ObjectiveTo summarize the latest advances in copper and cuproptosis in the field of breast cancer, and to provide a reference for clinical treatment decisions. MethodThe literatures related to copper and cuproptosis in recent years were read and summarized, and the research progress on the role of copper in breast cancer, the application of cuproptosis in the diagnosis and treatment of breast cancer were reviewed. ResultsCuproptosiswas a novel form of programmed cell death, which occurred via direct binding of copper to lipoylated components of the tricarboxylic acid (TCA) cycle, this resulted in lipoylated protein aggregation and subsequent iron-sulfur cluster protein loss, leading to proteotoxic stress and ultimately cell death. Cuproptosis induced proliferation and migration of breast cancer cell , mediated personalized immunotherapy, and participated in endocrine and chemotherapeutic drug resistance. ConclusionExploring the mechanism of cuproptosis provides potential applications for subsequent immunotherapy, endocrine therapy, and chemotherapy for breast cancer, leading to new effective strategies for patients.
ObjectiveTo further explore and discuss the value of laparoscopic appendectomy. MethodsThe clinical data of 200 patients underwent appendectomy in this hospital from April 2009 to December 2010 were collected. The operation time, postoperative hospital stay, cost of hospitalization, postoperative anal exhaust time, postoperative pain score, and surgical complications were compared between laparoscopic appendectomy and open appendectomy. ResultsThere were 8 cases conversion to the open approach in this series. The cost of laparoscopic appendectomy was higher than that of open appendectomy (Plt;0.05); the cases of chronic appendicitis, acute simple appendicitis, acute suppurative appendicitis within 36 h of onset treated by laparoscopic appendectomy had shorter operation time, shorter postoperative hospital stay, earlier postoperative anal exhaust time, and slighter postoperative pain than those treated by open appendectomy (Plt;0.05); the differences in postoperative hospital stay, postoperative anal exhaust time, postoperative pain of acute suppurative appendicitis more than 36 h of onset and acute gangrenous appendicitis treated by two types of surgery had no statistical significances (Pgt;0.05); the operation time of acute gangrenous appendicitis operated by laparoscopic surgery was longer than that by open appendectomy (Plt;0.05); incision infection rate of laparoscopic appendectomy was lower than that of open appendectomy (Plt;0.05). ConclusionsFor chronic appendicitis, acute simple appendicitis, and acute suppurative appendicitis within 36 h of onset, the outcome and advantages of laparoscopic appendectomy are outstanding, the value of application is clear; and for acute suppurative appendicitis more than 36 h of onset and acute gangrenous appendicitis, laparoscopic appendectomy is difficult and with high rate of conversion, no obvious advantages in recovery after surgery but an increase of medical costs, and the application value is not great.
ObjectiveTo compare the prognosis of neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC) in patients with T1-2N1-2M0 luminal breast cancer, and to analyze the factors affecting the prognosis. MethodsPatients with luminal breast cancer who met the inclusion criteria and had complete follow-up data from January 2014 to December 2019 were retrospectively collected. Patients received either neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy (AC), both based on anthracycline-containing regimens. Kaplan-Meier analysis was performed to estimate overall survival, and Cox proportional hazards regression was used to identify risk factors affecting 5-year cumulative overall survival rate. Statistical significance was defined as a P=0.05.ResultsA total of 206 patients (99 receiving NAC and 107 receiving AC) meeting the inclusion criteria were enrolled. The cohort comprised 101 patients with luminal A (57 AC, 44 NAC) and 105 with luminal B (50 AC, 55 NAC). At a median follow-up of 72.5 months, no significant differences in the 5-year cumulative overall survival rates were observed between AC and NAC patients (89.7% vs. 88.9%, P=0.571). However, the 5-year cumulative disease-free survival rate was significantly higher in the AC group as compared with the NAC group (85.0% vs. 73.5%, P<0.001). Subgroup analysis demonstrated no significant differences in the 5-year cumulative overall survival rates between AC and NAC patients within either luminal A (94.7% vs. 86.4%, P=0.727) or luminal B (84.0% vs. 89.3%, P=0.864). However, for patients with luminal A, the 5-year cumulative disease-free survival rate was significantly higher in the AC subgroup than in the NAC subgroup (93.0% vs. 77.3%, P<0.001). In contrast, no significant difference in the 5-year cumulative disease-free survival rate between AC and NAC was observed among patients with luminal B (74.0% vs. 71.4%, P=0.201). Multivariate analysis using the Cox proportional hazards model identified the following independent risk factors for lower 5-year cumulative overall survival rate in patients with T1-2N1-2M0 luminal breast cancer: N2 stage [HR (95%CI)=2.290 (1.249, 4.196)], lymphovascular invasion [HR (95%CI)=2.181 (1.182, 4.026)], omission of endocrine therapy [HR (95%CI)=6.013 (2.590, 13.965)], and absence of pathological complete response (pCR) after NAC [HR (95%CI)=2.403 (1.284, 4.496)]. ConclusionThe results of this study suggest that patients with T1-2N1-2M0 luminal breast cancer can achieve higher disease-free survival from AC, but it is still necessary to comprehensively consider the patient’s condition such as lymph node metastasis, vascular cancer thrombus, and other factors to formulate an individualized treatment plan to increase the overall survival rate of patients.