颈鳞癌发病风险的相关性,从翻译水平为头颈鳞癌提供新的筛检标志物。方法:收集118例头颈鳞癌患者和88例健康对照,均为西北地区汉族人。通过反向蛋白芯片实验检测研究对象外周血淋巴细胞中的5个核心核苷酸剪切修复蛋白的相对表达水平,采用卡方检验分析两组间一般特征的差异,并计算蛋白相对表达水平间的差异,logistic回归计算OR值及95%CI,最后通过绘制接受者操作特性曲线评价模型的诊断价值。结果:病例组XPB (Xeroderma pigmentosum, complementation group B)的表达水平显著低于对照组(P=0.013)。Logistic回归分析结果显示XPB高表达者相比,其低表达者头颈鳞癌患病风险的OR为1.74(95%CI,0.99-3.06)。此外,XPB的蛋白表达水平降低与SCCHN风险增加之间存在剂量反应关系(P_(trend)=0.042)。最后,我们通过接受者操作特性曲线计算曲线下面积,评估XPB表达水平的效应对于头颈鳞癌易感性筛检能力。包含XPB表达水平的效应模型中曲线下面积显著改善(P=0. 048)。结论:在西北地区汉族人中XPB的相对表达水平的降低与头颈鳞癌患病风险的增加相关。XPB表达水平的降低可能在既往吸烟者的头颈鳞癌患病风险中发挥更重要的作用。     

膝骨关节炎人群中血清锌与血脂紊乱的相关性研究

目的:探讨膝骨关节炎(Osteoarthritis,OA)人群中血清锌(Zinc,Zn)水平与血脂紊乱的相关性。方法:采用横断面研究,纳入在中南大学湘雅医院健康管理中心进行健康体检的935例膝OA患者作为研究对象。通过分光光度法检测纳入研究对象的血清Zn水平,并通过贝克曼库尔特AU 5800全自动生化分析仪检测血脂水平。根据血清Zn水平将研究人群进行五分类,采用Logistic回归模型探讨血清Zn水平与血脂紊乱的相关性。结果:Logistic回归模型结果显示,校正年龄和性别后,与第1分类(最低)血清Zn组相比,第2-5分类血清Zn组血脂紊乱患病率比值比和95%可信区间(95%confidence interval, 95%CI)分别为1.66 (95%CI:1.08, 2.56)、1.25 (95%CI:0.81, 1.93)、1.61 (95%CI:1.04, 2.49)和3.04 (95%CI:1.97, 4.68)(趋势检验P0.001)。多因素校正和性别亚组分析结果无明显变化。结论:膝OA人群血清Zn水平与血脂紊乱患病呈正相关,OA人群高血Zn可能为发生血脂紊乱的危险因素。     

不同基因型幽门螺杆菌感染与消化性溃疡患者血清炎症因子及CD4+T细胞、PINP水平的关系

目的探讨不同基因型H.pylori感染与消化性溃疡(PU)患者血清炎症因子及CD4⁺T细胞、Ⅰ型原胶原N端前肽(PINP)水平的关系,为后续研究提供参考。方法选择2017年8月至2019年3月于我院消化科就诊的122例PU患者为研究对象,其中H.pylori阴性患者50例[HP(-)组],H.pyloriⅠ型感染患者38例[HP(Ⅰ)组],H.pyloriⅡ型感染患者34例[HP(Ⅱ)组],对比各组患者血清炎症因子IL-17、IL-10、TNF-α和PINP及CD4⁺T淋巴细胞水平。采用Logistic回归对不同菌型H.pylori感染患者血清炎症因子及CD4⁺T细胞、PINP水平的相关性进行评估,并结合ROC曲线对其相应诊断价值进行评估。结果HP(-)组患者IL-17、IL-10、TNF-α水平最低,HP(Ⅰ)组患者IL-17、IL-10、TNF-α水平最高,组间差异有统计学意义(均P<0.001)。HP(-)组患者CD4⁺T细胞及PINP水平最低,HP(Ⅰ)组CD4⁺T细胞及PINP水平最高,组间差异有统计学意义(均P<0.001)。多因素Logistic回归显示,血清炎症因子及CD4⁺T细胞、PINP水平与H.pyloriⅠ型、H.pyloriⅡ型感染均有显著正相关性(均P<0.05)。ROC曲线分析显示,IL-17、IL-10、TNF-α、CD4⁺T细胞和PINP诊断H.pyloriⅠ型感染的AUC分别为0.863(95%CI:0.786~0.941)、0.844(95%CI:0.754~0.935)、0.907(95%CI:0.847~0.967)、0.921(95%CI:0.864~0.977)、0.742(95%CI:0.639~0.845),而诊断H.pyloriⅡ型感染的AUC分别为0.711(95%CI:0.599~0.823)、0.747(95%CI:0.641~0.854)、0.930(95%CI:0.874~0.986)、0.918(95%CI:0.861~0.974)、0.736(95%CI:0.631~0.840)。H.pylori阴性与CD4⁺T细胞和PINP水平无明显相关性(r=0.226,P=0.225),H.pyloriⅠ型、H.pyloriⅡ型感染与CD4⁺T细胞和PINP水平具有显著正相关性(r=0.428、0.367,P=0.007、0.033)。结论血清炎症因子及CD4⁺T细胞和PINP水平与PU患者H.pylori感染具有相关性,可作为临床辅助监测指标。     

妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义分析

目的:探讨妊娠梅毒患者外周血中Th17和Treg细胞水平及其临床意义。方法:选择2015年4月至2016年5月我院收治的35例妊娠梅毒患者作为观察组,并选择同期进行孕检的健康孕妇30例作为对照组。分析和比较其外周血Th17和Treg细胞水平及其诊断妊娠梅毒的临床价值。结果:观察组患者外周血Th17水平显著高于对照组,而外周血Treg水平显著低于对照组(P0.05)。多因素logistic回归分析结果显示外周血Th17和Treg水平与妊娠梅毒发病具有明显相关性。外周血Th17诊断妊娠梅毒的AUC为0.776,95%CI为0.656～0.896,外周血Treg诊断妊娠梅的ROC曲线下的面积(area under curve,AUC)为0.947,95%CI为0.897～997,Th17+Treg诊断妊娠梅毒的AUC为0.960,95%CI为0.913～1.000;Th17和Treg单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=-2.807、-0.375,P0.05);Th17+Treg联合检测的特异度、准确度分别为91.73%、93.28%,显著高于各指标单独检测(P0.05)。结论:妊娠梅毒患者外周血Th17细胞增多,Treg细胞减少,联合检测外周血Th17和Treg细胞水平诊断妊娠梅毒具有较高的准确度,可作为诊断妊娠梅毒的重要参考指标。     

CHA_2DS_2-VASc评分与同型半胱氨酸对非瓣膜性心房颤动患者发生血栓事件的预测价值

目的:探讨CHA_2DS_2-VASc评分与同型半胱氨酸对非瓣膜性心房颤动患者发生血栓事件的预测价值。方法:选取非瓣膜性心房颤动住院患者228例,根据是否发生血栓事件,分为血栓组146例和非血栓组82例,比较两组CHA_2DS_2-VASc评分、同型半胱氨酸的差异,通过Logistic回归分析和ROC曲线评估二者结合对非瓣膜性心房颤动患者发生血栓事件的预测价值。结果:血栓组CHA_2DS_2-VASc评分、同型半胱氨酸、D-二聚体、纤维蛋白原及低密度脂蛋白水平均显著高于非血栓组;Logistic回归分析显示CHA_2DS_2-VASc评分≥2分、同型半胱氨酸15.0μmol/L是发生血栓事件的独立危险因素(P0.05)。ROC曲线显示CHA_2DS_2-VASc评分和同型半胱氨酸预测血栓事件的曲线下面积分别为0.752(95%CI:0.654-0.762)和0.797(95%CI:0.709-0.825),二者联合预测血栓事件的曲线下面积为0.869(95%CI:0.827-0.918),显著高于二者单用(P0.05)。结论:CHA_2DS_2-VASc评分和同型半胱氨酸对非瓣膜性心房颤动患者发生血栓事件具有较高的预测价值,CHA_2DS_2-VASc评分≥2分且伴有同型半胱氨酸升高的非瓣膜性房颤患者是发生血栓事件的极高危人群。     

