赣州地区肺癌病理特征与临床流行病学调查研究

目的探讨赣州地区肺癌流行病学与病理特征,旨在了解该地区肺癌流行趋势,提高疾病筛查率,降低肺癌风险。方法选取我院2018年1月～2019年12月收治的300例肺癌患者为研究对象,分析患者的一般资料,并总结肺癌流行病学和病理特征。结果 300例肺癌患者中,发病年龄<40岁144例,≥40岁156例;男性患者155例,女性患者145例;城镇居民168例,农村居民132例;其中抽烟、饮酒者的肺癌构成比高于非抽烟、饮酒者,两者比较差异有统计学意义(P<0.05)。从肺癌患者年龄分布看,<40岁患者中,男女发病率构成比无差异性(P>0.05);年龄40～79岁和>80岁的两个年龄段患者中,男性肺癌患者构成比高于女性,两者比较具有统计学差异(P<0.05)。从肺癌病理类型看,男性患者腺癌和鳞状细胞癌构成比高于女性患者(P<0.05),而不同性别的小细胞癌和大细胞癌构成比无差异性(P>0.05)。结论赣州地区肺癌患者的发病年龄、性别比较无差异性,吸烟、酗酒是该病的重要因素,且该病多发于青壮年和老年群体,男性以腺癌和鳞状细胞癌为主。     

黑龙江地区400例乙型肝炎病毒基因分型与耐药突变研究

目的:运用基因芯片技术分析黑龙江地区乙型肝炎病毒(HBV)基因型分布特征及基因耐药变异情况。方法:随机选择2012年11月至2015年11月本医院乙型肝炎患者血清样本400例,应用PCR-反向点杂交的基因芯片技术对样本血清中HBV基因型及常见4类抗病毒药物耐药相关的多个位点进行检测,并进行数据分析。结果:400例样本中基因型分布以C型为主占83.25%(333例),B型7.25%(29例)、D型0.25%(1例)及混合基因型2.75%(11例);耐药突变位点检出188例,总耐药率为45.19%,其中突变位点236T(4.61%)提示阿德福韦酯单项耐药,耐药率为5.82%(10例),与拉米夫定耐药相关的为126例,突变位点以rt204I和(rt180M+rt240V)为主,显著高于其他抗病毒类药物,耐药风险较高。结论:黑龙江地区乙型肝炎基因分型以C为主,B型和其它混合型较少,且更容易对拉米夫定产生耐药。     

非小细胞肺癌组织NEK2、EPHA5表达与临床病理特征、EGFR突变和预后的关系

摘要 目的：探讨非小细胞肺癌（NSCLC）组织有丝分裂相关激酶2（NEK2）、促红细胞生成素产生肝细胞受体A5（EPHA5）表达情况,分析其与临床病理特征、表皮生长因子受体（EGFR）突变和预后的关系。方法：选取自2019年10月至2020年10月期间我院诊治的151例NSCLC患者作为研究对象,术中取其癌组织及癌旁正常组织（距离癌组织5cm以上）。采用实时荧光定量聚合酶链式反应（RT-PCR）检测EGFR基因表达。免疫组织化学法检测癌组织和癌旁组织中NEK2、EPHA5表达。比较癌组织和癌旁组织NEK2、EPHA5表达情况。分析不同临床病理特征NSCLC患者NEK2、EPHA5表达情况。分析EGFR突变型与野生型不同NEK2、EPHA5表达情况。Kaplan-Meier生存曲线分析不同NEK2、EPHA5表达对NSCLC患者的预后情况。结果：与癌旁组织比较,癌组织NEK2、EPHA5阳性表达率明显更高（均P＜0.05）;与TNM分期Ⅰ～Ⅱ期、无淋巴结转移和肿瘤直径＜5 cm患者相比,TNM分期ⅢA期、淋巴结转移和肿瘤直径≥5 cm患者的NEK2、EPHA5阳性表达率均明显更高（均P＜0.05）;EGFR突变型组NEK2、EPHA5阳性表达率显著高于EGFR野生型组（均P＜0.05）;NEK2阳性表达组和阴性表达组3年总生存率（OS）分别为40.40%（40/99）,57.69%（30/52）,EPHA5阳性表达组和阴性表达组患者3年OS分别为41.90%（44/105）,56.52%（26/46）,各阴性表达组患者累积生存显著高于阳性表达组（P＜0.05）。结论：NSCLC癌组织中NEK2、EPHA5阳性表达率升高,与TNM分期ⅢA期、淋巴细胞转移、肿瘤直径有关,还可能导致EGFR突变和不良预后。     

