Upregulated lncRNA PRNT promotes progression and oxaliplatin resistance of colorectal cancer cells by regulating HIPK2 transcription

BACKGROUND Colorectal cancer(CRC)is the third most common cancer and a significant cause of cancer-related mortality globally.Resistance to chemotherapy,especially during CRC treatment,leads to reduced effectiveness of drugs and poor patient outcomes.Long noncoding RNAs(lncRNAs)have been implicated in various pathophysiological processes of tumor cells,including chemotherapy resistance,yet the roles of many lncRNAs in CRC remain unclear.AIM To identify and analyze the lncRNAs involved in oxaliplatin resistance in CRC and to understand the underlying molecular mechanisms influencing this resistance.METHODS Gene Expression Omnibus datasets GSE42387 and GSE30011 were reanalyzed to identify lncRNAs and mRNAs associated with oxaliplatin resistance.Various bioinformatics tools were employed to elucidate molecular mechanisms.The expression levels of lncRNAs and mRNAs were assessed via quantitative reverse transcription-polymerase chain reaction.Functional assays,including MTT,wound healing,and Transwell,were conducted to investigate the functional implications of lncRNA alterations.Interactions between lncRNAs and trans-cription factors were examined using RIP and luciferase reporter assays,while Western blotting was used to confirm downstream pathways.Additionally,a xenograft mouse model was utilized to study the in vivo effects of lncRNAs on chemotherapy resistance.RESULTS LncRNA prion protein testis specific(PRNT)was found to be upregulated in oxaliplatin-resistant CRC cell lines and negatively correlated with homeodomain interacting protein kinase 2(HIPK2)expression.PRNT was demonstrated to sponge transcription factor zinc finger protein 184(ZNF184),which in turn could regulate HIPK2 expression.Altered expression of PRNT influenced CRC cell sensitivity to oxaliplatin,with overexpression leading to decreased sensitivity and decreased expression reducing resistance.Both RIP and luciferase reporter assays indicated that ZNF184 and HIPK2 are targets of PRNT.The PRNT/ZNF184/HIPK2 axis was implicated in promoting CRC progression and oxaliplatin resistance both in vitro and in vivo.CONCLUSION The study concludes that PRNT is upregulated in oxaliplatin-resistant CRC cells and modulates the expression of HIPK2 by sponging ZNF184.This regulatory mechanism enhances CRC progression and resistance to oxaliplatin,positioning PRNT as a promising therapeutic target for CRC patients undergoing oxaliplatin-based chemotherapy.

PhaseⅡstudy of oxaliplatin combined with S-1 and leucovorin(SOL)for Chinese patients with metastatic colorectal cancer

Background:Fluoropyrimidine and oxaliplatin are widely used for patients with colorectal cancer.This phase II study was conducted to evaluate the efficacy and safety of the combination of S-1,oxaliplatin,and leucovorin(SOL) in the treatment of Chinese patients with metastatic colorectal cancer(mCRC).Methods:Eligible patients with untreated mCRC from four hospitals in China received intravenous oxaliplatin(85 mg/m2) on day 1,oral S-1 twice daily(80-120 mg per day) on day 1-7,and leucovorin twice daily(50 mg per day)simultaneously with S-1,every 2 weeks.Results and discussion:Forty patients were enrolled in our study.In total,296 cycles of SOL were administered.The overall response rate was 50.0%.At a median follow-up of 27 months,progression-free survival and overall surviva were 7.0 months(95%confidence interval[CI]6.0-10.6 months) and 22.2 months(95%CI 15.1-29.3 months),respectively.The most common grade 3/4 non-hematological adverse events were diarrhea(n = 8,20.0%),nausea(n = 3,7.5%),and vomiting(n = 3,7.5%).The most common grade 3/4 hematological toxicities were thrombocytopenia(n = 3,7.5%),neutropenia(n = 1,2.5%),and abnormal alanine transaminase/aspartate transaminase levels(n = 1,2.5%).There was one treatment-related death.Conclusions:The data indicate that the SOL regimen is effective and moderately tolerated in Chinese patients with mCRC.Trial registration:Clinical trial

Bevacizumab plus infusional 5-fluorouracil,leucovorin and irinotecan for advanced colorectal cancer that progressed after oxaliplatin and irinotecan chemotherapy:A pilot study