血清ProGRP、SCCAg及HE4与非小细胞肺癌患者病理特征的关系及其诊断价值分析

目的:探讨血清胃泌素释放肽前体(ProGRP)、鳞状上皮细胞癌抗原(SCCAg)、人附睾蛋白4(HE4)水平与非小细胞肺癌(NSCLC)患者病理特征的关系,分析其对NSCLC的临床诊断价值。方法:选择2015年9月至2020年2月我院接诊的110例NSCLC患者(观察组)和100例健康志愿者(对照组)为研究对象,检测血清ProGRP、SCCAg、HE4水平。分析血清ProGRP、SCCAg、HE4水平与NSCLC患者临床病理特征的关系。采用受试者工作特征(ROC)曲线分析血清ProGRP、SCCAg、HE4诊断NSCLC的价值。结果:观察组血清ProGRP、SCCAg、HE4水平均高于对照组(P0.05),低中分化、TNMⅢ～Ⅳ期、淋巴结转移患者血清ProGRP、SCCAg水平分别高于高分化、TNMⅠ～Ⅱ期、无淋巴结转移患者(P0.05);TNM分期Ⅲ～Ⅳ期、淋巴结转移患者血清HE4水平分别高于TNMⅠ～Ⅱ期、无淋巴结转移患者(P0.05)。ROC曲线分析结果显示ProGRP、SCCAg、HE4、ProGRP+SCCAg+HE4诊断NSCLC的曲线下面积(AUC)分别为0.834(95%CI:0.779～0.888)、0.584(95%CI:0.507～0.662)、0.743(95%CI:0.675～0.811)、0.947(95%CI:0.910～0.984)。结论:NSCLC患者血清ProGRP、SCCAg、HE4水平明显升高,血清ProGRP、SCCAg水平与NSCLC患者分化程度、TNM分期和淋巴结转移有关,血清HE4水平与TNM分期和淋巴结转移有关。联合检测ProGRP、SCCAg、HE4对NSCLC诊断具有较高价值,可提高早期诊断准确性。     

上海市区女性肺癌的家族聚集性研究

我们利用在上海市区所开展的一项关于女性肺癌的较大规模人群基础上的病例对照研究资料,分析和评价了一级亲属患肺癌史者其在肺癌发生中的作用。文中重点分析了女性非吸烟者肺癌的材料。结果表明,先证者家系一级亲属患肺癌的风险性是对照组家系一级亲属的近3倍(OR=2.80,95% CI1.68-4.67)。对非吸烟先证者家系而言,比数比为2.62(95%CI1.52-4.5 2)。其中,腺癌、鳞癌、其他类和不明分类的肺癌的OR分别为2.79(95%CI 1.53-5.10)、3.88 (95%CI1.42-10.63)、1.26(95%CI0.27-6.01)、2.52 (95%CI1.16-5.49)。按年龄组分层分析的结果显示,35-59岁组与60-69岁组的比数比分别为4.01 (95%CI1.71-8.97)、 1.89(95%CI0.89-3.98)。非吸烟女性研究对象经多因素非条件logistic回归模型的分析后,比数比OR为2.71(95%CI1.54-4.76),有高度统计学意义。在该多变量回归模型的基础上估计的调整人群归因风险度为5.31%。 Abstract:The data set of a large population-based case-control study of female lung cancer conducted in Shanghai urban was used to investigate the contribution of lung cancer in first-degree relatives to lung cancer risk.The analysis in the paper is emphasized on non-smoking women.The results indicates that the risk of first-degree relatives with lung cancer is increased about 30fold(OR=2.80,95% CI:1.68-4.67),and for non-smoking probands the OR is 2.62(95% CI:1.52-4.52).The odds ratios of adeno-carcinoma,squamous cell carcinoma,others unknown of lung cancer are 2.79(95% CI:1.53-5.10),3.88(95% CI:1.42-10.63),1.26(95% CI:0.27-6.01),2.52(95% CI:1.16-5.49),respectively.For cases of age groups of 35 to 59 and 60 to 69 years of probands,with ORs of 4.01(95% CI:1.79-8.97)and 1.89(95% CI:0.89-3.98)respectively.The odds ratio from multivariable unconditional logistic regression is 2.71(95% CI:1.54-4.76).The estimation of adjusted population attributable risk is 5.31% based on the multivariable logistic regression model analysis.     