EGFR 突变种类与临床疗效关联

癌组织中表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变是应用靶向药物EGFR酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)治疗的一个重要相关因素及预测指标。对其突变的检测可以指导TKI类药物(TKIs)的最佳应用。该种突变常出现在非小细胞肺癌(NSCLC)中,尤其是在亚洲女性、肺腺癌、非吸烟者中,与非小细胞肺癌患者对TKIs治疗的敏感性密切相关。本文旨在探讨利用EGFR基因的已知突变热点的相关知识选择适合不同分子遗传学背景的群体或/和个体的"个体化"治疗方案,最终达到延长肺癌患者生存时间和提高生活质量的双重目的。     

EGFR突变种类与临床疗效关联

癌组织中表皮生长因子受体（epidermal growth factor receptor,EGFR）基因突变是应用靶向药物EGFR酪氨酸激酶抑制剂（tyrosine kinase inhibitor,TKI）治疗的一个重要相关因素及预测指标。对其突变的检测可以指导TKI类药物（TKIs）的最佳应用。该种突变常出现在非小细胞肺癌（NSCLC）中,尤其是在亚洲女性、肺腺癌、非吸烟者中,与非小细胞肺癌患者对TKIs治疗的敏感性密切相关。本文旨在探讨利用EGFR基因的已知突变热点的相关知识选择适合不同分子遗传学背景的群体或/和个体的＂个体化＂治疗方案,最终达到延长肺癌患者生存时间和提高生活质量的双重目的。     

EML-ALK突变阳性的肺癌患者EGFR突变检测及其临床特征

目的：检测表皮生长因子受体（epidermal growth factor receptor, EGFR）在间变性淋巴瘤激酶（anaplastic lymphoma kinase, ALK）融合基因突变的原发性肺癌（primary lung cancer）人群中的突变率,并分析其与病人临床病理特征间的关系。方法：入选的 106例病例均为中国西北五省人群,且经ALK 融合基因检测为阳性。将106 例患者的组织标本采用ARMS 方法检测EGFR基因 18-21 外显子的突变情况,统计分析双突变患者的临床病理特征。结果：106 例ALK 融合基因突变阳性的原发性肺癌患者的组织 标本,有7 例（6.6 %）同时存在EGFR突变,其中19 外显子缺失突变（19-del）的3 例（42.9 %）,L858R突变的2 例（28.5 %）,L861Q 和G719X 突变的各1 例（14.3 %）;7 例ALK 和双突变的患者中ALK 融合基因的突变均为EML4-ALK突变亚型1 （variant 1, V1）。7 例双阳性的患者中,6 例患者的年龄小于总体患者的中位年龄（53 岁),占85.7 %;男性患者4 例,占57.1 %;不吸 烟患者7 例,占100 %;腺癌患者4 例,占57.1 %,其中女性3例;肉瘤样癌2例,占28.6 %;粘液表皮样癌1例,占14.3 %。结论： EML4-ALK融合基因和EGFR突变能够共存,在EML4-ALK阳性的肺癌患者中,EGFR的突变率为6.6 %,双突变的患者大多年 轻且均无吸烟史,且双突变的女性患者均为腺癌。     

鳞状非小细胞肺癌的病理特征和治疗药物研究进展

鳞状非小细胞肺癌(sq-NSCLC)约占非小细胞肺癌(NSCLC)病例的 30%,其治疗难、预后差,是一种毁灭性的肺癌类型, 转移性 sq-NSCLC 的 5 年生存率不足 5%。近 20 年来,sq-NSCLC 治疗领域的进展甚微,尤其是一线治疗,导致该领域存在严重未满 足的临床需求,sq-NSCLC 患者迫切需要更多的新治疗方案。综述 sq-NSCLC 的临床病理特征和治疗药物的研究进展,为 sq-NSCLC 治 疗药物的深入研究与开发提供参考。     

