BMC Women's Health最新文献

{"title":"A lack of sexual autonomy is associated with increased loneliness in young mothers.","authors":"Chelsea Bunke, Tara Keck","doi":"10.1186/s12905-024-03479-0","DOIUrl":"https://doi.org/10.1186/s12905-024-03479-0","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a significant risk factor for both mental and physical health issues, including depression and increased mortality. Loneliness is reported at higher levels during life transitions, such as the transition to motherhood. Loneliness in mothers has far-reaching detrimental impacts on both mother and child, such as an increased risk of maternal depression and child abuse. Understanding the impact of different risk factors for loneliness, specifically in young mothers, may inform potential interventions for this at-risk group. The aim of this study was to determine whether mothers were lonelier than childfree women, and whether there are different risk factors for loneliness in mothers relative to childfree women, both for gender-associated and established risk factors for loneliness.</p><p><strong>Methods: </strong>This cross-sectional study included partnered mothers and partnered childfree women between the ages of 20 and 29 from the 2020 Generations and Gender Survey (GGS) in the Republic of Moldova. The De Jong Gierveld Loneliness Scale was used to assess overall, emotional, and social loneliness. A total of 11 potential risk factors were considered, across gender, well-being, relationships, and household status. Depending on the nature of the variables and their distributions, Wilcoxon rank-sum tests or Spearman correlation coefficients were used to assess loneliness risk factors for partnered mothers and childfree women.</p><p><strong>Results: </strong>Data from 396 mothers and 113 childfree women in the Republic of Moldova were analysed in this study. There was no significant difference between the mean overall, emotional, or social loneliness scores in partnered mothers and childfree women. A lack of sexual autonomy was a risk factor associated with social loneliness in young mothers, but not in childfree women. This was the only gendered risk factor that differed between populations. Other gendered risk factors were not significant for any types of loneliness in either population. There were differences between mothers and childfree women in several established risk factors for loneliness.</p><p><strong>Conclusion: </strong>Mothers were not lonelier than childfree women in this study, but a lack of sexual autonomy was a risk factor associated with loneliness only in mothers.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"3"},"PeriodicalIF":2.4,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of female genital schistosomiasis and human papillomavirus and cervical pre-cancer: a systematic review.","authors":"Amy Sturt, Tanvier Omar, Isaiah Hansingo, Paul Kamfwa, Amaya Bustinduy, Helen Kelly","doi":"10.1186/s12905-024-03514-0","DOIUrl":"10.1186/s12905-024-03514-0","url":null,"abstract":"<p><strong>Background: </strong>S. haematobium is a recognized carcinogen and is associated with squamous cell carcinoma of the bladder. Its association with high-risk(HR) human papillomavirus (HPV) persistence, cervical pre-cancer and cervical cancer incidence has not been fully explored.</p><p><strong>Methods: </strong>We searched OvidSP MEDLINE, OvidSP Embase, Global Index Medicus, PubMed and the Wiley Cochrane library without date or language restrictions up to April 20, 2024 for abstracts evaluating the association of female genital schistosomiasis (FGS) with the prevalence, incidence or persistence of cervical HR-HPV, and incidence of histology-verified cervical pre-cancer or cancer. Cervical pre-cancer defined using cervical cytology or visual inspection with acetic acid (VIA) was also considered, but as lower quality evidence. We assessed the risk of bias of included studies using a modified Newcastle Ottawa scale. This study is registered on PROSPERO: CRD42023389301.</p><p><strong>Results: </strong>We identified 1,170 publications and six studies were eligible for inclusion. Five studies were cross sectional and 1 was prospective. The studies describe 1081 women living in sub-Saharan Africa. One study from Zimbabwe reported an increased risk of HR-HPV prevalence at baseline in women with composite-FGS compared to women without FGS (aOR 1.9, 95% CI 1.1 - 3.6, p = 0.03), however no association was seen after 5 years of follow-up. Another study from KwaZulu-Natal reported an increased odds of any HPV prevalence among women with visual-FGS compared to women without FGS (aOR 1.71 [1.14 - 2.56], p = 0.01). However, a study in Madagascar did not show increased odds of any HPV among women with visual-FGS compared to women without FGS (OR 1.0 [0.82 - 1.2). Of 4 studies evaluating the association of FGS and cervical pre-cancer, one reported an increased risk of VIA abnormalities in women with molecular-FGS compared to those without (aOR 6.08, 95% CI 1.58 - 23.37). Three studies did not report an association between FGS and cervical pre-cancer (cytology defined (n = 2) and histology defined (n = 1)).