Startseite Lebenswissenschaften Vaginal metastasis from breast cancer: A case report
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Vaginal metastasis from breast cancer: A case report

  • Yunbo Yan , Tianjiao Guo , Minmei Zhang und Guozhong Cui EMAIL logo
Veröffentlicht/Copyright: 20. Juni 2023

Abstract

Breast cancer is one of the most common malignancies in women. However, cases of vaginal metastases of breast cancer are rarely reported in China and abroad. The main clinical symptom of vaginal metastases of breast cancer is vaginal bleeding. This article aims to provide a reference for the diagnosis and clinical management of vaginal metastases from breast cancer. This article describes in detail the management of a 50-year-old woman with vaginal metastases from breast cancer, who was admitted to the hospital with persistent vaginal bleeding without apparent causes. Persistent vaginal bleeding was found after two and a half years when her breast cancer surgery was performed. After comprehensive evaluation, vaginal mass resection was performed. Postoperative histopathology confirmed that the vaginal mass was breast cancer metastasis. The patient was treated with local radiotherapy and three cycles of eribulin and bevacizumab after the vaginal mass was removed. A reexamination of computed tomography showed that the chest wall metastases were less extensive than before. Orbital metastases were also reduced in size, which was revealed by the physical examination. The patient had since failed to return to hospital on time for a regular treatment due to personal reasons. After 9 months of follow-up, the patient died of multiple metastases. The diagnosis of vaginal masses is based on pathological examination, and systemic treatment should be the mainstay when extensive metastases are presented.

1 Introduction

Breast cancer is one of the most prevalent malignancies in women worldwide, and it is a major threat to women’s health. Breast cancer can spread to other parts of the body, leading to metastatic breast cancer. According to the statistics of many research reports, 6–60% of breast cancer patients are diagnosed as metastatic breast cancer at an early stage [1]. Metastases to the genital organs are less common, with the ovaries being the common site of metastases to the genital organs, but the vagina is rare [2]. A case of vaginal metastasis from surgically resected, pathologically confirmed breast cancer treated in our hospital is reported as follows.

2 Case presentation

A female, aged 50 years, was admitted to the Second Department of Thyroid and Breast Surgery of Cangzhou Central Hospital on July 26, 2019, complaining of a left breast swelling for 1 day. The patient was treated with a modified radical surgery for left breast cancer. According to the postoperative pathological and immunohistochemical results, the patient was diagnosed as triple-negative breast cancer (TNBC). After the surgery, eight cycles of intravenous chemotherapy with AC-T regimen were planned to be performed. Four cycles of intravenous chemotherapy with AC (doxorubicin liposome + cyclophosphamide) regimen and four cycles of intravenous chemotherapy with T (docetaxel) regimen were finally operated. Thereafter, in September 2020, the patient was examined that breast cancer metastasizes to sternum and parasternal soft tissue in a hospital in Beijing. After one cycle of TCb (docetaxel + carboplatin) intravenous chemotherapy, the patient was discharged. On January 29, 2021, during the reexamination at the Second Department of Thyroid and Breast Surgery of Cangzhou Central Hospital, the patient was found to have an increasing range of chest wall recurrence, which was considered to be in progress. It was advised to change the treatment into the chemotherapy regimen to NP (vinorelbine + cisplatin), which was given two cycles. The reexamination on April 16, 2021, showed that tumor was in progress and three cycles of camrelizumab were performed. The reexamination results on July 2021 revealed that there is a possibility of recurrence and chest wall metastasis. The patient was treated with radiotherapy + anlotinib-targeting therapy in a hospital in Tianjin. The patient complained that the chest wall occupancy was smaller than before during the examination in Tianjin in December 2021.

The patient was admitted to the First Department of Gynecology of Cangzhou Central Hospital on January 12, 2022, due to abnormal vaginal bleeding for 2 months. Gynecological examination revealed married vulva, vaginal patency, superfluous mass in the upper-third of the right vaginal wall, 3 cm in diameter, 0.8 cm in diameter at the tip, smooth cervix, anterior position of the uterus, normal size, no pressure pain, and no obvious abnormality in the bilateral adnexal area. Pathological results of vaginal mass tissue (Figure 1a): (vaginal wall mass) hypodifferentiated adenocarcinoma with mostly degenerated necrotic cells, not excluding the source of breast in combination with the history and immunohistochemistry, CK5/6 (small focal+) (Figure 1b), CK8/18 (+) (Figure 1c), P16 (partial+) (Figure 1d), P40 (−), Ki-67 (scattered+) (Figure 1e), Vimentin (−), GATA3 (focal+) (Figure 1f), CK7 (+) (Figure 1g), ER <1% (+) (positive control normal) (Figure 1h), PR <1% (+) (positive control normal) (Figure 1i), and Her-2 (0) (positive control normal).

