Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance syste...Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance system in China.Methods: We chose Hua County, Henan Province as the study site, and randomly selected 300 and 1,200 qualified inpatient electronic medical records(EMRs) as well as the New Rural Cooperative Medical Scheme(NCMS) claims records for cancer patients in Hua County People’s Hospital(HCPH) and Anyang Cancer Hospital(ACH) in 2017. Diagnostic information for NCMS claims was evaluated on an individual level, and sensitivity and positive predictive value(PPV) were calculated taking the EMRs as the gold standard.Results: The sensitivity of NCMS was 95.2%(93.8%-96.3%) and 92.0%(88.3%-94.8%) in ACH and HCPH,respectively. The PPV of the NCMS was 97.8%(96.7%-98.5%) in ACH and 89.0%(84.9%-92.3%) in HCPH.Overall, the weighted and combined sensitivity and PPV of NCMS in Hua County was 93.1% and 92.1%,respectively. Significantly higher sensitivity and PPV in identifying patients with common cancers than noncommon cancers were detected in HCPH and ACH separately(P<0.01).Conclusions: Identification of cancer patients by use of the NCMS is accurate on individual level, and it is therefore feasible to conduct claims-based cancer surveillance in areas not covered by cancer registries in China.展开更多
Objective:This study aimed to develop and validate a risk scoring system to identify high-risk individuals carrying malignant lesions in stomach for tailored gastric cancer screening.Methods:A gastric cancer risk scor...Objective:This study aimed to develop and validate a risk scoring system to identify high-risk individuals carrying malignant lesions in stomach for tailored gastric cancer screening.Methods:A gastric cancer risk scoring system(GC-RSS)was developed based on questionnaire-based predictors for gastric cancer derived from systematic literature review.To assess the capability of this system for discrimination,risk scores for 8,214 and 7,235 outpatient subjects accepting endoscopic examination in two endoscopy centers,and 32,630 participants in a community-based cohort in China were calculated to plot receiver operating characteristic curves and generate area under the curve(AUC).To evaluate the performance of GC-RSS,the screening proportion,sensitivity and detection rate ratio compared to universal screening were used under different risk score cutoff values.Results:GC-RSS comprised nine predictors including advanced age,male gender,low body mass index(<18.5 kg/m^(2)),family history of gastric cancer,cigarette smoking,consumption of alcohol,preference for salty food,irregularity of meals and consumption of preserved food.This tool performed well in determining the risk of malignant gastric lesions with AUCs of 0.763,0.706 and 0.696 in three validation sets.When subjects with risk scores≥5 were evaluated with endoscopy,nearly 50%of these endoscopies could be saved with a detection rate of over 1.5 times achieved.When the cutoff was set at 8,only about 10%of subjects with the highest risk would be offered endoscopy,and detection rates for gastric cancer could be increased 2-4 fold compared to universal screening.Conclusions:An effective questionnaire-based GC-RSS was developed and validated.This tool may play an important role in establishing a tailored screening strategy for gastric cancer in China.展开更多
Objective:We aimed to prospectively evaluate the association of oral microbiome with malignant esophageal lesions and its predictive potential as a biomarker of risk.Methods:We conducted a case-control study nested wi...Objective:We aimed to prospectively evaluate the association of oral microbiome with malignant esophageal lesions and its predictive potential as a biomarker of risk.Methods:We conducted a case-control study nested within a population-based cohort with up to 8 visits of oral swab collection for each subject over an 11-year period in a high-risk area for esophageal cancer in China.The oral microbiome was evaluated with 16 S ribosomal RNA(rRNA)gene sequencing in 428 pre-diagnostic oral specimens from 84 cases with esophageal lesions of severe squamous dysplasia and above(SDA)and 168 matched healthy controls.DESeq analysis was performed to identify taxa of differential abundance.Differential oral species together with subject characteristics were evaluated for their potential in predicting SDA risk by constructing conditional logistic regression models.Results:A total of 125 taxa including 37 named species showed significantly different abundance between SDA cases and controls(all P<0.05&false discovery rate-adjusted Q<0.10).A multivariate logistic model including 11 SDA lesion-related species and family history of esophageal cancer provided an area under the receiver operating characteristic curve(AUC)of 0.89(95%CI,0.84-0.93).Cross-validation and sensitivity analysis,excluding cases diagnosed within 1 year of collection of the baseline specimen and their matched controls,or restriction to screenendoscopic-detected or clinically diagnosed case-control triads,or using only bacterial data measured at the baseline,yielded AUCs>0.84.Conclusions:The oral microbiome may play an etiological and predictive role in esophageal cancer,and it holds promise as a non-invasive early warning biomarker for risk stratification for esophageal cancer screening programs.展开更多
