Risk stratification in gastric cancer lung metastasis: Utilizing an overall survival nomogram and comparing it with previous staging

BACKGROUND Gastric cancer(GC)is prevalent and aggressive,especially when patients have distant lung metastases,which often places patients into advanced stages.By identifying prognostic variables for lung metastasis in GC patients,it may be po-ssible to construct a good prediction model for both overall survival(OS)and the cumulative incidence prediction(CIP)plot of the tumour.AIM To investigate the predictors of GC with lung metastasis(GCLM)to produce nomograms for OS and generate CIP by using cancer-specific survival(CSS)data.METHODS Data from January 2000 to December 2020 involving 1652 patients with GCLM were obtained from the Surveillance,epidemiology,and end results program database.The major observational endpoint was OS;hence,patients were se-parated into training and validation groups.Correlation analysis determined va-rious connections.Univariate and multivariate Cox analyses validated the independent predictive factors.Nomogram distinction and calibration were performed with the time-dependent area under the curve(AUC)and calibration curves.To evaluate the accuracy and clinical usefulness of the nomograms,decision curve analysis(DCA)was performed.The clinical utility of the novel prognostic model was compared to that of the 7th edition of the American Joint Committee on Cancer(AJCC)staging system by utilizing Net Reclassification Improvement(NRI)and Integrated Discrimination Improvement(IDI).Finally,the OS prognostic model and Cox-AJCC risk stratification model modified for the AJCC system were compared.RESULTS For the purpose of creating the OS nomogram,a CIP plot based on CSS was generated.Cox multivariate regression analysis identified eleven significant prognostic factors(P<0.05)related to liver metastasis,bone metastasis,primary site,surgery,regional surgery,treatment sequence,chemotherapy,radiotherapy,positive lymph node count,N staging,and time from diagnosis to treatment.It was clear from the DCA(net benefit>0),time-de-pendent ROC curve(training/validation set AUC>0.7),and calibration curve(reliability slope closer to 45 degrees)results that the OS nomogram demonstrated a high level of predictive efficiency.The OS prediction model(New Model AUC=0.83)also performed much better than the old Cox-AJCC model(AUC difference between the new model and the old model greater than 0)in terms of risk stratification(P<0.0001)and verification using the IDI and NRI.CONCLUSION The OS nomogram for GCLM successfully predicts 1-and 3-year OS.Moreover,this approach can help to ap-propriately classify patients into high-risk and low-risk groups,thereby guiding treatment.

Different types of tumor microvessels in stageⅠ-ⅢA squamous cell lung cancer and their clinical significance

BACKGROUND Lung cancer(LC)is the leading cause of morbidity and mortality among malignant neoplasms.Improving the diagnosis and treatment of LC remains an urgent task of modern oncology.Previously,we established that in gastric,breast and cervical cancer,tumor microvessels(MVs)differ in morphology and have different prognostic significance.The connection between different types of tumor MVs and the progression of LC is not well understood.AIM To evaluate the morphological features and clinical significance of tumor MVs in lung squamous cell carcinoma(LUSC).METHODS A single-center retrospective cohort study examined medical records and archival paraffin blocks of 62 and 180 patients with stage I-IIIA LUSC in the training and main cohorts,respectively.All patients underwent radical surgery(R0)at the Orenburg Regional Cancer Clinic from May/20/2009 to December/14/2021.Tumor sections were routinely processed,and routine Mayer's hematoxylin and eosin staining and immunohistochemical staining for cluster of differentiation 34(CD34),podoplanin,Snail and hypoxia-inducible factor-1 alpha were performed.The morphological features of different types of tumor MVs,tumor parenchyma and stroma were studied according to clinicopathological characteristics and LUSC prognosis.Statistical analysis was performed using Statistica 10.0 software.Univariate and multivariate logistic regression analyses were performed to identify potential risk factors for LUSC metastasis to regional lymph nodes(RLNs)and disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with and without metastases in RLNs and those with and without disease recurrence.The effectiveness of the predictive models was assessed by the area under the curve.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.A value of P<0.05 was considered to indicate statistical significance.RESULTS Depending on the morphology,we classified tumor vessels into the following types:normal MVs,dilated capillaries(DCs),atypical DCs,DCs with weak expression of CD34,"contact-type"DCs,structures with partial endothelial linings,capillaries in the tumor solid component and lymphatic vessels in lymphoid and polymorphocellular infiltrates.We also evaluated the presence of loose,fine fibrous connective tissue(LFFCT)and retraction clefts in the tumor stroma,tumor spread into the alveolar air spaces(AASs)and fragmentation of the tumor solid component.According to multivariate analysis,the independent predictors of LUSC metastasis in RLNs were central tumor location(P<0.00001),the presence of retraction clefts(P=0.003),capillaries in the tumor solid component(P=0.023)and fragmentation in the tumor solid component(P=0.009),whereas the independent predictors of LUSC recurrence were tumor grade 3(G3)(P=0.001),stage N2(P=0.016),the presence of LFFCT in the tumor stroma(P<0.00001),fragmentation of the tumor solid component(P=0.0001),and the absence of tumor spread through the AASs(P=0.0083).CONCLUSION The results obtained confirm the correctness of our previously proposed classification of different types of tumor vessels and may contribute to improving the diagnosis and treatment of LUSC.

