Prognostic role of multiple abnormal genes in non-small-cell lung cancer

BACKGROUND Non-small-cell lung cancer(NSCLC)has the highest morbidity and mortality rates among all malignant tumor types.Although therapies targeting the mutated genes such as KRAS have been used in the clinic for many years,the prognosis remains poor.Therefore,it is necessary to further study the aberrant expression or mutation of non-target genes affecting the survival and prognosis.AIM To explore the impact of simultaneous abnormalities of multiple genes on the prognosis and survival of patients.METHODS We used R packages to analyze gene expression data and clinical data downloaded from The Cancer Genome Atlas(TCGA)database.We also collected samples from 85 NSCLC patients from the First People’s Hospital of Jingzhou City and retrospectively followed the patients.Multivariate Cox regression analysis and survival analysis were performed.RESULTS Analysis of gene expression data from TCGA revealed that the overexpression of the following single genes affected overall survival:TP53(P=0.79),PTEN(P=0.94),RB1(P=0.49),CTNNB1(P=0.24),STK11(P=0.32),and PIK3CA(P=0.013).However,the probability of multiple genes(TP53,PTEN,RB1,and STK11)affecting survival was 0.025.Retrospective analysis of clinical data revealed that sex(hazard ratio[HR]=1.29;[95%CI:0.64-2.62]),age(HR=1.05;[95%CI:1.02-1.07]),smoking status(HR=2.26;[95%CI:1.16-4.39]),tumor histology(HR=0.58;[95%CI:0.30-1.11]),cancer stage(HR=16.63;[95%CI:4.8-57.63]),epidermal growth factor receptor(EGFR)mutation(HR=1.82;[95%CI:1.05-3.16]),abundance(HR=4.95;[95%CI:0.78-31.36]),and treatment with tyrosine kinase inhibitors(TKIs)(HR=0.58;[95%CI:0.43-0.78])affected patient survival.Co-occurring mutations of TP53,PTEN,RB1,and STK11 did not significantly affect the overall survival of patients receiving chemotherapy(P=0.96)but significantly affected the overall survival of patients receiving TKIs(P=0.045).CONCLUSION Co-occurring mutation or overexpression of different genes has different effects on the overall survival and prognosis of NSCLC patients.Combined with TKI treatment,the co-occurring mutation of some genes may have a synergistic effect on the survival and prognosis of NSCLC patients.

Role of circular RNAs in gastrointestinal tumors and drug resistance

The incidence of gastrointestinal cancers has increased significantly over the past decade and gastrointestinal malignancies now rank among the leading causes of mortality globally.Although newer therapeutic strategies such as targeted therapies have greatly improved patient outcomes,their clinical success is limited by drug resistance,treatment failure and recurrence of metastatic disease.Therefore,there is an urgent need for further research identifying accurate and reliable biomarkers for precise treatment strategies.Circular RNAs(circRNAs)exhibit a covalently closed structure,high stability and biological conservation,and their expression is associated with the occurrence and development of gastrointestinal tumors.Moreover,circRNAs may significantly influence drug resistance of gastrointestinal cancers.In this article,we review the role of circRNAs in the occurrence and development of gastrointestinal cancer,their association with drug resistance,and potential application for early diagnosis,treatment and prognosis in gastrointestinal malignancies.Furthermore,we summarize characteristics of circRNA,including mechanism of formation and biological effects via mRNA sponging,chromatin replication,gene regulation,translational modification,signal transduction,and damage repair.Finally,we discuss whether circRNA-related noninvasive testing may be clinically provided in the future.This review provides new insights for the future development of diagnostics and therapeutics based on circRNAs in gastrointestinal tumors.

Could gastrointestinal tumor-initiating cells originate from cell-cell fusion in vivo?

Tumor-initiating cells(TICs)or cancer stem cells are believed to be responsible for gastrointestinal tumor initiation,progression,metastasis,and drug resistance.It is hypothesized that gastrointestinal TICs(giTICs)might originate from cell-cell fusion.Here,we systemically evaluate the evidence that supports or opposes the hypothesis of giTIC generation from cell-cell fusion both in vitro and in vivo.We review giTICs that are capable of initiating tumors in vivo with 5000 or fewer in vivo fused cells.Under this restriction,there is currently little evidence demonstrating that giTICs originate from cell-cell fusion in vivo.However,there are many reports showing that tumor generation in vitro occurs with more than 5000 fused cells.In addition,the mechanisms of giTIC generation via cell-cell fusion are poorly understood,and thus,we propose its potential mechanisms of action.We suggest that future research should focus on giTIC origination from cell-cell fusion in vivo,isolation or enrichment of giTICs that have tumor-initiating capabilities with 5000 or less in vivo fused cells,and further clarification of the underlying mechanisms.Our review of the current advances in our understanding of giTIC origination from cell-cell fusion may have significant implications for the understanding of carcinogenesis and future cancer therapeutic strategies targeting giTICs.

Percutaneous radiofrequency ablation is superior to hepatic resection in patients with small hepatocellular carcinoma

BACKGROUND It is not known whether percutaneous radiofrequency ablation(PRFA)has the same treatment efficacy and fewer complications than laparoscopic resection in patients with small centrally located hepatocellular carcinoma(HCC).AIM To compare the effectiveness of PRFA with classical laparoscopic resection in patients with small HCC and document the safety parameters.METHODS In this retrospective study,85 patients treated with hepatic resection(HR)and 90 PRFA-treated patients were enrolled in our hospital from July 2016 to July 2019.Treatment outcomes,including major complications and survival data,were evaluated.RESULTS The results showed that minor differences existed in the baseline characteristics between the patients in the two groups.PRFA significantly increased cumulative recurrence-free survival(hazard ratio 1.048,95%CI:0.265-3.268)and overall survival(hazard ratio 0.126,95%CI:0.025-0.973);PRFA had a lower rate of major complications than HR(7.78%vs 20.0%,P<0.05),and hospital stay was shorter in the PRFA group than in the HR group(7.8±0.2 d vs 9.5±0.3 d,P<0.001).CONCLUSION Based on the data obtained,we conclude that PRFA was superior to HR and may reduce complications and hospital stay in patients with small HCC.

Histamine Excites Rat GABAergic Ventral Pallidum Neurons via Co-activation of H1 and H2 Receptors

The ventral pallidum(VP) is a crucial component of the limbic loop of the basal ganglia and participates in the regulation of reward, motivation, and emotion.Although the VP receives afferent inputs from the central histaminergic system, little is known about the effect of histamine on the VP and the underlying receptor mechanism. Here, we showed that histamine, a hypothalamicderived neuromodulator, directly depolarized and excited the GABAergic VP neurons which comprise a major cell type in the VP and are responsible for encoding cues of incentive salience and reward hedonics. Both postsynaptic histamine H1 and H2 receptors were found to be expressed in the GABAergic VP neurons and co-mediate the excitatory effect of histamine. These results suggested that the central histaminergic system may actively participate in VP-mediated motivational and emotional behaviors via direct modulation of the GABAergic VP neurons. Our findings also have implications for the role of histamine and the central histaminergic system in psychiatric disorders.