</p><p><strong>Conclusion: </strong>There are limited and low quality data on the risk of HR-HPV infection and cervical pre-cancer and cancer among women with FGS. Given limited data, it was not possible to confirm or exclude an association between FGS and HPV, cervical pre-cancer, and cervical cancer and additional research is needed.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"2"},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online health information seeking behavior among breast cancer patients and survivors: a scoping review.","authors":"Jialin Chen, Yiwen Duan, Haozhi Xia, Runxi Xiao, Tingting Cai, Changrong Yuan","doi":"10.1186/s12905-024-03509-x","DOIUrl":"10.1186/s12905-024-03509-x","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review aims to summarize online health information seeking (OHIS) behavior among breast cancer patients and survivors, identify research gaps, and offer insights for future studies.</p><p><strong>Methods: </strong>Following Arksey and O'Malley's framework, we conducted a review across PubMed, Web of Science, CINAHL, MEDLINE, Cochrane, Embase, CNKI, Wanfang Data, and SinoMed, covering literature from 1 January 2014 to 13 August 2023. A total of 1,368 articles were identified, with 33 meeting the inclusion criteria. Two researchers independently screened, extracted, and summarized the data.</p><p><strong>Results: </strong>The studies addressed three main themes:OHIS behavior, factors associated with OHIS, and intervention programs on OHIS. Key information sources included national or nonprofit cancer organizations' websites, search engines, and social media. Commonly sought information involved breast cancer knowledge, treatment options, and prognosis, with information seeking behaviors varying by disease stages. While patients valued the convenience and accessibility of online resources, dissatisfaction was common due to inaccurate or misleading content. Factors such as age, education, income, disease characteristics, and psychological factors significantly influenced OHIS behaviors.</p><p><strong>Conclusion: </strong>This review identifies significant gaps in exploring OHIS behavior among breast cancer patients and survivors, highlighting the inadequacy of current interventions. Future research should focus on diverse age groups, refine the language of web-based health information, enhance user comprehension of professional content, and develop tailored information systems for different stages of the health journey.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'It's a secret in my life': frontstage and backstage experiences of women undergoing induced abortions in a rural community of Pakistan.","authors":"Rubeena Slamat, Piet Bracke, Melissa Ceuterick","doi":"10.1186/s12905-024-03482-5","DOIUrl":"10.1186/s12905-024-03482-5","url":null,"abstract":"<p><p>Abortion is taboo in Pakistani society, and it is stigmatised throughout the country, regardless of legal permission. Despite the burdens imposed by social norms of pronatalism and motherhood, women do exercise agency to have abortions. This study explores the experiences of women who have had induced abortions and maintained their social status within the community. Goffman's dramaturgical theory (frontstage and backstage behaviours) is applied in order to document these experiences. Data were collected through 38 in-depth interviews and six focus group discussions. The results are presented according to a grounded theory approach. The results of this study indicate that women exercise agency and stage abortions as miscarriages, which are culturally more acceptable. They do this with the help of support systems comprising family members and friends. They are able to maintain their social status by navigating between what Goffman refers to as the frontstage and backstage regions of their lives. In this study, these regions are not defined by physical boundaries, but by the presence of participants and audience. Women must therefore take care to behave appropriately, especially in the frontstage region. Even when women do opt for abortion, the experience is likely to result in the psychological burden of a lifelong memory.