Short- and long-term survival outcomes among never smokers who developed lung cancer

BackgroundLung cancer is the leading cause of cancer death in the US. While an extensive literature exists detailing lung cancer risk factors and mortality among patients with a history of tobacco use, the data are more limited among individuals who have never smoked. The purpose of this investigation is to compare survival rates between the two groups and evaluate potential risk factors among never smokers.MethodsThis retrospective study included 3380 smokers and 334 never smokers who were diagnosed with lung cancer at Stony Brook University Hospital between 2003 and 2016. 1-, 3-, 5- and 10-year survival outcomes, stratified by smoking status, were compared and Kaplan-Meier curves for overall survival are provided. Cox Proportional Hazard models were used to evaluate factors influencing survival among never smokers.ResultsNever smokers with lung cancer were more likely to be female, be diagnosed with adenocarcinoma histology, and had fewer comorbidities than lung cancer patients who smoked. Although 60% of patients were diagnosed at a later stage of disease development, regardless of smoking status, overall short- and long-term survival was significantly higher among never smokers compared to those with a history of tobacco use. In addition to age and stage at diagnosis, a history of diabetes was found to be a significant prognostic factor for decreased survival among never smokers (HR=3.15, 95% CI (1.74, 5.71)).ConclusionsData from the present investigation suggest that, regardless of smoking status, approximately three of every five lung cancer patients are diagnosed at a later stage, and that both short- and long-term survival outcomes are significantly better among never smokers compared to those with a history of tobacco use. Additional studies are required to validate these findings and better explain the mechanistic drivers for the improved outcomes among never smokers.     

BRCA1: a novel prognostic factor in resected non-small-cell lung cancer

Background

Although early-stage non-small-cell lung cancer (NSCLC) is considered a potentially curable disease following complete resection, patients have a wide spectrum of survival according to stage (IB, II, IIIA). Within each stage, gene expression profiles can identify patients with a higher risk of recurrence. We hypothesized that altered mRNA expression in nine genes could help to predict disease outcome: excision repair cross-complementing 1 (ERCC1), myeloid zinc finger 1 (MZF1) and Twist1 (which regulate N-cadherin expression), ribonucleotide reductase subunit M1 (RRM1), thioredoxin-1 (TRX1), tyrosyl-DNA phosphodiesterase (Tdp1), nuclear factor of activated T cells (NFAT), BRCA1, and the human homolog of yeast budding uninhibited by benzimidazole (BubR1).

Methodology and Principal Findings

We performed real-time quantitative polymerase chain reaction (RT-QPCR) in frozen lung cancer tissue specimens from 126 chemonaive NSCLC patients who had undergone surgical resection and evaluated the association between gene expression levels and survival. For validation, we used paraffin-embedded specimens from 58 other NSCLC patients. A strong inter-gene correlation was observed between expression levels of all genes except NFAT. A Cox proportional hazards model indicated that along with disease stage, BRCA1 mRNA expression significantly correlated with overall survival (hazard ratio [HR], 1.98 [95% confidence interval (CI), 1.11-6]; P = 0.02). In the independent cohort of 58 patients, BRCA1 mRNA expression also significantly correlated with survival (HR, 2.4 [95%CI, 1.01-5.92]; P = 0.04).

Conclusions

Overexpression of BRCA1 mRNA was strongly associated with poor survival in NSCLC patients, and the validation of this finding in an independent data set further strengthened this association. Since BRCA1 mRNA expression has previously been linked to differential sensitivity to cisplatin and antimicrotubule drugs, BRCA1 mRNA expression may provide additional information for customizing adjuvant antimicrotubule-based chemotherapy, especially in stage IB, where the role of adjuvant chemotherapy has not been clearly demonstrated.     

The anti-myeloma activity of a novel purine scaffold HSP90 inhibitor PU-H71 is via inhibition of both HSP90A and HSP90B1

Background

The ribonucleotide reductase M1 (RRM1) gene encodes the regulatory subunit of ribonucleotide reductase, the molecular target of gemcitabine. The overexpression of RRM1 mRNA in tumor tissues is reported to be associated with gemcitabine resistance. Thus, single nucleotide polymorphisms (SNPs) of the RRM1 gene are potential biomarkers of the response to gemcitabine chemotherapy. We investigated whether RRM1 expression in peripheral blood mononuclear cells (PBMCs) or SNPs were associated with clinical outcome after gemcitabine-based chemotherapy in advanced non-small cell lung cancer (NSCLC) patients.