Figure 1 
               Histopathology of vaginal mass. (a) Hematoxylin and eosin staining (magnification: 400×); (b) immunohistochemistry for CK5/6 (magnification: 400×); (c) immunohistochemistry for CK8/18 (magnification: 400×); (d) immunohistochemistry for P16 (magnification: 400×); (e) immunohistochemistry for Ki-67 (magnification: 400×); (f) immunohistochemistry for GATA3 (magnification: 400×); (g) immunohistochemistry for CK7 (magnification: 400×); (h) immunohistochemistry for ER (magnification: 400×); and (i) immunohistochemistry for PR (magnification: 400×).
Figure 1

Histopathology of vaginal mass. (a) Hematoxylin and eosin staining (magnification: 400×); (b) immunohistochemistry for CK5/6 (magnification: 400×); (c) immunohistochemistry for CK8/18 (magnification: 400×); (d) immunohistochemistry for P16 (magnification: 400×); (e) immunohistochemistry for Ki-67 (magnification: 400×); (f) immunohistochemistry for GATA3 (magnification: 400×); (g) immunohistochemistry for CK7 (magnification: 400×); (h) immunohistochemistry for ER (magnification: 400×); and (i) immunohistochemistry for PR (magnification: 400×).

The pelvic magnetic resonance scan with simultaneous enhancement revealed that (Figure 2): 1. occupancy of the right side of the wall of the upper middle vagina, a polyp was considered, and a biopsy was recommended to exclude malignant changes; and 2. pelvic effusion.

Figure 2 
               (a and b) T2-weighted coronal and sagittal magnetic resonance imaging (MRI) showed a mass in the right anterior wall of middle and upper segment of vagina (arrowhead).
Figure 2

(a and b) T2-weighted coronal and sagittal magnetic resonance imaging (MRI) showed a mass in the right anterior wall of middle and upper segment of vagina (arrowhead).

Complete relevant laboratory tests were performed after admission, and there is no obvious surgical contraindication. On January 17, 2020, a vaginal mass was operated under general anesthesia. The mass was mostly detached from the top of the right vaginal fornix, with a residual lesion of about 3 cm in diameter and a residual root of about the size of a copper penny, with a smooth normal cervical area. The tumor was completely removed at the normal tissue 0.5 cm outside the root, and no residual was found at the cutting edge. The patient was found to be recovered well after the operation and was given a blood transfusion to correct the anemia and was discharged 5 days after the operation. Postoperative pathology (Figure 3a and b): (vaginal wall mass) hypofractionated carcinoma, clinical and immunohistochemically considered to be of breast origin, Vimentin (+) (Figure 3c), CK5/6 (+) (Figure 3d), P63 (−), HMB45 (−), Melan-A focal (+) (Figure 3e), S-100 (−), and CK8/18 (+) (Figure 3f).

Figure 3 
               Postoperative histopathology of vaginal wall tumor. (a) Hematoxylin and eosin staining (magnification: 100×); (b) hematoxylin and eosin staining (magnification: 400×); (c) immunohistochemistry for Vimentin (magnification: 400×); (d) immunohistochemistry for CK5/6 (magnification: 400×); (e) immunohistochemistry for Melan-A (magnification: 400×); and (f) immunohistochemistry for CK8/18 (magnification: 400×).
Figure 3

Postoperative histopathology of vaginal wall tumor. (a) Hematoxylin and eosin staining (magnification: 100×); (b) hematoxylin and eosin staining (magnification: 400×); (c) immunohistochemistry for Vimentin (magnification: 400×); (d) immunohistochemistry for CK5/6 (magnification: 400×); (e) immunohistochemistry for Melan-A (magnification: 400×); and (f) immunohistochemistry for CK8/18 (magnification: 400×).

The patient was transferred to our department after surgery; meanwhile, orbital metastases were also diagnosed. Thereafter, the patient was given orbital radiotherapy followed by three cycles of eribulin and bevacizumab. On May 19, 2022, a CT reexamination showed that there is a reduction in the extent of chest wall metastases compared to the previous one. On examination, the orbital metastases were also smaller than before. The patient has since failed to return to hospital on time for a regular treatment for personal reasons. After 9 months of follow-up, the patient died of multiple metastases.

