Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis.

BACKGROUND: Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases, and it is associated with a large trauma: Most patients often have different degrees of malnutrition and immune dysfunction before surgery and are prone to various infectious complications during postoperative recovery, thus affecting the efficacy of surgical treatment. Therefore, early postoperative nutritional support can provide essential nutritional supply, restore the intestinal barrier and reduce complication occurrence. However, different studies have shown different conclusions. AIM: To assess whether early postoperative nutritional support can improve the nutritional status of patients based on literature search and meta-analysis. METHODS: Articles comparing the effect of early nutritional support and delayed nutritional support were retrieved from PubMed, EMBASE, Springer Link, Ovid, China National Knowledge Infrastructure, China Biology Medicine databases. Notably, only randomized controlled trial articles were retrieved from the databases (from establishment date to October 2022). The risk of bias of the included articles was determined using Cochrane Risk of Bias V2.0. The outcome indicators, such as albumin, prealbumin, and total protein, after statistical intervention were combined. RESULTS: Fourteen literatures with 2145 adult patients undergoing gastrointestinal surgery (1138 patients (53.1%) receiving early postoperative nutritional support and 1007 patients (46.9%) receiving traditional nutritional support or delayed nutritional support) were included in this study. Seven of the 14 studies assessed early enteral nutrition while the other seven studies assessed early oral feeding. Furthermore, six literatures had "some risk of bias," and eight literatures had "low risk". The overall quality of the included studies was good. Meta-analysis showed that patients receiving early nutritional support had slightly higher serum albumin levels, than patients receiving delayed nutritional support [MD (mean difference) = 3.51, 95%CI: -0.05 to 7.07, Z = 1.93, P = 0.05]. Also, patients receiving early nutritional support had shorter hospital stay (MD = -2.29, 95%CI: -2.89 to -1.69), Z = -7.46, P < 0.0001) shorter first defecation time (MD = -1.00, 95%CI: -1.37 to -0.64), Z = -5.42, P < 0.0001), and fewer complications (Odd ratio = 0.61, 95%CI: 0.50 to 0.76, Z = -4.52, P < 0.0001) than patients receiving delayed nutritional support. CONCLUSION: Early enteral nutritional support can slightly shorten the defecation time and overall hospital stay, reduce complication incidence, and accelerate the rehabilitation process of patients undergoing gastrointestinal surgery.

In vitro sequence-dependent synergism between paclitaxel and gefitinib in human lung cancer cell lines.

PURPOSE: In clinical trials, the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) administered concomitantly with first-line cytotoxicity chemotherapy failed to confer a survival benefit to patients with non-small-cell lung cancer (NSCLC). The aim of this study was to test whether paclitaxel followed by gefitinib is superior to other treatment schedules of NSCLC cell lines and to clarify the underlying mechanisms. METHODS: Human lung cancer cell lines with wild-type and mutant-type EGFR genes were used as in vitro models to define the differential effects of various schedules of paclitaxel with gefitinib treatment on cell growth, signaling pathway, and cell cycle distribution. RESULTS: Sequence-dependent antiproliferative effects differed between EGFR-TKI-resistant and EGFR-TKI-sensitive lung cancer cell lines. Exposure to paclitaxel resulted in an increased pEGFR level. This increase in phosphorylation was inhibited by subsequent exposure to gefitinib, whereas during the reverse sequence, the inhibition effect was reduced. After paclitaxel exposure, a higher level of pEGFR was observed in mitotic than in interphase cells. The sequence of paclitaxel followed by gefitinib resulted in greater anti-VEGF activity than did the reverse sequence. We confirmed that gefitinib arrested cells in G1, and paclitaxel arrested them in S phase. The sequence of paclitaxel followed by gefitinib arrested cells in G1, whereas the reverse sequence arrested cells in S and G2 phases. CONCLUSIONS: These findings suggest that the sequence of paclitaxel followed by gefitinib may be superior to other sequences in treating NSCLC cell lines. Our results also provide molecular evidence to support clinical treatment strategies for patients with lung cancer.