Methods

PBMC samples were obtained from 62 stage IIIB and IV patients treated with gemcitabine-based chemotherapy. RRM1 mRNA expression levels were assessed by real-time PCR. Three RRM1 SNPs, -37C→A, 2455A→G and 2464G→A, were assessed by direct sequencing.

Results

RRM1 expression was detectable in 57 PBMC samples, and SNPs were sequenced in 56 samples. The overall response rate to gemcitabine was 18%; there was no significant association between RRM1 mRNA expression and response rate (P = 0.560). The median progression-free survival (PFS) was 23.3 weeks in the lower expression group and 26.9 weeks in the higher expression group (P = 0.659). For the -37C→A polymorphism, the median PFS was 30.7 weeks in the C(-)37A group, 24.7 weeks in the A(-)37A group, and 23.3 weeks in the C(-)37C group (P = 0.043). No significant difference in PFS was observed for the SNP 2455A→G or 2464G→A.

Conclusions

The RRM1 polymorphism -37C→A correlated with PFS in NSCLC patients treated with gemcitabine-based chemotherapy. No significant correlation was found between PBMC RRM1 mRNA expression and the efficacy of gemcitabine.     

ERCC1和RRM1在非小细胞肺癌组织中的表达及意义

目的:观察非小细胞肺癌中ERCC1和RRM1表达,并探讨其临床意义。方法:选择本院及西安交通大学第一附属胸外二科于2013年1月-2013年6月收治的经术后病理证实为非小细胞癌肺癌患者40例作为研究对象,均采取免疫组化技术测定组织中ERCC1和RRM1表达水平,并分析ERCC1和RRM1表达水平与患者年龄、病理分期、是否淋巴结转移等相关因素之间的关系。结果:40例非小细胞肺癌患者中,ERCC1表达阴性28例(70.0%),阳性12例(30.0%);RRM1表达阴性9例(22.5%),阳性31例(77.5%)。ERCC1和RRM1表达阴性非小细胞肺患者生存期均优于表达阳性患者,均P0.05。患者非小细胞癌TNM分期及淋巴结转移转移情况与ERCC1及RRM1表达情况具有相关性,均P0.05。结论:非小细胞肺癌ERCC1和RRM1表达水平测定有助于预后情况,具有重要临床价值。     

MCM6、MCM7、KIAA1522蛋白联合检测对非小细胞肺癌诊断及预后预测的临床价值研究

摘要 目的：筛选肺癌蛋白分子标志物,寻找可诊断及预测肺癌预后的蛋白标志物。方法：选择2014年8月~2019年7月于西安市第四医院确诊并进行肺部切除手术的非小细胞肺癌(non-small-cell lung Cancer,NSCLC)患者80例,采用免疫组织化学(immunohistochemistry,IHC)检测NSCLC患者肺癌组织标本和癌旁MCM2(Minichromosome maintenance protein2, 微小染色体维持蛋白2)、MCM5(Minichromosome maintenance protein5,微小染色体维持蛋白5)、MCM6(Minichromosome maintenance protein6,微小染色体维持蛋白6)、MCM7(Minichromosome maintenance protein7,微小染色体维持蛋白7)、KIAA1522和KIAA0317蛋白表达阳性率,探讨多蛋白联合检测对NSCLC诊断及预后预测的临床应用价值。结果：肺癌组织中MCM2、MCM5、MCM6、MCM7、KIAA1522和KIAA0317的阳性表达率均显著高于癌旁正常肺组织(P＜0.05),其中MCM6、MCM7和KIAA1522在50 %以上;以MCM6、MCM7、KIAA15223蛋白联合检测肺癌组织,不同性别、不同年龄、类型和分期的NSCLC患者的联合蛋白阳性率无统计学差异(P＞0.05),且蛋白阳性率均大于80 %;MCM7高表达较之低表达或不表达的病例,显著增加患者的死亡风险(P=0.000)。男性(P=0.031)、III~IV期患者(P＜0.001)、以及低分化程度(P=0.012)也是患者的不良预后因素,多因素回归分析显示,MCM7是一个独立的预测指标(P=0.000), 与患者生存具有显著相关性,对预后有一定的预测作用。结论：NSCLC患者肺癌组织中MCM6、MCM7和KIAA1522呈高表达,三者联合检测对NSCLC的检测具有较高的准确性、敏感性和特异性,高水平的MCM7表达提示肺癌患者的不良预后。     