Recursive Partitioning Analysis Classification and Graded Prognostic Assessment for Non-Small Cell Lung Cancer Patients with Brain Metastasis:A Retrospective Cohort Study

Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients with brain metastasis （BM）.Methods：From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors （TKIs） in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox＇s regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models （RPA and GPA） were validated respectively.Results：All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval （95% CI） was 14 （12.3-15.8） months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different （P0.001）.In the multivariate analysis as RPA and GPA entered Cox＇s regression model,Karnofsky performance status （KPS） ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion：KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.

Elevated Circulating Levels of Osteopontin Are Associated with Metastasisin Advanced Non-Small Cell Lung Cancer

Objective：To investigate the relationship between postoperative metastasis and circulating levels of osteopontin in non-small cell lung cancer（NSCLC）.Methods：The expression of osteopontin mRNA were detected with RT-PCR technique.The circulating levels of osteopontin were measured through ELASA in 46 NSCLC cases that had not been received any anti-cancer treatment at the time of sampling.The tissues from fifteen patients with benign pulmonary diseases were studied as control group.Results：The overall median mRNA expression level of osteopontin was approximately 70-fold higher in tumor tissues than in matched normal lung tissues（P0.001）.Over-expression of osteopontin mRNA was significantly associated with clinical stage（P=0.009）.Advanced disease states had higher circulating level of osteopontin（stage I＋II versus stage III＋VI）.In multivariate analysis,stage was the only independent factor influencing circulating levels of osteopontin.All patients were followed up for 12 months,2 of the 46 patients with both osteopontin mRNA expression and elevated plasma osteopontin levels had local recurrence and 10 had distant metastasis.There was a significant difference in the osteopontin levels between metastasis group and non-metastasis group.Conclusion：Preoperative plasma levels of osteopontin are significantly associated with post-operative metastasis in advanced NSCLC.

The surgical prognosis of pIIIA/N2 non-small-cell lung cancers

Objective: The aim of the study was to identify prognostic factors in non-small-cell lung cancer (NSCLC) with N2 nodal involvement.Methods: A retrospective analysis of disease free survival and 5-year survival for NSCLC patients who underwent primary surgical resection without neoadjuvant chemotherapy were performed.Between January 1998 and May 2004,133 patients were enrolled.Several factors such as age,sex,skip metastasis,number of N2 lymph node stations,type of resection,histology,adjuvant therapy etc.,were recorded and analyzed.SPSS 16.0 software was used.Results: Overall 5-year survival for 133 patients was 32.33%,5-year survival for single N2 station and multiple N2 stations sub-groups were 39.62% and 27.50% respectively,and 5-year survival for cN0–1 and cN2 sub-groups were 37.78% and 20.93% respectively.COX regression analysis revealed that number of N2 station (P = 0.013,OR: 0.490,95% CI: 0.427–0.781) and cN status (P = 0.009,OR: 0.607,95% CI: 0.372–0.992) were two favorable prognostic factors of survival.Conclusion: Number of N2 station and cN status were two favorable prognostic factors of survival.In restrict enrolled circumstances,after combined therapy made up of surgery and postoperative adjuvant therapy have been performed,satisfied survival could be achieved.