[Effect of electroacupuncture on pain threshold and spinal NR2B subunit expression in a rat model of neuropathic pain].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on pain threshold and spinal NR2B subunit expression in a rat model of neuropathic pain due to chronic compression injury (CCI) of the sciatic nerve and explore the analgesic mechanism of EA. METHODS: Male SD rats weighing 200-280 g were randomly divided into 4 groups (n=10), namely the sham-operated group, CCI group, EA+CCI group, and sham EA+CCI group. All the rats underwent tests of the mechanical withdrawal threshold and thermal threshold. On day 13 after the surgery, all the rats were decapitated to collect the L4-6 segments of the spinal cord to examine NR2B expression using Western blotting. RESULTS: The postoperative mechanical withdrawal threshold and thermal threshold were significantly lowered in CCI, EA+CCI and sham EA+CCI groups as compared to those before the surgery (P<0.05). EA obviously alleviated the hypersensitivity in the rats with CCI and inhibited spinal NR2B expressions (P<0.05). No significant differences were found in the mechanical withdrawal threshold, thermal threshold or spinal NR2B subunit expression between CCI group and sham EA+CCI group (P>0.05). CONCLUSION: EA may alleviate neuropathic hypersensitivity partially by inhibiting NR2B expression in the spinal cord of rats with neuropathic pain resulting from CCI of the sciatic nerve.

Genetic evolution of epidermal growth factor receptor in adenocarcinoma with a bronchioloalveolar carcinoma component.

BACKGROUND: Epidermal growth factor receptor (EGFR) mutations may accumulate during the multistage progression of bronchioloalveolar carcinoma (BAC), leading to heterogeneity within the tumor. This study sought to determine whether metachronous adenocarcinomas with a BAC component emerging in the lung field arise from a single or multiple clones in the same individual. MATERIALS AND METHODS: Samples of adenocarcinomas exhibiting various degrees of BAC were obtained by thoracotomy. Sequential specimens were obtained upon detection of metachronous lesions in the lung field. Genomic DNA was extracted from specimens, and the presence of activating mutations in EGFR was determined via direct sequencing. Our pathologic findings, sequential image information, and genetic data were compared to track evidence of cancer evolution. RESULTS: Based on EGFR gene analyses of tumor specimens from 431 patients, 17 cases of sequential BAC-related adenocarcinomas, obtained by thoracotomy, were noteworthy. Upon alteration of the BAC/adenocarcinoma components, the EGFR tyrosine kinase inhibitor-untreated series, which had at least one episode of an EGFR-activating mutation, represented 3 potential hypotheses: no significant EGFR evolution for a single clone, genetic alterations from mutant to wild-type EGFR for multifocal lesions, or a switch from wild-type to mutant EGFR, leading to indeterminable cancer progression. CONCLUSION: Genetic analysis, in conjunction with pathologic and radiologic diagnoses, can be used to explore the origin of multifocal BAC. The single-clone model indicates subsequent disease progression, whereas genetic alterations from mutations to wild-type EGFR are suggestive of second primary carcinoma. In cases when additional lesions emerge after the radical resection of BAC-related lung cancer, sequential tumor samples should be obtained for further evaluation.

RRM1 single nucleotide polymorphism -37C-->A correlates with progression-free survival in NSCLC patients after gemcitabine-based chemotherapy.

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.

An autologous therapeutic dendritic cell vaccine transfected with total lung carcinoma RNA stimulates cytotoxic T lymphocyte responses against non-small cell lung cancer.

OBJECTIVE: The development of immunotherapy for malignancy is greatly limited by the characteristic weak antigenicity of tumors. The primary goal of this study was to circumvent the isolation and purification of tumor-specific antigen determinants by producing a vaccine using lung tumor RNA-loaded dendritic cells (DCs), and to test the response against lung cancer. METHODS: Total RNA was isolated from 18 lung carcinomas with positive carcinoembryonic antigen (CEA) and mucin-1 (MUC1) staining, as identified by immunohistochemistry. DCs and T-cells from peripheral blood mononuclear cells were generated in vitro, and then DCs in different stages were transfected with RNA using several different methods. The expression of CEA and MUC1 in RNA-transfected DCs was measured using flow cytometry. T-cells stimulated by DCs were harvested as effectors, and primary tumor cells cultured in vitro were used as targets. Cytotoxicity was determined by lactic dehydrogenase detection assay. RESULTS: Immature RNA-transfected DCs significantly increased the expression of CEA and MUC1, compared to mature transfected DCs. RNA transfection via electroporation resulted in significantly greater CEA and MUC1 expression than did transfection via lipofection or passive pulsing. Lymphocytes stimulated by DCs transfected with lung tumor RNA initiated a cytotoxic T lymphocyte (CTL) tumor-specific response. CONCLUSION: Immature DCs transfected with total lung carcinoma RNA by electroporation in vitro effectively stimulate antigen-specific CTL responses against tumor cells.