瞄准：与 infusional 评估 bevacizumab 的联合 5 氟尿嘧啶(5-FU ) ，甲酰四氢叶酸(LV ) 和在有先进颜色的病人的 irinotecan (FOLFIRI ) 有包括 irinotecan 和 oxaliplatin 的联合政体的表面的癌症(CRC ) pretreated。方法：十四个病人(中部的年龄 56 年) 与先进 CRC，都在基于 oxaliplatin 、基于 irinotecan 的联合化疗以后进行了，在这研究被注册。病人们与 irinotecan 的 2 h 注入被对待 d 上的 150 mg/m2 1 ，正 bevacizumab 为 d 上的 90 min 的 5 mg/kg iv 注入 2 ，并且 LV 20 mg/m2 的 iv 注射由 5-FU 的一丸大丸药跟随了 400 mg/m2 然后 22 h 在二连续的天给每 14 d 的 600 mg/m2 的连续注入。结果：化疗的周期的中部的数字是六(范围 3-12 ) 。反应率是 28.5% ，一个病人有完全的回答，并且三个病人有部分回答。八个病人有稳定的疾病。前进的中部的时间是 3.9 瞬间(95% CI 2.0-8.7 ) ，并且中部的全面幸存是 10.9 瞬间(95% CI 9.6-12.1 ) 。等级 3/4 嗜中性白血球减少症在五个病人发生了，并且这些中的二个得了 neutropenic 发烧。等级 3 血尿症和便血发生在一个。等级 2 蛋白尿发生在二个病人。然而，高血压，肠穿孔或 thromboembolic 事件没总共 90 个周期的发生。结论：有 FOLFIRI 的 Bevacizumab 很好被容忍并且在有重重地对待的先进 CRC 的病人的可行治疗。

Oxaliplatin,Fluorouracil and Leucovorin (FOLFOX) as First-line Chemotherapy for Metastatic or Recurrent Colorectal Cancer Patients

OBJECTIVE To investigate the efficiency and safety of the oxaliplatin, fluorouracil(5-FU)and leucovorin regimen(FOLFOX)in previously untreated patients with metastatic or recurrent colorectal cancer. METHODS Previously untreated patients with metastatic or recurrent colorectal cancer received 100 mg/m2 of oxaliplatin intravenously(IV)over 2 h on day 1,and IV 400 mg/m2 of leucovorin over 2 h followed by a bolus of 400 mg/m2 of 5-FU.Then 2,600~3,000 mg/m2 of 5-FU was administered by continuous infusion over 46 h. RESULTS An evaluated response rate was determined for 97 of 105 treated patients.The overal response rate was 35.1%,9 patients(9.3%) had a complete response and 25 patients(25.8%)a partial response.Thirty-two patients(33.0%)developed stable disease and 32.0%of the patients progressed.The median time to progression(TTP)was 7.7 months and the median overal survival 20.5 months.One and 2-year survival rates were 68%and 32%.Toxic effects based on the National Cancer Institute-Common Toxicity Criteria(NCI-CTC),reaching grade 3/4 were:neutropenia 12.3%, anemia 11.3%,vomiting 4.1%and diarrhea 7.2%.Grade 3 neuropathy was 5.1%.The overall survival rate of patients who had received a radical resection was superior to the patients who had not received a operation,or had received a pal iative resection(P=0.0658).The serum levels of CEA,ALP and LDH had no relationship with survival(P>0.05). CONCLUSION The FOLFOX regimen containing oxaliplatin,5-FU plus leucovorin was an efficacious regimen with good tolerability in previously untreated metastatic or recurrent colorectal cancer patients.

Multicenter Analysis of mFOLFOX6 with Oxaliplatin Stop-and-Go Strategy Using Oral Uracil-Tegafur with Leucovorin for Unresectable Colorectal Cancer in Elderly Patients

Background: This study evaluated the tolerability and efficacy of intermittent oxaliplatin treatment based on mFOLFOX6 using oral uracil-tegafur(UFT) and leucovorin(LV) maintenance therapy in the treatment of elderly patients with advanced colorectal cancer. Methods: Ten non-elderly patients (70 years) with advanced/recurrent colorectal cancer were enrolled in this prospective, multicenter cooperative group clinical trial. The mFOLFOX6 regimen was administered for eight cycles with maintenance therapy with oral UFT/LV treatment until progression. In cases with disease progression, mFOLFOX6 was reintroduced. Results: Grade 2 peripheral neuropathy was noted in 30.0% and 25.0% of the elderly and non-elderly patients, respectively. The observed time to treatment failure (TTF) was 6.3 months in the elderly patients and 6.4 months in the non-elderly patients. The disease control rate was 83.3% in each group. Conclusion: Our new stop-and-go strategy using oral UFT/LV is well-tolerated and effective even in elderly patients.

