硫链丝菌素诱导非小细胞肺癌细胞自噬性死亡

自噬在细胞的生命过程中起了非常重要的作用,它能通过清除受损的细胞器和过多的蛋白质以维持细胞内环境稳定基本能量代谢的稳定。然而,自噬的持续激活可导致细胞器以及必需的蛋白质的过度消耗,导致不依赖caspase的自噬性细胞死亡。因此,通过这种自噬途径诱导细胞死亡可能是癌症治疗的一种新方法。在本研究我们发现,硫链丝菌素能够减少非小细胞肺癌PC-9细胞的细胞活力和诱导细胞凋亡。另外,我们发现硫链丝菌素诱导了PC-9细胞自噬。此外,我们也发现硫链丝菌素诱导的细胞凋亡可以被自噬抑制剂3-甲基腺嘌呤(3-MA)阻止。这些结果表明,硫链丝菌素促进人体非小细胞肺癌细胞的自噬性死亡。在本研究我们的发现也提示硫链丝菌素联合自噬诱导剂可能在临床上对治疗人非小细胞肺癌有效。     

细胞自噬在吉非替尼治疗非小细胞肺癌中的作用及其机制研究

目的:观察吉非替尼对非小细胞肺癌细胞自噬的影响,并探讨其机制。方法:将BalB/CA-nu品系裸小鼠分成两组,各组20只,均造肺癌模型,其中吉非替尼治疗组小鼠在肺癌组模型的基础上给予吉非替尼25mg/kg 14d,停药后剖杀。取组织切片,通过免疫荧光、RT-PCR以及Western blot的试验方法检测自噬相关基因Beclin1和MAPLC3的表达。结果:免疫荧光、RT-PCR以及Western blot的试验方法检测均发现肺癌组小鼠组织中Beclin1和MAPLC3表达较低,而在吉非替尼处理组中,Beclin1和MAPLC3的表达明显升高,差异有统计学意义。结论:吉非替尼可以通过增强细胞自噬从而发挥对非小细胞肺癌的抑制作用。     

康莱特注射液联合化疗治疗晚期非小细胞肺癌的临床疗效

目的:探讨康莱特注射液联合化疗治疗晚期非小细胞肺癌患者的临床疗效。方法:选择我院60例晚期非小细胞肺癌患者,按随机数字表法平均分为两组各30例,两组患者均给予NP化疗方案治疗,研究组患者在此基础上联合康莱特注射液治疗。比较两组患者近期治疗疗效、生活质量Karnofsky评分、1年生存率、中位生存时间、平均生存时间以及毒副反应发生情况。结果:研究组患者近期治疗有效率为53.3%,明显高于对照组33.3%,比较差异具有统计学意义(X2=4.12,P0.05);研究组患者治疗后生活质量Karnofsky评分好转率为66.7%,明显高于对照组36.7%,比较差异具有统计学意义(X2=5.41,P0.05);研究组患者经治疗后1年生存率、中位生存时间和平均生存时间分别为60.0%、15.0个月和(11.0±5.1)个月,均明显高于对照组30.0%、9.0个月和(5.9±4.8)个月,两组比较差异具有统计学意义(X2=5.45,t=5.24,6.12,P0.05);研究组患者治疗过程毒副反应恶心呕吐及白细胞下降发生率均明显低于对照组,差异具有统计学意义(X2=4.27,5.08,P0.05)。结论:康莱特注射液联合化疗治疗晚期非小细胞肺癌患者的临床疗效显著,可明显改善患者生活质量,降低毒副反应发生率,值得临床推广应用。     