食管癌组织人端粒酶反转录酶、肿瘤转移相关蛋白1的表达与临床病理特征及预后的关系研究

摘要 目的： 探讨食管癌组织中人端粒酶反转录酶（hTERT）、肿瘤转移相关蛋白1（MTA1）的表达与临床病理特征及预后的关系。方法：选择2015年1月至2016年10月我院收治的食管癌患者80例,应用免疫组织化学染色法检测其癌组织和癌旁组织中hTERT、MTA1表达,分析食管癌组织中hTERT、MTA1表达与临床病理特征的关系及其表达的相关性。所有患者均随访36个月,观察不同hTERT、MTA1表达情况患者的生存情况并分析hTERT、MTA1的表达与患者预后的关系。结果：食管癌组织中hTERT、MTA1阳性率显著高于癌旁组织（P<0.05）。中低分化、TNM分期为III+IV期、有淋巴结转移者食管癌组织hTERT、MTA1阳性率分别高于高分化、TNM分期为I+II期、无淋巴结转移者（P<0.05）,不同性别、年龄、病灶最大直径者、肿瘤部位、病理类型食管癌组织hTERT、MTA1阳性率比较均无统计学差异（P>0.05）。Spearman相关分析显示,食管癌组织中hTERT表达与MTA1表达呈正相关（r=0.645,P=0.000）。随访36个月后,患者存活33例,存活率41.25%（33/80）,食管癌组织hTERT阴性、MTA1阴性患者生存率、中位生存期分别为64.29%（9/14）、23.6个月,60.87%（14/23）、24.9个月均显著优于hTERT阳性、MTA1阳性患者的36.36%（24/66）、19.2个月,33.33%（19/57）、18.5个月（P<0.05）。结论：食管癌组织中存在hTERT、MTA1异常高表达,其水平与食管癌的组织分化程度、TNM分期、淋巴结转移相关,且其表达情况与食管癌患者预后有密切关系。     

乳腺腺肌上皮瘤的病理特征

乳腺腺肌上皮瘤是一种少见的特殊类型乳腺良性肿瘤。Ｂｏｓｅｎ等报告１８例［１］，国内文献为个案报道。由于腺肌上皮瘤可多次复发，偶见转移，被视为低度或潜在的恶性肿瘤。为了了解其发病情况、病理特征，现将有关文献综述如下。１病理变化１．１大体形态肿块直径小的...     

肝癌基因组变异与分子分型

肿瘤是机体在各种致癌因素刺激下,基因组发生变异导致细胞失去正常生长调控而异常增殖的一种恶性疾病.肿瘤具有维持细胞增殖信号、逃避生长抑制、抗细胞凋亡、无限复制、诱导血管生成、激活侵袭和转移、能量代谢的重编程和免疫逃避等特点.原发性肝癌是一种高致死性的癌症类型,在中国发病率高,约占全世界发病人数的一半.肝细胞癌是原发性肝癌中的主要组织学亚型,与乙型和丙型肝炎病毒感染、酒精刺激、肥胖以及饮食污染等有关.遗传学和表观遗传突变事件的研究有助于理解肝癌的发病机制并对患者进行分子分型,而分子分型则可以指导临床个体化治疗和预后判断.     

Topography of mutational signatures in human cancer

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Heterogeneity of lipidomic profiles among lung cancer subtypes of patients