Oxaliplatin combined with 5-fluorouracil, leucovorin regimen for patients with advanced colorectal cancer

Objective: To observe the efficacy and tolerability of continuously infusing 5-fluorouracil (5-FU) / folic acid com- bined with oxaliplatin (L-OHP/5-FU/LV regimen) as first line treatment in advanced colorectal cancer. Methods: 23 patients of advanced colorectal cancer were treated with 5-FU 500 mg/d, civ, d1–d5, d8–d12, leucovorin 100 mg/d, iv gtt, d1, d8, folic acid tablet 60 mg/d, po, d2–d5, d9–d12, and oxaliplatin 65 mg/(m2?d), iv gtt, d1, d8, repeated every 21 days (one cycle).The effect was evaluated after two cycles. Results: Complete response in 2 cases and partial response in 10 cases were observed with an overall response rate of 47.18%. Adverse effects were mainly grade 1–2, including nausea, vomiting, diarrhea, dental ulcer, peripheral neuritis and myelosuppression. Conclusion: L-OHP/5-FU/LV regimen is an effective and better tolerated alterna- tive treatment in advanced colorectal cancer and yields promising clinical application.

Clinical Study of Combining Chemotherapy of Oxaliplatin or 5-Fluorouracil/Leucovorin with Hydroxycamptothecine for Advanced Colorectal Cancer

OBJECTIVE To estimate the short-time efficacy, sideeffects, survival rate after the treatment of combiningchemotherapy of oxaliplatin or 5-fluorouracil/leucovorin withhydroxycamptothecine (HCPT) for the patients with advancedcolorectal cancer.METHODS From January 2002 to November 2005, 59 patientswith advanced colorectal cancer confirmed by pathology wereenrolled into this study in the department of medical oncology,in the Sixth People's Hospital of Shanghai Jiaotong University,Shanghai. Patients' characteristics in two groups were similarlyconfirmed by statistic. All 37 patients in OH group receivedoxaliplatin (130 mg/m^2 d1) plus hydroxycamptothecine (6mg/m^2 d1-4), and all 22 patients in the HLF group receivedhydroxycamptothecine (6 mg/m^2 d1-4) plus leucovorin (300 mgd1-5) and 5-fluorouracil (0.375 g/m^2 d1-5). The regimens in bothgroups were 21-day cycle that was repeated three weeks. The sideeffects were evaluated. The efficacy was estimated after two cyclesof chemotherapy for each patient.RESULTS The efficacy of the treatment in the OH group with37 patients and in the HLF group with 22 patients was estimated.The overall response rate (CR + PR) was 32.4% in the OH groupand 22.7% in the HLF group. There was no complete response(CR) and there was no statistical significantly difference (x^2= 0.876,P = 0.704) in two groups. The 1-year survival rate was 30.98%in the OH group and 15.02% in the HLF group, and it had nosignificant difference between the two groups. The median PSFand OS were 5.83 months and 11.17 months in the OH group vs.7.40 months and 10.48 months in the HLF group, and it had nosignificant differences between the two groups (P > 0.05). Themajor side effects of grade Ⅲ and Ⅳ in the two groups weremyelosuppression and gastrointestinal reactions. The statisticallysignificant difference in side effects appeared in leukopenia (x^2 =17.173, P = 0.001), nausea/vomiting (x^2= 6.426, P = 0.039), diarrhea(x^2 = 16.245, P = 0.000) and peripheral neuropathy.CONCLUSION The efficacy was almost equal between theOH and the HLF groups, and the two regimens can be usedas the second-line treatments for the patients with colorectalcancer. Leucopenia, nausea, diarrhea and peripheral neuropathyappeared more in OH group, and anemia and thrombocytopeniawere almost equal between the OH and the HLF groups.

Emerging roles of non-coding RNAs in colorectal cancer oxaliplatin resistance and liquid biopsy potential

Colorectal cancer(CRC)is one of the most common malignancies of the digestive tract,with the annual incidence and mortality increasing consistently.Oxaliplatinbased chemotherapy is a preferred therapeutic regimen for patients with advanced CRC.However,most patients will inevitably develop resistance to oxaliplatin.Many studies have reported that non-coding RNAs(ncRNAs),such as microRNAs,long non-coding RNAs,and circular RNAs,are extensively involved in cancer progression.Moreover,emerging evidence has revealed that ncRNAs mediate chemoresistance to oxaliplatin by transcriptional and post-transcriptional regulation,and by epigenetic modification.In this review,we summarize the mechanisms by which ncRNAs regulate the initiation and development of CRC chemoresistance to oxaliplatin.Furthermore,we investigate the clinical application of ncRNAs as promising biomarkers for liquid CRC biopsy.This review provides new insights into overcoming oxaliplatin resistance in CRC by targeting ncRNAs.