Expression of Prostate-Specific Membrane Antigen in Lung Cancer Cells and Tumor Neovasculature Endothelial Cells and Its Clinical Significance

BackgroundProstate-specific membrane antigen (PSMA) has been found in tumor neovasculature endothelial cells (NECs) of non-prostate cancers and may become the most promising target for anti-tumor therapy. To study the value of PSMA as a potential new target for lung cancer treatment, PSMA expression in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) tissues and its relationship with clinicopathology were investigated in the current study.MethodsImmunohistochemistry was used to detect PSMA expression in a total of 150 lung specimens of patients with lung cancer. The data were analyzed using univariate and multivariate statistical analyses.ResultsThe percentages of NSCLC patients who had PSMA (+) tumor cells and PSMA (+) NECs were 54.02% and 85.06%, respectively. The percentage of patients younger than 60 years old who had PSMA (+) tumor cells was 69.05%, which was significantly greater than the percentage of patients aged 60 years or older (40.00%, p<0.05). A significant difference was observed in the percentage of NSCLC patients with PMSA (+) NECs and stage I or II cancer (92.98%) and those patients with stage III or IV cancer (76.77%). In the SCLC tissues, NEC PSMA expression (70.00%) did not differ significantly from NSCLC. SCLC tumor cells and normal lung tissues cells were all negative. There was no significant correlation between the presence of PSMA (+) NECs in SCLC patients and the observed clinicopathological parameters.ConclusionsPSMA is expressed not only in NECs of NSCLC and SCLC but also in tumor cells of most NSCLC patients. The presence of PSMA (+) tumor cells and PSMA (+) NECs in NSCLC was negatively correlated with age and the clinicopathological stage of the patients, respectively.     

血清外泌体lncRNA PCGEM1、miR-129-5p与非小细胞肺癌患者临床病理特征及预后的关系

摘要 目的：研究血清外泌体长链非编码核糖核酸（lncRNA）前列腺癌基因表达标记1（PCGEM1）、微小核糖核酸（miR）-129-5p与非小细胞肺癌（NSCLC）患者临床病理特征及预后的关系。方法：选取2016年2月-2018年1月南京脑科医院收治的125例NSCLC患者作为NSCLC组,同期选取体检的70例健康人群作为健康组。采集两组静脉血,提取血清外泌体;采用实时定量聚合酶链式反应（qRT-PCR）检测血清外泌体lncRNA PCGEM1、miR-129-5p表达情况;采用Pearson相关性分析lncRNA PCGEM1与miR-129-5p的关系。并分析血清外泌体lncRNA PCGEM1、miR-129-5p与NSCLC患者临床病理特征的关系。对NSCLC患者行5年随访,绘制Kaplan-Meier曲线分析预后情况,多因素Cox比例风险回归模型分析预后不良危险因素,受试者工作特征（ROC）曲线分析lncRNA PCGEM1、miR-129-5p对NSCLC预后的预测价值。结果：：NSCLC组lncRNA PCGEM1相对表达量高于健康组,miR-129-5p相对表达量低于健康组（P＜0.05）。血清外泌体lncRNA PCGEM1相对表达量与miR-129-5p表达呈负相关（r= -0.420,P＜0.05）。血清外泌体lncRNA PCGEM1、miR-129-5p表达与患者TNM分期、分化程度、淋巴结转移有关（P＜0.05）。Kplan-Meier生存曲线显示,lncRNA PCGEM1低表达组5年生存率69.05%高于lncRNA PCGEM1高表达组35.53%,miR-129-5p高表达组5年生存率68.09%高于miR-129-5p低表达组33.80%。多因素Cox比例风险回归显示,TNM分期III期、有淋巴结转移、lncRNA PCGEM1高表达、miR-129-5p低表达为NSCLC患者预后不良的独立危险因素（P＜0.05）。ROC曲线显示,lncRNA PCGEM1、miR-129-5p联合检测对NSCLC预后的预测曲线下面积（AUC）为0.865,预测价值高于两者单独预测。结论：NSCLC患者血清外泌体lncRNA PCGEM1表达上调、miR-129-5p表达下调,二者表达与NSCLC患者TNM分期、分化程度、淋巴结转移有关,且与患者预后密切相关,对NSCLC预后不良具有较好预测价值。     

Tumor BRCA1, RRM1 and RRM2 mRNA Expression Levels and Clinical Response to First-Line Gemcitabine plus Docetaxel in Non-Small-Cell Lung Cancer Patients

Background

Overexpression of RRM1 and RRM2 has been associated with gemcitabine resistance. BRCA1 overexpression increases sensitivity to paclitaxel and docetaxel. We have retrospectively examined the effect of RRM1, RRM2 and BRCA1 expression on outcome to gemcitabine plus docetaxel in advanced non-small-cell lung cancer (NSCLC) patients.