Expression of Maspin in Non-small Cell Lung Cancer and Its Relationship to Vasculogenic Mimicry

Maspin belongs to the serine protease inhibitor （serpin） family and has been proven to be a suppressor of tumor growth and metastasis in many types of tumors. The purpose of this study was to investigate the expression of maspin in non-small cell lung cancer （NSCLC） and its relationship to vasculogenic mimicry （VM）. A total of 160 specimens of NSCLC were involved in this study and 20 specimens of normal lung tissue served as controls. VM, microvessel density （MVD） and the expression of maspin were detected by using immunohistochemical staining. The results showed that the positive rates of maspin and VM in the NSCLC group were 48.1% （77/160） and 36.9% （59/160）, respectively, which were significantly different from those in the control group with the positive rates of maspin and VM being 100% and 0% respectively （P〈0.05）. VM, MVD and the expression level of maspin were significantly related to tumor differentiation, lymph node metastasis, clinical stages and postoperative survival time （all P〈0.05）. The maspin expression in patients with squamous cell carcinoma was significantly higher than that in those with adenocarcinoma （P〈0.05）. The maspin expression was negatively correlated with VM and MVD, and there was a positive correlation between VM and MVD. Maspin-negative expression, VM and high MVD score were negatively related to the 5-year-survival rate. PTNM stages, VM, MVD and maspin expression were independent prognostic factors for NSCLC （P〈0.05）. It was suggested that the loss of expression of maspin may participate in the invasion and metastasis of NSCLC and it has a positive relationship to VM in NSCLC. Combined detection of maspin, VM and MVD may help predict the progression and prognosis of NSCLC.

Role of surgical intervention in managing gastrointestinal metastases from lung cancer

AIM:To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal(GI)-tract metastases,focusing on therapeutic options and outcomes.METHODS:Our institution(the National Taiwan University Hospital) diagnosed 8159 patients with lung cancer between 1987 and 2008,of which 21 developed symptomatic GI metastases.This study reviewed all of the patients' information,including survival data,pathological reports,and surgical notes.RESULTS:The most common histological type of lung cancer was adenocarcinoma,and 0.26% of patients with lung cancer developed GI metastases.The median duration from lung cancer diagnosis to GI metastases was three months(range,0-108 mo),and the average time from diagnosis of GI metastasis to death was 2.8 mo.Most patients with symptomatic gastric and/or duodenal metastases exhibited GI bleeding and were diagnosed by panendoscopy.In contrast,small bowel metastases typically presented as an acute abdomen and were not diagnosed until laparotomy.All patients with small bowel or colonic metastases underwent surgical intervention,and their perioperative mortality was 22%.Our data revealed a therapeutic effect in patients with solitary GI metastasis and a favorable palliative effect on survival when metastases were diagnosed preoperatively.In patients with multiple GI metastases,the presentation varied according to the locations of the metastases.CONCLUSION:Surgical treatment is worthwhile in a select group of patients with bowel perforation or obstruction.Physicians should be more alert to symptoms or signs indicating GI metastases.