A Multicenter Cohort Study for XELOX (Capecitabine, Leucovorin plus Oxaliplatin) Therapy as First-Line Treatment in Elderly Patients with Unresectable Colorectal Cancer

Oxaliplatin-based chemotherapy with bevacizumab is now widely used for colorectal cancer patients. This study evaluated the efficacy and tolerability of XELOX (capecitabine + oxaliplatin + leucovorin combined) therapy with or without bevacizumab in elderly patients. One hundred and seven patients, consisting of 52 elderly (>70 years of age) and 55 non-elderly, with unresectable colorectal cancer were enrolled in this multicenter cooperative group study using a database between October 2009 and March 2012. We evaluated the outcomes in terms of the median time to treat failure (TTF), overall response rate (ORR), disease control rate (DCR) and tolerability in both age groups. The median TTF for the XELOX + bevacizumab regimen was 7.1 months in the non-elderly group and 8.1 months in the elderly group (p = 0.838). There was no significant difference in TTF between the two groups. The ORR and DCR in the non-elderly group were 30.8% and 73.1%, respectively. In the elderly group, the ORR was 40.0% and the overall DCR was 90.0%. No severe or uncontrollable adverse events were observed in the two groups. These data indicated that the XELOX chemotherapy with or without bevacizumab has an equivalent efficacy in both groups, without increasing the adverse events even in the elderly population.

Effects of oxaliplatin, leucovorin and fluorouracil on serum tumor markers, VEGF, CRP and matrix metalloproteinases in patients with advanced esophageal cancer

Objective: To investigate the effects of oxaliplatin, leucovorin and fluorouracil on serum tumor markers, VEGF, CRP and matrix metalloproteinases in patients with advanced esophageal cancer. Methods: From March 2012 to March 2017 a total of 248 patients with advanced esophageal cancer were selected as the study subjects. According to random data table, they were divided into control group (n=123) and observation group (n=125) according to random data table. The control group was treated with cisplatin combined with fluorouracil, leucovorin chemotherapy, and patients in the observation group received oxaliplatin, leucovorin and fluorouracil chemotherapy, all patients were treated for 2 cycles. The changes of serum tumor markers, VEGF, CRP and matrix metalloproteinase levels in the two groups before and after treatment was compared. Results: Before treatment, there was no significant difference of the levels of serum CA125, CA19-9, CEA, VEGF, CRP, MMP-2 and MMP-9 between the control group and the observation group. Compared with the group before treatment, the levels of CA125, CA19-9, CEA, VEGF, CRP, MMP-2 and MMP-9 in the two groups were significantly lower. After treatment, the level of CA125, CA19-9, CEA, VEGF, CRP, MMP-2 and MMP-9 in the observation group was significantly lower than those of the control group. Conclusion:Oxaliplatin, leucovorin and fluorouracil chemotherapy can effectively reduce the levels of serum tumor markers, VEGF, CRP and matrix metalloproteinase in patients with advanced esophageal cancer, it has important clinical value.

HOXB8 contributed to oxaliplatin chemo-resistance in colon cancercells by activating STAT3

Background:Homeobox B8(HOXB8),a member of HOX family,plays a key role in the development of colorectal cancer(CRC).However,the function of HOXB8 in oxaliplatin(OXA)resistance in CRC is still unclear.This study investigated the role and precise molecular mechanism of HOXB8 in OXA-resistant CRC cells.Methods:The cell viability was measured by the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide(MTT)assay,and the colony forming ability was determined by colony formation assay.The silencing RNA(siRNA)approach was used to knockdown HOXB8 in CRC cells while the lentiviral transfection system was used to establish stable HOXB8 overexpressing CRC cells.The protein and mRNA levels were evaluated by western blot and real-time reverse transcription-polymerase chain reaction.Results:HOXB8 expression was upregulated in OXA-resistant HCT116 cells(HCT116/OXA)compared to its level in the parent HCT116 cells.Knockdown of HOXB8 significantly inhibited CRC cell growth by suppressing the signal transducer and activator of transcription 3(STAT3)pathway.HOXB8 knockdown also potentiated cytotoxicity of OXA in CRC cells.Inversely,HOXB8 overexpression attenuated OXAinduced growth inhibition of HCT116 cells and RKO cells by activating STAT3 signaling.HOXB8 knockdown effectively inhibited HCT116/OXA cell viability regardless of OXA treatment by suppressing STAT3 signaling.Conclusions:These results shed light on the important functions of HOXB8 in OXA-resistant CRC and suggested that targeting HOXB8 might be an effective therapeutic strategy for select OXA-resistant CRC patients.