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"676"},"PeriodicalIF":2.4,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of serum lipid on recurrence of uterine fibroids: a single center retrospective study.","authors":"Yimin Ma, Jingjing Weng, Yingying Zhu","doi":"10.1186/s12905-024-03530-0","DOIUrl":"10.1186/s12905-024-03530-0","url":null,"abstract":"<p><strong>Background: </strong>We aimed to analyze the correlation between serum lipid levels [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and recurrence after uterine fibroids (UF) resection, and explore the predictive value of serum lipid levels in determining recurrence after myomectomy.</p><p><strong>Methods: </strong>In this retrospective cohort study, 323 patients undergoing first myomectomy who came from Li Huili Hospital, Ningbo Medical Center between December 2019 and January 2023 were included. The primary endpoint was the recurrence of UF within 12 months following surgery. Univariate and multivariate logistic regression analyses were adopted to evaluate the association between four serum lipid parameters and the risk of UF recurrence. All included patients were randomly assigned to the training group for nomogram development and the testing group for nomogram validation, with a ratio of 7:3. Receiver operator characteristic, calibration curves, and decision curve analysis were used to assess the predicting performance of constructed nomograms.</p><p><strong>Results: </strong>Totally, 98 developed the recurrence of UF within 12 months following surgery. Multivariate logistic regression analyses indicated that high levels of TC [odds ratio (OR) = 9.98, 95% confidence interval (CI): 4.28-23.30], LDL-C (OR = 11.31, 95% CI: 4.66-27.47) and HDL-C (OR = 2.37, 95% CI: 1.21-4.64) were associated with recurrence of UF risk. The association between TG level and UF recurrence risk did not statistical significance (P > 0.05). Four online prediction nomograms by integrating serum lipid levels and clinical features for predicting the risk of recurrence of UF were developed (TC-model, TG-model, LDL-C-model and HDL-C-model). Through verification, these models may have good prediction performance for predicting the recurrence of UF risk.</p><p><strong>Conclusion: </strong>This study developed and validated prediction nomograms for predicting the risk of UF recurrence. These nomograms can provide individual risk assessment for UF recurrence.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"677"},"PeriodicalIF":2.4,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of prognostic models for HER2-positive metastatic breast cancer in females: a retrospective population-based study.","authors":"Yan Chen, Yu Qiu, Haoyang Shen, Shuixin Yan, Jiadi Li, Weizhu Wu","doi":"10.1186/s12905-024-03526-w","DOIUrl":"10.1186/s12905-024-03526-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to construct, evaluate, and validate nomograms for breast cancer-specific survival (BCSS) and overall survival (OS) prediction in patients with HER2- overexpressing (HER2+) metastatic breast cancer (MBC).</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was used to select female patients diagnosed with HER2 + MBC between 2010 and 2015. These patients were distributed into training and validation groups (7:3 ratio). Variables were screened using univariate and multivariate Cox regression analyses, and BCSS and OS nomograms were constructed to determine one-, three-, and five-year survival probabilities. The nomograms were evaluated and validated using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. Stratification was evaluated using Kaplan-Meier curves and log-rank tests based on optimal total score cut-off values. We published web-based versions of these nomograms for clinical use.</p><p><strong>Results: </strong>A total of 2,151 eligible patients were randomized into training (n = 1,505) and validation (n = 646) groups. Independent prognostic factors of BCSS and OS included: age; marital status; race; oestrogen receptor status; surgery; chemotherapy; and bone, brain, liver, and lung metastases. The C-indices for the BCSS and OS training groups were 0.707 and 0.702, respectively. The ROC, calibration, and decision curves demonstrated the strength of the nomograms. According to cut-off values, patients were categorized into low-, intermediate-, and high-risk groups, with significant differences in survival outcomes between them.</p><p><strong>Conclusion: </strong>We constructed predictive nomograms and stratified risk to assess the prognosis of patients with HER2 + MBC, which could help inform therapeutic decisions.