Correlation between mitochondrial TRAP-1 expression and lymph node metastasis in colorectal cancer

AIM： To evaluate the effect of mitochondrial tumor ne- crosis factor receptor-associated protein-1 （TRAP-l） on the lymph node metastasis （LNM） in Chinese colorectal cancer （CRC） patients, and develop potential LNM- associated biomarkers for CRC using quantitative real- time polymerase chain reaction （RT-PCR） analysis. METHODS： Differences in mitochondrial TRAP-1 gene expression between primary CRC with LNM （LNM CRC） and without LNM （non-LNM CRC） were assessed in 96 Chinese colorectal carcinoma samples using quantita- tive RT-PCR analysis, Western blotting, and confirmed with immunohistochemical assay. The relationship between clinicopathological parameters and potential diaclnostic biomarkers was also examined.RESULTS： TRAP-1 was significantly upregulated in LNM CRC compared with non-LNM CRC, which was confirmed by RT-PCR, Western blotting and immuno- histochemical assay. The expression of TRAP-1 in two different metastatic potential human colorectal cancer cell lines, LoVo and HT29, was analyzed with Western blotting. The expression level of TRAP-1 was dramati- cally higher in LoVo than in HT29. Overexpression of TRAP-1 was significantly associated with LNM （90.2% in LNM group vs 22% in non-LNM group, P 〈 0.001）, the advanced tumor node metastasis stage （89.1% in LNM group vs 26.9% in non-LNM group, P 〈 0.001）, the increased 5-year recurrence rate （82.7% in LNM group vs 22.6% in non-LNM group, P 〈 0.001） and the decreased 5-year overall survival rate （48.4% in LNM vs 83.2% in non-LNM group, P 〈 0.001）. Univariate and multivariate analyses indicated that TRAP-1 expression was an independent prognostic factor for recurrence and survival of CRC patients （Hazard ratio of 2.445 in recurrence, P = 0.017; 2.867 in survival, P = 0.028）. CONCLUSION： Mitochondria TRAP-1 affects the lymph node metastasis in CRC, and may be a potential bio- marker for LNM and a prognostic factor in CRC. Over- expression of TRAP-1 is a predictive factor for the poor outcome of colorectal cancer patients. 2012 Baishideng. All rights reserved

Prognostic factors in patients with stage IV non-small cell lung cancer

Objective： To investigate the prognostic factors for stage Ⅳ non-small cell lung cancer （NSCLC） with distant metastasis and establish a reliable model of clinical prognostic index. Methods： From January 1990 to April 2005, 313 primary NSCLC patients with metastasis, who had been treated in Shanghai Chest Hospital, were reviewed. Survival time was estimated according to the Kaplan-Meier method. Cox proportional hazard regression model was used for multivariate analysis. Results：Among the 313 cases of non-small cell lung cancer （NSCLC） at stage Ⅳ, there were 218 and 95 patients with metastasis to single and different organs, respectively. The overall median survival time for all 313 cases of NSCLC patients was 10.8 （9.00, 12.30） months and the overall 1-, 2-, 3-, 4- and 5-year survival rate was 45%, 18%, 12%, 4% and 0%. There were 63, 174, 127, 36, 18, 11 and 5 patients with metastasis to brain （20.13%）, bone （55.59%）, lung （40.58%）, liver （11.50%）, adrenal gland （5.75%）, subcutaneous （3.51%） and others, respectively. The survival time was shortest in subcutaneous metastasis （4.6 months）, and liver 7.0 months, brain 8.0 months, adrenal gland 8.6 months, bone 10.6 months, lung 11.8 months. Kaplan-Meier estimation showed that patients anatomic typing, KPS, numbers of organ with metastasis, appetite, liver, adrenal gland and subcutaneous metastasis, body weight loss, smoking, index of smoking, chemotherapy, cycles of chemotherapy were the predictors of survival. Multivariate analysis showed survival statistically significant correlation with anatomic typing, KPS, appetite, liver and subcutaneous metastasis, body weight loss, cycles of chemotherapy. The relative risk （RR） was 1.51, 1.97, 1.55, 1.67, 2.56, and 2.56 respectively. Conclusion： Survival time decreases distinctly in patients who had distant metastasis to more than two different organs （P〈0.01）. Bone is the commonest organ for distant metastasis in lung cancer. The prognosis is poor when lung cancer appears subcutaneous metastasis and liver metastasis. Independent prognostic factors in patient with stage Ⅳ non-small cell lung cancer were liver and subcutaneous metastasis, anatomic typing, KPS, appetite, body weight loss, cycles of chemotherapy.