高尿酸血症人群血清钙与代谢综合征的相关性研究

目的:探讨血清钙(Calcium,Ca)水平与高尿酸血症(Hyperuricemia,HU)人群发生代谢综合征(Metabolic syndrome,MetS)的相关性。方法:纳入在中南大学湘雅医院健康管理中心进行健康体检的HU患者作为研究对象。通过Beckman Coulter AU 5800全自动生化分析仪检测纳入研究对象的血清Ca水平,根据中国糖尿病学会标准诊断MetS。根据血清Ca水平将研究人群进行四分类,采用Logistic回归模型探讨不同血清Ca水平与MetS患病的相关性。结果:共纳入711例HU患者作为研究对象,Logistic回归模型结果显示:未校正混杂因素时,与第1分类(最低)血清Ca组相比,总人群中第2-4分类血清Ca组MetS患病率比值比和95%可信区间(95%confidence interval,95%CI)分别为1.45 (95%CI:0.92, 2.29)、1.87 (95%CI:1.21, 2.89)和1.88 (95%CI:1.19,2.95)(趋势检验P=0.003),校正年龄和性别以及多因素校正后结果无明显变化。性别亚组分析结果显示该相关性只存在于男性亚组,女性亚组中无显著相关性。结论:男性HU人群血清Ca水平与MetS患病呈正相关,可能为MetS患病的危险因素,适当降低Ca的摄入可能有助于男性HU人群MetS的防治,而女性HU人群中血清Ca水平与MetS患病不相关。     

房颤射频消融术后复发风险预测评分系统的建立及评价

目的:探讨心房颤动(房颤)患者射频消融术后复发的风险因素,并依此构建个性化的风险评分系统。方法:选取2017年1~8月行射频消融术的房颤患者154例作为研究对象,依据术后3个月的随访结果将患者分为复发组及未复发组,采用单因素分析和Logistic回归分析对各风险因素进行分析,构建其评分系统,采用Hosmer-Lemeshow拟合优度检验和ROC曲线下面积评价评分系统的准确度及区分度。结果:术后随访3个月的结果显示共37例(24.03%)房颤患者出现复发,房颤类型、病程、体质量指数(BMI)、左房前后径(LAD)、左房容积(LAV)及超敏C反应蛋白(hs-CRP)水平均是房颤复发的独立风险因素(P<0.05)。构建的风险评分系统得分为0~26分,Hosmer-Lemeshow拟合优度检验:x^2=7.520,P=0.482;ROC曲线下面积为0.864(95%CI:0.837~0.891),预测评分值为15分时,约登指数最大(0.605),此时的敏感度和特异度分别为77.3%和83.2%。结论:房颤患者射频消融术后的复发率较高,依据风险因素构建的风险评分系统具有较高的预测效率和区分能力,可作为房颤患者射频消融术后复发风险评估的参考工具。     

Age at start of using tobacco on the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium (INHANCE)

BackgroundTobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk.MethodsWe analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models.ResultsWithout adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR_{<10 years vs. ≥30 years}: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR_{<10 years vs. ≥30 years}: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed.ConclusionsResults from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.     

Diabetes,metabolic syndrome and prostate cancer risk: Results from the EPICAP case-control study

BackgroundDiabetes may be associated with decreased prostate cancer (PCa) risk. However, previous studies have not always accounted for time since diabetes diagnosis or antidiabetic drug use. Futhermore, the role of metabolic syndrome (MetS) in PCa risk is still debated. We investigated the role of diabetes and MetS in PCa risk based on data from the Epidemiological study of PCa (EPICAP).MethodsEPICAP is a population-based case-control study that included 819 incident PCa cases in 2012–2013 and 879 controls frequency matched by age. MetS was characterized according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Logistic regression models adjusted for age, family history of PCa and ethnicity, were used to assess odds ratios (ORs) and their 95%conficence intervals (CIs) for the associations between diabetes, MetS and PCa risk.ResultsWhereas we did not observed an association between diabetes and PCa, a decreased risk of PCa has been highlighted with an increasing treated diabetes duration (p-trend=0.008). No association has been observed between MetS, the number of MetS criteria and the risk of PCa. However, we suggested that NSAIDs use could modify the association between MetS and PCa risk.ConclusionOur results suggest an inverse association between the duration of diabetes and PCa risk. The role of metabolic factors, such as MetS and its components, in PCa risk remains unclear and requires further investigations.     