Treatment outcome analysis of bevacizumab combined with cyclophosphamide and oxaliplatin in advanced pseudomyxoma peritonei

BACKGROUND Pseudomyxoma peritonei(PMP)is a rare peritoneal malignant tumor syndrome.Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy is its standard treatment.However,there are few studies and insufficient evidence regarding systemic chemotherapy of advanced PMP.Regimens for colorectal cancer are often used clinically,but there is no uniform standard for late-stage treatment.AIM To determine if bevacizumab combined with cyclophosphamide and oxaliplatin(Bev+CTX+OXA)is effective for treatment of advanced PMP.The primary study endpoint was progression-free survival(PFS).METHODS Retrospective analysis was conducted on the clinical data of patients with advanced PMP who received Bev+CTX+OXA regimen(bevacizumab 7.5 mg/kg ivgtt d1,oxaliplatin 130 mg/m2 ivgtt d1 and cyclophosphamide 500 mg/m2 ivgtt d1,q3w)in our center from December 2015 to December 2020.Objective response rate(ORR),disease control rate(DCR)and incidence of adverse events were evaluated.PFS was followed up.Kaplan-Meier method was used to draw survival curve,and log-rank test was used for comparison between groups.Multivariate Cox proportional hazards regression model was used to analyze the independent influencing factors of PFS.RESULTS A total of 32 patients were enrolled.After 2 cycles,the ORR and DCR were 3.1%and 93.7%,respectively.The median follow-up time was 7.5 mo.During the follow-up period,14 patients(43.8%)had disease progression,and the median PFS was 8.9 mo.Stratified analysis showed that the PFS of patients with a preoperative increase in CA125(8.9 vs 2.1,P=0.022)and a completeness of cytoreduction score of 2-3(8.9 vs 5.0,P=0.043)was significantly longer than that of the control group.Multivariate analysis showed that a preoperative increase in CA125 was an independent prognostic factor for PFS(HR=0.245,95%CI:0.066-0.904,P=0.035).CONCLUSION Our retrospective assessment confirmed that the Bev+CTX+OXA regimen is effective in second-or posterior-line treatment of advanced PMP and that adverse reactions can be tolerated.A preoperative increase in CA125 is an independent prognostic factor of PFS.

Cerium Oxide Nanoparticles Protect against Oxaliplatin Induced Testicular Damage: Biochemical, Histological, Immunohistochemical, and Genotoxic Study

Oxaliplatin is a chemotherapeutic drug used for colorectal cancer treatment. The testicular toxic effect is one of its recorded toxicities which resulted in a few studies. Oxidative stress could be a direct cause of this testicular toxicity. Cerium oxide nanoparticles (CONPs) are optimistic antioxidants for applications in medicine. The aim of the work is to study the protective effect of CONPs on testicular toxicity induced by oxaliplatin in rats. Forty adult male albino rats were divided into 4 groups: Control group, CONPs group (60 mg/kg, 5 times/week), Oxaliplatin group (4 mg/kg, twice/week), and Oxaliplatin & CONPs group, for 4 weeks. Seventy-two hours after the last administration, blood samples were taken for hormonal levels and testes were used for both histopathology and immunohistochemical microscopic examination. Sperm smears were also performed and their results were statistically analyzed to detect any sperm abnormalities. Oxaliplatin increased MDA levels. SOD and GPx activity was decreased. GSH levels were decreased. Also, it decreased the sperm cell count and serum testosterone, and anti-Müllerian hormon. In the testicular sections, significant histopathology changes were seen and immunohistochemical examination confirmed these results. Upon supplementation of CONPs with oxaliplatin decreased MDA levels. SOD and GPx activity was increased, and GSH did not change. In testicular sections, normal morphology was seen. Also, there was an increase in the sperm cell count and serum testosterone anti-Müllerian with significant improvement of testicular architecture, and immunohistochemical examination confirmed these results. The utilization of CONPs produced significant protection against all of the above-mentioned changes.

Cancerous inhibitor of protein phosphatase 2A enhances chemoresistance of gastric cancer cells to oxaliplatin