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"675"},"PeriodicalIF":2.4,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migrated intra-uterine device to infra-umbilical skin: a rare case report.","authors":"Nigat Amsalu Addis, Yared Alem Sibhat, Yohannis Derbew Molla, Wasihun Nigdu Mengestu, Abebe Sinknew Seid, Michael Argaw Damite, Misganaw Abere Worku","doi":"10.1186/s12905-024-03522-0","DOIUrl":"10.1186/s12905-024-03522-0","url":null,"abstract":"<p><strong>Introduction: </strong>IUDs are effective, reversible and safe methods of contraception. The mechanism of action of IUDs as a group is inducing endometrial atrophy, apoptosis, altering tubal motility; preventing sperm permeability, fertilization, and implantation. Complications of IUD include menstrual disturbance, pelvic pain, and increased risk of ectopic pregnancy with contraceptive failure, device expulsion, uterine perforation or transmural migration with misplacement of the device. Pregnancies and IUD migration are uncommon complications, occurring in 1 to 2 from 1,000 users. The clinical presentation of migrated IUDs depends on the final anatomic location at diagnosis. Migration can be asymptomatic and incidentally found while imaging for any other diagnosis or may have various acute clinical presentations.</p><p><strong>Case presentation: </strong>We present the case of a 38-years-old Ethiopian woman with unusual migration of IUD to the infra-umbilical skin. She had infra-umbilical skin discoloration associated with intermittent itching for two months duration. On physical examination, there was diffuse violaceous patch over the infra-umbilical skin measuring 7 centimeters on its longest dimension and visible foreign body (IUD) with tiny sinus tract formation. Visible stem of copper-containing IUD was grasped by ring forceps and removed with gentle traction without complication during or following extraction. Removal of misplaced IUD with completely non-invasive manner makes this case special in addition to the unique site of migration to the infra-umbilical skin.</p><p><strong>Conclusion and recommendation: </strong>To our knowledge, this is what likely to be the first reported case of IUD migration to the infra-umbilical skin which bestows a new finding to the existing literatures. Despite rare occurrence, possible IUD complications should be included in the informed consent process before insertion. Self-examination of the strings and vigilant evaluation at regular checkup is recommended for early detection of migrated IUDs.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"672"},"PeriodicalIF":2.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel prognostic score of recurrence for endometrial cancer patients with staging surgery.","authors":"Tomoka Maehana, Naoki Kawahara, Junya Kamibayashi, Motoki Matsuoka, Keita Waki, Ryuji Kawaguchi, Fuminori Kimura","doi":"10.1186/s12905-024-03528-8","DOIUrl":"10.1186/s12905-024-03528-8","url":null,"abstract":"<p><strong>Background: </strong>Recently, there have been an increasing number of reports on the association between inflammatory markers and the prognosis of malignant tumors. However, the current inflammatory indicators have limited accuracy. We aimed to develop a new scoring system for predicting endometrial cancer recurrence using inflammatory markers, tumor markers, and histological diagnoses.</p><p><strong>Methods: </strong>Patients with primary, previously untreated, and suspected endometrial cancer who underwent surgery at the Nara Medical University Hospital between January 2007 and December 2020 were included and followed up until March 2024. Items were divided into positive and negative using scores based on cutoff values and placed into the new scoring system, the endometrial tumor-related (ETR) score.</p><p><strong>Results: </strong>We found that positive postoperative histological examination of lymph node metastasis and myometrial invasion, high levels of carcinoembryonic antigen and D-dimer in preoperative blood tests, and a large difference in preoperative and postoperative white blood cell counts were significantly associated with recurrence. The sensitivity and specificity of recurrence prediction using the ETR score were not inferior to those using the International Federation of Gynecology and Obstetrics staging system, which is considered the best prognostic factor for survival.</p><p><strong>Conclusions: </strong>The ETR score is a significant prognostic marker of recurrence in patients who have undergone staging surgery, with complete surgical tumor removal.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"671"},"PeriodicalIF":2.