Chronic metformin intake and gastric cancer: A pooled analysis within the Stomach cancer Pooling (StoP) Project

IntroductionThe association between chronic use of metformin and risk of gastric cancer (GC) has been investigated with contradicting results. We aimed to study the association between chronic use of metformin and GC by using data from the Stomach cancer Pooling (StoP) Project, an epidemiological consortium of case-control studies on GC.MethodsData from three studies of the StoP Project with available information on metformin intake were analyzed.Multivariable logistic regression models were used to estimate study-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between chronic use of metformin and GC risk. Analyses were adjusted for sex, age, socioeconomic status, body mass index, smoking status, alcohol drinking status, and history of diabetes. Study-specific ORs and 95% CIs were then pooled with a random-effects model.The dose-response relationship between the duration of metformin intake and GC was assessed with a one-stage logistic model, and the duration of intake was modelled using second-order fractional polynomials.ResultsThe OR of GC in metformin users versus non-users was 1.01 (95% CI=0.61, 1.67). The association between metformin and GC did not change among different strata of study participants’ characteristics or when restricting the analyses to those with a history of diabetes.The dose-response analysis showed a slightly reducing trend in the OR of GC and a borderline significant association with increasing duration of metformin intake.ConclusionsThe results of our study do not clearly support an association between chronic use of metformin and GC, warranting further research.     

Job strain and risk of esophageal and cardia cancers

BackgroundFew studies have investigated work-related stress in relation to esophageal or cardia cancers.MethodsOur nationwide Swedish population-based case-control study included 189 and 262 esophageal and cardia adenocarcinoma cases respectively, 167 esophageal squamous-cell carcinoma cases and 820 controls. We derived each study participant's occupation of longest duration from occupational histories and applied a psychosocial job-exposure matrix. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression, in multivariable models.ResultsJob strain was positively associated with risk of esophageal adenocarcinoma (OR 3.2, 95% CI 1.0–9.8) and squamous-cell carcinoma (OR 4.0, 95% CI 1.6–10.5), but not with cardia adenocarcinoma. No associations regarding demands, control, social support or iso strain were observed, except for a positive association between high control and risk of esophageal squamous-cell carcinoma (OR 1.5, 95% CI 1.0–2.3).ConclusionJob strain seems to increase the risk of both histological types of esophageal cancer.     

Type II diabetes and metabolic syndrome in relation to head and neck squamous cell carcinoma risk: A SEER-Medicare database study

BackgroundDiabetes and metabolic syndrome have been found to increase the risk of various cancers. Previous studies indicated that diabetes may increase the risk of head and neck squamous cell carcinoma (HNSCC). Metabolic syndrome has not been investigated as a risk factor. We tested whether type II diabetes or metabolic syndrome were associated with HNSCC using a very large database of medical administrative records, providing the ability to investigate relatively weak effects and stratify by subgroups.MethodsWe identified persons diagnosed with HNSCC between 1994 and 2007 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. We selected controls from a 5% sample of Medicare beneficiaries and frequency matched to cases on sex and duration of enrollment. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between type II diabetes/metabolic syndrome and HNSCC, adjusted for potential confounders, among 14,022 cases and 42,066 controls.ResultsWe observed a very weak inverse association between type II diabetes and HNSCC (OR = 0.92; 95% CI, 0.88–0.96) and a moderate inverse association for metabolic syndrome (OR = 0.81; 95% CI, 0.78–0.85). Associations were modified by tobacco use, with null results for type II diabetes among never users (OR = 1.00; 95% CI, 0.95–1.06) and inverse associations among ever users (OR = 0.80; 95% CI, 0.75–0.86).ConclusionsWe observed moderate inverse associations between metabolic syndrome and HNSCC and weak inverse associations between type II diabetes and HNSCC, which was contrary to the evidence to date. Inadequate control for confounding factors, such as overweight/obesity, may have influenced results.     

Parity and risk of developing breast cancer according to tumor subtype: A systematic review and meta-analysis