  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and has been approved by Ethics Committee of Cangzhou Central Hospital.

3 Discussion

The patient’s history, imaging data, postoperative pathology, and immunohistochemical findings led to the diagnosis of postoperative vaginal metastases from breast cancer. The mechanism of breast cancer metastasis to the vagina is still unknown, but considering that the patient had multiple distant metastases to the sternum, parasternal soft tissues, and chest wall, it is more likely that the vaginal metastases came from hematogenous metastases [2]. The common sites of distant metastases from breast cancer are lung, bone, liver, and supraclavicular lymph nodes [2]. Metastases from breast cancer to the genital organs are less common, with the ovaries being the common site of metastases to the genital organs, but the vagina is rare. Primary tumors associated with metastatic vaginal adenocarcinoma are most commonly found in the uterus and rarely in the breast [3]. Primary vaginal cancers account for only 1% of all gynecological malignancies [3]. The majority of primary vaginal cancer cases are squamous cell carcinomas [2,4,5], and other histological types, such as adenocarcinoma, are extremely rare [5]. Therefore, histopathological examination is essential for an accurate diagnosis [4,6]. When a vaginal tumor shows pathologically to be an adenocarcinoma, the possibility of metastasis of the lesion must be considered [5].

Clinical signs of metastasis to the vagina include vaginal bleeding, vaginal masses, vaginal discharge, vaginal staining, and perineal discomfort [3,5]. MRI evaluation is useful in detecting vaginal lesions and distinguishing adenocarcinoma from squamous cell carcinoma. Adenocarcinoma usually has a high T2WI signal, whereas squamous cell carcinoma appears as intermediate T2WI and low T1WI signal on MRI [5].

Vinorelbine, a semi-synthesized vinca alkaloid belonging to the Catharanthus alkaloid group, is a cell cycle-specific agent that exhibits cytotoxicity through binding to tubulin, thereby disrupting the microtubule formation during mitosis [6]. Vinorelbine has no cross-resistance to anthracyclines and taxanes, and it is an effective agent for the treatment of recurrent and metastatic TNBC [6]. Vinorelbine and cisplatin, which act on various targets, exhibit a synergistic anticancer activity and have shown a relatively high efficacy against TNBC [6]. In the 2022 Breast Cancer Diagnosis and Treatment Guidelines issued by Chinese Society of Clinical Oncology, the NP scheme has become a Class 1A recommended combined treatment scheme after the failure of triple-negative taxane treatment for advanced breast cancer [7]. Camrelizumab is a programmed death receptor 1 (PD-1) inhibitor. PD-1 is a member of the CD28 superfamily that is expressed mainly in activated T-lymphocytes and myeloid cells, functioning as a crucial immunosuppressive molecule [8]. The PD-1 mainly consists of an extracellular immunoglobulin variable region, a hydrophobic transmembrane region, and an intracellular region. The tail of the intracellular region has an immunoreceptor tyrosine-based inhibitory motif and an immunoreceptor tyrosine-based switch motif (ITSM). PD-1 is an essential immune checkpoint receptor for activated T cells and plays a critical role in immunosuppression control [8]. Binding to its ligand programmed death ligand-1 (PD-L1) induces the phosphorylation of tyrosine in ITSM of PD-1, which dephosphorylates downstream protein kinases Syk and PI3K, inhibiting the transcription and translation of genes and cellular factors required for T cell activation. Tumor cells can inhibit the killing function of T cells by high expression of PD-L1, thus contributing to immune escape [8]. TNBC is the most immunogenic subtype of breast cancer with higher levels of PD-L1 expression and tumor-infiltrating lymphocytes than other subtypes, suggesting that it is more likely to benefit from treatment with immune checkpoint inhibitors [9]. Anlotinib is a new type of small-molecule antiangiogenic tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor, fibroblast growth factor receptor, platelet-derived growth factor receptors, and c-kit [10]. Anlotinib inhibits cell migration and capillary-like tube formation, and angiogenesis induced by vascular endothelial growth factor (VEGF). Anlotinib also decreased the expression of proangiogenic factors, and enhanced the expression of immune cell adhesion molecules and chemokines and their receptors [10]. It suppressed tumor angiogenesis and normalized the remaining blood vessels [10]. In one study [10], anlotinib was found to show good efficacy and manageable toxicity in patients with metastatic breast cancer who had failed standard treatment. It is emerging as a treatment option for metastatic breast cancer.

