BackgroundThe effects of body mass index (BMI) and reproductive factors may vary among breast cancer molecular subtypes, evidence of which is lacking in East Asia.MethodsFrom 2002 to 2010, 1256 breast cancer patients and 1416 healthy women were recruited. Anthropometric and reproductive factors were collected from medical charts. Breast cancer subtype was defined by ER, PR, and HER2 status. Polytomous logistic regression was used to evaluate associations between risk factors and breast cancer subtypes, with subgroup analysis by menopausal status. A meta-analysis of relevant published studies in East Asia was also performed.ResultsIn our case-control study, late menarche was negatively associated with luminal tumor risk (Ptrend = 0.03). Higher BMI was associated with risk of both luminal and triple-negative tumors (Ptrend<0.001). Late age at first live birth was associated with a 1.41- to 2.08-fold increased risk of all subtypes, while late menopause increased risk by 2.62–5.56 times. Heterogeneity of these associations was not detected for different menopausal statuses. The meta-analysis revealed a positive dose-response relationship between BMI and risk of both luminal and ER-PR- subtypes (Ptrend<0.05). Early menarche and nulliparity increased luminal tumor risk by 1.39 and 1.26 times, respectively. Non-breastfeeding also increased the risk of all subtypes.ConclusionsFor East Asian women, overweight, late menopause, and lack of breastfeeding appear to increase risk of both luminal and ER−PR− tumors. Early menarche and nulliparity mainly impacted luminal tumor risk. These associations were not impacted by menopausal status.

Ovarian cancer is the third most common cancer in the female reproductive organs and epithelial ovarian cancer has the highest lethality of all gynecological cancers. Pomegranate fruit juice (PFJ) has been shown to inhibit the growth of several types of cancer other than ovarian cancer. In this study, we exposed the ovarian cancer cell line A2780 to PFJ and two of its components (ellagic acid and luteolin). MTT and wound healing assays demonstrated that all three treatments suppressed the proliferation and migration of the ovarian cancer cells. In addition, western blotting and ELISA assays showed that the expression levels of MMP2 and MMP9 gradually decreased after treatment with increasing concentrations of ellagic acid and luteolin. To confirm our findings in the in vitro experiments, we used another ovarian cancer cell line, ES-2, in nude mice experiments. All three treatments inhibited tumor growth without obvious side-effects. Furthermore, compared with the control group, the expression levels of MMP2 and MMP9 were depressed. Ellagic acid induced a greater effect than luteolin, suggesting that ellagic acid might be a promising candidate for further preclinical testing for treatment of human ovarian cancer.

Observational studies assessing the association of dietary fat and risk of ovarian cancer yield discrepant results. Pertinent prospective cohort studies were identified by a PubMed search from inception to December 2015. Sixteen independent case-control and nine cohort studies on dietary fat intake were included, with approximately 900,000 subjects in total. Relative risks (RRs) with 95% confidence intervals were pooled using a random effects model. Heterogeneity, sensitivity analysis and publication bias were assessed; subgroup analysis and analysis stratified by EOC histology were conducted. The reported studies showed a significant increase of ovarian cancer risk with high consumption of total-, saturated-, and trans-fats, while serous ovarian cancer was more susceptible to dietary fat consumption than other pathological subtypes. No evidence of positive association between dietary fat intake and ovarian cancer risk was provided by cohort studies. Menopausal status, hormone replacement therapy, body mass index (BMI), and pregnancy times, modified the objective associations. In conclusion, the meta-analysis findings indicate that high consumption of total, saturated and trans-fats increase ovarian cancer risk, and different histological subtypes have different susceptibility to dietary fat.

PurposeThe prognosis of lung cancer with brain metastasis is poor. The purpose of this study was to investigate the distribution of brain metastasis and explore its relationship with pathology and genetic mutations.Patients and methodsBetween June 2015 and July 2018, 335 patients from Shandong Provincial Hospital affiliated to Shandong University who had been firstly diagnosed with brain metastasis from lung cancer were retrospectively reviewed. All metastatic lesions were detected in the corresponding area using magnetic resonance imaging (MRI).ResultsA total of 2046 metastatic lesions were found. Of the 335 patients, 21.2% (71/335) had a single brain metastasis and 78.8% (264/335) had multiple lesions. The cerebellum (56%; 189/335), right parietal lobe (54%; 182/335), right frontal lobe (47%; 157/335), and left frontal lobe (45%; 152/335) were the regions with the highest incidence of brain metastasis. The different pathological types of lung cancer showed different distribution of brain metastasis. In lung adenocarcinoma, the left frontal lobe (53%; 111/208), right frontal lobe (48%; 100/208) and cerebellum (56%; 116/208) exhibited higher brain metastases, while the cerebellum (61%; 45/74) and the right frontal lobe (46%; 34/74) had the highest incidence of brain metastasis from small-cell carcinoma. For lung squamous cell carcinoma, the cerebellum (70%; 14/20) was the most common site for metastasis. Adenocarcinoma was the most common pathological type in patients regardless of the number of lesions (ie, single or multiple brain metastases). Comparison of 37 cases with epidermal growth factor receptor (EGFR) gene mutation versus 26 cases without mutations showed that there was no correlation between the distribution of brain metastasis and gene mutation.ConclusionThe different pathological types of lung cancer demonstrate different distribution of brain metastasis. These findings may have significant implications in the diagnosis and treatment of brain metastasis from lung cancer.

Background:The effect of maternal weights on the risk of iron deficiency anemia (IDA) during pregnancy remains unclear. The study aimed to investigate the association between maternal weight indicators and IDA during pregnancy.Methods:We conducted a cohort study to examine the association between maternal weight indicators, including prepregnancy body mass index and the rate of gestational weight gain (GWG), and the risk of IDA among Chinese pregnant women. Data about new-onset IDA at different trimesters from a national cross-sectional survey were collected; information regarding baseline variables and rate of GWG from women participating in the survey were retrospectively collected. Tested IDA and reported IDA were documented. Multilevel logistic regression to examine the association between maternal weight indicators and the risk of IDA after adjusting for potential confounders was conducted.Results:This study enrolled 11,782 pregnant women from 24 hospitals from September 19, 2016, to November 20, 2016. Among those, 1515 (12.9%) IDA events were diagnosed through test (test IDA); 3915 (33.3%) were identified through test and patient reporting (composite IDA). After adjusting for confounders and cluster effect of hospitals, underweight pregnant women, compared with normal women, were associated with higher risk of test IDA (adjusted odds ratio [aOR]: 1.35, 95% confidence interval [CI]: 1.17–1.57 and composite IDA (aOR: 1.35, 95% CI: 1.21–1.51); on the contrary, overweight and obese women had lower risk of test IDA (aOR: 0.68, 95% CI: 0.54–0.86 overweight; aOR: 0.30, 95% CI: 0.13–0.69 obese) and composite IDA (aOR: 0.77, 95% CI: 0.67–0.90 overweight; aOR: 0.34, 95% CI: 0.21–0.55 obese). The higher rate of GWG was associated with higher risk of IDA (test aOR: 1.86 95% CI: 1.26–2.76; composite aOR: 1.54, 95% CI: 1.16–2.03).Conclusions:Pregnant women who are underweight before pregnancy and who have faster GWG are more likely to develop IDA. Enforced weight control during pregnancy and use of iron supplements, particularly among underweight women, may be warranted.