BackgroundClinical breast cancer subtypes are categorized basing on the expression of hormone receptors and overexpression of the human epidermal growth factor receptor 2 (HER2). It is still unclear whether parity impact the risk of different breast cancer subtypes.MethodsWe searched eight mainstream databases for published epidemiologic studies that assessed the relationship between parity and risk of breast cancer subtypes up to January 12, 2021. Parity number were unified into nulliparity and ever parity. The random-effects or fixed-effect models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs) among different subtypes. Restricted cubic spline analysis with four knots was applied to determine the relationship of parity number and risk of breast cancer subtypes.ResultsWe pooled sixteen case-control and four cohort studies, and performed an analysis including 7795 luminal A, 3576 luminal B, 1794 HER2-overexpressing, and 5192 triple-negative breast cancer cases among 1135131 participants. The combined ORs for ever parity versus nulliparity indicated a 34% reduction in luminal A risk (OR=0.66, 95% CI: 0.56–0.78), and a 29% reduction in luminal B risk (OR=0.71, 95% CI: 0.63–0.81), there was no significant association in HER2-overexpressing or TNBC risk. In the dose-response analysis, we observed a potentially non-linear and gradually increasing protective relationship between the number of parity and luminal breast cancer risk.ConclusionsThe effect of parity on breast cancer seems to vary among breast tumor subtypes, and it plays a protective role in luminal breast cancer.     

Five-year relative survival and determinants of excess mortality in patients with head and neck and thyroid cancers: A population-based study from Golestan province,Northern Iran

BackgroundWe aimed to assess relative survival (RS) and determinants of excess mortality rate in patients with head and neck squamous cell carcinomas (HNSCC) and thyroid cancer in Golestan province, Northern Iran.MethodsWe recruited new primary HNSCC and thyroid cancer cases from Golestan, 2006–2016. Five-year age-standardized RS with their 95% confidence intervals (CIs) were calculated. The relationships between different variables with excess mortality rates were assessed by estimating adjusted excess hazard ratios (aEHRs) with their 95% CIs.ResultsOverall, 718 cases of HNSCC and 386 thyroid cancer cases were enrolled. Five-year age-standardized RS (95% CI) were 36% (31−41) and 61% (52−69) in HNSCC and thyroid cancer patients, respectively. There were significant relationship between excess mortality rates in HNSCC patients with metastasis (aEHR= 3.31; 95%CI: 2.26–4.84), treatment type (4.19; 2.54–6.91, for no treatment as compared to receiving both surgery and chemoradiotherapy), age (2.16; 1.57–2.96, for older age group) and smoking (2.00; 1.45–2.75, for smokers as compared to non-smokers). Determinant of the excess mortality in thyroid cancer patients included metastasis (19.65; 8.08–47.79), tumor morphology (12.27; 4.62–32.58, for anaplastic cancer as compared to papillary cancer), treatment type (8.95, 4.13–19.4, for no treatment as compared to receiving both surgery and iodine therapy) and age (2.31; 1.17–4.54, for older age group).ConclusionOur findings suggested low RS for thyroid cancer in our population, while the estimates for HNSCC were comparable with other population. Metastasis, treatment type and age were determinants of mortality both in thyroid and HNSCC patients.     

Toxoplasma gondii infection/exposure and the risk of brain tumors: A systematic review and meta-analysis

BackgroundBrain tumors are among the most fatal cancers with substantial morbidity and mortality worldwide. Epidemiologic evidence suggests that infectious agents, especially, protozoan parasite Toxoplasma gondii could be a possible risk factor or contributor. Here, we performed a systematic review and meta-analysis to evaluate the possible association between T. gondii infection/exposure and risk of brain tumors.MethodsWe searched the PubMed, Embase, Scopus, and Web of Science collection databases from inception through 1st of December 2021. Pooled estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were generated using random effects models. We did the subgroup analysis according to tumor types. Statistical tests for heterogeneity and sensitivity analyses were applied.ResultsA total of seven eligible studies comprising 2323 patients diagnosed with brain tumors and 5131 healthy controls were included in the meta-analysis. T. gondii infection/exposure prevalence was 24.2% (95%CI, 12.7%–41.2) in cases and 12.9% (95%CI, 7.0–22.6%) in control subjects. Pooled analysis showed an overall OR of 1.96 (95%CI, 1.37–2.80), indicating a significant increased risk of brain tumors associated with T. gondii infection/exposure. In subgroup analysis T. gondii infection/exposure was significantly associated with gliomas (OR: 1.64, 95%CI, 1.15–2.33), meningioma (OR: 2.30, 95%CI, 1.0–5.27) and other types of brain tumors (OR: 2.19, 95%CI, 1.02–4.71).ConclusionThis study provides suggestive evidence for an association between T. gondii infection/exposure and brain tumors. Our findings should be further confirmed by well-designed cohort studies with strict control of confounders. Moreover, we suggest that future studies also focus on the effect of T. gondii infection/exposure to the types of brain tumors.