Correlation between ultrasonic tumor volume doubling time (TVDT) and malignant molecule expression in breast cancer

Objective:To investigate the correlation between ultrasonic tumor volume doubling time (TVDT) and malignant molecule expression in breast cancer.Methods: A total of 118 patients with breast cancer undergoing surgical treatment in this hospital between August 2016 and August 2017 were selected as breast cancer group and 100 patients with breast adenoma undergoing adenoma resection in this hospital during the same period were selected as breast adenoma group. The differences in TVDT levels as well as proliferation-related gene and invasion-related gene mRNA expression in lesion tissue were compared between the two groups of patients. Pearson test was used to assess the intrinsic relationship between ultrasonic TVDT level in patients with breast cancer and malignant molecule expression in tumor. Results: The tumor TVDT level of breast cancer group was lower than that of breast adenoma group;pro-proliferation genes PKM2, Notch1 and FSCN1 mRNA expression in tumor tissue of breast cancer group were higher than those of breast adenoma group whereas anti-proliferation genes FBXW7, HSG and EBP50 mRNA expression were lower than those of breast adenoma group;pro-invasion genes Gab2 and VEGF mRNA expression in tumor tissue of breast cancer group were higher than those of breast adenoma group whereas anti-invasion genes NDRG1, DKK-1 and NUAK1 mRNA expression were lower than those of breast adenoma group. The Pearson test showed that the TVDT level of breast cancer was directly correlated with the expression of proliferation-related genes and invasion-related genes.Conclusion: Ultrasonic TVDT level of breast cancer decreases abnormally, and the specific TVDT level is directly correlated with tumor cell proliferation and invasion activity.

Evaluation of imatinib mesylate(Gleevec) on KAI1/CD82 gene expression in breast cancer MCF-7 cells using quantitative real-time PCR

Objective: To evaluate the effect of imatinib mesylate on cell viability, anti cancer effect through modulation of KAI1/CD82 gene expression in breast cancer MCF-7 cell line.Methods: The effects of imatinib mesylate on cell viability in MCF-7 cell line were assessed using MTT assay and IC_(50) value was determined. GAPDH and KAI1/CD82 were selected as reference and target genes, respectively. Quantitative real time PCR technique was applied for investigation of KAI1/CD82 gene expression in human breast cancer MCF-7 cells. Subsequently, the quantity of KAI1 compared to GAPDH gene expressions were analyzed using the formula; 2^(-DDCt).Results: Imatinib was showed to have a dose-dependent inhibitory effect on the viability of MCF-7 cells. CD82/GAPDH gene expression ratios were 1.322 ± 0.030(P > 0.05),2.052 ± 0.200(P < 0.05), 2.151 ± 0.270(P < 0.05) for 10, 20 and 40 mmol/L of imatinib concentrations.Conclusions: Based on the present data, imatinib mesylate might modulate metastasis by up-regulating KAI1/CD82 gene expression in human breast MCF-7 cancer cell line.

Tumor-Immune Interaction System with the Effect of Time Delay and Hyperglycemia on the Breast Cancer Cells

Breast cancer in women is a complicated and multifaceted disease. Studies have demonstrated that hyperglycemia is one of the most significant risk factors for breast cancer. Hyperglycemia is when the sugar level in human blood is too high, which means excess glucose. Glucose excess can encourage the growth, invasion, and migration of breast cancer cells at the cellular level. Though, the effects of glucose on the dynamics of breast cancer cells have been examined mathematically by a system of ordinary differential equations. However, the non-instantaneous biological occurrences leading to the secretion of immuno-suppressive cytokines by tumors to evade immune surveillance and the immune cells’ derivation of cytokines to attack the tumor cells are not yet discussed. Therefore, investigating the biological process involved in the dynamics of tumors, immune and normal cells with excessive glucose concentration is inviolable to determining the best procedure for controlling tumors’ uncontrollable growth. Time delay, denoted by τ, is used to describe the time tumor cells take to secrete immunosuppressive cytokines to evade immune surveillance and the time immune cells take to recognize and attack the tumor cells. We have studied the local stability analysis of the biological steady states in both delayed and non-delayed system. The Routh-Hurwitz stability criterion is used to analyze the dynamical equilibrium of the cells’ population. Hopf bifurcation was analyzed by using time delay s as a bifurcation parameter. The analytical results suggest an unstable scenario for a tumor-free equilibrium point as normal cells are bound to grow to their carrying capacity. The result predicts a stable system for coexisting equilibrium when the interaction is instantaneous (τ = 0). However, when τ > 0, the coexisting equilibrium point switches from stable to unstable. The numerical results not only validate all the analytical results but also show the case of possible situations when glucose concentration is varied, indicating that both tumor growth and immune system efficiency are highly affected by the level of glucose in the blood. This concluded that the delay in the secretion of cytokines by immune cells and derivation cytokines by the tumors helps to identify the possible chaotic situation under different glucose concentration and the extent to which such delay can have on restoration of the normal cells when glucose concentration is low.

