用于非小细胞肺癌治疗的第三代 EGFR-TKIs 研究进展

肺癌是全球致死率最高的恶性肿瘤,其中非小细胞肺癌(NSCLC)占全部肺癌病例的 80% 左右。相较于传统化疗,表皮生长因 子受体酪氨酸激酶抑制剂(EGFR-TKIs)用于 EGFR 突变型 NSCLC 患者,可获得更为卓越的疗效。但是,EGFR-TKIs 长期使用会产生 获得性耐药,主要机制为 EGFR T790M 突变。临床研究表明,以奥希替尼、rociletinib 和 HM61713 为代表的第三代 EGFR-TKIs 对 EGFR T790M 突变阳性 NSCLC 具有较好的疗效,为 EGFR T790M 突变阳性患者的有效治疗带来了新的希望。综述第三代 EGFR-TKIs 的最新临床研究及耐药机制研究进展。     

体外联合使用指纹区及高波数区拉曼光谱诊断胃癌

目的:研究正常胃粘膜和胃癌组织在拉曼光谱指纹区(800-1 800 cm-1)和高波数区(2 800-3 000 cm-1)的光谱特征,并将其联合使用建立胃癌诊断模型。方法:收集38例正常胃粘膜和37例胃癌组织活检标本,采用785 nm激发光拉曼光谱仪进行拉曼光谱采集。比较正常胃粘膜和胃癌组织在指纹区和高波数区的拉曼光谱异同,使用偏最小二乘判别分析(PLS-DA)结合留一法交叉验证建立诊断模型。结果:1)胃癌组织在853 cm~(-1),879cm~(-1),1 003 cm~(-1),1 047 cm~(-1),1 173 cm-1,1 304 cm~(-1),1 319 cm~(-1),1 338 cm~(-1),1 374 cm-1、2 932 cm-1谱峰处与正常胃粘膜的拉曼峰强度差异有统计学意义(P0.05)2)将拉曼光谱指纹区和高波数区联合,利用PLS-DA建立胃癌诊断模型的敏感性为94.59%(35/37),特异性为86.84(33/38),正确率为90.6%(68/75)。结论:正常胃粘膜和胃癌组织在拉曼光谱指纹区和高波数区均有显著差异,将上述两区联合使用建立模型诊断胃癌能取得良好的诊断效果。     

Discovery and preliminary structure–activity relationship of 1H-indazoles with promising indoleamine-2,3-dioxygenase 1 (IDO1) inhibition properties

Indoleamine 2,3-dioxygenase 1 (IDO1)-mediated kynurenine pathway of tryptophan degradation is identified as an important immune effector pathway in the tumor cells to escape a potentially effective immune response. IDO1 is an attractive target for anticancer therapy and the discovery of IDO1 inhibitors has been intensely ongoing in both academic research laboratories and pharmaceutical organizations. Our study discovered that 1H-indazole was a novel key pharmacophore with potent IDO1 inhibitory activity. A series of new 1H-indazole derivatives were synthesized and determined the enzyme inhibitory activities, and the compound 2g exhibited the highest activity with an IC₅₀ value of 5.3 μM. The structure–activity relationships (SARs) analysis of the 1H-indazole derivatives as novel IDO1 inhibitors indicated that the 1H-indazole scaffold is necessary for IDO1 inhibition, and the substituent groups at the both 4-position and 6-position largely affect inhibitory activity. The docking model exhibited that the effective interactions of 1H-indazoles with ferrous ion of heme and key residues of hydrophobic Pocket A and B ensured the IDO1 inhibitory activities. The study suggested that the 1H-indazole was a novel interesting scaffold for IDO inhibition for further development.     

New imidazoquinoxaline derivatives: Synthesis,biological evaluation on melanoma,effect on tubulin polymerization and structure–activity relationships

Microtubules are considered as important targets of anticancer therapy. EAPB0503 and its structural imidazo[1,2-a]quinoxaline derivatives are major microtubule-interfering agents with potent anticancer activity. In this study, the synthesis of several new derivatives of EAPB0503 is described, and the anticancer efficacy of 13 novel derivatives on A375 human melanoma cell line is reported. All new compounds show significant antiproliferative activity with IC₅₀ in the range of 0.077–122 μM against human melanoma cell line (A375). Direct inhibition of tubulin polymerization assay in vitro is also assessed. Results show that compounds 6b, 6e, 6g, and EAPB0503 highly inhibit tubulin polymerization with percentages of inhibition of 99%, 98%, 90%, and 84% respectively. Structure–activity relationship studies within the series are also discussed in line with molecular docking studies into the colchicine-binding site of tubulin.     