Methodology and Principal Findings

Tumor samples were collected from 102 chemotherapy-naïve advanced NSCLC patients treated with gemcitabine plus docetaxel as part of a randomized trial. RRM1, RRM2 and BRCA1 mRNA levels were assessed by quantitative PCR and correlated with response, time to progression and survival. As BRCA1 levels increased, the probability of response increased (Odds Ratio [OR], 1.09: p = 0.01) and the risk of progression decreased (hazard ratio [HR], 0.99; p = 0.36). As RRM1 and RRM2 levels increased, the probability of response decreased (RRM1: OR, 0.97; p = 0.82; RRM2: OR, 0.94; p<0.0001) and the risk of progression increased (RRM1: HR, 1.02; p = 0.001; RRM2: HR, 1.005; p = 0.01). An interaction observed between BRCA1 and RRM1 allowed patients to be classified in three risk groups according to combinations of gene expression levels, with times to progression of 10.13, 4.17 and 2.30 months (p = 0.001). Low BRCA1 expression was the only factor significantly associated with longer time to progression in 31 patients receiving cisplatin-based second-line therapy.

Conclusions

The mRNA expression of BRCA1, RRM1 and RRM2 is potentially a useful tool for selecting NSCLC patients for individualized chemotherapy and warrants further investigation in prospective studies.     

非小细胞肺癌组织PRRX1、VASH-1与微血管密度、临床病理参数和预后的关系研究

摘要 目的：探讨非小细胞肺癌（NSCLC）组织配对相关同源框蛋白1（PRRX1）、血管抑制蛋白1（VASH-1）与微血管密度（MVD）、临床病理参数和预后的关系。方法：选择2018年1月至2020年1月辽宁省金秋医院行手术切除的156例NSCLC患者的癌组织及癌旁正常组织标本。应用免疫组织化学染色法检测癌组织及癌旁组织PRRX1、VASH-1的阳性表达率,并进行MVD计数。比较PRRX1阳性表达组/阴性表达组、VASH-1阳性表达组/阴性表达组MVD计数。分析PRRX1、VASH-1与NSCLC患者病理参数的关系。随访3年,应用Kaplan-Meier生存曲线分析PRRX1、VASH-1阳性/阴性表达与NSCLC患者预后的关系。结果：与癌旁组织相比,NSCLC患者癌组织PRRX1阳性表达率降低,VASH-1阳性表达率升高（P<0.05）。与PRRX1阴性NSCLC患者相比,PRRX1阳性NSCLC患者癌组织MVD降低,与VASH-1阴性NSCLC患者相比,VASH-1阳性NSCLC患者癌组织MVD升高（P<0.05）。与TNM I~II期、无淋巴结转移NSCLC患者的癌组织相比,TNM Ⅲ A期、淋巴结转移NSCLC患者的癌组织中PRRX1阳性表达率降低,VASH-1阳性表达率升高（P<0.05）。Kaplan-Meier法分析显示,PRRX1阳性组3年总体生存率（OS）、3年无病生存率（DFS）高于PRRX1阴性组（P<0.05）,VASH-1阴性组3年OS、3年DFS高于VASH-1阳性组（P<0.05）。结论：NSCLC患者的癌组织中PRRX1阳性表达率降低,VASH-1阳性表达率升高,与淋巴结转移、TNM分期及不良预后有关。     