Standard therapy for vaginal metastases from breast cancer has not been established. Treatment options for vaginal metastases include surgical resection, radiotherapy, and chemotherapy, both monotherapy and combination therapies [4]. Researchers including Bellati and Filippo have reported the first case of surgical treatment for isolated vaginal metastasis of breast cancer [11]. After 12 months of follow-up after surgery, the patient is still free from disease. It demonstrates that surgery is an effective choice for the treatment of isolated vaginal metastasis of breast cancer. While surgical resection and radiotherapy are commonly used for patients with isolated vaginal metastases [12], systemic therapy is used for patients with extensive metastases [2,4]. Eribulin (Halaven) is a fully synthetic analogue of chondroitin B and is a non- taxane inhibitor of microtubule dynamics. Compared to other microtubule protein-targeting agents such as violet shirts and perillyl alkaloids, eribulin has a unique mode of action. It can inhibit elongation (polymerization) rather than shortening (depolymerization) of microtubules to induce cancer cell death [13]. Bevacizumab is a humanized anti-VEGF monoclonal antibody that controls tumor growth by inhibiting VEGF-A and slowing down the growth of new blood vessels [14]. The efficacy of eribulin and bevacizumab on vaginal metastases could not be assessed as the patient had already had the vaginal metastases removed prior to systemic therapy. Further studies are needed to explore in the treatment of vaginal metastases from breast cancer due to the non-universal nature of this case and the limited evidence to guide treatment.

Vaginal metastases from breast cancer treatment with surgery, chemotherapy, and/or radiation directly affect the reproductive organs and sexual health. Vulvovaginal atrophy (VVA), a direct consequence of estrogen deficiency, is a commonly reported symptom, including symptoms, which are typically progressive and unlikely to resolve spontaneously, such as vulvovaginal dryness, burning or irritation, dyspareunia, or urinary symptoms of urgency, dysuria, or recurrent urinary tract infection [15]. Approximately 50–75% of breast cancer survivors suffer from one or more VVA symptoms [16]. This is even more a problem for patients with vaginal metastasis of breast cancer. Therefore, attention to sexual life and quality of life (QoL) is imperative to the complete care of these women. Overall, in these patients, the available armamentarium encompasses vaginal lubricants, moisturizers, estrogens, dehydroepiandrosterone, CO2 laser, ospemifene, and counseling [17]. CO2 laser treatment improves blood flow in vaginal tissues, healthy vaginal epithelium, and muscle tone; causes collagen contraction; restores elasticity of the vaginal canal; and improves the extracellular matrix of the mucosal structures and function with findings similar to a premenopausal state [15]. Pieralli et al. in 2016 were among the first to evaluate the use of CO2 laser treatment on 50 breast cancer survivors with contraindications to hormonal treatments: the results demonstrated a significant improvement of VVA dyspareunia after three sessions of treatment [18]. Preliminary results of the feasibility EPIONE trial showed that laser therapy reduces vaginal mucosal dryness in women with VVA that developed after systemic breast cancer therapy, but two CO2 laser sessions were used [19]. QoL preservation after anticancer therapy is a challenge for vaginal metastases from breast cancer.

An important prognostic factor for patients with vaginal metastases from breast cancer is the presence of secondary lesions in other organs [20], a fact that was observed in this case. When breast cancer presents with vaginal metastases, metastases from other sites have often already occurred; therefore, the prognosis is poor [21] (Table 1).

Table 1

Disease development process and the treatment line

Time Disease development Treatment
2019.07 Left breast swelling for 1 day A modified radical surgery for left breast cancer and eight cycles of intravenous chemotherapy with AC-T regimen
2020.09 Breast cancer metastasizes to sternum and parasternal soft tissue One cycle of TCb (docetaxel + carboplatin) intravenous chemotherapy
2021.01 An increasing range of chest wall recurrence considered as tumor progression Two cycles of NP (vinorelbine + cisplatin) chemotherapy regimen
2021.04 Tumor progression Three cycles of camrelizumab
2021.07 Recurrence and chest wall metastasis Radiotherapy + anlotinib targeting therapy
2022.01 Abnormal vaginal bleeding for 2 months Excision of vaginal mass
2022.01 Orbital metastases Orbital radiotherapy followed by three cycles of eribulin and bevacizumab
2022.10 The patient died of multiple metastases

4 Conclusion

Vaginal metastases from breast cancer are very rare. Histopathological examination is essential for an accurate diagnosis. When extensive metastases are present, systemic therapy should be the mainstay. Eribulin in combination with bevacizumab may be effective in the treatment of vaginal metastases from breast cancer.


