BACKGROUND The incidence of multiple primary lung cancer(MPLC)in China is 0.52%-2.45%.Most primary lung cancer cases have reported two lesions or three in rare cases.We report a rare case of bilateral simultaneous mul...BACKGROUND The incidence of multiple primary lung cancer(MPLC)in China is 0.52%-2.45%.Most primary lung cancer cases have reported two lesions or three in rare cases.We report a rare case of bilateral simultaneous multiple primary lung adenocarcinoma of four different genotypes.CASE SUMMARY A 58-year-old woman was admitted to our hospital on June 29,2021,and upon physical examination,four multiple pulmonary nodules were identified in both lungs.Further computed tomography(CT)images revealed the presence of ground glass nodules,predicted to be high-risk cancer lesions by artificial intelligence.With the guidance of three-dimensional reconstruction of preo-perative CT images,the nodules were resected under thoracoscopy.Postoperative pathological investigation revealed that the nodule types were adenocarcinoma in situ,invasive alveolar adenocarcinoma,and microinvasive adenocarcinoma.The excised nodules were further sequenced using high-throughput sequencing(semiconductor sequencing method)of 26 lung cancer genes to confirm that the four lesions were not homologous.The patient was discharged on postoperative day 8,that is,on July 15,2021.One month later,she returned to the hospital for followup and reexamination.Chest CT examination showed that she had re-covered well,and no obvious exudation and effusion were found in both pleural cavities.Evaluation of postoperative pulmonary function showed that her forced vital capacity was 1.40 L(preoperative value,2.27 L)and forced expiratory volume was 1.24 L(preoperative value,2.23 L).CONCLUSION The surgical plan for multiple pulmonary nodules should be carefully considered.For carefully selected patients with concurrently occurring multiple lung nodules in both lungs,sublobectomy is a safe and feasible plan for concurrent bilateral resection of the lesions.Genetic sequencing is necessary for MPLC diagnosis and treatment.展开更多
Previous studies have demonstrated that Chinese lung adenocarcinoma(LUAD)patients have unique genetic characteristics,however,the specific genomic features relating to the development and treatment of LUAD in the Chin...Previous studies have demonstrated that Chinese lung adenocarcinoma(LUAD)patients have unique genetic characteristics,however,the specific genomic features relating to the development and treatment of LUAD in the Chinese population are not fully understood.Here,we applied the ultra-deep targeted sequencing to 66 Chinese LUAD samples,accompanied by comparative analysis with 162 Caucasian LUAD in The Cancer Genome Atlas.We focused on the 68 recurrently mutated genes and results revealed that the panel-based tumor mutational burden(pTMB)is significantly higher in the Chinese LUAD(P=0.0017).Additionally,the percentage of smoking-associated C>A transversion is significantly lower in Chinese LUAD(15.5%vs.39.7%,P=5.69×10^(-27)),while C>T transition is more frequent in Chinese LUAD(35.8%vs.25.7%,P=2.67×10^(-5)),which indicated the ethnic difference in mutation types.Notably,novel driver genes(GNAS and JAK1)that are peculiar to Chinese LUAD were identified,and a more convergent distribution of mutations was observed in the Chinese cohort(P=0.012)compared with scattered mutations in Caucasian LUAD.Our results present a distinct genomic profile of Chinese LUAD compared to Caucasians LUAD and elucidate the ethnic difference in mutation distribution besides the type and rate.展开更多