ERCC1 codon118基因表达在预测三代含铂方案治疗晚期非小细胞肺癌疗效中的意义

目的:探讨ERCC1codon118基因表达对预测三代含铂方案治疗晚期非小细胞肺癌疗效的影响。方法:对我院收治的240例晚期非小细胞肺癌患者进行ERCC1codon118基因多样性检测,以及对各基因型对三代含铂方案治疗晚期非小细胞肺癌疗效进行比较。结果:C/C组与C/T组+T/T组患者其肿瘤分化程度、临床分期、肿瘤大小、血管侵犯等基本资料无明显的相关性(P>0.05);C/C组患者其无进展生存时间以及生存时间、1年、2年以及3年生存率为13.2±5.4月、25.4±4.3月、62.88%、23.48%以及14.39%,明显高于对照组的6.2±4.3月、10.5±3.2月、26.85%、8.33%、1.85%。结论:ERCC1codon118基因表达可能与预测三代含铂方案治疗晚期非小细胞肺癌敏感性有关。     

小细胞肺癌患者铂类化疗所致周围神经毒性与SNP相关性

小细胞肺癌（SCLC）患者的治疗正在发生改变,但含铂双药联合化疗仍然是大多数SCLC患者的治疗基础。SCLC患者在接受化学治疗同时,还需忍受药物毒性引起的周围神经毒性（peripheral neurotoxicity,PN）等相关毒副作用。周围神经毒性主要表现为刺痛、麻木、虚弱或灼痛,且呈剂量依赖性。药物基因组学现已发展为一种有效的研究方法,目前可以利用基因组学获得关于药物反应的个体间差异的相关遗传信息,从而避免周围神经毒性的发生,以达到精准治疗的目的。单核苷酸多态性（single nucleotide polymorphism,SNP）定义为在基因组水平上由于单个核苷酸的变异而导致的DNA序列多态性。人类可遗传变异中最多的就是SNP,甚至在已知的所有多态性中90%以上都是单核苷酸变异。本文就小细胞肺癌患者铂类药物引起的周围神经毒性与相关GSTP1和GSTM1基因、ERCC1基因、ABCC2和ABCC4基因、SCNAs基因、CYP2C8基因、AGXT基因的SNP之间的关系作一简要综述。     

晚期非小细胞肺癌p53 和ERCC1 表达状态与顺铂为主的联合方案化疗的近期有效率的相关性研究*

目的:研究晚期非小细胞肺癌不同的p53和ERCC1表达状态与基于顺铂为主的姑息化疗近期有效率的相关性。方法:对经顺铂联合多西他赛或顺铂联合吉西他滨治疗的48例晚期非小细胞肺癌患者进行回顾性分析,利用既往免疫组化资料,观察基于顺铂为主的方案近期有效率(RR)的影响因素及化疗不良反应。结果:全组48例患者均完成至少两周期化疗,并行疗效评价。该组患者化疗的近期有效率为28例(58.3%),RR与不同的转移病灶部位(P=0.042)及病灶数目(P=0.034)有显著差异。该类方案的近期有效率与ERCC1状态(P=0.012)密切相关,而与p53表达状态(P=0.401)无关。毒性反应主要是骨髓抑制、脱发及消化道反应等。结论:晚期非小细胞肺癌ERCC1阴性患者较ERCC1阳性患者运用顺铂为主的联合方案化疗的近期有效率较高。ERCC1可能是顺铂疗效预测的敏感因子。p53的表达状态可能不是该类方案的疗效预测因子。     

自噬与非小细胞肺癌对吉非替尼耐药关系的实验研究

目的:探讨细胞自噬与非小细胞肺癌对Gefitinib耐药的相关性,寻找逆转非小细胞肺癌对Gefitinib耐药的新靶点。方法:以体外培养的人非小细胞肺癌Gefitinib敏感细胞PC-9与Gefitinib耐药细胞PC-9/GR为研究对象,通过MTT法检测Gefitinib对PC-9及PC-9/GR细胞存活率的影响;Western blot检测Gefitinib对PC-9及PC-9/GR细胞中自噬相关蛋白LC3的表达的影响;流式细胞术检测自噬诱导剂雷帕霉素和Gefitinib对PC-9/GR细胞凋亡率的影响。结果:PC-9/GR细胞Gefitinib IC50为PC-9细胞的200倍以上,具有非常明显的耐药性。PC-9/GR细胞中LC3II的表达显著低于PC-9/GR细胞(P0.05)。Rapamycin联合Gefitinib作用于PC-9/GR细胞可以明显提高其细胞凋亡率(P0.05)。结论:细胞自噬减弱与非小细胞肺癌对Gefitinib耐药有关,诱导细胞自噬可能逆转非小细胞肺癌对Gefitinib耐药。     

