重组人白细胞介素11对非小细胞肺癌患者转移和生存的影响

目的观察重组人白细胞介素11(rhIL-11)对非小细胞肺癌(NSCLC)转移和生存的影响。方法回顾性分析比较2012年6月~2015年6月120例NSCLC患者化疗过程中使用与不使用rhIL-11的患者的肿瘤远处转移发生率、发生转移时间、肿瘤进展时间(TTP)和总生存期(OS)的差异。结果使用rhIL-11的患者60例(A组),未使用的患者60例(B组)。治疗6个月后肿瘤转移率比较:A组、B组为80.0%、63.3%,P=0.043。发生转移时间比较:A组、B组为(5.3±1.3)个月、(5.8±1.2)个月,P=0.026。TTP比较:A组、B组为(4.1±0.8)个月、(4.7±0.8)个月,P=0.000;OS:A组(9.7±0.5)个月,B组(9.9±0.3)个月,两组OS比较,无统计学差异(P=0.053)。结论 rhIL-11可能促进NSCLC转移。

非小细胞肺癌患者血清RUNX3基因异常甲基化的检测及意义

目的探讨非小细胞肺癌患者血清中runt相关转录因子3（runt-related transcription factor3,RUNX3）基因启动子区域甲基化状况及其临床意义。方法甲基化特异性聚合酶链反应（methylation-specific polymerase chain reaction,MSP）法检测62例NSCLC和30例肺部良性疾病患者和16例健康体检者血清中RUNX3启动子区域甲基化状况,并分析其与临床特征的关系。结果 RUNX3甲基化检出率在NSCLC患者为40.32%（25/62）,而肺部良性疾病患者和健康体检者血清未检出（Fisher精确检验,P〈0.05）。NSCLC患者血清RUNX3基因甲基化在腺癌检出率高于鳞癌（51.43%vs.25.93%,χ2=4.12,P〈0.05）,Ⅰ~Ⅱ期甲基化检出率（8/11,72.73%）高于Ⅲ~Ⅳ期（17/51,33.33%）,与NSCLC患者性别、年龄、吸烟指数、分化程度无明显相关（P〉0.05）。结论 RUNX3异常甲基化可能在NSCLC发生、发展中起重要作用,有望成为NSCLC辅助诊断的分子标志。

非小细胞肺癌患者血清O6-甲基鸟嘌呤-DNA-甲基转移酶基因异常甲基化检测及其临床意义

目的探讨非小细胞肺癌（non—small cell lung cancer，NSCLC）患者血清中 O6-甲基鸟嘌呤-DNA-甲基转移酶（ O6-methylguanine-DNA—methyltransferase，MGMT）基因启动子区域甲基化的改变状况及其临床意义。方法基因测序法检测62例NSCLC患者、30例肺部良性疾病患者和16例健康体检者血清中MGMT基因启动子区域甲基化状况，并分析其与临床特征的关系。结果NSCLC患者血清MGMT基因甲基化检出率为27．42％（17／62），而肺部良性疾病患者和健康体检者血清未检出MGMT基因甲基化（Fisher精确概率法，P〈0．01）。MGMT基因甲基化检出率与NSCLC患者年龄、性别、病理类型、分化程度无明显相关，但在晚期患者中检出率较高（P〈0．05）。MGMT基因甲基化患者吸烟指数（年·支）明显高于非甲基化患者（P〈0．01）。结论MGMT基因异常甲基化可能在NSCLC发生、发展中起重要作用，有望成为NSCLC辅助诊断的分子标记。

HRCT Scans of Peripheral Non-Small Cell Lung Cancers and their Relationship with Cyclin D1 Expression:a Longitudinal Study

OBJECTIVE To investigate cyclin D1 expression in peripheral lung cancers and its relationship with CT signs and prognosis. METHODS Cyclin D1 expression in peripheral lung cancers and its relationship with the CT imaging and prognosis were analyzed retrospectively by means of SP immunohistochemistry and spiral CT scanning in 92 patients with peripheral lung cancer verified by pathology. RESULTS Cyclin D1 expression was related to deep lobulation,spiculate protuberance,short thin spinules sign and mediastina lymph node metastasis.Cyclin D1 expression was not related to tumor size,cavity,pleural indentation,histological type,differentiation,tumor TNM stage,age or sex.Cyclin D1 was a negative prognostic factor whose over-expression indicated a poor prognosis. CONCLUSION Cyclin D1 expression may play an important role in the occurrence,progress and CT scan results of lung cancers.Cyclin D1 was a negative factor whose over-expression implied a poor prognosis.Detection of the cyclin D1 and observation of the CT scan can be considered as indexes of clinical diagnosis and prognostic evaluation.

