Journal of the Chinese Medical Association : JCMA最新文献

{"title":"First-line immune checkpoint inhibitors plus chemotherapy in Taiwanese patients with extensive-stage small-cell lung cancer.","authors":"Ying-Ting Liao, Ruei-Lin Sun, Hsu-Ching Huang, Chia-I Shen, Yen-Han Tseng, Yung-Hung Luo, Yuh-Min Chen, Chi-Lu Chiang","doi":"10.1097/JCMA.0000000000001260","DOIUrl":"10.1097/JCMA.0000000000001260","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have demonstrated survival benefits when combined with platinum and etoposide (EP) in first-line (1L) treatment for extensive-stage small-cell lung cancer (ES-SCLC). We investigated the real-world outcomes, adverse events (AEs), and prognostic factors of Taiwanese patients with ES-SCLC receiving 1L ICI + EP.</p><p><strong>Methods: </strong>We analyzed the clinical characteristics, objective response rates, disease control rates (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related AEs of patients with ES-SCLC who received ICI + EP or EP alone as 1L treatment.</p><p><strong>Results: </strong>A total of 33 patients received ICI + EP, and 199 received EP alone. The 1L ICI + EP group had longer OS than did the 1L EP group (median: 13.9 months vs 8.5 months; p = 0.003). Baseline liver metastasis was associated with shorter 1L PFS, whereas undergoing consolidative thoracic radiotherapy (cTRT) was associated with longer 1L PFS. Baseline liver metastasis, severe hematological AEs (grade ≥ 3), and a neutrophil-to-lymphocyte ratio (NLR) of ≥4 were associated with shorter OS.</p><p><strong>Conclusion: </strong>Adding ICIs to 1L chemotherapy provides survival benefits in ES-SCLC, while close monitoring for AEs is required. cTRT enhances local tumor control and improves PFS. Liver metastasis is associated with shorter PFS and OS. Severe hematological AEs and an elevated NLR predict poor OS in patients with ES-SCLC undergoing immunochemotherapy.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"624-631"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive genomic profiling of Taiwanese triple-negative breast cancer with a large targeted sequencing panel.","authors":"Chi-Cheng Huang, Yi-Chen Yeh, Han-Fang Cheng, Bo-Fang Chen, Chun-Yu Liu, Yi-Fang Tsai, Hsiang-Ling Ho, Ling-Ming Tseng","doi":"10.1097/JCMA.0000000000001258","DOIUrl":"10.1097/JCMA.0000000000001258","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a leading cause of cancer-related deaths in women, particularly those with the triple-negative (TN) phenotype. Although novel therapeutic options are emerging, most are biomarker-driven. This study used comprehensive genomic profiling (CGP) via targeted sequencing to identify actionable alterations in a TN subcohort of the VGH-TAYLOR study.</p><p><strong>Methods: </strong>The study included patients with either early-stage (defined by first-line surgery or neoadjuvant therapy) or late-stage (defined by relapse or de novo metastatic disease) breast cancer. CGP was performed using the Illumina TruSight Oncology 500 assay. The level of actionability was assessed using the European Society for Medical Oncology (ESMO) Scale of Clinical Actionability of Molecular Targets (ESCAT) criteria, with additional annotations provided by the PierianDx software and OncoKB database.</p><p><strong>Results: </strong>CGP was successfully performed on 104 TN breast cancer samples. The most common actionable genes (occurring in >10% of cases) were PIK3CA (38%), BRCA2 (25%), PTEN (13%), BRCA1 (13%), ERBB2 (12%), and ERBB3 (11%). After applying a stringent per-variant filter, these frequencies were reduced to 22%, 6%, 5%, 4%, 4%, and 1% for PIK3CA , PTEN , BRCA2 , BRCA1 , AKT1 , and PALB2 , respectively. Based on the standard cut-off of 10 mutations/megabase, 24 samples were classified as tumor mutation burden (TMB)-high, whereas 80 were TMB-low. The proportion of TMB-high cases was lower among the early-stage patients compared to the late-stage patients (19% vs 36%; p < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates the clinical feasibility and utility of large-scale CGP, enabling the investigation of a broad range of genes and multi-gene signatures, such as TMB and microsatellite instability (MSI). The identification of actionable biomarkers offers the potential to expand therapeutic opportunities for TN breast cancer patients.