BACKGROUND Cancerous inhibitor of protein phosphatase 2A(CIP2A)is a newly discovered oncogene.It is an active cell proliferation regulatory factor that inhibits tumor apoptosis in gastric cancer(GC)cells.CIP2A is functionally related to chemoresistance in various types of tumors according to recent studies.The underlying mechanism,however,is unknown.Further,the primary treatment regimen for GC is oxaliplatin-based chemotherapy.Nonetheless,it often fails due to chemoresistance of GC cells to oxaliplatin.AIM The goal of this study was to examine CIP2A expression and its association with oxaliplatin resistance in human GC cells.METHODS Immunohistochemistry was used to examine CIP2A expression in GC tissues and adjacent normal tissues.CIP2A expression in GC cell lines was reduced using small interfering RNA.After confirming the silencing efficiency,3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium and flow cytometry assays were used to evaluate cell proliferation and apoptosis caused by oxaliplatin treatment.Further,the key genes and protein changes were verified using realtime quantitative reverse transcription PCR and Western blotting,respectively,before and after intervention.For bioinformatics analysis,we used the R software and Bioconductor project.For statistical analysis,we used GraphPad Prism 6.0 and the Statistical Package for the Social Sciences software version 20.0(IBM,Armonk,United States).RESULTS A high level of CIP2A expression was associated with tumor size,T stage,lymph node metastasis,Tumor Node Metastasis stage,and a poor prognosis.Further,CIP2A expression was higher in GC cells than in normal human gastric epithelial cells.Using small interfering RNA against CIP2A,we discovered that CIP2A knockdown inhibited cell proliferation and significantly increased GC cell sensitivity to oxaliplatin.Moreover,CIP2A knockdown enhanced oxaliplatin-induced apoptosis in GC cells.Hence,high CIP2A levels in GC may be a factor in chemoresistance to oxaliplatin.In human GC cells,CIP2A regulated protein kinase B phosphorylation,and chemical inhibition of the protein kinase B signaling pathway was significantly associated with increased sensitivity to oxaliplatin.Therefore,the protein kinase B signaling pathway was correlated with CIP2Aenhanced chemoresistance of human GC cells to oxaliplatin.CONCLUSION CIP2A expression could be a novel therapeutic strategy for chemoresistance in GC.

Prostaglandin F_(2α)synthase promotes oxaliplatin resistance in colorectal cancer through prostaglandin F_(2α)-dependent and F_(2α)-independent mechanism

BACKGROUND Oxaliplatin(Oxa)is the first-line chemotherapy drug for colorectal cancer(CRC),and Oxa resistance is crucial for treatment failure.Prostaglandin F_(2α)synthase(PGF 2α)(PGFS),an enzyme that catalyzes the production of PGF_(2α),is involved in the proliferation and growth of a variety of tumors.However,the role of PGFS in Oxa resistance in CRC remains unclear.AIM To explore the role and related mechanisms of PGFS in mediating Oxa resistance in CRC.METHODS The PGFS expression level was examined in 37 pairs of CRC tissues and paracancerous tissues at both the mRNA and protein levels.Overexpression or knockdown of PGFS was performed in CRC cell lines with acquired Oxa resistance(HCT116-OxR and HCT8-OxR)and their parental cell lines(HCT116 and HCT8)to assess its influence on cell proliferation,chemoresistance,apoptosis,and DNA damage.For determination of the underlying mechanisms,CRC cells were examined for platinum-DNA adducts and reactive oxygen species(ROS)levels in the presence of a PGFS inhibitor or its products.RESULTS Both the protein and mRNA levels of PGFS were increased in the 37 examined CRC tissues compared to the adjacent normal tissues.Oxa induced PGFS expression in the parental HCT116 and HCT8 cells in a dosedependent manner.Furthermore,overexpression of PGFS in parental CRC cells significantly attenuated Oxainduced proliferative suppression,apoptosis,and DNA damage.In contrast,knockdown of PGFS in Oxa-resistant HCT116 and HCT8 cells(HCT116-OxR and HCT8-OxR)accentuated the effect of Oxa treatment in vitro and in vivo.The addition of the PGFS inhibitor indomethacin enhanced the cytotoxicity caused by Oxa.Treatment with the PGFS-catalyzed product PGF_(2α)reversed the effect of PGFS knockdown on Oxa sensitivity.Interestingly,PGFS inhibited the formation of platinum-DNA adducts in a PGF_(2α)-independent manner.PGF_(2α)exerts its protective effect against DNA damage by reducing ROS levels.CONCLUSION PGFS promotes resistance to Oxa in CRC via both PGF_(2α)-dependent and PGF_(2α)-independent mechanisms.

不同营养状态对结直肠癌患者奥沙利铂化疗致周围神经毒性(OIPN)的影响

目的 探讨营养状态对结直肠癌患者发生奥沙利铂致周围神经毒性(OIPN)的影响。方法 选取2022年7月至2023年5月无锡市江南大学附属医院收治的219例结直肠癌患者,收集患者资料,运用SPSS 26.0对影响因素进行统计分析。结果 219例结直肠癌患者中有144例发生了OIPN,作为OIPN组;75例没有发生OIPN,作为非OIPN组。Spearman分析显示两组患者并发症、营养风险筛查2002(NRS2002)评分、白蛋白、血红蛋白等指标差异有统计学意义(P <0.05);Logistic回归分析显示白蛋白与并发症是OIPN发生的独立危险因素,在此基础上构建Nomogram预测模型,为临床评估和预测OIPN发生提供新的方法和思路。结论 白蛋白水平低下与发生并发症是OIPN的独立危险因素,其中白蛋白水平与患者的营养状况密切相关,该预测模型对预测结直肠癌患者OIPN发生具有较好的临床应用价值。