Recently,an increasing number of young never-smokers are diagnosed with lung cancer.The aim of this study is to investigate the genetic predisposition of lung cancer in these patients and discover candidate pathogenic...Recently,an increasing number of young never-smokers are diagnosed with lung cancer.The aim of this study is to investigate the genetic predisposition of lung cancer in these patients and discover candidate pathogenic variants for lung adenocarcinoma in young never-smokers.Peripheral blood was collected from 123 never-smoking east-Asian patients diagnosed with lung adenocarcinoma before the age of 40.Whole-exome sequencing(WES)was conducted on genomic DNA extracted from peripheral blood cells.As a result,3,481 single nucleotide variants were identified.By bioinformatical tools and the published gene list associated with genetic predisposition of cancer,pathogenic variants were detected in ten germline genes:ATR,FANCD2,FANCE,GATA2,HFE,MSH2,PDGFRA,PMS2,SDHB,and WAS.Patients with pathogenic variants were more likely to occur in females(9/10,90.0%)and have stage IV lung adenocarcinoma(4/10,40%).Furthermore,germline muta-tions in 17 genes(ASB18,B3GALT5,CLEC4F,COL6A6,CYP4B1,C6orf132,EXO1,GATA4,HCK,KCP,NPHP4,PIGX,PPIL2,PPP1R3G,RRBP1,SALL4,and TTC28),which occurred in at least two patients,displayed potentially pathogenic effects.Gene ontology analysis further showed that these genes with germline mutations were mainly located in nucleo-plasm and associated with DNA repair-related biological processes.The study provides spectrum of pathogenic variants and functional explanation for genetic predisposition of lung adenocarcinoma in young never-smokers,which sheds a light on prevention and early diagnosis of lung cancer.展开更多
BACKGROUND Genetic tests are increasingly performed for the management of unresectable pancreatic cancer.For genotyping aimed samples current guidelines recommend using core specimens,although based on moderate qualit...BACKGROUND Genetic tests are increasingly performed for the management of unresectable pancreatic cancer.For genotyping aimed samples current guidelines recommend using core specimens,although based on moderate quality evidence.However,in clinical practice among the endoscopic ultrasound(EUS) guided tissue acquisition methods,fine needle aspiration(FNA) is the most widely performed.AIM To assess the adequacy for next generation sequencing(NGS) of the DNA yielded from EUS-FNA pancreatic adenocarcinoma(PDAC) samples.METHODS Between November 2018 and December 2021,105 patients with PDAC confirmed by EUS-FNA were included in the study at our tertiary gastroenterology center.Either 22 gauge(G) or 19G FNA needles were used.One pass was dedicated to DNA extraction.DNA concentration and purity(A260/280,A260/230) were assessed by spectrophotometry.We assessed the differences in DNA parameters according to needle size and tumor characteristics(size,location) and the adequacy of the extracted DNA for NGS(defined as A260/280 ≥ 1.7,and DNA yield:≥ 10 ng for amplicon based NGS,≥ 50 ng for whole exome sequencing [WES],≥ 100 ng for whole genome sequencing [WGS]) by analysis of variance and ttest respectively.Moreover,we compared DNA purity parameters across the different DNA yield categories.RESULTS Our cohort included 49% male patients,aged 67.02 ± 8.38 years.The 22G needle was used in 71%of the cases.The DNA parameters across our samples varied as follows:DNA yield:1289 ng(inter quartile range:534.75-3101),A260/280 = 1.85(1.79-1.86),A260/230 = 2.2(1.72-2.36).DNA yield was > 10 ng in all samples and > 100 ng in 93% of them(one sample < 50 ng).There were no significant differences in the