溶瘤腺病毒ZD55对类肝癌干细胞的抑制效应

溶瘤腺病毒能够靶向和杀死癌症干细胞,被认为是一种很有前景的抗癌药物.已有研究表明,溶瘤腺病毒ZD55能够靶向肝癌,并且表现出明显的细胞毒性效应.然而,其对肝癌干细胞是否具有同样地杀伤效力仍需进一步探讨.利用悬浮培养富集类肝癌干细胞,并验证其肝癌干细胞的特征.进一步通过MTT、结晶紫染色、Hoechst染色、Western blot和流式细胞术等检测ZD55对类肝癌干细胞的细胞存活率、凋亡诱导和病理效应等.结果发现,悬浮培养的类肝癌干细胞具有自我更新和分化能力、高表达干细胞相关转录因子(如NANOG和OCT4)、处于静息状态和具有耐药性等特性,溶瘤腺病毒处理后表现出明显的细胞毒性效应和杀伤特性,类肝癌干细胞的最低生存率仅为26.7%.ZD55能够非常明显地诱导类肝癌干细胞凋亡,其凋亡率最高达到60%.因此,ZD55可能会成为靶向肝癌干细胞的一种很有前景的治疗药物,对肝癌的临床治疗具有一定的应用价值.     

TrkB Promotes Breast Cancer Metastasis via Suppression of Runx3 and Keap1 Expression

In metastatic breast cancer, the acquisition of malignant traits has been associated with the increased rate of cell growth and division, mobility, resistance to chemotherapy, and invasiveness. While screening for the key regulators of cancer metastasis, we observed that neurotrophin receptor TrkB is frequently overexpressed in breast cancer patients and breast cancer cell lines. Additionally, we demonstrate that TrkB expression and clinical breast tumor pathological phenotypes show significant correlation. Moreover, TrkB expression was significantly upregulated in basal-like, claudin-low, and metaplastic breast cancers from a published microarray database and in patients with triple-negative breast cancer, which is associated with a higher risk of invasive recurrence. Interestingly, we identified a new TrkB-regulated functional network that is important for the tumorigenicity and metastasis of breast cancer. We demonstrated that TrkB plays a key role in regulation of the tumor suppressors Runx3 and Keap1. A markedly increased expression of Runx3 and Keap1 was observed upon knockdown of TrkB, treatment with a TrkB inhibitor, and in TrkB kinase dead mutants. Additionally, the inhibition of PI3K/AKT activation significantly induced Runx3 and Keap1 expression. Furthermore, we showed that TrkB enhances metastatic potential and induces proliferation. These observations suggest that TrkB plays a key role in tumorigenicity and metastasis of breast cancer cells through suppression of Runx3 or Keap1 and that it is a promising target for future intervention strategies for preventing tumor metastasis and cancer chemoprevention.     

Sex steroid-induced DNA methylation changes and inflammation response in prostate cancer

BackgroundSex steroid hormones have been reported to induce inflammation causing dysregulation of cytokines in prostate cancer cells. However, the underlying epigenetic mechanism has not well been studied. The objective of this study was to evaluate the effect of sex steroid hormones on epigenetic DNA methylation changes in prostate cancer cells using a signature PCR methylation array panel that correspond to 96 genes with biological function in the human inflammatory and autoimmune signals in prostate cancer. Of the 96-gene panel, 32 genes showed at least 10% differentially methylation level in response to hormonal treatment when compared to untreated cells. Genes that were hypomethylated included CXCL12, CXCL5, CCL25, IL1F8, IL13RAI, STAT5A, CXCR4 and TLR5; and genes that were hypermethylated included ELA2, TOLLIP, LAG3, CD276 and MALT1. Quantitative RT-PCR analysis of select genes represented in a cytokine expression array panel showed inverse association between DNA methylation and gene expression for TOLLIP, CXCL5, CCL18 and IL5 genes and treatment of prostate cancer cells with 5′-aza-2′-deoxycytidine with or without trichostatin A induced up-regulation of TOLLIP expression. Further analysis of relative gene expression of matched prostate cancer tissues when compared to benign tissues from individual patients with prostate cancer showed increased and significant expression for CCL18 (2.6-fold; p < 0.001), a modest yet significant increase in IL5 expression (1.17-fold; p = 0.015), and a modest increase in CXCL5 expression (1.4-fold; p = 0.25). In conclusion, our studies demonstrate that sex steroid hormones can induce aberrant gene expression via differential methylation changes in prostate carcinogenesis.     