Objective： There have been few population-based studies evaluating health related quality of life（HRQOL） in rural populations in China, and this study aimed to assess the current status of and risk factors for HRQO...Objective： There have been few population-based studies evaluating health related quality of life（HRQOL） in rural populations in China, and this study aimed to assess the current status of and risk factors for HRQOL in a general rural population in high risk region of esophageal cancer in China.Methods： From November 2015 to September 2016, 12,085 permanent residents aged 45–69 years from 257 villages in the Endoscopic Screening for Esophageal Cancer in China（ESECC） trial（Clinical Trials.gov：NCT01688908） randomly selected from Hua County, Henan Province, China were interviewed. The EQ-5 D-3 L,a generic measure of HRQOL, and a questionnaire were used to assess their HRQOL and potential risk factors.Results： Among all the participants, 30.62% of the participants reported problems in at least one EQ-5 D dimension. Pain/discomfort（25.52%） was the most frequently reported problem followed by anxiety/depression（7.97%）, mobility（5.82%）, usual activities（2.61%） and self-care（1%）. These rural residents had a mean EQ-5 D index score of 0.948, and lower EQ-5 D index scores were associated with older age, female gender, lower levels of household annual per capita income, living alone, using shallow wells as main source of drinking water, exposure to family members smoking, testiness, unhealthy dietary habits, overweight or obesity, upper gastrointestinal cancer related symptoms and chronic diseases.Conclusions： Rural residents in China have a relatively low quality of life. Health promotion programs in this population should focus on the elderly, especially elderly women and the elderly living alone. Improving basic living circumstances and primary medical care services should be priorities. Results of this study will also serve as the basis for the cost-utility evaluation in our ESECC screening trial.展开更多
Background:Clinical opportunistic screening is a cost-effective cancer screening modality.This study aimed to establish an easyto-use diagnostic model serving as a risk stratification tool for identification of indivi...Background:Clinical opportunistic screening is a cost-effective cancer screening modality.This study aimed to establish an easyto-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods:We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China.The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics.The final model was derived based on unconditional logistic regression,and predictors were selected according to the Akaike information criterion.External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results:This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors,including advanced age,male gender,family history of gastric cancer,low body mass index,unexplained weight loss,consumption of leftover food,consumption of preserved food,and epigastric pain.This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve(AUC)of 0.791(95%confidence interval[CI]:0.750-0.831).External validation of the model in the general population generated an AUC of 0.696(95%CI:0.570-0.822).This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion:This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.展开更多
Esophageal squamous cell carcinoma （ESCC） has a high mortality rate. To determine the molecular basis of ESCC development, this study sought to identify characteristic genome-wide alterations in ESCC, including exon...Esophageal squamous cell carcinoma （ESCC） has a high mortality rate. To determine the molecular basis of ESCC development, this study sought to identify characteristic genome-wide alterations in ESCC, including exonic mutations and structural alterations. The clinical implications of these genetic alterations were also analyzed. Exome sequencing and verification were performed for nine pairs of ESCC and the matched blood samples, followed by validation with additional sam- ples using Sanger sequencing. Whole-genomc SNP arrays were employed to detect copy number alteration （CNA） and loss of heterozygosity （LOH） in 55 cases, including the nine ESCC samples subjected to exome sequencing. A total of 108 non-synonymous somatic mutations （NSSMs） in 102 genes were verified in nine patients. The chromatin modification process was found to be enriched in our gene ontology （GO） analysis. Tumor genomes with TP53 mutations were signifi- cantly more unstable than those without TP53 mutations. In terms of the landscape of genomic alterations, deletion of 9p21.3 covering CDKN2A/2B （30.9%）, amplification of 1 1q13.3 covering CCND1 （30.9%）, and TP53 point mutation （50.9%） occurred in two-thirds of the cases. These results suggest that the deregulation of the G1 phase during the cell cycle is a key event in ESCC. Furthermore, six minimal common regions were found to be significantly altered in ESCC samples and three of them, 9p21.3, 7p 11.2, and 3p 12.1, were associated with lymph node metastasis. With the high correlation of TP53 mutation and genomic instability in ESCC, the amplification of CCND1, the deletion of CDKN2A/2B, and the somatic mutation of TP53 appear to play pivotal roles via G1 deregulation and therefore helps to classify this cancer into different genomic subtypes. These findings provide clinical significance that could be useful in future molecular diagnoses and therapeutic targeting.展开更多