lncRNA DGCR5在非小细胞肺癌组织中的表达及其与临床病理特征的相关性分析

摘要 目的：探究lncRNA DGCR5在非小细胞肺癌(NSCLC)组织中的表达及其与临床病理特征的相关性。方法：选取2020年1月至2021年12月在我院肿瘤科收治的进行手术治疗的NSCLC患者86例,在手术期间从患者获得肿瘤和非肿瘤的肺癌旁组织样本。采用qRT-PCR测定肿瘤组织及癌旁组织中lncRNA DGCR5表达水平。分析lncRNA DGCR5表达水平与NSCLC患者性别、年龄、临床分期、T分期、N分期等临床病理参数的关系,lncRNA DGCR5表达水平与患者预后总生存期（OS）和无进展生存期（PFS）的关系。结果：与癌旁组织相比,lncRNA DGCR5在NSCLC肿瘤组织中的表达水平相对较低,差异具有统计学意义（P<0.01）。lncRNA DGCR5表达与肿瘤分化程度、TNM分期、肿瘤体积、淋巴转移和远处转移之间存在明显相关性,差异具有统计学意义（P<0.05）。采用Kaplan-Meier法进行生存分析,研究发现lncRNA DGCR5高表达组中位OS及中位DFS分别显著高于lncRNA DGCR5低表达组（P<0.05）。低分化程度、II+ IIIa临床分期、N1-N3淋巴转移、远处转移、及lncRNA DGCR5 低表达均与NSCLC患者总生存率和无进展生存率相关。结论：LncRNA DGCR5在NSCLC患者肿瘤组织中的表达量降低,NSCLC患者血LncRNA DGCR5表达水平与分化程度、TNM分期、淋巴转移、远处转移及预后具有相关性。LncRNA DGCR5可作为早期诊断和治疗NSCLC的新型生物标志物。     

CXC chemokine ligand 4 (CXCL4) is predictor of tumour angiogenic activity and prognostic biomarker in non-small cell lung cancer (NSCLC) patients undergoing surgical treatment

Objective: To evaluate the association of CXC chemokine ligand 4 (CXCL4) plasma levels with tumour angiogenesis in non-small cell lung cancer (NSCLC) and to assess association of CXCL4 with clinical outcomes.

Patients and methods: Fifty patients with early stage NSCLC who underwent pulmonary resection. CXCL4 levels were analysed by ELISA. Angiogenesis was assessed by immunohistochemistry, and microvessel density (MVD) count.

Results: There was positive correlation between MVD and CXCL4 levels. Patients with higher CXCL4 levels had worse overall and disease-free survival.

Conclusions: Plasma levels of CXCL4 are associated with tumour vascularity. Increased CXCL4 levels in NSCLC patients undergoing treatment may indicate active cancer-induced angiogenesis associated with relapse and worse outcome.     

High expression levels of pyrimidine metabolic rate–limiting enzymes are adverse prognostic factors in lung adenocarcinoma: a study based on The Cancer Genome Atlas and Gene Expression Omnibus datasets

Reprogramming of metabolism is described in many types of cancer and is associated with the clinical outcomes. However, the prognostic significance of pyrimidine metabolism signaling pathway in lung adenocarcinoma (LUAD) is unclear. Using the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) datasets, we found that the pyrimidine metabolism signaling pathway was significantly enriched in LUAD. Compared with normal lung tissues, the pyrimidine metabolic rate–limiting enzymes were highly expressed in lung tumor tissues. The high expression levels of pyrimidine metabolic–rate limiting enzymes were associated with unfavorable prognosis. However, purinergic receptors P2RX1, P2RX7, P2RY12, P2RY13, and P2RY14 were relatively downregulated in lung cancer tissues and were associated with favorable prognosis. Moreover, we found that hypo-DNA methylation, DNA amplification, and TP53 mutation were contributing to the high expression levels of pyrimidine metabolic rate–limiting enzymes in lung cancer cells. Furthermore, combined pyrimidine metabolic rate–limiting enzymes had significant prognostic effects in LUAD. Comprehensively, the pyrimidine metabolic rate–limiting enzymes were highly expressed in bladder cancer, breast cancer, colon cancer, liver cancer, and stomach cancer. And the high expression levels of pyrimidine metabolic rate–limiting enzymes were associated with unfavorable prognosis in liver cancer. Overall, our results suggested the mRNA levels of pyrimidine metabolic rate–limiting enzymes CAD, DTYMK, RRM1, RRM2, TK1, TYMS, UCK2, NR5C2, and TK2 were predictive of lung cancer as well as other cancers.

     

HOXC8通过调控PDX1的表达促进非小细胞肺癌的生长与EMT过程

摘要 目的：探索HOXC8与PDX1在非小细胞肺癌（non-small lung cancer, NSCLC）细胞生长及上皮间质转化（Epithelial-mesenchymal transition, EMT）的作用机制。方法：通过转录组测序、荧光定量PCR及染色质免疫沉淀等方法筛选并鉴定HOXC8调控的靶基因;通过Western blot、CCK-8、克隆集落生成及生物信息学等手段分析靶基因PDX1在非小细胞肺癌中的作用。结果：实验证明HOXC8可结合到PDX1基因的启动子上,并作为转录因子激活PDX1的表达。PDX1的表达促进NSCLC细胞的生长与EMT过程,而沉默PDX1能显著地抑制NSCLC细胞的生长与EMT过程,并诱导细胞的凋亡。通过分析已知的肿瘤数据库, 我们发现在NSCLC中PDX1的表达显著高于正常组织,且PDX1的高表达与肺癌患者的预后不良呈显著的相关性。结论：本研究发现HOXC8-PDX1轴在非小细胞肺癌中起着重要的调节作用, 可有望成为非小细胞肺癌治疗的新靶点。     