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Acknowledgement

The authors would like to thank the patient for her willingness to give her consent and approval for publication of this report.

  1. Funding information: Authors state no funding involved.

  2. Author contributions: Yunbo Yan was responsible for conceiving and writing the manuscript of the case. Guozhong Cui was in charge of providing and revising the case. Tianjiao Guo was responsible for collecting the images and the data. Minmei Zhang contributed to literature research and the technical support. All authors have read and approved the submitted version of this manuscript.

  3. Conflict of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during this study are available from the corresponding author on a reasonable request.

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Received: 2023-02-15
Revised: 2023-05-02
Accepted: 2023-05-02
Published Online: 2023-06-20

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  79. Molecular complexity analysis of the diagnosis of Gitelman syndrome in China
  80. Effects of maternal calcium and protein intake on the development and bone metabolism of offspring mice
  81. Identification of winter wheat pests and diseases based on improved convolutional neural network
  82. Ultra-multiplex PCR technique to guide treatment of Aspergillus-infected aortic valve prostheses
  83. Virtual high-throughput screening: Potential inhibitors targeting aminopeptidase N (CD13) and PIKfyve for SARS-CoV-2
  84. Immune checkpoint inhibitors in cancer patients with COVID-19
  85. Utility of methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses
  86. Integrated analysis of the microbiome and transcriptome in stomach adenocarcinoma
  87. Berberine suppressed sarcopenia insulin resistance through SIRT1-mediated mitophagy
  88. DUSP2 inhibits the progression of lupus nephritis in mice by regulating the STAT3 pathway
  89. Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
  90. Genetic alterations of KRAS and TP53 in intrahepatic cholangiocarcinoma associated with poor prognosis
  91. Granulomatous polyangiitis involving the fourth ventricle: Report of a rare case and a literature review
  92. Studying infant mortality: A demographic analysis based on data mining models
  93. Metaplastic breast carcinoma with osseous differentiation: A report of a rare case and literature review
  94. Protein Z modulates the metastasis of lung adenocarcinoma cells
  95. Inhibition of pyroptosis and apoptosis by capsaicin protects against LPS-induced acute kidney injury through TRPV1/UCP2 axis in vitro
  96. TAK-242, a toll-like receptor 4 antagonist, against brain injury by alleviates autophagy and inflammation in rats
  97. Primary mediastinum Ewing’s sarcoma with pleural effusion: A case report and literature review
  98. Association of ADRB2 gene polymorphisms and intestinal microbiota in Chinese Han adolescents
  99. Tanshinone IIA alleviates chondrocyte apoptosis and extracellular matrix degeneration by inhibiting ferroptosis
  100. Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data
  101. Effect of periostin on bone metabolic and autophagy factors during tooth eruption in mice
  102. HP1 induces ferroptosis of renal tubular epithelial cells through NRF2 pathway in diabetic nephropathy
  103. Intravaginal estrogen management in postmenopausal patients with vaginal squamous intraepithelial lesions along with CO2 laser ablation: A retrospective study
  104. Hepatocellular carcinoma cell differentiation trajectory predicts immunotherapy, potential therapeutic drugs, and prognosis of patients
  105. Effects of physical exercise on biomarkers of oxidative stress in healthy subjects: A meta-analysis of randomized controlled trials
  106. Identification of lysosome-related genes in connection with prognosis and immune cell infiltration for drug candidates in head and neck cancer
  107. Development of an instrument-free and low-cost ELISA dot-blot test to detect antibodies against SARS-CoV-2
  108. Research progress on gas signal molecular therapy for Parkinson’s disease
  109. Adiponectin inhibits TGF-β1-induced skin fibroblast proliferation and phenotype transformation via the p38 MAPK signaling pathway
  110. The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma
  111. α-Fetoprotein contributes to the malignant biological properties of AFP-producing gastric cancer
  112. CXCL12/CXCR4/CXCR7 axis in placenta tissues of patients with placenta previa
  113. Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis
  114. Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction
  115. Diagnostic value of serum neuroactive substances in the acute exacerbation of chronic obstructive pulmonary disease complicated with depression
  116. Research progress of AMP-activated protein kinase and cardiac aging
  117. TRIM29 knockdown prevented the colon cancer progression through decreasing the ubiquitination levels of KRT5
  118. Cross-talk between gut microbiota and liver steatosis: Complications and therapeutic target
  119. Metastasis from small cell lung cancer to ovary: A case report