Digital image analysis of AgNORs in cervical smears of women with premalignant and malignant lesions of the uterine cervix

We performed a hospital-based, unmatched case-control study to investigate the association between progressive stages of cervical neoplasia and digital analysis of cell proliferation by silver stained nucleolus organizer region associated proteins (AgNORs). We measured cell proliferation levels in the cervical epithelial cells of 10 women with low grade squamous intraepithelial lesions (LG-SIL), eight with high grade squamous intraepithelial lesions (HG-SIL), 11 with cervical cancer (CC) and eight with no cervical lesions (controls) using the AgNORs technique. Cell proliferation was measured by digital image analysis (DIA). DIA revealed increased total areas of AgNORs in HG-SIL and CC compared to LG-SIL and control patients. AgNORs with a kidney or cluster shape exhibited greater areas than those with a spherical or long shape. We propose a cut-off of 118 pixels to differentiate benign (control and LG-SIL) from malignant (HG-SIL and CC) lesions. DIA of AgNORs is a simple and inexpensive method for studying proliferation. The increased total area of AgNORs in malignant lesions provides information regarding cell behavior and may be related to cervical carcinogenesis; however, further validation studies are required to establish its usefulness in cytological analysis.     

胸腔镜食管癌切除术后肺部感染患者肺功能和炎症因子水平的关系研究

目的:研究胸腔镜食管癌切除术后肺部感染患者肺功能和炎症因子水平的关系。方法:选取2015年3月～2018年7月我院收治的食管癌患者120例为研究对象,将其以随机数字表法分成对照组和观察组。对照组予以传统开胸手术治疗,观察组则予以胸腔镜食管切除术治疗。分别比较两组术后肺部感染发生情况、手术前后肺功能以及炎症因子水平变化情况,并分析胸腔镜食管癌切除术后肺部感染患者肺功能与炎症因子的关系。结果:观察组患者术后肺部感染发生率为13.33%(8/60),低于对照组的36.67%(22/60),差异有统计学意义(P0.05)。术后观察组用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC均高于对照组,差异均有统计学意义(均P0.05)。术后1 d、术后5 d观察组白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及C反应蛋白(CRP)水平均低于对照组,差异均有统计学意义(均P0.05)。经Pearson相关性分析可得:胸腔镜食管癌切除术后肺部感染患者FVC、FEV1、FEV1/FVC与IL-6、IL-10、CRP均呈负相关性(均P0.05)。结论:胸腔镜食管癌切除术可显著降低患者肺部感染发生风险,且术后肺部感染患者肺功能与炎症反应存在密切相关,降低术后肺部感染发生率的机制可能与减轻机体炎症反应有关。     

超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值分析

目的:探讨超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值。方法:选择我院2012年1月至2017年12月收治的66例乳腺疾病患者,所有患者术前均经钼靶X线及彩色多普勒超声检查,分析其病理结果,分析钼靶X线、彩色多普勒超声及二者联合对乳腺肿块的检查结果(边缘毛刺征、血管、淋巴结、微小钙化),比较其对乳腺癌的灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果:66例患者中,经病理检查发现恶性肿瘤34例,良性肿瘤32例。与病理检测相比,彩色多普勒超声联合钼靶X线对乳腺肿块的良恶性检出率无差异性(P0.05),而彩色多普勒超声,钼靶X线的良恶性检出率均显著降低(P0.05)。彩色多普勒超声与钼靶X线良恶性检出率对比无差异(P0.05),但均低于彩色多普勒超声联合钼靶X线的检出率(P0.05)。彩色多普勒超声与钼靶X线对乳腺癌的边缘毛刺征的检出率对比无统计学意义(P0.05);彩色多普勒超声对血管和淋巴结的检出率明显高于钼靶X线,而微小钙化的检出率明显低于钼靶X线,对比差异有统计学意义(P0.05)。彩色多普勒超声联合钼靶X线的灵敏度、特异度、准确度、阳性预测值及阴性预测值均明显高于彩色多普勒超声及钼靶X线(P0.05),钼靶X线及彩色多普勒超声间对比无统计学意义(P0.05)。结论:彩色多普勒超声与钼靶X线对直径小于1 cm乳腺癌的诊断各有优势,二者联合应用的诊断价值优于单一诊断方法。