Circular RNA circFBXO7 attenuates non-small cell lung cancer tumorigenesis by sponging miR-296-3p to facilitate KLF15-mediated transcriptional activation of CDKN1A

BackgroundAccumulating evidence indicates that circular RNAs (circRNAs) play important roles in various cancers. Hsa_circ_0008832 (circFBXO7) is a circRNA generated from the second exon of the human F-box only protein 7 (FBXO7). Mouse circFbxo7 is a circRNA generated from the second exon of mouse F-box only protein 7 (Fbxo7). The role of human circFBXO7 and mouse circFbxo7 in non-small cell lung cancer (NSCLC) has not been reported.MethodsThe expression of circFBXO7 was measured by quantitative real-time PCR. Survival analysis was performed to explore the association between the expression of circFBXO7 and the prognosis of patients with NSCLC. Lung cancer cell lines were transfected with plasmids. Cell proliferation, cell cycle, and tumorigenesis were evaluated to assess the effects of circFBXO7. Fluorescence in situ hybridization assay was used to identify the location of circFBXO7 and circFbxo7 in human and mouse lung cancer cells. Luciferase reporter assay was conducted to confirm the relationship between circFBXO7 and microRNA.ResultsIn this study, we found that circFBXO7 was downregulated in NSCLC tissues and cell lines. NSCLC patients with high circFBXO7 expression had prolonged overall survival. Overexpression of circFBXO7 inhibited cell proliferation both in vitro and in vivo. Mechanistically, we demonstrated that circFBXO7 upregulated the expression of miR-296-3p target gene Krüppel-like factor 15 (KLF15) and KLF15 transactivated the expression of CDKN1A.ConclusionsCircFBXO7 acts as a tumor suppressor by a novel circFBXO7/miR-296-3p/KLF15/CDKN1A axis, which may serve as a potential biomarker and therapeutic target for NSCLC.     

Cav-1通过增加IncRNA HOTAIR的表达促进非小细胞肺癌细胞增殖

目的:探讨Cav-1对非小细胞肺癌(NSCLC)细胞增殖的影响及其分子机制。方法:取我院收治的2017年1月至2018年1月15例NSCLC患者手术切除的肺组织,并获取肺癌旁组织15例。实时定量PCR检测其中Cav-1和lncRNA HOTAIR的表达。进一步检测Cav-1和lncRNA HOTAIR在各肺癌细胞系中的表达。采用脂质体3000介导将si CAV-1和pcDNA3.1/CAV-1转染入NSCLC细胞系中,实时定量PCR检测lncRNA HOTAIR的表达,CCK-8检测细胞增殖。随后,将si HOTAIR以及pcDNA3.1/HOTAIR转染入CAV-1过表达的NSCLC细胞系中,CCK-8检测细胞增殖情况。结果:NSCLC患者手术切除的肺组织中CAV-1m RNA和HOTAIR lncRNA的表达均显著高于其在癌旁组织(P0.001)。与健康人肺组织上皮细胞系(NuLi-1)相比,各肺癌细胞系中CAV-1 m RNA和HOTAIR lncRNA的表达均显著增加,鳞状细胞癌细胞系(SK-MES-1)除外。si CAV-1显著降低NSCLC中CAV-1的表达(P0.01)以及其增殖能力,而pcDNA3.1/CAV-1显著增加NSCLC中CAV-1的表达(P0.01)以及其增殖。与对照si RNA相比,si CAV-1显著降低HOTAIR lncRNA的表达(P 0.05)。与对照质粒相比,pcDNA3.1/CAV-1显著增加HOTAIR lncRNA的表达(P0.01)。si HOTAIR可显著抑制NSCLC细胞增殖(P0.05),且可明显取消pcDNA3.1/CAV-1转染对NSCLC细胞增殖的促进作用(P0.05),而pcDNA3.1/HOTAIR可显著增加NSCLC细胞增殖(P0.05),且CAV-1过表达可增强pcDNA3.1/HOTAIR对NSCLC细胞增殖的促进作用(P0.05),而si CAV-1转染可抑制pcDNA3.1/HOTAIR对NSCLC细胞增殖的促进作用。结论:CAV-1通过上调lncRNA HOTAIR的表达促进肺癌细胞的增殖。     