[Correlation of DNA-dependent protein kinase catalytic subunit expression to radiosensitivity of non-small cell lung cancer cell lines].

BACKGROUND AND OBJECTIVE: DNA-dependent protein kinase catalytic subunit (DNA-PKcs) plays an important role in repairing irradiation-induced DNA double-strand break (DSB), and affects the radiosensitivity of tissue cells. This study was to detect the expression of DNA-PKcs in different non-small cell lung cancer (NSCLC) cell lines and evaluate its correlation to radiosensitivity. METHODS: The content and activity of DNA-PKcs in five NSCLC cell lines A549, H1299, L78, PGCL3 and H460 were measured by Western blot and the DNA-PK activity assay. Cell survival was analyzed using clonogenic formation assay. RESULTS: The radiosensitivities of five NSCLC cell lines were different. The values of survival fraction at 2 Gy (SF2) were 0.74 in A549 cells, 0.25 in H1299 cells, 0.21 in H460 cells, 0.48 in PGCL3 cells, and 0.58 in L78 cells. The protein levels of DNA-PKcs were 3.26+/-0.98 in A549 cells, 0.51+/-0.07 in L78 cells, 0.51+/-0.11 in H1299 cells, 0.86+/-0.23 in H460 cells, and 2.60+/-0.76 in PGCL3 cells. The activity values of DNA-PKcs were 8.30+/-1.03 in A549 cells, 2.45+/-0.52 in H1299 cells, 0.11+/-0.02 in H460 cells, 4.13+/-0.87 in PGCL3 cells, and 0.42+/-0.07 in L78 cells. In adenocarcinoma and large cell carcinoma cell lines, SF2 were correlated to DNA-PKcs content (P<0.05, r=0.95) and activity (P=0.03, r=0.98). CONCLUSION: DNA-PKcs is an important factor to predict the radiosensitivity in adenocarcinoma and large cell lung cancer cell lines.

Clinicopathologic and molecular features of epidermal growth factor receptor T790M mutation and c-MET amplification in tyrosine kinase inhibitor-resistant Chinese non-small cell lung cancer.

To investigate the clinicopathologic and molecular features of the T790M mutation and c-MET amplification in a cohort of Chinese non-small cell lung cancer (NSCLC) patients resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). EGFR TKI-resistant NSCLC patients (n = 29) and corresponding tumor specimens, and 53 samples of postoperative TKI-naïve NSCLC patients were collected. EGFR exon 19, 20, and 21 mutations were analyzed. And c-MET gene copy number was determined. The EGFR T790M mutation in exon 20 was not detected in the population of 53 TKI-naïve patients, but found in 48.3% (14/29) of the enrolled TKI-resistant patients. c-MET was amplified in 3.8% (2/53) of the TKI-naïve NSCLC patients and highly amplified in 17.2% (5/29) of the cohort. Most of T790M mutations were frequently associated with non-smoker, adenocarcinoma and EGFR activating mutations. Three male patients with T790M mutation occurred with wild-type EGFR, and were resistant to the treatments following TKI resistance. Features of c-MET amplification in TKI-naïve patients were indistinguishable from TKI-resistant patients. In the group of wild-type EGFR, patients with T790M mutation had median progression free survival (PFS) and overall survival (OS) as 9.6 months and 12.6 months, respectively; whereas the median PFS and OS of c-MET amplified patients was 4.1 months and 8.0 months, respectively. These results suggest that EGFR T790M mutation and c-MET amplification can occur in TKI-resistant NSCLC with wild-type EGFR, and these genetic defects might be related to different survival outcome. c-MET amplification in TKI-naïve or -resistant patients might share similarities in clinicopathologic features.

Expression of cyclin D1 splice variants is differentially associated with outcome in non-small cell lung cancer patients.