Expressions of Livin and Smac Proteins in Non-Small Cell Lung Cancer

Objective： To investigate the expression characteristics of Livin and second mitochondrial activator of Caspase （Smac） proteins in non-small cell lung cancer （NSCLC）, and analyze their effect on patients＇ prognosis. Methods： The expressions of Livin and Smac proteins were detected in 89 NSCLC tissue samples and 25 normal lung tissue samples by immunohistochemical technique. Results： The positive expression rates of Livin and Smac proteins in NSCLC tissues were 53.9%, and 58.4% respectively, higher than that in normal lung tissues（P〈0.01）. Livin protein expression correlated with Smac protein significantly（Χ^2=1 8.451, P=0.000, r=0.455）. The expression level of Livin protein was closely related to lymph node metastasis, TNM stage and histological type （P〈0.05）, but not to sex, age, differentiation grade （P〉0.05）. The expression level of Smac protein was closely related to lymph node metastasis, TNM stage （P〈0.01）, but not to sex, age, histological types （P〉0.05）. Kaplan-Meier analysis revealed a significant impact on survival by Livin protein in NSCLC （P〈0.01）, but not by Smac protein （P〉0.05）. Conclusion： Overexpression of Livin protein may play a promoting role in the occurrence and progression of NSCLC. Moreover, it may bring an adverse effect on patients＇ prognosis. Although overexpression of Smac protein affects the occurrence and progression of NSCLC, it has no relationship with the prognosis. Livin protein may be helpful to evaluate the progression of NSCLC, and to predict the prognosis.

非小细胞肺癌新辅助免疫治疗的预后影响因素:病理淋巴结转移程度与原发灶缓解程度

目的探讨新辅助免疫治疗后病理淋巴结转移情况及原发灶缓解程度对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的影响。方法回顾性分析40例接受新辅助免疫治疗后行手术切除的NSCLC患者的临床病理资料。评估病理淋巴结分期(N1/N2)和原发灶缓解程度[完全缓解(pathological complete response,pCR)/主要缓解(major pathological response,MPR)/非客观缓解(non-objective response,non-OR)]与无进展生存期(progression-free survival,PFS)的关系,并构建预后风险分层模型。结果病理淋巴结分期和原发灶缓解程度单独考虑时,与PFS无显著相关性,且两者无显著交互作用。对于N1患者,pCR/MPR的PFS优于non-OR(P=0.038);对于N2患者,原发灶缓解程度与PFS无显著相关性。将患者分为低危组(N1+pCR/MPR)和高危组(N1+non-OR/N2),两组PFS差异显著(P=0.003)。结论新辅助免疫治疗后,病理淋巴结转移程度和原发灶缓解程度是NSCLC预后的关键影响因素。基于两者的预后风险分层模型有助于指导个体化治疗决策,但仍需前瞻性研究验证。

伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素

目的:分析伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素。方法:回顾性分析2022年1月至2023年1月在该院接受伽马刀立体定向放射治疗的121例肺癌脑转移瘤患者的临床资料。统计伽玛刀立体定向放射治疗肺癌脑转移瘤患者的预后情况,采用Logistic回归分析伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素。结果:121例伽马刀立体定向放射治疗肺癌脑转移瘤患者预后不良40例,设为预后不良组,预后良好81例,设为预后良好组;预后不良组脑转移瘤最大直径≥3 cm、血清鳞状细胞癌抗原(SCC-Ag)≥3.80 ng/mL、血清细胞角蛋白19片段(CYFRA21-1)≥7.52 ng/mL、血清神经元特异性烯醇化酶(NSE)≥50.81μg/L占比均高于预后良好组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,血清SCC-Ag≥3.80 ng/mL、血清NSE≥50.81μg/L均为伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的危险因素(OR>1,P<0.05)。结论:血清SCC-Ag≥3.80 ng/mL、血清NSE≥50.81μg/L均为伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的危险因素。