The Potential Role of Pharmacogenomic and Genomic in the Adjuvant Treatment of Early Stage Non Small Cell Lung Cancer

Although notable progress has been made in the treatment of non-small-cell lung cancer (NSCLC) in recent years, this disease is still associated with a poor prognosis. Despite early-stage NSCLC is considered a potentially curable disease following complete resection, the majority of patients relapse and eventually die after surgery. Adjuvant chemotherapy prolongs survival, altough the absolute improvement in 5-year overall survival is only approximately 5%.Trying to understand the role of genes which could affect drug activity and response to treatment is a major challenge for establishing an individualised chemotherapy according to the specific genetic profile of each patient. Among genes involved in the DNA repair system, the excision repair cross-complementing 1 (ERCC1) is a useful markers of clinical resistance to platinum-based chemotherapy. In the International Lung Cancer Trial (IALT) adjuvant chemotherapy significantly prolonged survival among patients with ERCC1 negative tumors but not among ERCC1-positive patients. BRCA1 and ribonucleotide reductase M1 (RRM1), two other key enzymes in DNA synthesis and repair, appear to be modulators of drug sensitivity and may provide additional information for customizing adjuvant chemotherapy.Several clinical trials suggest that overexpression of class III β-tubulin is an adverse prognostic factor in cancer since it could be responsible for resistance to anti-tubulin agents. A retrospective analysis of NCIC JBR.10 trial showed that high tubulin III expression is associated with a higher risk of relapse following surgery alone but also with a higher probability of benefit from adjuvant cisplatin plus vinorelbine chemotherapy.Finally, the use of gene expression patterns such as the lung metagene model could provide a potential mechanism to refine the estimation of a patient’s risk of disease recurrence and could affect treatment decision in the management of early stage of NSCLC.In this review we will discuss the potential role of pharmacogenomic approaches to guide the medical treatment of early stage NSCLC.Key Words: NSCLC, adjuvant treatment, molecular markers, ERCC1, RRM1, β-tubulin, EGFR.     

Decrease of PDSS2 expression,a novel tumor suppressor,in non-small cell lung cancer

Background: Prenyl diphosphate synthase subunit 2 (PDSS2) gene has recently been reported as a potential tumor suppressor. The association of PDSS2 and non-small cell lung cancer (NSCLC) has not been known. Methods: To investigate its association with NSCLC, we examined the expression level of PDSS2 in 28 paired clinical samples of non-small cell lung cancer tissues and surrounding normal tissues. Results: PDSS2 was constitutionally expressed in normal lung tissues regardless of sex, race and smoking history. An overall decreased PDSS2 expression was found in the tumor tissues compared to surrounding normal tissues. Decrease in PDSS2 expression was more severe in poorly and poor-to-moderately differentiated lung cancers, while the decrease was not significant in moderately to well-differentiated tumors. Moreover, the expression of PDSS2 decreased more in higher pathological stage, and in patients with lymph node metastasis. The decrease in PDSS2 expression in tumor tissues was not related to sex or histological type of NSCLC, but was related to smoking history. No correlation has been found between PDSS2 and the clinical factors of EGRF, Ki-67 and p53. Conclusion: Taken together, decreased expression of PDSS2 in NSCLC was evident. This is an initial report for the expression of PDSS2 in relation to different factors in lung cancer. Loss of PDSS2 could serve as a potential biomarker in NSCLC development. The role of PDSS2 as a tumor suppressor, and the mechanism of its potential anti-tumor action in NSCLC warrant further investigation.     