concentration and A260/280 between samples by needle size.Needle size was the only independent predictor of A260/230 which was higher in the 22G samples(P =0.038).NGS adequacy rate was 90% for 19G samples regardless of NGS type,and for 22G samples it reached 89% for WGS adequacy and 91% for WES and amplicon based NGS.Samples with DNA yield > 100 ng had significantly higher A260/280(1.89 ± 0.32 vs 1.34 ± 0.42,P = 0.013).Tumor characteristics were not corelated with the DNA parameters.CONCLUSION EUS-FNA PDAC samples yield DNA adequate for subsequent NGS.DNA amount was similar between 22G and 19G FNA needles.DNA purity parameters may vary indirectly with needle size.展开更多
目的:探讨下调生长阻滞和DNA损伤诱导蛋白45β(growth arrest and DNA damage inducible protein 45β,GADD45β)表达对PC9肺腺癌细胞及吉非替尼敏感性的影响。方法:设计并合成GADD45β基因小干扰RNA(GADD45β-small interfering RNA,GA...目的:探讨下调生长阻滞和DNA损伤诱导蛋白45β(growth arrest and DNA damage inducible protein 45β,GADD45β)表达对PC9肺腺癌细胞及吉非替尼敏感性的影响。方法:设计并合成GADD45β基因小干扰RNA(GADD45β-small interfering RNA,GADD45β-siRNA)序列,通过慢病毒介导将GADD45β-siRNA转入PC9肺腺癌细胞中,通过实时荧光定量PCR(quantitative real-time PCR,qRT-PCR)和Western印迹检测转染前后PC9肺腺癌细胞GADD45β的mRNA及蛋白水平,采用膜联蛋白V(annexin V)-别藻蓝蛋白(allophycocyanin,APC)双染流式细胞法检测转染后细胞凋亡水平;通过流式细胞术检测转染后细胞内DNA含量,计算转染后细胞各周期时相百分率,分析转染对细胞生长周期的影响;通过计数克隆形成数检测RNA干扰对细胞成瘤能力的影响;采用MTT法检测PC9肺腺癌细胞的吉非替尼半数抑制浓度IC50。结果:筛选出5'-AAATCCACTTCACGCTCAT-3'为GADD45β基因RNA干扰的有效序列。转染GADD45β-siRNA 48 h后,qRT-PCR和Western印迹结果显示PC9肺腺癌细胞GADD45β的mRNA和蛋白表达水平明显下调(均P<0.05),细胞凋亡率明显增加(P<0.05),且成瘤克隆数明显减少(P<0.05);PC9肺腺癌细胞位于S期及G2/M期细胞增多(P<0.05),吉非替尼的IC50明显下降(P<0.05)。结论:PC9肺腺癌细胞转染GADD45β-siRNA后,能成功下调GADD45β基因的mRNA和蛋白表达;下调GADD45β表达可降低PC9肺腺癌细胞的克隆形成能力,促进细胞凋亡;下调GADD45β表达可明显提高PC9肺腺癌细胞对吉非替尼的敏感性。展开更多
基金Supported by National Natural Science Foundation of China,No.81860379 and No.82160410。
文摘BACKGROUND The incidence of multiple primary lung cancer(MPLC)in China is 0.52%-2.45%.Most primary lung cancer cases have reported two lesions or three in rare cases.We report a rare case of bilateral simultaneous multiple primary lung adenocarcinoma of four different genotypes.CASE SUMMARY A 58-year-old woman was admitted to our hospital on June 29,2021,and upon physical examination,four multiple pulmonary nodules were identified in both lungs.Further computed tomography(CT)images revealed the presence of ground glass nodules,predicted to be high-risk cancer lesions by artificial intelligence.With the guidance of three-dimensional reconstruction of preo-perative CT images,the nodules were resected under thoracoscopy.Postoperative pathological investigation revealed that the nodule types were adenocarcinoma in situ,invasive alveolar adenocarcinoma,and microinvasive adenocarcinoma.The excised nodules were further sequenced using high-throughput sequencing(semiconductor sequencing method)of 26 lung cancer genes to confirm that the four lesions were not homologous.The patient was discharged on postoperative day 8,that is,on July 15,2021.One month later,she returned to the hospital for followup and reexamination.Chest CT examination showed that she had re-covered well,and no obvious exudation and effusion were found in both pleural cavities.Evaluation of postoperative pulmonary function showed that her forced vital capacity was 1.40 L(preoperative value,2.27 L)and forced expiratory volume was 1.24 L(preoperative value,2.23 L).CONCLUSION The surgical plan for multiple pulmonary nodules should be carefully considered.For carefully selected patients with concurrently occurring multiple lung nodules in both lungs,sublobectomy is a safe and feasible plan for concurrent bilateral resection of the lesions.Genetic sequencing is necessary for MPLC diagnosis and treatment.