非小细胞肺癌脑转移高危因素分析

目的分析影响非小细胞肺癌(NSCLC)脑转移的高危因素。方法回顾性分析2020-2024年福建医科大学肿瘤临床医学院/福建省肿瘤医院/复旦大学附属肿瘤医院福建医院收治的258例NSCLC患者的性别、年龄等临床及病理类型、分子病理信息,结合采用的治疗方式,综合分析影响NSCLC脑转移的高危因素。结果(1)年轻、女性患者,EGFR突变及ALK基因重排NSCLC患者,脑转移发生率上升。(2)年轻NSCLC患者出现脑膜转移的风险较高,EGFR突变NSCLC患者出现脑膜转移的风险显著增加。(3)针对NSCLC脑转移患者,在靶向治疗的基础上,配合脑部放疗、抗肿瘤血管生成及免疫治疗;而如果患者出现脑膜转移,在靶向治疗的基础进行抗肿瘤血管生成治疗。结论NSCLC脑转移的高危因素包括年轻、女性、EGFR突变及合并ALK重排突变。通过早期识别和干预这些高危因素,有助于提高NSCLC脑转移患者的生存率和生活质量。

不同病理分型的初治非小细胞肺癌骨转移患者的预后分析

目的了解不同病理类型的初治非小细胞肺癌(Non-small cell lung cancer,NSCLC)骨转移患者经过不同一线治疗方案的预后,以便对临床预测疾病进展、指导治疗、改善预后提供帮助。方法选择安徽医科大学附属巢湖医院2019年1月1日至2023年12月31日收入初治伴有骨转移的403名NSCLC患者,运用生存分析(Log-rank检验)进行单因素分析,Cox回归多因素分析,发现组织病理分型是影响患者预后的独立因素(P=0.001,HR=1.952),之后去除该因素对预后的影响,将全部人数按照病理组织分型分为腺癌组(316例)、鳞癌组(87例)两组后再次使用Cox回归模型进行多因素分析,分析影响生存预后的因素。结果在此次数据分析中,病理类型为鳞癌的患者的中位生存期(median overall survival,mOS)为15月(95%CI:12.85~17.15),中位无进展生存期(median progression-free survival,mPFS)为9月(95%CI:7.34~10.67),而腺癌组患者的mOS为25月(95%CI:23.26~26.74),mPFS为16月(95%CI:14.43~17.57),差异有统计学意义。整体组的OS受到多方面因素的影响,包括初诊时美国东部肿瘤协作组织(Eastern Cooperative Oncology Group,ECOG)评分状态(1分/>1分)、骨转移至躯干+四肢骨+颅骨、骨转移灶数量≥4个、ALK靶点基因突变、以及一线治疗使用化疗+靶向治疗等因素影响;同样地,PFS也受到上述因素的影响。另外在以病理组织分型为依据的腺癌组模型以及鳞癌组模型中得出化疗+靶向治疗,化疗+免疫治疗分别为两组的保护因素,ALK靶点基因突变仅为腺癌组的保护因素。结论本研究进一步确认了初治NSCLC骨转移患者的预后影响因素,为临床治疗提供了重要参考。