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"641-649"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macular vessel density is associated with cognitive function in preclinical p.R544C NOTCH3 mutation carriers.","authors":"Chien-Chih Chou, Chiao-Ying Liang, Chen-Yu Lin, I-Jong Wang, Chia-Jen Chang, Jun-Peng Chen, Hsin Tung, Hung-Chieh Chen, Hsian-Min Chen, Yi-Ming Chen, Wei-Ju Lee","doi":"10.1097/JCMA.0000000000001262","DOIUrl":"10.1097/JCMA.0000000000001262","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to examine the relationship between retinal microcirculation, brain white matter hyperintensities (WMH) seen on magnetic resonance imaging (MRI), and cognitive decline in asymptomatic carriers of NOTCH3 mutations, a preclinical stage of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.</p><p><strong>Methods: </strong>Forty-nine asymptomatic carriers without stroke history or cognitive complaints were studied. Retinal vessel density and WMH volume were measured via optical coherence tomography angiography and MRI, respectively. Cognitive function was assessed using various tests.</p><p><strong>Results: </strong>In a multivariable regression model which included both, the whole brain WMH volume and parafoveal vessel density of superficial retinal plexus (SRP) as independent variables, parafoveal vessel density of SRP emerged as a significant predictor for Montreal Cognitive Assessment (MoCA) score ( β = -0.31; 95% confidence interval, -0.1516 to -0.0002; p = 0.044) in this cohort, and consistent findings were observed for Color Trails Tests (CTT)-1 and CTT-2 scores.</p><p><strong>Conclusion: </strong>In asymptomatic NOTCH3 mutation carriers, higher parafoveal vessel density of the SRP may serve as an indicator of cognitive decline, and may also indicate autoregulatory compensatory mechanisms in response to a dysfunctional capillary plexus, potentially signifying early-stage cognitive decline.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"601-608"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic insights for neuroendocrine prostate cancer.","authors":"Peng-Hui Wang, Szu-Ting Yang, Chia-Hao Liu","doi":"10.1097/JCMA.0000000000001255","DOIUrl":"10.1097/JCMA.0000000000001255","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"583-584"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of PBRM1 rs2251219 with major depressive disorder and biochemical variables in a Taiwanese cohort.","authors":"Kuan-Ju Chou, Chuan-Hsun Yu, Yu-Ting Yan, Po-Hsiu Kuo, Shih-Jen Tsai","doi":"10.1097/JCMA.0000000000001245","DOIUrl":"10.1097/JCMA.0000000000001245","url":null,"abstract":"<p><strong>Background: </strong>Genetic studies have identified more than 100 loci linked to major depressive disorder (MDD), underscoring its polygenic characteristics. Although the protein polybromo-1 ( PBRM1 ) rs2251219 polymorphism was reported to be associated with MDD, this has not been corroborated by additional studies. In the present study, the associations between PBRM1 rs2251219, MDD, and key biochemical variables were evaluated in a large Taiwanese cohort.</p><p><strong>Methods: </strong>Data were collected from 117 679 individuals aged 30 to 90 years who were enrolled in the Taiwan Biobank. MDD diagnoses were based on self-reported data validated through national insurance claims records. Genotyping was conducted with an Axiom Genome-Wide Array, and associations with biochemical variables were analyzed through a general linear model adjusted for age and sex.</p><p><strong>Results: </strong>A significant association was observed between PBRM1 rs2251219 and MDD risk ( p = 0.021 for genotype and p = 0.025 for allele). Individuals with the T allele had a higher MDD risk than C/C genotype carriers did. Biochemical differences were also observed, with T/T carriers with lower body mass index, platelet counts, albumin concentrations, and fasting glucose levels and higher red blood cell counts, hematocrit levels, and uric acid levels.</p><p><strong>Conclusion: </strong>The PBRM1 rs2251219 polymorphism was associated with both MDD and biochemical measurement variation. These findings support the effects of the PBRM1 rs2251219 polymorphism on blood protein levels and psychiatric traits.