基金supported by grants from projects supported by the National Natural Science Foundation of China(91959113,81972358,and 81572893)the Natural Science Foundation of Jiangsu Province(BK20180036 and BE2017733)。
文摘Previous studies have demonstrated that Chinese lung adenocarcinoma(LUAD)patients have unique genetic characteristics,however,the specific genomic features relating to the development and treatment of LUAD in the Chinese population are not fully understood.Here,we applied the ultra-deep targeted sequencing to 66 Chinese LUAD samples,accompanied by comparative analysis with 162 Caucasian LUAD in The Cancer Genome Atlas.We focused on the 68 recurrently mutated genes and results revealed that the panel-based tumor mutational burden(pTMB)is significantly higher in the Chinese LUAD(P=0.0017).Additionally,the percentage of smoking-associated C>A transversion is significantly lower in Chinese LUAD(15.5%vs.39.7%,P=5.69×10^(-27)),while C>T transition is more frequent in Chinese LUAD(35.8%vs.25.7%,P=2.67×10^(-5)),which indicated the ethnic difference in mutation types.Notably,novel driver genes(GNAS and JAK1)that are peculiar to Chinese LUAD were identified,and a more convergent distribution of mutations was observed in the Chinese cohort(P=0.012)compared with scattered mutations in Caucasian LUAD.Our results present a distinct genomic profile of Chinese LUAD compared to Caucasians LUAD and elucidate the ethnic difference in mutation distribution besides the type and rate.
基金supported by the National Natural Science Foundation of China(81772466)Shanghai Rising-Star Program(21QC1400600)+1 种基金Ministry of Science and Technology of the People’s Republic of China(2017YFA0505500,2016YFA0501800)Science and Technology Commission of Shanghai Municipality(19XD1401300).
文摘Recently,an increasing number of young never-smokers are diagnosed with lung cancer.The aim of this study is to investigate the genetic predisposition of lung cancer in these patients and discover candidate pathogenic variants for lung adenocarcinoma in young never-smokers.Peripheral blood was collected from 123 never-smoking east-Asian patients diagnosed with lung adenocarcinoma before the age of 40.Whole-exome sequencing(WES)was conducted on genomic DNA extracted from peripheral blood cells.As a result,3,481 single nucleotide variants were identified.By bioinformatical tools and the published gene list associated with genetic predisposition of cancer,pathogenic variants were detected in ten germline genes:ATR,FANCD2,FANCE,GATA2,HFE,MSH2,PDGFRA,PMS2,SDHB,and WAS.Patients with pathogenic variants were more likely to occur in females(9/10,90.0%)and have stage IV lung adenocarcinoma(4/10,40%).Furthermore,germline muta-tions in 17 genes(ASB18,B3GALT5,CLEC4F,COL6A6,CYP4B1,C6orf132,EXO1,GATA4,HCK,KCP,NPHP4,PIGX,PPIL2,PPP1R3G,RRBP1,SALL4,and TTC28),which occurred in at least two patients,displayed potentially pathogenic effects.Gene ontology analysis further showed that these genes with germline mutations were mainly located in nucleo-plasm and associated with DNA repair-related biological processes.The study provides spectrum of pathogenic variants and functional explanation for genetic predisposition of lung adenocarcinoma in young never-smokers,which sheds a light on prevention and early diagnosis of lung cancer.