Introduction:This study aimed to evaluate the performance of the Medical-Insurance-System-based Cancer Surveillance System(MIS-CASS)in estimating cancer incidence by comparing the results with the Beijing Cancer Regis...Introduction:This study aimed to evaluate the performance of the Medical-Insurance-System-based Cancer Surveillance System(MIS-CASS)in estimating cancer incidence by comparing the results with the Beijing Cancer Registry(BCR),which is one of the highest-quality population-based cancer registries in China.Methods:Using lymphoma as an example,we extracted relevant claims data from the administrative systems of medical insurance in Beijing(2012–2020)and estimated the most current lymphoma incidence in Beijing(2019)using a standard data processing procedure.The absolute number of new cases,crude incidence rate,and age-standardized incidence rate of lymphoma were compared with the latest data reported by the BCR(2017).Results:Both lymphoma incidence rates and age distribution of new cases estimated based on MISCASS were similar to the BCR data(crude incidence rate:9.8/100,000 vs.10.6/100,000).However,because MIS-CASS included more designated hospitals and covered a larger local stationary population irrespective of household registration(hukou),the absolute number of incident lymphoma cases identified by MIS-CASS was 39.1%higher than that reported by the BCR(2,002 vs.1,439).Conclusions:The MIS-CASS approach reflected the actual cancer burden in a more complete and timely manner as compared with the current BCR,providing new insights for improving cancer surveillance strategies in China.展开更多
Fuel-driven dissipative self-assembly,which is a well-established concept in recent years,refers to out-of-equilibrium molecular self-assembly initiated and supported by the addition of active molecules (chemical fuel...Fuel-driven dissipative self-assembly,which is a well-established concept in recent years,refers to out-of-equilibrium molecular self-assembly initiated and supported by the addition of active molecules (chemical fuel).It widely exists in nature since many temporary,active micro- or nanostructures in living bodies are generated by the dissipative self-assembly of biomolecules.Therefore,the study on dissipative self-assembly provides a good opportunity to have an insight into the microscopic mechanism of living organisms.In the meantime,dissipative assembly is thought to be a potential pathway to achieve dynamic,temporary supramolecular materials.Recently,a number of temporary materials have been developed with the aid of strategies for realizing dissipative self-assembly.Some of their properties,including solubility,stiffness,turbidity,color,or self-healing ability,change upon the addition of chemical fuel but spontaneously restore with chemical fuel consumption.The dynamic of these materials brings them various unprecedented functions.In this review,the principles of fabricating a fuel-driven temporary material are first reviewed.Subsequently,recent examples of fuel-driven temporary materials are emphatically summarized,including gels,self-erased inks,nanoreactors,self-healing materials,nanochannels,and droplets.Finally,the challenges of developing fuel-driven temporary materials and some perspectives on the function and application of such kind of materials are discussed.展开更多
Extensive efforts have been put into reducing the heavy burden of esophageal squamous cell carcinoma(ESCC)in China.However,the joint impact of prevention and treatment on the long-term overall survival(OS)of ESCC pati...Extensive efforts have been put into reducing the heavy burden of esophageal squamous cell carcinoma(ESCC)in China.However,the joint impact of prevention and treatment on the long-term overall survival(OS)of ESCC patients remains largely unknown.We consecutively recruited 13,255 ESCC patients from two Chinese centers:the Northern center,located in a high-risk area with abundant screening programs;and the Southern center,situated in a non-high-risk area with improved clinical practices.Inter-center comparison,longitudinal intra-center comparison,and a simulation analysis were conducted to investi-gate the influence of tumor downstaging and high-quality clinical treatment on OS.During a follow-up period of 12.52 years,the Northern center exhibited higher