microRNA-30b在非小细胞肺癌中的表达及预后分析

目的 探讨微小RNA-30b（miRNA-30b）在非小细胞肺癌（NSCLC）中的表达情况,并进一步分析miR-30b与NSCLC患者预后的相关性。方法 收集41例NSCLC患者的肿瘤组织及其正常组织（距离肿瘤组织>5cm）,采用real-time PCR法检测miR-30b的表达情况,并对预后进行分析。结果 肿瘤组织miR-30b的表达水平显著低于正常组织（P<0.01）;miR-30b的表达水平与临床分期、淋巴结转移及EGFR基因突变显著相关（P<0.05）。Kaplan-Meier分析显示肿瘤组织中miR-30b高表达组的生存时间明显高于低表达组（P<0.05）。结论 MiR-30b在NSCLC中的表达是下调的,可作为NSCLC预后的一个新的潜在标志物。     

Positive nodal status is still a risk factor for long-term survivors of non-small cell lung cancer 5 years after complete resection

BackgroundLung cancer has a poor prognosis; the number of long-term survivors (LTSs) is small compared with that of other cancers. Few studies have focused on late recurrence in LTSs with lung cancer. The purpose of this study was to analyze the risk factors for survival and late recurrence in LTSs after disease-free period of 5 years.MethodsA retrospective analysis of patients with a disease-free survival of at least 5 years after surgical resection for non-small cell lung cancer (NSCLC) between January 1998 and December 2012 was conducted. Patients who underwent neo-adjuvant therapy, had an incomplete resection, or had advanced stage (stages IIIb and IV) cancer were excluded.ResultsA total of 1,254 (53.2%) of 2,357 patients were enrolled. Of these, 759 (60.5%) were men, and the mean patient age was 61.9±10.1 (range, 10–87 years) years. Pathologic N0 (997 patients, 79.5%) and stage I (860 patients, 68.6%) were the dominant stages. Late recurrence occurred in 22 patients (1.8%) 5 years postoperatively. On multivariate analysis, male sex, older age, node-positive status, and late recurrence were found to be independent risk factors for overall survival (OS), while a node-positive status was the only independent risk factor for disease-free survival [hazard ratio (HR) =3.824; P=0.002; 95% confidence interval (CI): 1.658–8.821].ConclusionsThe nodal stage at the time of surgical resection was found to be an independent risk factor for both OS and disease-free survival 5 years after initial treatment in patients with completely resected NSCLC.     

Effectiveness and Safety of First-Line Pembrolizumab in Older Adults with PD-L1 Positive Non-Small Cell Lung Cancer: A Retrospective Cohort Study of the Alberta Immunotherapy Database

The emergence of immunotherapy revolutionized the treatment of non-small-cell-lung cancer (NSCLC), with multiple landmark clinical trials establishing the efficacy of these agents. However, many patients who receive immunotherapy in clinical practice would be considered clinical trial ineligible. One such population that is often under-represented in clinical trials is older adults. In the current study, we evaluated clinical and safety outcomes in this population. Overall, older adults (>70 years of age) and younger adults had comparable clinical outcomes with an equivalent objective response rate (ORR), time to treatment failure (TTF), and median overall survival (p = 0.67, p = 0.98, and p = 0.91, respectively). Furthermore, the safety outcomes were equivalent between the cohorts with similar rates of immune-related adverse events (irAEs), irAE-related hospitalizations, and all-cause hospitalization (p = 0.99, p = 0.63, and p = 0.74, respectively). While older age was not found to impact overall survival, multivariant analysis revealed that a poor Eastern Cooperative Oncology Group (ECOG) status, low body-mass-index (BMI), and poor/intermediate lung immune prognostic index (LIPI) were all associated with worse survival. In conclusion, age does not impact the efficacy or safety of pembrolizumab in NSCLC, and therefore advanced age should not be a deterrent for treating these patients with pembrolizumab. Physicians and care providers can thus focus on other factors that may influence therapeutic outcomes.     

circ_0072088通过调控miR-545-3p/STAT3轴促进非小细胞肺癌细胞的恶性生物学行为

目的:探究环状RNA(circular RNA,circRNA)0072088在非小细胞肺癌(non-small cell lung cancer,NSCLC)细胞中的生物学功能及其作用机制.方法:在公共基因芯片数据库Gene Expression Omnibus(GEO)中下载GSE101684数据集,通过GEO2R...     

