No abstract

No abstract

The chemokine receptor CXCR7 has been suggested to play important roles in the progression of several types of cancers. However, few studies have investigated the biological roles of CXCR7 in head and neck squamous cell carcinoma (HNSCC). CXCR7 expression and its clinical implications were examined in 103 HNSCC tissues using immunohistochemistry (IHC). The biological roles and mechanisms of CXCR7-mediated signaling pathways were investigated in HNSCC cells through CXCR7 overexpression in vitro and in vivo. High expression of CXCR7 was significantly associated with tumor size (P = 0.007), lymph node metastasis (P = 0.004), and stage (P = 0.020) in HNSCC. Overexpression of CXCR7 in HNSCC cells enhanced cell migration and invasion in vitro and promoted lymph node metastasis in vivo. CXCR7 also induced epithelial-mesenchymal transition through PI3K/AKT. CXCR7 increased secretion of transforming growth factor-β1 (TGF-β1) and promoted EMT through phosphorylated Smad2/3. Taken together, our results provide functional and mechanistic roles of CXCR7 as a master regulator of oncogenic TGF-β1/Smad2/3 signaling in HNSCC, suggesting that CXCR7 might be a therapeutic target for the treatment of HNSCC.Head and neck squamous cell cancer (HNSCC) constitutes a heterogeneous group of cancers. HNSCC is an epithelial malignancy with primary sites in the lip, oral cavity, pharynx, larynx, and paranasal sinuses 1,2 . High cure rates are achieved for localized HNSCC using surgery, radiation, and chemoradiation. However, recurrence after curative resection is common, and survival rates for recurrent/metastatic disease remain poor, with a 10% 5-year overall survival rate 3 . Therefore, an understanding of the molecular mechanisms of cancer progression is necessary to advance the treatment of HNSCC.In the tumor microenvironment, chemokine signaling systems play critical roles in tumor progression, invasion, migration, and metastasis 4 . Chemokines and chemokine receptors are differentially expressed in various malignant tumors 5,6 . Growing evidence shows that CXCR7 plays a crucial role in the development of tumors 7 . Furthermore, upregulation of CXCR7 serves as an oncogene in various cancers, such as breast and lung cancer 5,8 .Tumors metastasize through decreased cell adhesion, basement membrane perforation, migration by circulation, immune escape, and formation of colonies at distant sites 9 . Epithelial-mesenchymal transition (EMT) is essential for initiation and progression of metastasis 10,11 . Transforming growth factor (TGF)-β signaling is known to induce EMT through various intracellular messengers. Recent studies have shown that TGF-β promotes tumor progression and metastasis by regulating chemokines or chemokine receptors in the tumor MethodsPatients and tumor samples. A total of 103 HNSCC tissues were recruited from the Chungnam National University Hospital. All samples used in the study were approved by the ethics committee of Chungnam National University Hospital. Written informed consent was obtained from all the patients. ...

Context. To respect a patient's wish for end-of-life care, ''the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life'' was enacted in South Korea in 2016. Current understanding of people who would be involved in advance care planning (ACP) is crucial to disseminate it systematically. Objectives. The objective of this study was to investigate awareness and attitudes toward ACP in South Korea. Methods. A multicenter, nationwide cross-sectional study was conducted a survey regarding ACP among four groups that would have different positions and experiences: 1,001 cancer patients, 1,006 family caregivers, 928 physicians, and 1,005 members of the general public. Results. A total of 16% of the general population, 33% of the patients and caregivers, and 61% of the physicians had knowledge of advance directives. More than 63% of the general population, above 72% of the patients and caregivers, and 97% of the physicians were willing to do so when the disease status was aggravated or terminal. The possibility for changing the plan, uncertainty as to whether directives would actually be followed, and psychological discomfort were common reasons for not wanting to engage in ACP. Routine recommendations for a specific medical condition, heightened accessibility, and health insurance support were common factors that could help facilitate ACP. Conclusion. Our findings suggest that strategies for promoting ACP should reflect different perspectives among the general public, patients, family caregivers, and physicians. Public advocacy, resources for approaching and integrating ACP into routine health care, as well as systematic support provisions are needed.

Background/AimsRenal complications related to BCR-ABL1-negative myeloproliferative neoplasms (MPNs) have not been examined fully in Asian populations.MethodsWe analyzed estimated glomerular filtration rate (eGFR) and its changes with time retrospectively in patients with BCR-ABL1-negative MPN from 2005 to 2015.ResultsThe prevalence of chronic kidney disease (CKD) was 11% (6.6% having stage 3 and 4.4% having stage 4). In a linear regression analysis of eGFR versus time (years), overall, patients showed increased eGFR (mL/min/1.73 m2) by 0.51 (95% confidence interval [CI], –0.30 to 1.33; p = 0.22). Patients with polycythemia vera (PV), and those treated with hydroxyurea, showed statistically significant increases in eGFR (1.59; 95% CI, 0.28 to 2.90; p = 0.22 in PV; and 1.55; 95% CI, 0.56 to 2.54; p = 0.22 in treatment with hydroxyurea). In total, 17 patients (20.5%) showed rapid loss of eGFR (<–3 mL/min/1.73 m2per year). This rapid loss in eGFR was associated with a higher incidence of kidney disease (23.5% vs. 6.1%, p= 0.05) and a higher percentage of patients with high neutrophil (>7.0 × 109 /L) and high monocyte (> 0.7 × 109 /L) counts (76.5% vs. 50%, p=0.05; 52.9% vs. 28.8%, p= 0.06, respectively). More patients had high serum lactate dehydrogenase (> 500 U/L) levels (52.9% vs. 25.8%, p = 0.03) at diagnosis.ConclusionsCKD is prevalent in patients with BCR-ABL1-negative MPN. Active cytoreductive therapy has the potential to improve kidney function in BCR-ABL1-negative MPN.