median survival than the Southern center(6.22 vs.3.15 years;H_(Radjusted)=0.73,95%CI:0.69-0.77).Mediation analysis demonstrated that its OS advantage was largely(77.7%)attributed to earlier TNM stage(stage 0-II:51.3%vs.24.6%).In temporal analyses,patient survival in the Southern center gradually improved(median survival during 2015-2018 vs.2009-2014:3.58 vs.2.93 years;H_(Radjusted)=0.86,95%CI:0.79-0.94),coinciding with the progress of treatment-related indices(completeness of TNM staging in discharge diagnosis[from 53.7%to 99.6%],adoption of minimally invasive esophagectomy[from 0.0%to 51.1%]and right thoracic esophagectomy[from 12.4%to 86.4%],etc.).Simulation analysis further demonstrated that integrating both downstaging and high-quality treatment would lead to the best survival.Tumor downstaging and high-quality clinical treatment have a joint impact on ESCC patient survival.Establishing a comprehensive strategy that inte-grates cancer prevention with optimal clinical treatment is crucial for alleviating the ESCC burden.展开更多
基金supported by the National Natural Science Foundation of China (No. 30930102, 81473033)the National Key R&D Program of China (No. 2016YFC0901404)+2 种基金the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority (No. XXZ0204)the Science Foundation of Peking University Cancer Hospital (No. 2017-4)the Open Project funded by the Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing (No. 2017-10)
文摘Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance system in China.Methods: We chose Hua County, Henan Province as the study site, and randomly selected 300 and 1,200 qualified inpatient electronic medical records(EMRs) as well as the New Rural Cooperative Medical Scheme(NCMS) claims records for cancer patients in Hua County People’s Hospital(HCPH) and Anyang Cancer Hospital(ACH) in 2017. Diagnostic information for NCMS claims was evaluated on an individual level, and sensitivity and positive predictive value(PPV) were calculated taking the EMRs as the gold standard.Results: The sensitivity of NCMS was 95.2%(93.8%-96.3%) and 92.0%(88.3%-94.8%) in ACH and HCPH,respectively. The PPV of the NCMS was 97.8%(96.7%-98.5%) in ACH and 89.0%(84.9%-92.3%) in HCPH.Overall, the weighted and combined sensitivity and PPV of NCMS in Hua County was 93.1% and 92.1%,respectively. Significantly higher sensitivity and PPV in identifying patients with common cancers than noncommon cancers were detected in HCPH and ACH separately(P<0.01).Conclusions: Identification of cancer patients by use of the NCMS is accurate on individual level, and it is therefore feasible to conduct claims-based cancer surveillance in areas not covered by cancer registries in China.
基金supported by the National Science&Technology Fundamental Resources Investigation Program of China(No.2019FY101102)the National Natural Science Foundation of China(No.82073626,81773501)+5 种基金the National Key R&D Program of China(No.2016YFC0901404)the Beijing-Tianjin-Hebei Basic Research Cooperation Project(No.J200016)the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(No.XXZ0204)the Beijing Hospitals Authority Youth Programme(No.QML20201101)Sanming Project of Shenzhen(No.SZSM201612061)the Beijing Nova Program(No.Z201100006820093)。
文摘Objective:This study aimed to develop and validate a risk scoring system to identify high-risk individuals carrying malignant lesions in stomach for tailored gastric cancer screening.Methods:A gastric cancer risk scoring system(GC-RSS)was developed based on questionnaire-based predictors for gastric cancer derived from systematic literature review.To assess the capability of this system for discrimination,risk scores for 8,214 and 7,235 outpatient subjects accepting endoscopic examination in two endoscopy centers,and 32,630 participants in a community-based cohort in China were calculated to plot receiver operating characteristic curves and generate area under the curve(AUC).To evaluate the performance of GC-RSS,the screening proportion,sensitivity and detection rate ratio compared to universal screening were used under different risk score cutoff values.Results:GC-RSS comprised nine predictors including advanced age,male gender,low body mass index(<18.5 kg/m^(2)),family history of gastric cancer,cigarette smoking,consumption of alcohol,preference for salty food,irregularity of meals and consumption of preserved food.This tool performed well in determining the risk of malignant gastric lesions with AUCs of 0.763,0.706 and 0.696 in three validation sets.When subjects with risk scores≥5 were evaluated with endoscopy,nearly 50%of these endoscopies could be saved with a detection rate of over 1.5 times achieved.When the cutoff was set at 8,only about 10%of subjects with the highest risk would be offered endoscopy,and detection rates for gastric cancer could be increased 2-4 fold compared to universal screening.Conclusions:An effective questionnaire-based GC-RSS was developed and validated.This tool may play an important role in establishing a tailored screening strategy for gastric cancer in China.