  120. The early diagnosis and pathogenic mechanisms of sepsis-related acute kidney injury
  121. The effect of NK cell therapy on sepsis secondary to lung cancer: A case report
  122. Erianin alleviates collagen-induced arthritis in mice by inhibiting Th17 cell differentiation
  123. Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
  124. Signalling pathways in the osteogenic differentiation of periodontal ligament stem cells
  125. Crosstalk between lactic acid and immune regulation and its value in the diagnosis and treatment of liver failure
  126. Clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma
  127. Traumatic brain injury and rTMS-ERPs: Case report and literature review
  128. Extracellular fibrin promotes non-small cell lung cancer progression through integrin β1/PTEN/AKT signaling
  129. Knockdown of DLK4 inhibits non-small cell lung cancer tumor growth by downregulating CKS2
  130. The co-expression pattern of VEGFR-2 with indicators related to proliferation, apoptosis, and differentiation of anagen hair follicles
  131. Inflammation-related signaling pathways in tendinopathy
  132. CD4+ T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review
  133. Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study
  134. Bioinformatics analysis to identify potential biomarkers for the pulmonary artery hypertension associated with the basement membrane
  135. Influence of MTHFR polymorphism, alone or in combination with smoking and alcohol consumption, on cancer susceptibility
  136. Catharanthus roseus (L.) G. Don counteracts the ampicillin resistance in multiple antibiotic-resistant Staphylococcus aureus by downregulation of PBP2a synthesis
  137. Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
  138. Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
  139. TCL1A+ B cells predict prognosis in triple-negative breast cancer through integrative analysis of single-cell and bulk transcriptomic data
  140. Ezrin promotes esophageal squamous cell carcinoma progression via the Hippo signaling pathway
  141. Ferroptosis: A potential target of macrophages in plaque vulnerability
  142. Predicting pediatric Crohn's disease based on six mRNA-constructed risk signature using comprehensive bioinformatic approaches
  143. Applications of genetic code expansion and photosensitive UAAs in studying membrane proteins
  144. HK2 contributes to the proliferation, migration, and invasion of diffuse large B-cell lymphoma cells by enhancing the ERK1/2 signaling pathway
  145. IL-17 in osteoarthritis: A narrative review
  146. Circadian cycle and neuroinflammation
  147. Probiotic management and inflammatory factors as a novel treatment in cirrhosis: A systematic review and meta-analysis
  148. Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
  149. SPOP regulates the expression profiles and alternative splicing events in human hepatocytes
  150. Knockdown of SETD5 inhibited glycolysis and tumor growth in gastric cancer cells by down-regulating Akt signaling pathway
  151. PTX3 promotes IVIG resistance-induced endothelial injury in Kawasaki disease by regulating the NF-κB pathway
  152. Pancreatic ectopic thyroid tissue: A case report and analysis of literature
  153. The prognostic impact of body mass index on female breast cancer patients in underdeveloped regions of northern China differs by menopause status and tumor molecular subtype
  154. Report on a case of liver-originating malignant melanoma of unknown primary
  155. Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer
  156. The fibroblast growth factor–Klotho axis at molecular level
  157. Characterization of amiodarone action on currents in hERG-T618 gain-of-function mutations
  158. A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS
  159. Effect of autologous platelet-rich plasma on new bone formation and viability of a Marburg bone graft
  160. Small breast epithelial mucin as a useful prognostic marker for breast cancer patients
  161. Continuous non-adherent culture promotes transdifferentiation of human adipose-derived stem cells into retinal lineage
  162. Nrf3 alleviates oxidative stress and promotes the survival of colon cancer cells by activating AKT/BCL-2 signal pathway
  163. Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
  164. Case report of atypical undernutrition of hypoproteinemia type
  165. Down-regulation of COL1A1 inhibits tumor-associated fibroblast activation and mediates matrix remodeling in the tumor microenvironment of breast cancer
  166. Sarcoma protein kinase inhibition alleviates liver fibrosis by promoting hepatic stellate cells ferroptosis
  167. Research progress of serum eosinophil in chronic obstructive pulmonary disease and asthma
  168. Clinicopathological characteristics of co-existing or mixed colorectal cancer and neuroendocrine tumor: Report of five cases
  169. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis
  170. Precisional detection of lymph node metastasis using tFCM in colorectal cancer
  171. Advances in diagnosis and treatment of perimenopausal syndrome
  172. A study of forensic genetics: ITO index distribution and kinship judgment between two individuals