Improvements of quality of life in patients with advanced non-small cell lung cancer treated with gefitinib

Objective： The aim of this study was to evaluate the effect of gefitinib on improvement of quality of life （QoL） of patients with advanced non-small cell lung cancer （NSCLC）. Methods： There were 70 patients with advanced NSCLC. One oral gefitinib tablet （250 mg） was administered every day without interruption unless disease progression or unacceptable toxicity occurred. The impact of treatment on disease-related symptoms and QoL was evaluated with the Chinese versions of European Organization for Research and Treatment of Cancer Quality of Life Questionnaires （EORTC QLQ-C30 and QLQ- LC13）. Results： Fifty-eight patients had finished the questionnaires. The mean scores of five functioning scales （physical, role, emotional, cognitional and social） were 62.64, 56.03, 68.41, 64.67, 60.63 respectively after eight weeks of treatment, which were 52.30, 49.43, 64.39, 59.79, 52.30 respectively before treatment, and the mean score of global QoL after and before treatment was 60.17 and 52.70 respectively. There was statistical difference in five functioning scales and global QoL （P 〈 0.05）. Mean scores of main general symptoms （fatigue and appetite loss） were 57.66 and 48.08 respectively after eight weeks of treatment, which were 61.11 and 51.72 respectively before treatment, and mean scores of disease-related symptoms （dyspnoea, coughing, empsyxis, pain in chest）were 48.66, 47.13, 26.82, 24.71 respectively after eight weeks of treatment, which were 54.98, 53.64, 27.78, 28.54 respectively before treatment. There was statistical difference in fatigue, dyspnoea, cough and pain in chest （P 〈 0.05）. Response rate of five functioning and global QoL were all more than 50% after gefitinib treatment. Response rate of main general symptoms and disease-related symptoms were all more than 40%. QoL and symptom response correlated with disease control. The patients with better QoL had longer survival. Conclusion： gefitinib treatment can improve the QoL and symptoms of advanced NSCLC patient     

非小细胞肺癌患者ERCC1蛋白表达与铂类标准方案化疗敏感性的关系研究

目的:研究探讨Ⅲ、Ⅳ期非小细胞肺癌(NSCLC)患者癌组织内DNA破坏修复酶-错配切除交叉互补修复酶1(excision repair cross-complementing 1,ERCC1)的表达与铂类标准化疗(SC)方案化疗敏感性的关系。方法:共入选Ⅲ、Ⅳ期NSCLC患者120例,完成试验可评价的53例,对化疗前通过气管镜或经皮肺穿刺的组织学标本ERCC1行免疫组化检测。患者给予4~6周期铂类为基础的SC化疗,对患者化疗后的总生存期(overall survival,OS)、肿瘤进展时间(time to progression,TTP)及化疗后反应率(response rate,RR)进行评价。结果:53例患者中,ERCC1染色阳性27例,阳性率为50.94%。ERCC1阳性组患者化疗后RR、OS及TTP分别为25.9%、(294.78±127.52)天及(183.71±82.07)天,与ERCC1阴性组患者RR53.8%、OS(415.50±204.75)天、TTP(256.92±133.29)天比较,差异均有统计学意义(P值分别为0.038、0.0126和0.019)。结论:ERCC1表达不同可能是化疗方案中铂类药物敏感性差别的重要因素,本研究可为临床上NSCLC患者个体化疗方案(TC)的制定提供参考。     

多西他赛每周方案联合顺铂二线治疗治疗非小细胞肺癌

目的 研究多西他赛每周方案联合顺铂二线治疗非小细胞肺癌(NSCLC)的疗效和毒性反应.方法 48例晚期非小细胞肺癌患者,既往曾接受1个含铂方案治疗,采用多西他赛30 mg/m2,静脉滴注60 min,第1、8、15 d给药,顺铂40 mg静脉滴注60 min,第1～3 d,每28 d为1周期.患者的行为状态评分(PS)均为ECOG≤2.结果 48例患者均可评价,总共化疗周期数为189周期.1例完全缓解(CR)占2.1%,14例部分缓解(PR)占29.2%,有效率(ORR)为31.3%,中位生存时间为37周,1年生存率为33%,粒细胞减少与乏力为主要的毒性反应,其他的毒性反应为脱发和体液潴留.结论 多西他赛30 mg/m2每周给药联合顺铂二线治疗NSCLC有确切的疗效且耐受性好.     