基金the National Natural Science Foundation of China(No.30930102,82073626,81502855,81773501)the National Key R&D program of China(No.2016YFC0901404)+4 种基金the National Special Programme of Scientific and Technological Resources Investigation(No.2019FY101102)the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(No.XXZ0204)the Beijing Natural Science Foundation(No.7182033)the Beijing Municipal Administration of Hospital’s Youth Programme(No.QML20171101)the Science Foundation of Peking University Cancer Hospital(No.2020-7)。
文摘Objective:We aimed to prospectively evaluate the association of oral microbiome with malignant esophageal lesions and its predictive potential as a biomarker of risk.Methods:We conducted a case-control study nested within a population-based cohort with up to 8 visits of oral swab collection for each subject over an 11-year period in a high-risk area for esophageal cancer in China.The oral microbiome was evaluated with 16 S ribosomal RNA(rRNA)gene sequencing in 428 pre-diagnostic oral specimens from 84 cases with esophageal lesions of severe squamous dysplasia and above(SDA)and 168 matched healthy controls.DESeq analysis was performed to identify taxa of differential abundance.Differential oral species together with subject characteristics were evaluated for their potential in predicting SDA risk by constructing conditional logistic regression models.Results:A total of 125 taxa including 37 named species showed significantly different abundance between SDA cases and controls(all P<0.05&false discovery rate-adjusted Q<0.10).A multivariate logistic model including 11 SDA lesion-related species and family history of esophageal cancer provided an area under the receiver operating characteristic curve(AUC)of 0.89(95%CI,0.84-0.93).Cross-validation and sensitivity analysis,excluding cases diagnosed within 1 year of collection of the baseline specimen and their matched controls,or restriction to screenendoscopic-detected or clinically diagnosed case-control triads,or using only bacterial data measured at the baseline,yielded AUCs>0.84.Conclusions:The oral microbiome may play an etiological and predictive role in esophageal cancer,and it holds promise as a non-invasive early warning biomarker for risk stratification for esophageal cancer screening programs.
基金supported by the Charity Project of National Ministry of Health (No. 201202014)the Natural Science Foundation of China (No. 81473033)+2 种基金the National Key R&D Program of China (No. 2016YFC0901404)the Science Foundation of Peking University Cancer Hospital (No. 2017-4)the Open Project funded by Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing (No. 2017-10)
文摘Objective： There have been few population-based studies evaluating health related quality of life（HRQOL） in rural populations in China, and this study aimed to assess the current status of and risk factors for HRQOL in a general rural population in high risk region of esophageal cancer in China.Methods： From November 2015 to September 2016, 12,085 permanent residents aged 45–69 years from 257 villages in the Endoscopic Screening for Esophageal Cancer in China（ESECC） trial（Clinical Trials.gov：NCT01688908） randomly selected from Hua County, Henan Province, China were interviewed. The EQ-5 D-3 L,a generic measure of HRQOL, and a questionnaire were used to assess their HRQOL and potential risk factors.Results： Among all the participants, 30.62% of the participants reported problems in at least one EQ-5 D dimension. Pain/discomfort（25.52%） was the most frequently reported problem followed by anxiety/depression（7.97%）, mobility（5.82%）, usual activities（2.61%） and self-care（1%）. These rural residents had a mean EQ-5 D index score of 0.948, and lower EQ-5 D index scores were associated with older age, female gender, lower levels of household annual per capita income, living alone, using shallow wells as main source of drinking water, exposure to family members smoking, testiness, unhealthy dietary habits, overweight or obesity, upper gastrointestinal cancer related symptoms and chronic diseases.Conclusions： Rural residents in China have a relatively low quality of life. Health promotion programs in this population should focus on the elderly, especially elderly women and the elderly living alone. Improving basic living circumstances and primary medical care services should be priorities. Results of this study will also serve as the basis for the cost-utility evaluation in our ESECC screening trial.