  173. Acute lupus pneumonitis resembling miliary tuberculosis: A case-based review
  174. Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm
  175. Fractalkine modulates pulmonary angiogenesis and tube formation by modulating CX3CR1 and growth factors in PVECs
  176. Novel risk prediction models for deep vein thrombosis after thoracotomy and thoracoscopic lung cancer resections, involving coagulation and immune function
  177. Exploring the diagnostic markers of essential tremor: A study based on machine learning algorithms
  178. Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging
  179. An online diagnosis method for cancer lesions based on intelligent imaging analysis
  180. Medical imaging in rheumatoid arthritis: A review on deep learning approach
  181. Predictive analytics in smart healthcare for child mortality prediction using a machine learning approach
  182. Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival
  183. A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia
  184. TNF-α and IL-8 levels are positively correlated with hypobaric hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats
  185. Stochastic gradient descent optimisation for convolutional neural network for medical image segmentation
  186. Comparison of the prognostic value of four different critical illness scores in patients with sepsis-induced coagulopathy
  187. Application and teaching of computer molecular simulation embedded technology and artificial intelligence in drug research and development
  188. Hepatobiliary surgery based on intelligent image segmentation technology
  189. Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy
  190. Analysis of early diagnosis methods for asymmetric dementia in brain MR images based on genetic medical technology
  191. Early diagnosis for the onset of peri-implantitis based on artificial neural network
  192. Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy
  193. Forecast of pain degree of lumbar disc herniation based on back propagation neural network
  194. SPA-UNet: A liver tumor segmentation network based on fused multi-scale features
  195. Systematic evaluation of clinical efficacy of CYP1B1 gene polymorphism in EGFR mutant non-small cell lung cancer observed by medical image
  196. Rehabilitation effect of intelligent rehabilitation training system on hemiplegic limb spasms after stroke
  197. A novel approach for minimising anti-aliasing effects in EEG data acquisition
  198. ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis
  199. Clinical role of CYP1B1 gene polymorphism in prediction of postoperative chemotherapy efficacy in NSCLC based on individualized health model
  200. Lung nodule segmentation via semi-residual multi-resolution neural networks
  201. Evaluation of brain nerve function in ICU patients with Delirium by deep learning algorithm-based resting state MRI
  202. A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis
  203. Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer’s disease
  204. Effectiveness of the treatment of depression associated with cancer and neuroimaging changes in depression-related brain regions in patients treated with the mediator-deuterium acupuncture method
  205. Molecular mechanism of colorectal cancer and screening of molecular markers based on bioinformatics analysis
  206. Monitoring and evaluation of anesthesia depth status data based on neuroscience
  207. Exploring the conformational dynamics and thermodynamics of EGFR S768I and G719X + S768I mutations in non-small cell lung cancer: An in silico approaches
  208. Optimised feature selection-driven convolutional neural network using gray level co-occurrence matrix for detection of cervical cancer
  209. Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis
  210. Pathogenic bacteria and treatment resistance in older cardiovascular disease patients with lung infection and risk prediction model
  211. Adoption value of support vector machine algorithm-based computed tomography imaging in the diagnosis of secondary pulmonary fungal infections in patients with malignant hematological disorders
  212. From slides to insights: Harnessing deep learning for prognostic survival prediction in human colorectal cancer histology
  213. Ecology and Environmental Science
  214. Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem
  215. Comparing the differences of prokaryotic microbial community between pit walls and bottom from Chinese liquor revealed by 16S rRNA gene sequencing
  216. Effects of cadmium stress on fruits germination and growth of two herbage species
  217. Bamboo charcoal affects soil properties and bacterial community in tea plantations
  218. Optimization of biogas potential using kinetic models, response surface methodology, and instrumental evidence for biodegradation of tannery fleshings during anaerobic digestion
  219. Understory vegetation diversity patterns of Platycladus orientalis and Pinus elliottii communities in Central and Southern China
  220. Studies on macrofungi diversity and discovery of new species of Abortiporus from Baotianman World Biosphere Reserve