康莱特注射液联合NP方案化疗治疗老年晚期非小细胞肺癌的临床观察

目的:探讨康莱特注射液联合NP方案治疗老年晚期非小细胞肺癌患者的近期疗效、毒副反应及生活质量.方法:将127例患者随机分为两组,治疗组64例,予NP方案:NVB25mg/m2第1、8天静点+DDP 80mg/m2分三天,第1,2,3天静点,每3周重复.同时给予康莱特液200ml qd第1-21天静点.对照组予NP方案:NVB25ml/m2第1、8天静点+DDP 80mg/m2分三天,第1,2,3天静点,每3周重复.两组患者在治疗4周期后,进行评价.结果:在近期疗效上,治疗组优于对照组.P＜0.05.在白细胞减少、贫血及呕吐的发生上,治疗组优于对照组,均P＜0.05.生活质量的提高及体重的增加方面,治疗组优于对照组,均P＜0.05.结论:康莱特注射液联合NP方案化疗治疗老年晚期非小细胞肺癌,能提高近期疗效,减少毒副反应,提高生活质量.     

DC-CIK联合化疗治疗晚期非小细胞肺癌的疗效及对免疫功能的影响

目的:研究树突细胞-细胞因子诱导杀伤细胞(DC-CIK)免疫疗法联合化疗治疗晚期非小细胞肺癌(NSCLC)的疗效及对免疫功能的影响。方法:选取2014年1月至2015年12月就诊于我院的60例Ⅲb~Ⅳ晚期NSCLC患者,采用随机数字表法分为联合组和化疗组各30例。联合组采用DC-CIK免疫疗法联合化疗(顺铂+吉西他滨),1个月为一个周期。化疗组仅进行单纯化疗,1个月为一个周期。比较两组患者近期疗效、无进展生存期(PFS)、总生存期(OS)、免疫功能、生活质量以及不良反应。结果:联合组DCR显著高于化疗组(P0.05),联合组的中位PFS高于化疗组(P0.05)。联合组治疗后外周血中的CD3+、CD3+CD4+和NK细胞较治疗前显著上升(P0.05),CD3+CD8+细胞较治疗前显著下降(P0.05),且治疗后联合组的CD3+、CD3+CD4+和NK细胞较化疗组显著上升(P0.05),CD3+CD8+细胞较化疗组显著降低(P0.05)。联合组疲乏、疼痛、食欲不振、睡眠障碍发生率低于化疗组(P0.05)。联合组白细胞减少率、血小板减少率显著低于化疗组(P0.05)。结论:DC-CIK联合化疗治疗NSCLC患者的疗效显著,可提高DCR,延长患者的PFS,提高患者的免疫功能和生活质量,减少不良反应。     

晚期非小细胞肺癌患者外周血Th17细胞和Treg细胞水平与化疗敏感相关性研究

目的:探讨晚期非小细胞肺癌患者外周血Th17细胞和Treg细胞水平和化疗敏感性相关性。方法:2选取78例晚期非小细胞肺癌患者为病例组,同时纳入健康人群40例为对照组。病例组肺癌患者采用TP方案,化疗前后采用流式细胞计数检测外周血Th17(CD4~+γ-IFN~+)、Treg(CD4~+CD25~+Foxp3~+)水平,完成2个化疗疗程后,评价化疗效果及敏感性。结果:病例组外周血Th17细胞和Treg细胞水平明显高于对照组,差异有统计学意义(p0.05)。病例组第一次和第二次化疗前外周血Th17细胞和Treg细胞水平高于化疗后水平,差异有统计学意义(p0.05)。根据WHO实体肿瘤化疗效果判定标准,CR为化疗敏感组、PR、SD为化疗有效,PD为化疗无效,将所有病例组分为化疗敏感性组、有效组和无效。第一次化疗前和第二次化疗前外周血Th17细胞和Treg细胞水平,化疗敏感组水平明显高于有效组和无效组,而有效组水平高于无效组,差异有统计学意义(p0.05)。结论:肺癌患者晚期外周血Th17细胞和Treg细胞水平明显升高,其Th17细胞和Treg细胞水平和化疗敏感性呈正相关的趋势。     