基金supported by grants from the National Science and Technology Fundamental Resources Investigation Program of China(No.2019FY101102)the National Natural Science Foundation of China(No.82073626)+1 种基金the National Key Research and Development Program of China(No.2021YFC2500405)the Sanming Project of Shenzhen(No.SZSM201612061).
文摘Background:Clinical opportunistic screening is a cost-effective cancer screening modality.This study aimed to establish an easyto-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods:We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China.The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics.The final model was derived based on unconditional logistic regression,and predictors were selected according to the Akaike information criterion.External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results:This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors,including advanced age,male gender,family history of gastric cancer,low body mass index,unexplained weight loss,consumption of leftover food,consumption of preserved food,and epigastric pain.This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve(AUC)of 0.791(95%confidence interval[CI]:0.750-0.831).External validation of the model in the general population generated an AUC of 0.696(95%CI:0.570-0.822).This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion:This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.
基金supported by the National Basic Research Program of China from the National Ministry of Science and Technology(973 Program)to YK(Grant No.2011CB504300)and to HC(Grant No.2012CB910800)the National Natural Science Foundation of China(Grant No.30930102)to YK+3 种基金the National High-tech R&D Program of China(863 ProgramGrant No.2012AA022502)Key Research Program of the Chinese Academy of Sciences of China(Grant No.KJZD-EW-L06-2)to CZthe Open Fund of MOE Key Laboratory of Carcinogenesis and Translational Research(Grant No.2014KAIFANG-4)to JB
文摘Esophageal squamous cell carcinoma （ESCC） has a high mortality rate. To determine the molecular basis of ESCC development, this study sought to identify characteristic genome-wide alterations in ESCC, including exonic mutations and structural alterations. The clinical implications of these genetic alterations were also analyzed. Exome sequencing and verification were performed for nine pairs of ESCC and the matched blood samples, followed by validation with additional sam- ples using Sanger sequencing. Whole-genomc SNP arrays were employed to detect copy number alteration （CNA） and loss of heterozygosity （LOH） in 55 cases, including the nine ESCC samples subjected to exome sequencing. A total of 108 non-synonymous somatic mutations （NSSMs） in 102 genes were verified in nine patients. The chromatin modification process was found to be enriched in our gene ontology （GO） analysis. Tumor genomes with TP53 mutations were signifi- cantly more unstable than those without TP53 mutations. In terms of the landscape of genomic alterations, deletion of 9p21.3 covering CDKN2A/2B （30.9%）, amplification of 1 1q13.3 covering CCND1 （30.9%）, and TP53 point mutation （50.9%） occurred in two-thirds of the cases. These results suggest that the deregulation of the G1 phase during the cell cycle is a key event in ESCC. Furthermore, six minimal common regions were found to be significantly altered in ESCC samples and three of them, 9p21.3, 7p 11.2, and 3p 12.1, were associated with lymph node metastasis. With the high correlation of TP53 mutation and genomic instability in ESCC, the amplification of CCND1, the deletion of CDKN2A/2B, and the somatic mutation of TP53 appear to play pivotal roles via G1 deregulation and therefore helps to classify this cancer into different genomic subtypes. These findings provide clinical significance that could be useful in future molecular diagnoses and therapeutic targeting.
基金Supported by the National Science&Technology Fundamental Resources Investigation Program of China(2019FY101102)the National Natural Science Foundation of China(82073626)+3 种基金the National Key R&D Program of China(2016YFC0901404)the Beijing-Tianjin-Hebei Basic Research Cooperation Project(J200016)the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(XXZ0204)the Taikang Yicai Public Health and Epidemic Control Fund(TKYC-GW-2020).