结肠癌肝转移与肺转移关键基因集筛选及功能分析

目的挖掘结肠癌转移的关键基因及其临床意义。方法基于TCGA和GEO(GSE41258)中的结肠癌数据集,利用WGCNA包和Limma包分析结肠癌转移相关的基因集,并分析基因集对预后及肿瘤临床分其的影响。随后利用Metascape构建每一个关键基因的蛋白互作网络,并利用DAVID根据蛋白互作网络进行功能富集分析。最后,利用TIDE数据库,从免疫角度分析关键基因对细胞毒性T细胞的免疫浸润以及免疫应答的影响。结果本研究筛选出了CNN1、CXCL10、CXCL11、MGP、SPINK4和PBK 6个关键基因,不仅影响患者预后,同时与结肠癌的肿瘤分期呈现线性关系。通过KEGG与GO富集发现结肠癌肝转移关键基因网络调控细胞因子功能、中心粒细胞驱化以及单核细胞驱化等免疫过程,而在结肠癌肺转移关键基因网络调控RAS信号通路,这些结果揭示了结肠癌不同转移途径的机制差异。其中,CNN1、MGP抑制细胞毒性T细胞的免疫应答,PBK促进细胞毒性T细胞的免疫应答。结论CNN1、CXCL10、CXCL11、MGP、SPINK4和PBK 6个基因可以作为结肠癌转移的筛查分子标志物,并在结肠癌的免疫治疗中发挥作用,为潜在的结肠癌的治疗靶标。

Tis~T1期非小细胞肺癌脏层胸膜受累与淋巴结转移的相关性

目的探讨Tis~T1期非小细胞肺癌(NSCLC)脏层胸膜受累情况与淋巴结转移的相关性。方法回顾性分析84例Tis~T1期NSCLC患者的临床资料。所有患者均行肺叶切除术+系统性淋巴结清扫术治疗,术后将病理标本送检,明确患者胸膜脏层浸润(VPI)状态,依据VPI分为分为PL0组与PL1/PL2组。收集两组患者年龄、性别、体质量指数、基础疾病、肿瘤大小、病理类型、肿瘤位置、脉管瘤栓、术前癌胚抗原(CEA)水平、基础疾病及淋巴结转移情况等资料。分析VPI与临床病理特征及淋巴结转移的关系。结果84例患者中18例合并VPI,脏层胸膜受累率为21.43%(18/84);PL1/PL2组肿瘤大小2~3 cm、术前CEA水平≥3.5 ng/L占比高于PL0组,差异有统计学意义(P<0.05);PL1/PL2组淋巴结转移率、N2比率高于PL0组,差异有统计学意义(P<0.05)。结论Tis~T1期NSCLC患者VPI与淋巴结转移存在密切关系,当合并VPI时则需考虑存在淋巴结转移,术中应予以广泛淋巴结清扫,避免术后复发转移。

肺癌组织中GALNT7的表达变化及其临床意义

目的 探讨N-乙酰氨基半乳糖转移酶7(GALNT7)在肺癌组织中的表达及其与临床病理特征和预后的关系。方法 收集2016年2月至2018年2月深圳市龙华区人民医院90例接受手术切除的肺癌患者癌组织及配对癌旁正常组织标本。采用免疫组织化学法检测肺癌组织及癌旁正常组织中GALNT7蛋白表达;采用实时荧光定量PCR(qPCR)检测肺癌组织及癌旁正常组织中GALNT7 mRNA的相对表达水平;分析GALNT7 mRNA表达与肺癌患者的临床病理特征及预后的关系。Kaplan-Meier法分析GALNT7表达与患者生存率之间的关系;Cox比例风险回归模型分析影响患者预后的独立因素。结果 GALNT7蛋白在肺癌组织中的高表达率为55.56%(50/90),显著高于癌旁正常组织中的11.11%(10/90),差异有统计学意义(P<0.05)。肺癌组织的GALNT7 mRNA表达水平为1.51±0.25,显著高于癌旁正常组织(1.02±0.18),差异有统计学意义(P<0.05)。GALNT7 mRNA表达与肿瘤大小、吸烟史、TNM分期、分化程度及淋巴结转移有关(P<0.05)。Kaplan-Meier生存分析显示,GALNT7低表达组患者的5年生存率显著高于高表达组(P<0.05);多因素Cox回归分析显示,淋巴结转移、GALNT7水平是影响肺癌患者预后的独立因素(P<0.05)。结论 GALNT7异常高表达参与肺癌的发生,且有作为肺癌患者预后预测分子标志物的潜力。