XPA A23G polymorphism is associated with the elevated response to platinum-based chemotherapy in advanced non-small cell lung cancer

DNA repair capacity （DRC） is correlated with sensitivity of cancer cells toward platinum-based chemotherapy. We hypothesize that genetic polymorphisms in DNA repair gene XPA （xeroderma pigmentosum group A） and XPG （xeroderma pigmentosum group G） （ERCC5, excision repair cross-complementation group 5）, which result in inter-individual differences in DNA repair efficiency, may predict clinical response to platinum agents in advanced non-small cell lung cancer （NSCLC） patients. In this study, we find that the A → G change of XPA A23G polymorphism significantly increased response to platinum-based chemotherapy. Polymorphism in XPG His46His was associated with a decreased treatment response, but was not statistically significant.     

Drug-induced cell cycle perturbation in chemotherapy of patients with non-small cell lung cancer

To observe in vivo cell cycle perturbation in the chemotherapy of lung cancer, tumour cell kinetics during the first course of chemotherapy were measured in seven patients with histologically-verified non-small cell lung cancer. The tumour cells were aspirated from six lymph nodes and one subcutaneous nodule both prior to treatment and twice weekly after the administration of chemotherapeutic agents. The nuclear DNA content of aspirated tumour cells was measured with a scanning microdensitometer at a wavelength of 550 nm after the modified Feulgen reaction. The cell population in cell cycle was estimated with a cumulated percentage scale. Marked cell cycle perturbation occurred within one week after initiation of chemotherapy. There was a decrease in the G1 cell population, from 70.6 +/- 9.1% to 26.1 +/- 11.4%, and a corresponding increase of cells in G2-M phase, from 21.4 +/- 8.7% to 63.7 +/- 10.0%. The proportion of cells in S phase was slightly increased from 8.0 +/- 1.5% to 10.1 +/- 3.2% during this period. The degree of cell cycle changes was unrelated to the clinical response to chemotherapy.     

Elevated exhalation of hydrogen peroxide in patients with non-small cell lung cancer is not affected by chemotherapy

Objectives: Reactive oxygen species, which are implicated in the process of carcinogenesis, are also responsible for cell death during chemotherapy (CHT). Therefore, the aim of the study was to evaluate exhaled H₂O₂ levels in non-small cell lung cancer (NSCLC) patients before and after CHT.

Methods: Thirty patients (age 61.3?±?9.3 years) with advanced NSCLC (stage IIIB–IV) and 15 age-matched healthy cigarette smokers were enrolled into the study. Patients received four cycles of cisplatin or carboplatin with vinorelbine every three weeks. Before and after the first, second, and fourth cycle, the concentration of H₂O₂ in exhaled breath condensate was measured with respect to treatment response.

Results: At the baseline, NSCLC patients exhaled 3.8 times more H₂O₂ than the control group (0.49?±?0.14 vs. 0.13?±?0.03?µmol/L, P?2O₂ levels independent of the treatment response (partial remission vs. progressive disease). Pre- and post-CHT cycles of H₂O₂ levels generally correlated positively.

Discussion: The study demonstrated the occurrence of oxidative stress in the airways of advanced NSCLC patients. Exhaled H₂O₂ level was not affected by CHT and independent of treatment results and changes in the number of circulating neutrophils.     