  221. Food Science
  222. Effect of berrycactus fruit (Myrtillocactus geometrizans) on glutamate, glutamine, and GABA levels in the frontal cortex of rats fed with a high-fat diet
  223. Guesstimate of thymoquinone diversity in Nigella sativa L. genotypes and elite varieties collected from Indian states using HPTLC technique
  224. Analysis of bacterial community structure of Fuzhuan tea with different processing techniques
  225. Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
  226. Mycobiota in Slovak wine grapes: A case study from the small Carpathians wine region
  227. Elemental analysis of Fadogia ancylantha leaves used as a nutraceutical in Mashonaland West Province, Zimbabwe
  228. Microbiological transglutaminase: Biotechnological application in the food industry
  229. Influence of solvent-free extraction of fish oil from catfish (Clarias magur) heads using a Taguchi orthogonal array design: A qualitative and quantitative approach
  230. Chromatographic analysis of the chemical composition and anticancer activities of Curcuma longa extract cultivated in Palestine
  231. The potential for the use of leghemoglobin and plant ferritin as sources of iron
  232. Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM
  233. Bioengineering and Biotechnology
  234. Biocompatibility and osteointegration capability of β-TCP manufactured by stereolithography 3D printing: In vitro study
  235. Clinical characteristics and the prognosis of diabetic foot in Tibet: A single center, retrospective study
  236. Agriculture
  237. Biofertilizer and NPSB fertilizer application effects on nodulation and productivity of common bean (Phaseolus vulgaris L.) at Sodo Zuria, Southern Ethiopia
  238. On correlation between canopy vegetation and growth indexes of maize varieties with different nitrogen efficiencies
  239. Exopolysaccharides from Pseudomonas tolaasii inhibit the growth of Pleurotus ostreatus mycelia
  240. A transcriptomic evaluation of the mechanism of programmed cell death of the replaceable bud in Chinese chestnut
  241. Melatonin enhances salt tolerance in sorghum by modulating photosynthetic performance, osmoregulation, antioxidant defense, and ion homeostasis
  242. Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas
  243. Identification of rice leaf diseases and deficiency disorders using a novel DeepBatch technique
  244. Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture
  245. Animal Sciences
  246. Effect of ketogenic diet on exercise tolerance and transcriptome of gastrocnemius in mice
  247. Combined analysis of mRNA–miRNA from testis tissue in Tibetan sheep with different FecB genotypes
  248. Isolation, identification, and drug resistance of a partially isolated bacterium from the gill of Siniperca chuatsi
  249. Tracking behavioral changes of confined sows from the first mating to the third parity
  250. The sequencing of the key genes and end products in the TLR4 signaling pathway from the kidney of Rana dybowskii exposed to Aeromonas hydrophila
  251. Development of a new candidate vaccine against piglet diarrhea caused by Escherichia coli
  252. Plant Sciences
  253. Crown and diameter structure of pure Pinus massoniana Lamb. forest in Hunan province, China
  254. Genetic evaluation and germplasm identification analysis on ITS2, trnL-F, and psbA-trnH of alfalfa varieties germplasm resources
  255. Tissue culture and rapid propagation technology for Gentiana rhodantha
  256. Effects of cadmium on the synthesis of active ingredients in Salvia miltiorrhiza
  257. Cloning and expression analysis of VrNAC13 gene in mung bean
  258. Chlorate-induced molecular floral transition revealed by transcriptomes
  259. Effects of warming and drought on growth and development of soybean in Hailun region
  260. Effects of different light conditions on transient expression and biomass in Nicotiana benthamiana leaves
  261. Comparative analysis of the rhizosphere microbiome and medicinally active ingredients of Atractylodes lancea from different geographical origins
  262. Distinguish Dianthus species or varieties based on chloroplast genomes
  263. Comparative transcriptomes reveal molecular mechanisms of apple blossoms of different tolerance genotypes to chilling injury
  264. Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation
  265. An advanced approach for fig leaf disease detection and classification: Leveraging image processing and enhanced support vector machine methodology
  266. Erratum
  267. Erratum to “Protein Z modulates the metastasis of lung adenocarcinoma cells”
  268. Erratum to “BRCA1 subcellular localization regulated by PI3K signaling pathway in triple-negative breast cancer MDA-MB-231 cells and hormone-sensitive T47D cells”
  269. Retraction
  270. Retraction to “Protocatechuic acid attenuates cerebral aneurysm formation and progression by inhibiting TNF-alpha/Nrf-2/NF-kB-mediated inflammatory mechanisms in experimental rats”
Heruntergeladen am 27.1.2026 von https://www.degruyterbrill.com/document/doi/10.1515/biol-2022-0623/html
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