三维适形放疗联合GP方案同步治疗局部晚期非小细胞肺癌临床观察

目的探讨三维适形放疗联合GP方案同步化疗治疗局部晚期非小细胞肺癌的近期疗效和急性毒副反应。方法40例Ⅲ期非小细胞肺癌患者采用三维适形放疗,同时予GP方案化疗（G：吉西他滨1000mg／m^2,第l,8天;P：顺铂30mg／m^2,第1-3天,每28天1个周期）。结果肺原发灶总有效率为85％;纵隔转移淋巴结总有效率为91．9％,急性毒副反应主要是骨髓抑制、胃肠道反应和轻中度放射性食管炎、放射性肺炎,均可耐受。结论三维适形放疗与GP方案同步放化疗治疗局部晚期非小细胞肺癌有较好近期疗效。     

不同标本类型在非小细胞肺癌基因检测中的应用及意义

目的 研究分析不同标本类型在非小细胞肺癌（NSCLC）患者的驱动基因检出率,并分析表皮生长因子受体（EGFR）、间变性淋巴瘤激酶（ALK）、C-ros原癌基因1-受体酪氨酸激酶（ROS1）、Kristen鼠肉瘤病毒原癌基因同源体（KRAS）、鼠类肉瘤滤过性毒菌致癌基因同源体B（BRAF）等驱动基因异常情况及与临床病理特征关系。方法 收集2021年1月—2021年12月我院病理科明确诊断为NSCLC样本180例,包括手术切除标本25例,肺活检标本80例,恶性胸腔积液细胞蜡块标本29例,转移病灶标本46例,采用扩增阻滞突变系统（ARMS）法检测驱动基因突变状态。结果 5种驱动基因的总突变率为53.33 %（96/180）,驱动基因突变可在不同标本类型中检出,不同标本间突变率比较差异无统计学意义（P＞0.05）。EGFR基因突变率40.56%（73/180）,性别及组织类型突变率比较差异有统计学意义（P<0.05）,年龄类型突变率比较差异无统计学意义（P＞0.05）;KRAS基因突变率6.11%（11/180）,其中性别类型突变率比较差异有统计学意义（P<0.05）,年龄与组织类型突变率比较差异无统计学意义（P＞0.05）;ALK融合基因突变率4.44/%（8/180）,年龄、性别及组织类型突变率比较差异无统计学意义（P＞0.05）;BRAF基因突变率1.11%（2/180）,ROS1融合基因突变率1.11%（2/180）。结论 不同标本类型均可检出驱动基因,增加了临床基因检测的取样途径。NSCLC患者EGFR基因突变率明显高于其他驱动基因,EGFR基因突变与患者性别及组织类型有差异,KRAS基因突变与患者性别有差异;ALK、ROS1、BRAF基因突变率较低,但指导NSCLC治疗有重要意义。多基因联合检测可一次获取更多驱动基因突变信息,能够更快、更全面地指导临床治疗     

COX-2-related tumor immune microenvironment in non-small cell lung cancer: a novel signature to predict hot and cold tumor

BackgroundAt present, non-small cell lung cancer (NSCLC) remains a great threat to the health of people worldwide. Immune checkpoint inhibitors (ICIs) have shown positive results in the treatment of advanced NSCLC. However, the treatment response of ICIs is not stable and unpredictable. We used a bioinformatics analysis to determine a novel signature to diagnose the hot and cold tumor in NSCLC which may guide the programmed cell death protein 1/programmed cell death 1 ligand 1 (PD-1/PD-L1) therapeutic strategy.MethodsThe RNA-seq dataset and clinical data of 485 lung adenocarcinoma (LUAD) and 473 lung squamous cell carcinoma (LUSC) samples from The Cancer Genome Atlas (TCGA) database. Tumor infiltrating immune cells was calculated by CIBERSORT algorithm and ConsensusClusterPlus was used to classify the hot and cold tumor. Least absolute shrinkage and selection operator (LASSO) regression, Support Vector Machine (SVM) and Gaussian Mixture Model (GMM) were performed to determine the diagnostic area under curve (AUC) of novel signature of ICIs treatment. Overall survival (OS) analysis was based on the Kaplan-Meier statistical method.ResultsIn this study, we found that the expression of PD-1/PD-L1 is associated with COX2 (PTGS2) expression. We identified novel signatures [STMN3, KIRREL1, SH2D3C, VCL, PDCD1, CD274, PTGS2, combined diagnostic (AUC) =0.838], in order to diagnose the hot and cold tumor subtype to indicate the treatment response of PD-1/PD-L1 inhibitor in NSCLC. Furthermore, we found that in hot tumor subtype, high PDCD1 expression group had worse OS than low PDCD1 expression group (P=0.047); high SH2D3C expression group had worse OS than low SH2D3C expression group either (P=0.003). SH2D3C was correlated to PD-1 expression in NSCLC samples (R=0.49, P<0.001). We speculated that SH2D3C likely plays a crucial role in PD-1-related immunotherapy in NSCLC patients. Pathway enrichment showed that the focal adhesion (P=0.005) and actin cytoskeleton (P=0.022) pathways were associated with OS.ConclusionsThis study aimed to identify the classification of hot and cold tumors, and develop a novel signature to predict the ICI treatments response for PD-1/PD-L1 high expression NSCLC patients.