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific associations of prenatal Chinese famine exposure with cataract risk at age sixty: a cross-sectional study.","authors":"Yuanyou Xia, Xiaoyang Xu, Siyao Wang","doi":"10.1186/s12905-024-03538-6","DOIUrl":"10.1186/s12905-024-03538-6","url":null,"abstract":"<p><strong>Background: </strong>Age-related cataract (ARC) is among the most common blinding eye disorders among the elderly. Prenatal nutrition may cause irreversible damage to the development of the ocular crystalline lens. Nevertheless, the potential association between prenatal malnutrition and age-related cataract has not been thoroughly examined. We investigated the prevalence of cataract at the age of 60 after prenatal exposure to Chinese famine (1959-1961) and particularly evaluated whether there was a disparity in this effect between men and women.</p><p><strong>Methods: </strong>We utilized the health examination medical record system of a large-scale comprehensive hospital to screen individuals born in Chongqing, China and undergoing eye health examinations. Participants were categorized based on their year of birth into the famine-exposed group (1960) and the non-exposed group (1963), with their medical records at age 60 extracted from the database. Univariate and multivariate logistic regression analyses were conducted to investigate the association between famine exposure and the risk of developing ARC by age 60.</p><p><strong>Results: </strong>The prevalence of ARC was significantly higher in the famine-exposed group (60.26%) compared to the non-exposed group (47.90%) (P < 0.001). After adjusting for diabetes history, body mass index (BMI), fasting blood glucose (FBG) level, and high-density lipoprotein (HDL) level using multivariate logistic regression analysis, the risk of ARC remained significantly higher in the famine-exposed group (OR:1.63; 95%CI:1.31-2.03). Subgroup analysis by sex indicated that women exposed to famine (OR: 1.77; 95% CI: 1.25-2.52) exhibited a higher risk of ARC compared to men (OR: 1.53; 95% CI: 1.16-2.03).</p><p><strong>Conclusions: </strong>Prenatal exposure to famine might increase the risk of ARC among Chinese adults at age 60, and women exhibit a higher susceptibility than men.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"670"},"PeriodicalIF":2.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating traditional biomarkers and emerging predictors to assess neoadjuvant chemotherapy efficacy in breast cancer: a multifactorial analysis of Ki-67, CDK4, EGFR, TILs and ctDNA.","authors":"Tianzhao Du, Ye Yuan, Shulan Sun, Zhichao Gao, Xiaoshuai Li","doi":"10.1186/s12905-024-03486-1","DOIUrl":"10.1186/s12905-024-03486-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyse the correlation between the expression of cell proliferation-associated antigen (Ki-67), cell cycle protein-dependent kinase 4 (CDK4), epidermal growth factor receptor (EGFR), tumour-infiltrating lymphocytes (TILs) and circulating tumour DNA (ctDNA) with the outcome and prognosis of patients with breast cancer (BC) undergoing neoadjuvant chemotherapy (NACT).</p><p><strong>Methods: </strong>We retrospectively analysed the clinicopathological data of 231 patients with BC who underwent preoperative NACT at XX Hospital between 1 January 2018 and 31 December 2021. Logistic regression models were used to analyse factors influencing NACT efficacy. The Cox risk regression model was used to analyse prognostic factors. The TILs were assessed on pre-treatment biopsies, and ctDNA levels were monitored during NACT. Propensity score matching and subgroup analyses were performed.</p><p><strong>Results: </strong>After 4-6 cycles of chemotherapy, the response rate was 77.92% (180/231), with 58.87% (136/231) achieving pathological complete response (pCR). Multifactorial analysis showed that tumour, node and metastasis (TNM) stage II, EGFR positivity, low Ki-67 expression, CDK4 negativity, non-triple-negative subtypes and effective NACT results were associated with higher pCR rates. Higher TIL levels correlated with increased pCR rates (72.4% for high TILs vs 39.1% for low TILs, p < 0.001). The ctDNA levels decreased significantly in patients with pCR compared with patients without pCR during NACT (p < 0.001). After propensity score matching, the 3-year disease-free survival rate was significantly higher in the pCR group (88.9% vs 71.1%, p = 0.003). Subgroup analysis revealed varying pCR rates and predictive biomarkers across BC subtypes.</p><p><strong>Conclusion: </strong>The TNM classification, EGFR, Ki-67, CDK4 expression, BC subtype and NACT results have predictive value for pCR in patients with BC. Lower TNM classification, lower Ki-67 expression and EGFR positivity are associated with better outcomes. High TIL levels and significant decreases in ctDNA during NACT correlate with improved response and prognosis. These findings highlight the potential for integrating traditional clinicopathological factors with novel biomarkers for personalised treatment strategies in BC.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"674"},"PeriodicalIF":2.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}