The Use of PSA Doubling Time to Predict Prognosis and the Use of PSA Response to Assess the Success for Prostate Cancer Patients Undergoing Docetaxel Chemotherapy

In the targeted therapy era, it is critical to know the certain points to start or discontinue chemotherapy for patients with castration resistant metastatic prostate cancer. The prognostic factors to determine this response are still not clear yet. We tried to find out if the PSA doubling time helps us to predict the patients who will benefit from docetaxel chemotherapy most, and also to question the value of the PSA response to chemotherapy. Retrospectively, 70 patients who had hormone refractory metastatic prostate cancer that were given at least 4 cycles of docetaxel chemotherapy between 2002 and 2015 were evaluated. After the onset of docetaxel, PSA response to therapy and overall survival rates were analyzed to figure out if these parameters were related to PSA doubling time. The only statistically significant prognostic parameter affecting overall survival was the best PSA response rate to docetaxel chemotherapy being over or under 50%. The most significant parameter that affects the PSA doubling time was the clinical stage at the time of diagnosis. PSA doubling time is not a useful predictive tool for predicting response to docetaxel. By means of overall survival, the clinical stage at the time of diagnosis was the best predictive tool for our cohort. The best PSA response rate to docetaxel chemotherapy was found to be a valuable parameter. The study being retrospective and the low number of patients included in this cohort can be the main weaknesses of this study. Further studies to determine which other factors can be useful are needed.

Challenges to the early diagnosis and treatment of breast cancer in developing countries

This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.

Clinical significance of serum miR-21 in breast cancer compared with CA153 and CEA

Objective： MicroRNA-21 （miR-21） has been shown to be a key regulator of carcinogenesis. There were few reports about the comparison of serum miR-21 with conventional tumor markers. This study aimed to explore the diagnostic value of circulating miR-21 as a tumor marker in breast cancer （BC） and compare it with CA15 3 and carcinoembryonic antigen （CEA）. Methods： Circulating miR-16 and miR-21 were amplified and quantitatively detected by real-time PCR in 89 BC patients and 55 healthy controls. The levels of CA153 and CEA were measured through assays. Then the sensitivity in diagnosis of BC was compared among miR-21, CA153 and CEA. Results： The level of serum miR-21 was significantly higher in BC patients than controls （P〈0.001）. The sensitivity and specificity of miR-21 were 87.6% and 87.3%, respectively, whereas the sensitivities of CEA and CA153 were only 22.47% and 15.73%. Con^lusions： Compared with CEA and CA153, serum miR-21 has a higher sensitivity in diagnosis of BC. Although not correlated with the status of ER, PR and clinical stages, serum miR-21 may be a potential diagnostic indicator for BC, especially for the early stage.

Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Objective/Background: Qualitative assessment of uncertain (type II) time-intensity curves (TICs) in breast DCE-MRI is problematic and operator dependent. The aim of this work is to evaluate if a semi-quantitative assessment of uncertain TICs could improve overall diagnostic performance. Methods: In this study 49 lesions from 44 patients were retrospectively analysed. Per each lesion one region-of-interest (ROI)- averaged TIC was qualitatively evaluated by two radiologists in consensus: all the ROIs resulted in type II (uncertain) TIC. The same TICs were semi-quantitatively re-classified on the basis of the difference between the signal intensities of the last-time-point and of the peak: this difference was classified according to two different cut-off ranges (±5% and ±3%). All patients were cytological or histological biopsy proven. Fisher test and McNemar test were performed to evaluate if results were statistically significant (p < 0.05). Results: Using ±5% cut-off 16 TICs were reclassified as type III and 12 as type I while 21 were reclassified again as type II. Using ±3% 22 TICs were reclassified as type III and 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histological-cytological results: the sensitivity, specificity, positive and negative predictive values obtained with ±3% were 77%, 91%, 91% and 78% respectively while using ±5% were 58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26/28 (93%) TICs were correctly reclassified while using the ±3% cut-off 34/38 (90%) TICs were correctly reclassified (p < 0.05). Conclusions: Semi-quantitative methods in kinetic curve assessment on DCE-MRI could improve classification of qualitatively uncertain TICs, leading to a more accurate classification of suspicious breast lesions.