Lung cancer is a leading cause of cancer‐related deaths with an increasing incidence and poor prognoses. To further understand the regulatory mechanisms of lipidomic profiles in lung cancer subtypes, we measure the profiles of plasma lipidome between health and patients with lung cancer or among patients with squamous cell carcinomas, adenocarcinoma or small cell lung cancer and to correct lipidomic and genomic profiles of lipid‐associated enzymes and proteins by integrating the data of large‐scale genome screening. Our studies demonstrated that circulating levels of PS and lysoPS significantly increased, while lysoPE and PE decreased in patients with lung cancer. Our data indicate that lung cancer‐specific and subtype‐specific lipidomics in the circulation are important to understand mechanisms of systemic metabolisms and identify diagnostic biomarkers and therapeutic targets. The carbon atoms, dual bonds or isomerism in the lipid molecule may play important roles in lung cancer cell differentiations and development. This is the first try to integrate lipidomic data with lipid protein‐associated genomic expression among lung cancer subtypes as the part of clinical trans‐omics. We found that a large number of lipid protein‐associated genes significantly change among cancer subtypes, with correlations with altered species and spatial structures of lipid metabolites.     

Proteome profiling for the identification of lung cancer signatures

Evaluation of: Taguchi A, Politi K, Pitteri SJ et al. Lung cancer signatures in plasma based on proteome profiling of mouse tumor models. Cancer Cell 20(3), 289–299 (2011).

Comprehensive and in-depth discovery of the disease proteome is an important issue in recent proteomics developments. Previous studies have shown a number of biomarkers discovered in various diseases, including lung cancer. Some of them are potentially useful in lung cancer diagnostics and prognostics. However, few of them can act as organ-specific biomarkers to extensively compare multiple cancer models. This article evaluates a recently published study employing comparative proteomics on multiple genetically engineered mouse models and sheds light on the usefulness and application of the discovered marker panel for human lung cancer diagnostics.     

Doxorubicin kinetics and effects on lung cancer cell lines using in vitro Raman micro‐spectroscopy: binding signatures,drug resistance and DNA repair

Raman micro‐spectroscopy is a non‐invasive analytical tool, whose potential in cellular analysis and monitoring drug mechanisms of action has already been demonstrated, and which can potentially be used in pre‐clinical and clinical applications for the prediction of chemotherapeutic efficacy. To further investigate such potential clinical application, it is important to demonstrate its capability to differentiate drug mechanisms of action and cellular resistances. Using the example of Doxorubicin (DOX), in this study, it was used to probe the cellular uptake, signatures of chemical binding and subsequent cellular responses, of the chemotherapeutic drug in two lung cancer cell lines, A549 and Calu‐1. Multivariate statistical analysis was used to elucidate the spectroscopic signatures associated with DOX uptake and subcellular interaction. Biomarkers related to DNA damage and repair, and mechanisms leading to apoptosis were also measured and correlated to Raman spectral profiles. Results confirm the potential of Raman spectroscopic profiling to elucidate both drug kinetics and pharmacodynamics and differentiate cellular drug resistance associated with different subcellular accumulation rates and subsequent cellular response to DNA damage, pointing towards a better understanding of drug resistance for personalised targeted treatment.

     

Characterization of age signatures of DNA methylation in normal and cancer tissues from multiple studies

Background

DNA methylation (DNAm) levels can be used to predict the chronological age of tissues; however, the characteristics of DNAm age signatures in normal and cancer tissues are not well studied using multiple studies.

Results

We studied approximately 4000 normal and cancer samples with multiple tissue types from diverse studies, and using linear and nonlinear regression models identified reliable tissue type-invariant DNAm age signatures. A normal signature comprising 127 CpG loci was highly enriched on the X chromosome. Age-hypermethylated loci were enriched for guanine–and-cytosine-rich regions in CpG islands (CGIs), whereas age-hypomethylated loci were enriched for adenine–and-thymine-rich regions in non-CGIs. However, the cancer signature comprised only 26 age-hypomethylated loci, none on the X chromosome, and with no overlap with the normal signature. Genes related to the normal signature were enriched for aging-related gene ontology terms including metabolic processes, immune system processes, and cell proliferation. The related gene products of the normal signature had more than the average number of interacting partners in a protein interaction network and had a tendency not to interact directly with each other. The genomic sequences of the normal signature were well conserved and the age-associated DNAm levels could satisfactorily predict the chronological ages of tissues regardless of tissue type. Interestingly, the age-associated DNAm increases or decreases of the normal signature were aberrantly accelerated in cancer samples.