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"650-654"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture treatment enhances synaptic plasticity in middle cerebral artery occlusion mice via the miR-670-3p/HMGB1 axis.","authors":"Jingyan Cheng, Guoyuan Pan, Zhen Wang, Haoran Chu, Yanpeng Pu","doi":"10.1097/JCMA.0000000000001226","DOIUrl":"10.1097/JCMA.0000000000001226","url":null,"abstract":"<p><strong>Background: </strong>Electroacupuncture (EA) is a form of physical therapy rooted in traditional Chinese medicine, which has been widely used in clinical practice. This study aimed to explore the effect of EA treatment on synaptic plasticity in mice subjected to middle cerebral artery occlusion (MCAO) and to elucidate the associated molecular mechanisms.</p><p><strong>Methods: </strong>After MCAO modeling, C57BL/6 mice underwent EA treatment and/or miR-670-3p mimic injection, followed by assessment of neurological deficit by modified neurological severity score (mNSS) and cerebral infarction areas were evaluated via TTC staining. The changes of synaptic ultrastructure related parameters were observed using transmission electron microscopy (TEM). The expression levels of miR-670-3p, HMGB1, TLR4/NF-κB pathway-related proteins, and synapse-associated proteins (Synapsin I, PSD95, BDNF, and GAP43) were quantified by real-time quantitative polymerase chain reaction (RT-qPCR) and western blot analysis. The binding relationship between miR-670-3p and HMGB1 was assessed through dual-luciferase reporter assays and RNA pull-down assays.</p><p><strong>Results: </strong>Mice that underwent EA treatment or miR-670-3p mimic injection exhibited increased miR-670-3p expression, reduced expression levels of HMGB1 and TLR4/NF-κB pathway-related proteins, improved neurological function, and enhanced synaptic plasticity. Furthermore, the combination of EA treatment and miR-670-3p mimic injection produced a synergistic effect, further amplifying these outcomes. Mechanistically, miR-670-3p was found to negatively regulate HMGB1.</p><p><strong>Conclusion: </strong>EA treatment enhances synaptic plasticity in MCAO mice by promoting miR-670-3p expression to negatively regulate the HMGB1/TLR4/NF-κB pathway.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"520-529"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is C3c structure useful as biomarkers for epithelial ovarian cancer?","authors":"Peng-Hui Wang, Wei-Ting Chao, Tsung-Cheng Kuo","doi":"10.1097/JCMA.0000000000001253","DOIUrl":"10.1097/JCMA.0000000000001253","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"493-494"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreaticoduodenectomy for metastatic melanoma to the ampulla of Vater: a pooled cases analysis.","authors":"Chieh-Ning Hsi, Shin-E Wang, Bor-Shiuan Shyr, Shih-Chin Chen, Yi-Ming Shyr, Bor-Uei Shyr","doi":"10.1097/JCMA.0000000000001185","DOIUrl":"10.1097/JCMA.0000000000001185","url":null,"abstract":"<p><strong>Background: </strong>Metastatic melanoma of the ampulla of Vater is rare. The purpose of this study was to summarize the characteristics and outcomes of metastatic melanoma in the ampulla of Vater and highlight the impact of surgery on the prognosis of patients with metastatic melanoma.</p><p><strong>Methods: </strong>Pooled data from a case encountered at our institution and from all sporadic cases published on PubMed and MEDLINE between 1996 and 2023 were analyzed.</p><p><strong>Results: </strong>Fourteen patients with metastatic melanoma in the ampulla of Vater were enrolled. Ten (73%) of primary melanomas were cutaneous and two were mucosal. Jaundice was the most common symptom (86%). The size of metastatic melanoma to the ampulla ranged from 1.5 to 8 cm, with a median of 2.75 cm. Concomitant metastasis to other organs occurred in 82% of the patients at the time of diagnosis, most commonly in the brain, lungs, and liver (36% each). Among the reported cases, pancreaticoduodenectomy was performed in five patients. The overall 1-year survival rate was 27.3%, with a median survival of 4 months. Wide excision of the primary lesion and chemotherapy significantly improved survival rates (50% vs. 0%, p = 0.048).</p><p><strong>Conclusion: </strong>There may be a trend toward improved survival in patients undergoing pancreaticoduodenectomy followed by chemotherapy. Given the availability of effective systemic therapies, metastatic melanoma of the ampulla of Vater does not necessarily preclude major surgeries.