Functional Time Series Models to Estimate Future Age-Specific Breast Cancer Incidence Rates for Women in Karachi, Pakistan

Background： Breast cancer is the most common female cancer in Pakistan. The incidence of breast cancer in Pakistan is about 2.5 times higher than that in the neighboring countries India and Iran. In Karachi, the most populated city of Pakistan, the age-standardized rate of breast cancer was 69.1 per 100,000 women during 1998-2002, which is the highest recorded rate in Asia. The carcinoma of breast in Pakistan is an enormous public health concern. In this study, we examined the recent trends of breast cancer incidence rates among the women in Karachi. Methods： We obtained the secondary data of breast cancer incidence from various hospitals. They included Jinnah Hospital, KIRAN （Karachi Institute of Radiotherapy and Nuclear Medicine）, and Civil hospital, where the data were available for the years 2004-2011. A total of 5331 new cases of female breast cancer were registered during this period. We analyzed the data in 5-year age groups 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75＋. Nonparametric smoothing were used to obtained age-specific incidence curves, and then the curves are decomposed using principal components analysis to fit FTS （functional time series） model. We then used exponential smoothing statspace models to estimate the forecasts of incidence curve and construct prediction intervals. Results： The breast cancer incidence rates in Karachi increased with age for all available years. The rates increased monotonically and are relatively sharp with the age from 15 years to 50 years and then they show variability after the age of 50 years. 10-year forecasts for the female breast cancer incidence rates in Karachi show that the future rates are expected to remain stable for the age-groups 15-50 years, but they will increase for the females of 50-years and over. Hence in future, the newly diagnosed breast cancer cases in the older women in Karachi are expected to increase. Conclusion： Prediction of age related changes in breast cancer incidence rates will provide useful information for controlling the overall burden of cancer in Pakistan and also serve as a resource for health planning in future research. Moreover, these models will be the most useful for modeling and projecting future trends of other cancers and chronic diseases.

Prostate-specific antigen doubling time and response to cabazitaxel in a hormone-resistant metastatic prostate cancer patient

We report a case of metastatic castration-resistant prostate cancer, who received prior treatment with docetaxel and was then given cabazitaxel as salvage therapy. The patient was monitored by prostate-specific antigen doubling time and prostate-specific antigen absolute value. The prostate-specific antigen doubling time was found to be a good response predictor in the patient.

Double Ribbons campaign: How to reduce the incidence of breast cancerand cervical cancer in Chinese women

The Double Ribbons campaign is a combination of the pink ribbon and the blue ribbon.China has launched the"Double Ribbon Campaign,"which includes free screening for both breast and cervical cancers.In this paper,by briefly describing the characteristics of breast cancer and cervical cancer,this paper summarizes the screening data of Changle County People's Hospital in Shandong Province in the past ten years,clarifies the importance of early screening,early diagnosis and early treatment of diseases,summarizes experience,defines goals,and promotes the long-term development of China's health cause.

Effectiveness of complex decongestive therapy in management of breast cancer associated lymphedema

Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.

MUC2 mRNA detection in peripheral blood and bone marrow of breast cancer patients reveals micrometastasis

Tumor dissemination to distant organ is the main cause of death. Therefore there is urgent need to set up sensitive methods for early detection of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in peripheral blood (PB) and bone marrow (BM) specimens of breast cancer patients. We aim to detect MUC2 mRNA positive cells in PB and BM of breast cancer patients;to relate this to patient relapse. In this study to detect MUC2 mRNA positive cells (tumor marker), PB and BM samples were collected from 50 breast cancer patients after operation and before adjuvant therapy with 20 PB from healthy individuals as negative controls. Chi-square test was used to analyze data. MUC2 mRNA by using Real-time PCR was detected in 9 (18%) of PB and in 10 (20%) of BM samples and none of the healthy individuals. The relapse rate among MUC2-positive patients was significance in BM (P < 0.004) and MUC2-positive patients had a shorter disease free survival than the negative patients in BM samples (p < 0.05). This study shows MUC2 can be a suitable marker for detection of micrometastasis in breast cancer patients at early stages of cancer.