VEGF、P-ACC、LKB1在非小细胞肺癌组织中的表达及意义

目的:探究非小细胞肺癌组织中血管内皮生长因子(VEGF)、磷酸化乙酰辅酶A羟化酶(P-ACC)、肝激酶B1(LKB1)表达及其与肿瘤血管生成的关系。方法:将我院收治的83例非小细胞肺癌(NSCLC)患者作为研究对象,取其NSCLC病理组织样本进行研究,同时取其远离肿瘤的外周正常肺组织作为对照。采用免疫组化法测定其NSCLC病理组织样本和正常组织样本VEGF、P-ACC、LKB1的表达情况,分析比较NSCLC病理组织的VEGF、P-ACC、LKB1表达情况与其病理特征及肿瘤血管生成的关系。结果:NSCLC组织样本的VEGF阳性表达率为72.29%,明显高于癌旁正常组织样本(22.89%)(P0.05);同时,其P-ACC、LKB1阳性表达率分别为31.33%、61.45%,明显低于癌旁正常组织样本(分别为75.90%、90.36%)(P0.05)。NSCLC组织VEGF阳性表达与N分期、临床分期以及肿瘤微血管密度(MVD)有关,P-ACC阳性表达与T分期、临床分期以及MVD有关,LKB1阳性表达与N分期、临床分期、分化程度以及MVD有关(P0.05)。在样本中,VEGF阳性NSCLC组织的MVD水平明显高于VEGF阴性样本,而P-ACC、LKB1阳性NSCLC组织的MVD水平明显低于阴性样本(P0.05)。结论:非小细胞肺癌组织中VEGF在呈高表达,P-ACC、LKB1呈现低表达。VEGF、P-ACC、LKB1的表达与NSCLC临床病理特征及肿瘤血管生成均存在密切联系,对于预测NSCLC癌细胞的生长、浸润和转移具有重要意义。     

miR-204通过抑制OGT的表达调控非小细胞肺癌细胞的增殖和迁移

目的:探究miR-204和O-连接N-乙酰氨基葡萄糖转移酶(O link N-acetylglucosamine transferase,OGT)对非小细胞肺癌(Non-small cell lung cancer,NSCLC)细胞增殖和转移的影响,并深入分析其可能机制。方法:采用Oncomine及KM-Ploter数据库分析OGT在肺癌组织中的表达及与肺癌患者预后的关系;采用慢病毒转染人非小细胞肺癌A549及永生化人肺支气管上皮细胞BEAS-2B,分别构建OGT稳定下调和过表达的细胞系,利用CCK-8、平板克隆和裸鼠皮下成瘤实验检测细胞增殖的情况,划痕实验、Transwell实验和裸鼠尾静脉注射肺转移模型检测细胞转移的情况。利用数据库分析可能参与OGT调控的microRNA,并用双荧光素酶报告基因验证。利用TCGA数据库分析miR-204在肺癌中的表达情况,并在30例肺癌组织及其对应癌旁组织中分析miR-204与OGT之间的相关性。结果:OGT在肺癌组织中呈高表达,且与患者的不良预后相关(HR=1.22,P 0.01);OGT的表达上调肺癌细胞的增殖和转移;miR-204可以负向调控OGT的表达,且miR-204在肺癌组织中表达水平显著低于癌旁组织,在肺癌组织中miR-204的水平与OGT的表达水平呈负相关(R~2=-0.4729,P 0.01)。结论:在非小细胞肺癌中,miR-204的降低通过上调OGT的表达促进肺癌的增殖和转移。     

PD-1 and PD-L1 Expression in NSCLC Indicate a Favorable Prognosis in Defined Subgroups

Background

Immunotherapy can become a crucial therapeutic option to improve prognosis for lung cancer patients. First clinical trials with therapies targeting the programmed cell death receptor PD-1 and its ligand PD-L1 have shown promising results in several solid tumors. However, in lung cancer the diagnostic, prognostic and predictive value of these immunologic factors remains unclear.

Method

The impact of both factors was evaluated in a study collective of 321 clinically well-annotated patients with non-small lung cancer (NSCLC) using immunohistochemistry.

Results

PD-1 expression by tumor infiltrating lymphocytes (TILs) was found in 22%, whereas tumor cell associated PD-L1 expression was observed in 24% of the NSCLC tumors. In Fisher’s exact test a positive correlation was found for PD-L1 and Bcl-xl protein expression (p = 0.013). Interestingly, PD-L1 expression on tumor cells was associated with improved overall survival in pulmonary squamous cell carcinomas (SCC, p = 0.042, log rank test), with adjuvant therapy (p = 0.017), with increased tumor size (pT2-4, p = 0.039) and with positive lymph node status (pN1-3, p = 0.010). These observations were confirmed by multivariate cox regression models.

Conclusion

One major finding of our study is the identification of a prognostic implication of PD-L1 in subsets of NSCLC patients with pulmonary SCC, with increased tumor size, with a positive lymph node status and NSCLC patients who received adjuvant therapies. This study provides first data for immune-context related risk stratification of NSCLC patients. Further studies are necessary both to confirm this observation and to evaluate the predictive value of PD-1 and PD-L1 in NSCLC in the context of PD-1 inhibition.