文摘Introduction:This study aimed to evaluate the performance of the Medical-Insurance-System-based Cancer Surveillance System(MIS-CASS)in estimating cancer incidence by comparing the results with the Beijing Cancer Registry(BCR),which is one of the highest-quality population-based cancer registries in China.Methods:Using lymphoma as an example,we extracted relevant claims data from the administrative systems of medical insurance in Beijing(2012–2020)and estimated the most current lymphoma incidence in Beijing(2019)using a standard data processing procedure.The absolute number of new cases,crude incidence rate,and age-standardized incidence rate of lymphoma were compared with the latest data reported by the BCR(2017).Results:Both lymphoma incidence rates and age distribution of new cases estimated based on MISCASS were similar to the BCR data(crude incidence rate:9.8/100,000 vs.10.6/100,000).However,because MIS-CASS included more designated hospitals and covered a larger local stationary population irrespective of household registration(hukou),the absolute number of incident lymphoma cases identified by MIS-CASS was 39.1%higher than that reported by the BCR(2,002 vs.1,439).Conclusions:The MIS-CASS approach reflected the actual cancer burden in a more complete and timely manner as compared with the current BCR,providing new insights for improving cancer surveillance strategies in China.
基金financially supported by the Heilongjiang Provincial Natural Science Foundation of China(LH2022B009)National Natural Science Foundation of China(21704023,U20A20339).
文摘Fuel-driven dissipative self-assembly,which is a well-established concept in recent years,refers to out-of-equilibrium molecular self-assembly initiated and supported by the addition of active molecules (chemical fuel).It widely exists in nature since many temporary,active micro- or nanostructures in living bodies are generated by the dissipative self-assembly of biomolecules.Therefore,the study on dissipative self-assembly provides a good opportunity to have an insight into the microscopic mechanism of living organisms.In the meantime,dissipative assembly is thought to be a potential pathway to achieve dynamic,temporary supramolecular materials.Recently,a number of temporary materials have been developed with the aid of strategies for realizing dissipative self-assembly.Some of their properties,including solubility,stiffness,turbidity,color,or self-healing ability,change upon the addition of chemical fuel but spontaneously restore with chemical fuel consumption.The dynamic of these materials brings them various unprecedented functions.In this review,the principles of fabricating a fuel-driven temporary material are first reviewed.Subsequently,recent examples of fuel-driven temporary materials are emphatically summarized,including gels,self-erased inks,nanoreactors,self-healing materials,nanochannels,and droplets.Finally,the challenges of developing fuel-driven temporary materials and some perspectives on the function and application of such kind of materials are discussed.
基金supported by the National Key R&D Program of China(2021YFC2500405)the Natural Science Foundation of Beijing Municipality(7182033).
文摘Extensive efforts have been put into reducing the heavy burden of esophageal squamous cell carcinoma(ESCC)in China.However,the joint impact of prevention and treatment on the long-term overall survival(OS)of ESCC patients remains largely unknown.We consecutively recruited 13,255 ESCC patients from two Chinese centers:the Northern center,located in a high-risk area with abundant screening programs;and the Southern center,situated in a non-high-risk area with improved clinical practices.Inter-center comparison,longitudinal intra-center comparison,and a simulation analysis were conducted to investi-gate the influence of tumor downstaging and high-quality clinical treatment on OS.During a follow-up period of 12.52 years,the Northern center exhibited higher median survival than the Southern center(6.22 vs.3.15 years;H_(Radjusted)=0.73,95%CI:0.69-0.77).Mediation analysis demonstrated that its OS advantage was largely(77.7%)attributed to earlier TNM stage(stage 0-II:51.3%vs.24.6%).In temporal analyses,patient survival in the Southern center gradually improved(median survival during 2015-2018 vs.2009-2014:3.58 vs.2.93 years;H_(Radjusted)=0.86,95%CI:0.79-0.94),coinciding with the progress of treatment-related indices(completeness of TNM staging in discharge diagnosis[from 53.7%to 99.6%],adoption of minimally invasive esophagectomy[from 0.0%to 51.1%]and right thoracic esophagectomy[from 12.4%to 86.4%],etc.).Simulation analysis further demonstrated that integrating both downstaging and high-quality treatment would lead to the best survival.Tumor downstaging and high-quality clinical treatment have a joint impact on ESCC patient survival.Establishing a comprehensive strategy that inte-grates cancer prevention with optimal clinical treatment is crucial for alleviating the ESCC burden.