A double constrained robust capon beamforming based imaging method for early breast cancer detection

Ultra-wideband （UWB） microwave images are proposed for detecting small malignant breast tumors based on the large contrast of electric parameters between a malignant tumor and normal breast tissue. In this study, an antenna array composed of 9 antennas is applied to the detection. The double constrained robust capon beamforming （DCRCB） algorithm is used for reconstructing the breast image due to its better stability and high signal-to-interference-plus-noise ratio （SINR）. The successful detection of a tumor of 2 mm in diameter shown in the reconstruction demonstrates the robustness of the DCRCB beamforming algorithm. This study verifies the feasibility of detecting small breast tumors by using the DCRCB imaging algorithm.

Multiple Primary Malignancies: Metastatic Renal with Early Breast and Endometrial Cancers: A Case Report

Double primary malignancies could be divided into two categories, depending on the interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has occurred as a result of previous treatment with radiation or chemotherapy. Second primary malignancy can occur at any age but it’s commonly at old age. A 46 premenopausal female patient presented to our outpatient clinic complaining from a mass in her right breast, routine metastatic work-up for distant metastasis declared multiple hepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy to tender and weight bearing sites followed by 4 cycles of systemic chemotherapy FEC regimen were received. Tru-cut needle biopsy from renal mass detected renal cell carcinoma of clear cell type, the patient started sunitinib and tamoxifen with bisphosphonate (Zoledronic acid), assessment of the response revealed reduction of the size and number of HFLs, and the size of renal mass, so the patient was decided to do cytoreductive nephrectomy and then continued on TAM and sunitinib. Collectively, due to the rising incidence of multiple primary malignancies, further studies should be done not only for better clinical evaluation and treatments but also for accurate determination of possible causes, pathogenesis, effective managements and screening programs.

三阴性乳腺癌IL-17基因Real-time RT-qPCR检测法的建立与应用

目的:建立Real-time RT-qPCR(实时荧光定量RT-PCR)检测IL-17的方法,应用该方法检测三阴性乳腺癌(three negative breast cancer,TNBC)组织IL-17 mRNA的水平。方法:以TNBC组织为实验组,纤维腺瘤旁正常乳腺组织为对照组,并经HE染色病理分析确诊,Trizol法提取总RNA并反转录为c DNA。选β-actin作为内参,建立SYBR GreenⅠReal-time RT-qPCR检测法。利用该方法检测两组IL-17和β-actin的初始模板量,IL-17/β-actin计算IL-17 mRNA的相对表达量。结果:IL-17扩增效率为98.6%,相关系数0.997,溶解曲线为特异单峰,变异系数小于2.0%,IL-17 mRNA在TNBC组[(0.64±0.12)×10^(-2)]的相对表达高于正常对照组[(0.43±0.07)×10^(-2)],差异有统计学意义(P=0.025)。结论:成功建立了人源IL-17的Real-time RT-qPCR检测方法,TNBC组IL-17的高表达提示其可能与TNBC有一定关系,为研究TNBC的发病机制奠定了理论基础。