Association between microRNA-146a, -499a and -196a-2 SNPs and non-small cell lung cancer: a case–control study involving 2249 subjects

MicroRNA (miR) acts as a negative regulator of gene expression. Many literatures have suggested that miRs may be involved in the process of cell proliferation, inflammation, oxidative stress, energy metabolism and epithelial–mesenchymal transition. Thus, miRs may be implicated in the occurrence of non-small cell lung cancer (NSCLC). In the current investigation, we included 2249 subjects (1193 NSCLC patients and 1056 controls) and designed a study to identify the relationship of miR-146a rs2910164 C/G, -499a rs3746444 A/G and -196a-2 rs11614913 T/C with the risk of NSCLC. The risk factors (e.g., body mass index (BMI), sex, smoking, drinking and age) was used to adjust the odds ratios (ORs) and 95% confidence intervals (CIs). After conducting a power value assessment, we did not confirm that the miR-single nucleotide polymorphisms (SNPs) genotypic distributions were different in NSCLC cases and controls. However, the association of miR-196a-2 rs11614913 with a decreased risk of NSCLC was identified in the female subgroup (adjusted P=0.005, power = 0.809 for TC vs. TT, and adjusted P=0.004, power = 0.849 for CC/TC vs. TT). In addition, gene–gene interaction analysis showed that rs11614913 TC/3746444 AA and rs11614913 CC/rs3746444 AA could also reduce the susceptibility to NSCLC (rs11614913 TC/rs3746444 AA vs. rs11614913 TT/rs3746444 AA, P=0.001, power = 0.912 and rs11614913 CC/rs3746444 AA vs. rs11614913 TT/rs3746444 AA, P=0.003, power = 0.836). In conclusion, in overall comparisons, we did not confirm that the rs2910164, rs3746444, and rs11614913 SNPs genotypic distributions were different in NSCLC cases and controls. However, this case–control study demonstrates that miR-196a-2 rs11614913 may be a protective factor for the development of NSCLC among female patients.     

MiRNA调控非小细胞肺癌转移的研究进展

微小RNA是内源性的非编码小RNA分子,通过与靶mRNA的结合在转录后水平调控基因的表达,从而参与众多生命活动的调控。NSCLC是严重威胁人类健康的恶性肿瘤,侵袭转移是其主要特征,也是其治疗失败和死亡的主要原因。miRNA可以通过促进上皮-间质转化、金属基质蛋白酶表达,以及血管生成来促进NSCLC转移,而且miRNA在调节肺癌干细胞特性中也发挥着重要作用。转移相关的miRNA已成为肺癌靶向治疗的新靶点。     

Rocaglamide enhances NK cell-mediated killing of non-small cell lung cancer cells by inhibiting autophagy

Targeting macroautophagy/autophagy is a novel strategy in cancer immunotherapy. In the present study, we showed that the natural product rocaglamide (RocA) enhanced natural killer (NK) cell-mediated lysis of non-small cell lung cancer (NSCLC) cells in vitro and tumor regression in vivo. Moreover, this effect was not related to the NK cell recognition of target cells or expressions of death receptors. Instead, RocA inhibited autophagy and restored the level of NK cell-derived GZMB (granzyme B) in NSCLC cells, therefore increasing their susceptibility to NK cell-mediated killing. In addition, we further identified that the target of RocA was ULK1 (unc-51 like autophagy activating kinase 1) that is required for autophagy initiation. Using firefly luciferase containing the 5´ untranslated region of ULK1, we found that RocA inhibited the protein translation of ULK1 in a sequence-specific manner. Taken together, RocA could block autophagic immune resistance to NK cell-mediated killing, and our data suggested that RocA was a promising therapeutic candidate in NK cell-based cancer immunotherapy.     

Finding biomarkers for non-small cell lung cancer diagnosis and prognosis

Despite of several decades of efforts,lung cancer remains one of most deadly diseases,with a 5-year survival rate approximately 15％ worldwide.In China,the situation is even worse.Although there is no o...