CaMKK2调控肝细胞癌化疗耐药性的作用和机制

目的 探讨钙/钙调蛋白依赖性蛋白激酶激酶2(calcium/calmodulin-dependent protein kinase kinase 2,CaMKK2)调控肝细胞癌(hepatocellular carcinoma, HCC)化疗耐药性的作用及其机制。方法 (1)为了检测CaMKK2在HCC耐药细胞株中的表达变化,将实验分为亲本组和耐药组。采用浓度梯度递增法建立奥沙利铂(oxaliplatin, OXA)耐药细胞株MHCC97H/OXA和Hep3B/OXA。采用Western blot检测CaMKK2的磷酸化和总蛋白表达水平。(2)为了检测CaMKK2对肝细胞癌化疗药性的调控作用,将实验分为对照组和CaMKK2敲除组。采用CRISPR/Cas9技术敲除MHCC97H/OXA和Hep3B/OXA细胞株中的CaMKK2基因表达,采用Western blot验证CaMKK2敲除效率。采用细胞计数试剂盒-8(cell counting kit-8,CCK-8)实验检测CaMKK2敲除对MHCC97H/OXA和Hep3B/OXA细胞株细胞存活率的影响。采用流式细胞术检测CaMKK2敲除对MHCC97H/OXA和Hep3B/OXA细胞株凋亡的影响。采用Western blot检测CaMKK2敲除对微管相关蛋白1轻链3(microtubule-associated protein 1 light chain 3,LC3)、p62、腺苷酸活化蛋白激酶(adenosine 5′-monophosphate-activated protein kinase, AMPK)和UNC-51样激酶1(UNC51-like kinase 1,ULK1)蛋白表达水平的影响。(3)为了验证CaMKK2对肝细胞癌化疗药性的调控作用,将实验分为CaMKK2敲除+空载体组和CaMKK2敲除+CaMKK2载体组。采用Western blot检测CaMKK2的蛋白表达水平。采用CCK-8实验检测重新表达CaMKK2对CaMKK2敲除的细胞耐药性的影响。采用Western blot检测重新表达CaMKK2对CaMKK2敲除的细胞中AMPK、ULK1和LC3蛋白表达水平的影响。结果 (1)与亲本组相比,耐药组HCC细胞株中CaMKK2的总蛋白表达水平无显著变化(P>0.05),而CaMKK2的磷酸化水平显著升高(P<0.01)。(2)与对照组比较,CaMKK2敲除组细胞中CaMKK2表达水平显著减少(P<0.01)。与对照组比较,CaMKK2敲除组HCC耐药细胞对OXA的敏感性显著提高(P<0.05),OXA细胞凋亡率显著升高(P<0.01)。与对照组比较,CaMKK2敲除组LC3Ⅱ/LC3Ⅰ显著降低,p62蛋白水平显著升高,p-AMPK/AMPK以及p-ULK1/ULK1显著降低(均P<0.01)。(3)与CaMKK2敲除+空载体组比较,CaMKK2敲除+CaMKK2载体组HCC耐药细胞对OXA的敏感性显著降低(P<0.01),LC3Ⅱ/LC3Ⅰ、p-AMPK/AMPK和p-ULK1/ULK1显著升高(P<0.01)。结论 基因敲除CaMKK2有效逆转HCC化疗耐药性,其作用机制与调控AMPK/ULK1介导的自噬通路相关。