SELDI-TOF-MS技术筛查预测乳腺癌患者曲妥珠单抗耐药的生物标志物

目的:应用表面加强激光解析电离化飞行时间质谱技术(surface enhanced laser desorption/ionization-time of flight-mass spectrometry,SELDI-TOF-MS)比较乳腺癌曲妥珠单抗治疗耐药患者与非耐药患者血清蛋白质谱的差异,筛选预测乳腺癌患者曲妥珠单抗耐药的标志蛋白。方法:选择福建省肿瘤医院2008年1月至2009年10月曲妥珠单抗治疗的乳腺癌患者35例,以临床界定标准将患者分为耐药组(11例)和非耐药组(24例)。应用SELDI-TOF-MS技术检测两组患者外周血蛋白质表达谱的差异,以差异蛋白峰值比1.5为耐药的蛋白界定标准,以此标准判定患者耐药与否。分析该蛋白界定标准评判曲妥珠单抗耐药的灵敏度、特异度以及阳性预测值、阴性预测值。结果:以临床界定标准评判的曲妥珠单抗耐药的发生与患者年龄、分期、腋窝淋巴结转移和ER/PR双阴无关。临床耐药组和非耐药组患者外周血蛋白质表达谱比较显示,耐药患者的蛋白质峰7971Da、9284Da显著降低(P<0.05)。以蛋白界定标准评判患者曲妥单抗耐药与非耐药,7971Da评判时的灵敏度为81.82%(9/11)、特异度为83.33%(20/24)、阳性预测值为69.23%(9/13)、阴性预测值为90.91%(20/22);以9284Da评判时的灵敏度为72.73%(8/11)、特异度为79.17%(19/24)、阳性预测值为61.54%(8/13)、阴性预测值为86.36%(19/22)。结论:应用SELDI-TOF-MS技术检测的差异蛋白质峰7971Da、9284Da似可作为预测乳腺癌患者曲妥珠单抗耐药的生物标志物。

MALDI-TOF质谱在乳腺癌诊断及分型中的应用

目的应用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术建立乳腺癌诊断预测模型,寻找乳腺癌血清中的差异蛋白质/多肽,并区分三阴性乳腺癌(TNBC)与非三阴性乳腺癌(NTNBC)。方法共纳入61例乳腺癌患者、60例乳腺纤维腺瘤患者及44例体检健康者。按照3∶1的比例随机分为训练组(乳腺癌患者45例,体检健康者33例)和验证组(乳腺癌患者16例,健康人对照11例)。采用弱阳离子交换磁珠(WCX-MB)提取血清蛋白质/肽,基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术检测并筛选出差异峰,构建诊断预测模型并初步验证。观察分析乳腺癌患者血清蛋白质谱分子变化。结果应用ClinProTools软件构建了乳腺癌组与健康组的诊断预测模型。遗传算法(GA)模型的特异性为90.9%,敏感性为93.8%,准确性为92.6%。对纤维腺瘤组和对照组、乳腺癌组和纤维腺瘤组以及TNBC组和NTNBC组分别进行聚类分析,发现有显著差异峰可将其准确区分:差异峰m/z 4220.9、5920.36在纤维腺瘤组中的峰强度明显高于对照组,但其在乳腺癌组中的峰强度明显低于纤维腺瘤组;差异峰m/z 4220.9、5920.36在TNBC组中的峰强度明显高于NTNBC组。结论应用MALDI-TOF-MS技术建立的乳腺癌诊断预测模型具有高敏感性、高特异性的特点,该技术可用于乳腺癌患者的鉴别诊断以及区分乳腺癌的基因分型。

Metachronous double malignancy involving the kidney and the breast: A case report

The occurrence of multiple primary cancers is rare;it can be missed as a disease progression. The etiology remains controversial. We report a case of a 55-year-old female with metastatic renal cell carcinoma treated with sutent followed by left sided nephrectomy. Follow-up CT showed increase in the size of the right axillary lymph nodes which was proven after biopsy to be metastatic adenocarcinoma of the breast. Any suspicious disease progression in a single site not compatible with disease history should be biopsied for confirmation. The relationship between renal cell carcinoma and breast cancer is still unclear, and more case reports are required to determine this relationship.

Genetic counseling in post-genomic era: Don't pretend to know the meaning of a gene mutation if you don't know

In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.

Rapid killer:Lung squamous cell cancer

Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma,squamous cell carcinoma,bronchioloalveolar carcinoma,and poorly differentiated carcinoma.Usually,NSCLC,in contrast to SCLC,spreads locally,and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation:We present the case of a 72-year-old male,recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits.Few days after diagnosis,the patient had severe respiratory distress.This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion:To our knowledge,there are few reported cases where lung adenocarcinoma progressed rapidly over days.Squamous cell carcinoma usually takes 3 to 6 months to double in size,but in our case,the progression was very fast.In the last decade,it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients.On the other hand,further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma.Hence,this aggressive tumor is a“rapid killer.”