The short-term efficacy of icotinib on the treatment of advanced non-small-cell lung cancer

Objective： The aim of the study was, （1） to observe the short-term efficacy and adverse reactions of icotinib hydrochloride on the treatment of advanced non-small cell lung cancer （NSCLC）; （2） to explore whether there is difference in the efficacy of icotinib hydrochloride among the subgroups of sex, age, smoking history, classification of CEA, histological type, multi-line treatment and PS score. Methods： The study was conducted to collect 138 patients taking icotinib hydrochloride with advanced non-small cell lung cancer in hospitals of Dalian （China） from September 1st 2011 to June 14th 2012. All patients had taken icotinib hydrochloride （125 mg three times a day） until the disease was progressed or the adverse reactions could not be tolerated. During the period of taking it, other anti-tumor treatments were forbidden. We observed the symptoms, such as cough, short breath, hemoptysis, pain. The objective efficacy was evaluated by RECIST criteria, and the adverse reactions related to the treatment was assessed on the basis of NCl-CTC 3.0. Results： Of all patients, CR was 1 （0.7%）, PR was 59 （42.8%）, SD was 37 （26.8%）, PD was 41 （29.7%）. And ORR was 43.5% （60/138）, DCR 70.3% （97/138）. The DCR of females was 83.5% （71/85） versus 49.1% （26/53） of males. The difference of ORR and DCR between the two subgroups had statistical significance （X2 = 8.065, P = 0.05; X2 = 18.577, P = 0.000）. The difference of ORR and DCR between the subgroups of patients after or before 70 years old had no statistical significance. The difference of ORR and DCR between the subgroups of smoking and non-smoking had statistical significance （X2 = 8.492; X2 = 13.602）. The difference of ORR and DCR between the CEA subgroups had statistical significance （X2 = 14.141; X2 = 14.160）, showed 81 patients with abnormal CEA before the treatment with ORR 56.8.0% （46/81）, DCR 81.5% （66/81）; 57 patients of normal CEA before the treatment with ORR 24.6% （14/57）, DCR 52.6% （30/57）. The 36 patients （26.1%） using icotinib hydrochloride as the first-line treatment, 78 patients （56.5%） using icotinib hydrochloride as the second-line, 20 patients （14.5%） using icotinib hydrochloride as the third-line, and 4 patients （2.9%） with tyrosine kinase inhibitor （TKI） resistance, there was statistical difference of DCR among the multi-groups above （~2 = 11.734, P = 0.008）. ORR was 31.1% （14/45） versus DCR 53.3% （24/45） in 45 patients with PS 3-4 points, and ORR was 49.4% （46/93） versus DCR 78.5% （73/93） in 93 patients with PS 0-2 points, and there was statistical difference （X2 = 4.156; X2 = 9.149）. The main adverse reactions were rash （26.8%）, diarrhea （13.8%）, mild liver function abnormal （10.9%）. Conclusion： The short-term efficacy of icotinib hydrochloride on the treatment of advanced NSCLC is positive, and the relevant adverse reactions are mild. The efficacy is better when the patient is female, non-smoker, treated as first-line, with higher CEA before treatment and lower PS scores.

Screening study on new tumor marker periplakin for lung cancer

Objective: The aim of this study was to use lung cancer targeting binding polypeptide ZS-9 to screen cDNA library of human lung cancer and obtain ZS-9 specific ligand to confirm tumor marker of non small-cell lung cancer. Methods: Artificially synthesize biotin labeled peptide ZS-9, anchored ZS-9 in the enzyme label plate coupled by avidin, used ZS-9 as probe to screen cDNA library of human lung cancer, after screening, obtained bacteriophage clone specifically binding with anchored polypeptide ZS-9. Extracted plasmid of bacteriophage and performed sequencing after amplified by PCR. Results: It was demonstrated by bioinformatic analysis on the sequence of ligand binded by lung cancer specific peptide ZS-9 that the ligand was the cytoskeletal protein periplakin on the surface of lung cancer cells, suggesting that periplakin might be a new marker for non-small-cell lung cancer in lung cancer. Conclusion: Use specific lung cancer binding peptide to screen new tumor marker periplakin in lung cancer and further studies on its biologic functions in genesis and development of lung cancer are still needed.