白屈菜碱对小鼠肺癌细胞皮下移植瘤生长和血管生成的抑制作用及其机制

目的:探讨白屈菜碱对肺癌移植瘤小鼠肿瘤生长和血管生成的影响,并阐明其作用机制。方法:选取32只健康C57BL/6小鼠,制备Lewis肺癌移植瘤小鼠模型。将小鼠随机分为模型组(0.9%氯化钠)、低剂量白屈菜碱组(25 mg·kg^(-1)白屈菜碱)、高剂量白屈菜碱组(50 mg·kg^(-1)白屈菜碱)和阳性对照组(60 mg·kg^(-1)环磷酰胺),每组8只。称量各组小鼠移植瘤质量并计算抑瘤率,计算各组小鼠胸腺指数和脾脏指数,采用酶联免疫吸附测定(ELISA)法检测各组小鼠血清中白细胞介素2(IL-2)、γ干扰素(INF-γ)和肿瘤坏死因子α(TNF-α)水平,免疫组织化学法检测各组小鼠肿瘤组织中血管内皮生长因子(VEGF)蛋白表达情况并计算微血管密度(MVD)及VEGF蛋白表达评分,Westernblotting法检测各组小鼠肿瘤组织中核因子κB(NF-κB)和缺氧诱导因子1α(HIF-1α)蛋白表达水平。结果:与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠移植瘤质量均降低(P<0.05);与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠移植瘤质量均降低(P<0.05),抑瘤率均升高(P<0.05);与高剂量白屈菜碱组比较,阳性对照组小鼠移植瘤质量均降低(P<0.05),抑瘤率升高(P<0.05)。与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠脾脏指数和胸腺指数均升高(P<0.05);与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠脾脏指数及胸腺指数均升高(P<0.05);与高剂量白屈菜碱组比较,阳性对照组小鼠脾脏指数和胸腺指数均升高(P<0.05)。ELISA法,与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠血清中IL-2、INF-γ和TNF-α水平均升高(P<0.05);与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠血清中IL-2、INF-γ和TNF-α水平均升高(P<0.05);与高剂量白屈菜碱组比较,阳性对照组小鼠血清中IL-2、INF-γ和TNF-α水平均升高(P<0.05)。与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠肿瘤组织MVD降低(P<0.05);与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠肿瘤组织MVD降低(P<0.05);与高剂量白屈菜碱组比较,阳性对照组小鼠肿瘤组织中MVD降低(P<0.05)。与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠肿瘤组织中VEGF蛋白表达量减少;与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠肿瘤组织中VEGF蛋白表达量减少;与高剂量白屈菜碱组比较,阳性对照组小鼠肿瘤组织中VEGF蛋白表达量减少;模型组、低剂量白屈菜碱组、高剂量白屈菜碱组和阳性对照组小鼠肿瘤组织VEGF蛋白表达评分比较差异有统计学意义(P<0.05)。Western blotting法,与模型组比较,低和高剂量白屈菜碱组及阳性对照组小鼠肿瘤组织中NF-κB和HIF-1α蛋白表达水平降低(P<0.05);与低剂量白屈菜碱组比较,高剂量白屈菜碱组和阳性对照组小鼠肿瘤组织中NF-κB和HIF-1α蛋白表达水平降低(P<0.05);与高剂量白屈菜碱组比较,阳性对照组小鼠肿瘤组织中NF-κB和HIF-1α蛋白表达水平降低(P<0.05)。结论:白屈菜碱能够抑制Lewis肺癌移植瘤小鼠肿瘤组织生长、保护免疫器官和抑制肿瘤血管生成,可能通过靶向NF-κB/HIF-1α信号通路和下调NF-κB及HIF-1α蛋白表达水平发挥治疗作用。

多西他赛腹腔灌注联合SOX方案化疗与DOS方案化疗对晚期胃癌伴癌性腹水患者生活质量的影响比较

目的比较多西他赛腹腔灌注联合SOX方案化疗与DOS方案化疗对晚期胃癌伴癌性腹水患者生活质量的影响。方法选取2016年1月—2018年1月广西医科大学第一附属医院收治的晚期胃癌伴癌性腹水的患者78例,按1∶1的比例随机分为D-SOX组(双通路模式)和DOS组(传统模式),每组39例。D-SOX组腹腔灌注多西他赛联合SOX方案化疗,DOS组采取多西他赛、奥沙利铂、替吉奥传统模式方案化疗。2组均以21 d为1个周期,每2个周期评估疗效,化疗2~8周期。通过EORTC生活质量测定量表QLQ-C30与QLQ-STO22对2组最佳生活质量改善、改善程度的差异及恶化风险等进行评估。结果D-SOX组中功能量表包括躯体功能、社会功能以及症状量表中与腹水导致相关的症状均有明确改善。特别是在呼吸困难、吞咽困难领域、进食受限领域、口干及疼痛方面,D-SOX组在延缓恶化时间方面较DOS组有明显优势(HR:0.48~0.54)。结论多西他赛腹腔灌注联合SOX方案化疗较DOS方案化疗有更好的生活质量改善优势,对患者体力改善、症状缓解及延缓恶化均有积极作用。

肝窦阻塞综合征的研究进展

肝窦阻塞综合征(HSOS)也被称为肝小静脉闭塞病,是一类由各种原因导致的肝血窦阻塞和肝小静脉闭塞纤维化的肝脏血管性疾病。本文系统阐述了HSOS的认识过程和命名演变、病因和发病机制、临床表现、诊断与鉴别诊断、预防和治疗等方面的研究进展。HSOS可发生于接受骨髓造血干细胞移植清髓处理、放射/化学治疗和摄入含吡咯生物碱药物的人群,常见临床表现为腹胀、肝区胀痛、腹水、黄疸、肝大等。针对不同病因,HSOS的诊断标准也不相同,需要与其他药物性肝病、肝静脉流出道梗阻等疾病相鉴别。去纤苷和低分子肝素分别对造血干细胞和吡咯生物碱相关的HSOS具有治疗作用,奥沙利铂化疗导致的HSOS目前尚无有效治疗药物。