血清LncRNA MALAT1和microRNA-124水平检测对非小细胞肺癌患者预后的评估价值

目的:探究长链非编码RNA-转移相关肺腺癌转录本1(LncRNA MALAT1)和微小RNA-124(microRNA-124)对非小细胞肺癌(NSCLC)患者预后的预测效能。方法:选取2020年06月至2022年06月我院收治的124例NSCLC患者作为研究对象,入院后,收集患者的病历资料,检测入院时外周血LncRNA MALAT1、microRNA-124的相对表达量。电话随访12个月记录患者的死亡率,分为生存组和死亡组,分析NSCLC患者预后的影响因素,评估血清LncRNA MALAT1、microRNA-124对NSCLC患者预后的预测效能。结果:死亡组患者的IV期占比及LncRNA MALAT1相对表达量高于生存组,microRNA-124相对表达量低于生存组。Logistic遂步分析显示,病理分期IV期(OR=12.342,95%CI:4.295~36.765)、LncRNA MALAT1(OR=5.371,95%CI:1.836~15.714)及microRNA-124(OR=0.257,95%CI:0.089~0.752)是NSCLC患者死亡的影响因素(P<0.05)。LncRNA MALAT1与microRNA-124呈负相关(P<0.05)。受试者工作特性曲线(ROC)分析显示,LncRNA MALAT1及microRNA-124单一及联合预测NSCLC患者预后的灵敏度分别为0.741(95%CI:0.601~0.846)、0.759(95%CI:0.621~0.861)、0.815(95%CI:0.682~0.903),特异度分别为0.825(95%CI:0.705~0.906)、0.762(95%CI:0.635~0.856)、0.841(95%CI:0.723~0.917),曲线下面积(AUC)分别为0.781、0.760、0.839。联合预测效能更高(P<0.05)。结论:LncRNA MALAT1及microRNA-124可用于预测NSCLC患者的预后,且预测效能良好。

立体定向放射治疗对非小细胞肺癌脑转移患者肿瘤标志物及预后的影响

目的探讨立体定向放射治疗对非小细胞肺癌(NSCLC)脑转移患者肿瘤标志物及预后的影响。方法选取2019年1月至2021年12月山东省戴庄医院收治的NSCLC脑转移患者60例,按随机数表法分为对照组和观察组,每组各30例。对照组予以常规化疗,观察组加用立体定向放射治疗,化疗3个周期后评价。比较两组临床疗效、生存情况、肿瘤标志物、生存质量及不良反应发生情况。结果观察组临床疗效、生存情况优于对照组,差异有统计学意义(P<0.05);治疗后,观察组肿瘤标志物水平低于对照组,生活质量各领域评分高于对照组,差异有统计学意义(P<0.05);两组各不良反应发生率比较,差异无统计学意义(P>0.05)。结论立体定向放射治疗有利于NSCLC脑转移患者病情控制,可降低肿瘤标志物水平,改善患者生存情况,且安全可靠,值得临床应用。

表皮生长因子受体在非小细胞肺癌中的表达及与患者临床特征的关系

目的探讨表皮生长因子受体(EGFR)在非小细胞肺癌(NSCLC)中的表达及与患者临床特征的关系。方法收集95例NSCLC患者的NSCLC组织和癌旁正常组织,采用免疫组化法检测各组织中EGFR表达情况,比较不同临床特征NSCLC患者NSCLC组织中的EGFR表达情况。结果NSCLC组织中EGFR阳性表达率明显高于癌旁正常组织,差异有统计学意义(P﹤0.01)。有淋巴结转移和预后差NSCLC患者NSCLC组织中EGFR阳性表达率分别高于无淋巴结转移和预后良好患者,差异均有统计学意义(P﹤0.05)。结论EGFR在NSCLC患者中高表达,EGFR检测可用于诊断NSCLC,并预测预后,与患者淋巴结转移密切相关。