Conclusion

These tissue type-invariant DNAm age signatures in normal and cancer can be used to address important questions in developmental biology and cancer research.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-997) contains supplementary material, which is available to authorized users.     

In silico mutational studies of Hsp70 disclose sites with distinct functional attributes

The Mutation‐Minimization Method (MuMi) to study the local response of proteins to point mutations has been introduced here. The heat shock protein Hsp70 as the test system since it displays features that have been studied in great detail has been used here. It has many conserved residues, serves several different functions on each of its domains, and displays interdomain allostery. For the analysis of spatial arrangement of residues within the protein, the network properties of the wild type (WT) protein as well as its all single alanine residue mutants using MuMi has been investigated. The measures to express the amount of change from the WT structure upon mutation and compare these deviations to find potential critical sites have been proposed. The functional significance of the potential sites to the parameter that uncovers them has been mapped. It was found that sites directly involved in binding were sensitive to mutations and were characterized by large displacements. On the other hand, sites that steer large conformational changes typically had increased reachability upon alanine mutations occurring elsewhere in the protein. Finally, residues that control communication within and between domains reside on the largest number of paths connecting pairs of residues in the protein. Proteins 2015; 83:2077–2090. © 2015 Wiley Periodicals, Inc.     

Treatment of stage IIIB squamous-cell lung cancer with pembrolizumab combined with chemotherapy to achieve pCR: a case report

Lung cancer is currently the leading cause of global cancer-related deaths and its incidence increases every year. Most squamous-cell lung cancers are in the advanced stage at diagnosis. This study reported a case of a 66-year-old man diagnosed with unresectable stage IIIB squamous-cell lung cancer (cT2aN3M0), who was treated with pembrolizumab combined with paclitaxel (albumin-bound) + nedaplatin. After four cycles, a follow-up chest computed tomography (CT) scan showed the disappearance of the original right lower lobe lung mass with cavitation-like changes, and a follow-up chest CT scan 6w later revealed a solid nodule measuring approximately 1.5 cm in diameter within the cavity. Subsequent surgical excision of the residual primary lesion was performed to achieve complete pathological remission. The patient was treated with pembrolizumab combined with paclitaxel (albumin-bound) + nedaplatin and achieved complete pathological remission with surgical excision.     

Comprehensive analysis of novel three-long noncoding RNA signatures as a diagnostic and prognostic biomarkers of human triple-negative breast cancer

Currently, traditional predictors of prognosis (tumor size, nodal status, progesterone receptor [PR], estrogen receptor [ER], or human epidermal growth factor receptor-2 [HER2]) are insufficient for precise survival prediction for triple-negative breast cancer (TNBC). Long noncoding RNAs (lncRNAs) have been observed to exert critical functions in cancer, including in TNBC. Nevertheless, systematically tracking expression-based lncRNA biomarkers based on the sequence data for the prediction of prognosis in TNBC has not yet been investigated. To ascertain whether biomarkers exist that can distinguish TNBC from adjacent normal tissue or nTNBC, we implemented a comprehensive analysis of lncRNA expression profiles and clinical data of 1097 BC samples from The Cancer Genome Atlas database. A total of 1510 differentially expressed lncRNAs in normal and TNBC samples were extracted. Similarly, 672 differentially expressed lncRNAs between nTNBC and TNBC samples were detected. The receiver operating characteristic curve analysis indicated that three upregulated lncRNAs (AC091043.1, AP000924.1, and FOXCUT) may be of strong diagnostic value for predicting the existence of TNBC in the training and validation sets (area under the curve (AUC > 0.85). Kaplan-Meier analysis demonstrated that the other three lncRNAs (AC010343.3, AL354793.1, and FGF10-AS1) were associated with the prognosis of TNBC patients (P < 0.05). We used the three overall survival (OS)-related lncRNAs to establish a three-lncRNA signature. Multivariate Cox regression analysis suggested that the three-lncRNA signature was a prognostic factor independent of other clinical variables ( P < 0.01) for predicting OS in TNBC patients that could be utilized to classify patients into high- or low-risk subgroups. Our results might provide efficient signatures for clinical diagnosis and prognostic evaluation of TNBC.