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"561-567"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of metachronous advanced colorectal adenoma after polypectomy.","authors":"Tsan-Hsuan Chang, Lee-Won Chong, Hung-Chuen Chang, Yu-Hwa Liu, Cheuk-Kay Sun, Kou-Ching Yang, Yu-Min Lin","doi":"10.1097/JCMA.0000000000001239","DOIUrl":"10.1097/JCMA.0000000000001239","url":null,"abstract":"<p><strong>Background: </strong>Adenoma recurrence following polypectomy remains a major clinical concern, necessitating the optimization of risk assessment strategies. This study explored key risk factors for metachronous advanced adenomas, focusing on metabolic factors and initial colonoscopic findings, to offer recommendations regarding risk stratification and surveillance.</p><p><strong>Methods: </strong>This retrospective study included individuals who had undergone two colonoscopies between January 2014 and February 2020, with adenomas detected during the initial examination. The associations of various factors-such as age, sex, metabolic disorders, and baseline colonoscopic findings-with metachronous advanced adenomas were investigated.</p><p><strong>Results: </strong>Of 33 073 individuals who underwent baseline colonoscopy, 2013 met the eligibility criteria. Multivariate analysis indicated that age of ≥45 years, male sex, and baseline colonoscopic findings were key predictors of metachronous advanced adenomas. The adjusted odds ratio (OR; 95% CI) values for metachronous advanced adenomas in patients with multiple (≥3) diminutive adenomas, those with multiple (≥3) small adenomas, and those with advanced adenomas were 1.56 (95% CI, 0.87-2.80), 3.27 (95% CI, 2.02-5.29), and 5.41 (95% CI, 3.73-7.83), respectively, compared with the results in patients with one or two nonadvanced adenomas.</p><p><strong>Conclusion: </strong>This study highlights the importance of baseline colonoscopy in identifying patients at elevated risk of developing metachronous advanced adenomas, particularly advanced adenomas. On the basis of our findings, we recommend integrating risk stratification by adenoma size, number, and histology into postpolypectomy surveillance guidelines. Personalized surveillance intervals informed by baseline findings and patient-specific risk factors may help clinicians optimize follow-up strategies and improve clinical outcomes.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"538-544"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of machine learning algorithms to identify risk factors for depression in type 2 diabetes mellitus patients: A Taiwan diabetes registry study.","authors":"Yu-Wen Su, Wayne Huey-Herng Sheu, Chii-Min Hwu, Yu-Cheng Chen, Jung-Fu Chen, Yun-Shing Peng, Chien-Ning Huang, Yi-Jen Hung, Harn-Shen Chen","doi":"10.1097/JCMA.0000000000001250","DOIUrl":"10.1097/JCMA.0000000000001250","url":null,"abstract":"<p><strong>Background: </strong>We analyzed variables reported during routine clinical practice using a registrational database to estimate risk factors for depression in people with type 2 diabetes mellitus.</p><p><strong>Methods: </strong>A Patient Health Questionnaire (PHQ-9) score of 15 was selected as the cut-off for clinically meaningful depression. Missing data was either filled in with a median value, the k -nearest neighbors' method, or the entire variable was removed. Logistic regression, random forest, and decision tree machine learning models were used to decide which factors were most relevant to depression. The accuracy of each algorithm was evaluated with a testing set.</p><p><strong>Results: </strong>When all variables were included in the logistic regression model, the area under the receiver operating characteristic curve was 0.81. In the random forest model, the most important factor was quality of life (QoL). Upon removing QoL-related variables, bloating, and autoimmune disease became the greatest contributing factors. Model accuracy was 83.1%. In the decision tree model, QoL was also observed as the most decisive factor. Upon removing QoL variables, bloating was the first node. Model accuracy was 82.5%.</p><p><strong>Conclusion: </strong>QoL, bloating, and autoimmune disease were the most important factors associated with depression in type 2 diabetes mellitus patients.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"513-519"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}