基金The Executive Agency for Higher Education,Research,Development and Innovation Funding-research,No.PN-Ⅲ-P1-1.2-PCCDI-2017-0797 (PANCNGS)
文摘BACKGROUND Genetic tests are increasingly performed for the management of unresectable pancreatic cancer.For genotyping aimed samples current guidelines recommend using core specimens,although based on moderate quality evidence.However,in clinical practice among the endoscopic ultrasound(EUS) guided tissue acquisition methods,fine needle aspiration(FNA) is the most widely performed.AIM To assess the adequacy for next generation sequencing(NGS) of the DNA yielded from EUS-FNA pancreatic adenocarcinoma(PDAC) samples.METHODS Between November 2018 and December 2021,105 patients with PDAC confirmed by EUS-FNA were included in the study at our tertiary gastroenterology center.Either 22 gauge(G) or 19G FNA needles were used.One pass was dedicated to DNA extraction.DNA concentration and purity(A260/280,A260/230) were assessed by spectrophotometry.We assessed the differences in DNA parameters according to needle size and tumor characteristics(size,location) and the adequacy of the extracted DNA for NGS(defined as A260/280 ≥ 1.7,and DNA yield:≥ 10 ng for amplicon based NGS,≥ 50 ng for whole exome sequencing [WES],≥ 100 ng for whole genome sequencing [WGS]) by analysis of variance and ttest respectively.Moreover,we compared DNA purity parameters across the different DNA yield categories.RESULTS Our cohort included 49% male patients,aged 67.02 ± 8.38 years.The 22G needle was used in 71%of the cases.The DNA parameters across our samples varied as follows:DNA yield:1289 ng(inter quartile range:534.75-3101),A260/280 = 1.85(1.79-1.86),A260/230 = 2.2(1.72-2.36).DNA yield was > 10 ng in all samples and > 100 ng in 93% of them(one sample < 50 ng).There were no significant differences in the concentration and A260/280 between samples by needle size.Needle size was the only independent predictor of A260/230 which was higher in the 22G samples(P =0.038).NGS adequacy rate was 90% for 19G samples regardless of NGS type,and for 22G samples it reached 89% for WGS adequacy and 91% for WES and amplicon based NGS.Samples with DNA yield > 100 ng had significantly higher A260/280(1.89 ± 0.32 vs 1.34 ± 0.42,P = 0.013).Tumor characteristics were not corelated with the DNA parameters.CONCLUSION EUS-FNA PDAC samples yield DNA adequate for subsequent NGS.DNA amount was similar between 22G and 19G FNA needles.DNA purity parameters may vary indirectly with needle size.
文摘目的:探讨下调生长阻滞和DNA损伤诱导蛋白45β(growth arrest and DNA damage inducible protein 45β,GADD45β)表达对PC9肺腺癌细胞及吉非替尼敏感性的影响。方法:设计并合成GADD45β基因小干扰RNA(GADD45β-small interfering RNA,GADD45β-siRNA)序列,通过慢病毒介导将GADD45β-siRNA转入PC9肺腺癌细胞中,通过实时荧光定量PCR(quantitative real-time PCR,qRT-PCR)和Western印迹检测转染前后PC9肺腺癌细胞GADD45β的mRNA及蛋白水平,采用膜联蛋白V(annexin V)-别藻蓝蛋白(allophycocyanin,APC)双染流式细胞法检测转染后细胞凋亡水平;通过流式细胞术检测转染后细胞内DNA含量,计算转染后细胞各周期时相百分率,分析转染对细胞生长周期的影响;通过计数克隆形成数检测RNA干扰对细胞成瘤能力的影响;采用MTT法检测PC9肺腺癌细胞的吉非替尼半数抑制浓度IC50。结果:筛选出5'-AAATCCACTTCACGCTCAT-3'为GADD45β基因RNA干扰的有效序列。转染GADD45β-siRNA 48 h后,qRT-PCR和Western印迹结果显示PC9肺腺癌细胞GADD45β的mRNA和蛋白表达水平明显下调(均P<0.05),细胞凋亡率明显增加(P<0.05),且成瘤克隆数明显减少(P<0.05);PC9肺腺癌细胞位于S期及G2/M期细胞增多(P<0.05),吉非替尼的IC50明显下降(P<0.05)。结论:PC9肺腺癌细胞转染GADD45β-siRNA后,能成功下调GADD45β基因的mRNA和蛋白表达;下调GADD45β表达可降低PC9肺腺癌细胞的克隆形成能力,促进细胞凋亡;下调GADD45β表达可明显提高PC9肺腺癌细胞对吉非替尼的敏感性。