Real-time reverse transcription polymerase chain reaction and immunohistochemistry were used to evaluate the messenger RNA (mRNA) and protein expression levels of total cyclin D1 and its splice variants (cyclin D1a and cyclin D1b) in 102 paired malignant and nonmalignant tissues from patients with non-small cell lung cancer, respectively. The expression levels of total cyclin D1 and its splice variants were significantly up-regulated in malignant tissues than in nonmalignant tissues at both mRNA and protein levels. Although the expression levels of cyclin D1a were higher than those of cyclin D1b, the relative expression ratios of cyclin D1b mRNA between malignant and nonmalignant lung tissues were obviously higher than those of cyclin D1a mRNA. Analysis of variance showed that cyclin D1b mRNA expression was significantly associated with the histologic grade, lymph node metastasis, distant metastasis, and tumor stage of patients, whereas cyclin D1a mRNA expression was not related to clinicopathologic characteristics except sex. Patients with cyclin D1b mRNA expression above the median value had shorter survival than those below the median value (P = .033). Similarly, cyclin D1b immunopositivity was also associated with histologic grade, and patients with immunostaining positivity for cyclin D1b showed poor survival (P = .005). Multivariate analysis demonstrated that cyclin D1b immunopositivity was an independent risk factor in survival of patients with non-small cell lung cancer (P = .018). Our data show that cyclin D1b, rather than canonical cyclin D1a, might contribute to the development of non-small cell lung cancer. Cyclin D1b would be a better prognostic indicator for non-small cell lung cancer as compared to total cyclin D1 or cyclin D1a.

Better survival with EGFR exon 19 than exon 21 mutations in gefitinib-treated non-small cell lung cancer patients is due to differential inhibition of downstream signals.

Somatic mutations in the epidermal growth factor receptor (EGFR) kinase domain are associated with sensitivity to tyrosine kinase inhibitors (TKIs) in patients with non-small cell lung cancer (NSCLC). Our clinical data showed NSCLC patients with exon 19 deletions survived longer following gefitinib treatment than those with exon 21 point mutations. We aimed to investigate whether these two mutations produced differences in phosphorylation of EGFR and downstream signals. Two stable cell lines expressing these mutations were obtained by transfection. Inhibition of phosphorylation of EGFR, Akt, and Erk by gefitinib was detected using Western blotting, and cell inhibition tests were conducted to evaluate the bio-behavior. Gefitinib inhibited the phosphorylation of EGFR, Akt, and Erk to a greater degree in exon 19 deletion cells than in L858R cells. Gefitinib produced G1 arrest in more of the cells with exon 19 deletion than with L858R. This might be attributable to patient selection in TKIs therapy.

EGFR/KRAS mutations and gefitinib therapy in Chinese NSCLC patients.

BACKGROUND: For gefitinib treatment for non-small cell lung cancer (NSCLC), KRAS mutations reportedly behave as a resistance marker, and the epidermal growth factor receptor (EGFR) as a responsive marker. It is known that Asians and Caucasians have different responses to gefitinib. We investigated the KRAS and EGFR mutation status in a group of Chinese patients with advanced NSCLC who were treated with gefitinib after a failed chemotherapy. MATERIAL AND METHODS: Genomic DNA extracted from tumor specimens of 24 patients with advanced NSCLC, who failed at least 1 prior platinum-based chemotherapy regimen before gefitinib treatment, was subjected to nested polymerase chain reaction (PCR) to amplify codons 12, 13, 59, and 61 of the KRAS gene and exons 18-21 of the EGFR gene for direct sequencing. RESULTS: For the 24 patients, no KRAS gene mutation was found. 15 patients (62.5%, 15/24) harbored EGFR mutations which included deletion mutations in exon 19 and missense mutations in exon 21. CONCLUSION: KRAS mutation may occur at a very low frequency in Chinese NSCLC patients regardless of pathology, smoking status, or gender. Unlike EGFR, the low incidence of KRAS mutations may undermine its role in predicting the clinical response to EGFR tyrosine kinase inhibitors.

[Construction of an eukaryotic expression vector for PRL-2 and its effect on human hepatocellular carcinoma cell invasiveness and migration in vitro].

OBJECTIVE: To construct an eukaryotic expression vector for PRL-2 and evaluate its effect on the invasiveness and migration of a human hepatocellular carcinoma cell line. METHODS: RT-PCR was performed to amplify the complete PRL-2 open reading frame using the total mRNA of hepatocellular carcinoma HepG2 cells as the template. PRL-2 gene was inserted into the pGEM T easy vector and sequenced, and the correct PRL-2 sequence was subcloned into the mammalian expression vector pcDNA3.1+. The constructed PRL-2 vector was transfected into CL1 cells via lipofectamine, and the stable expression of PRL-2 mRNA was detected by RT-PCR, the expressed protein identified by immunohistochemistry and Western blotting, and the effect of PRL-2 on the adhesion ability of CL-1 cell evaluated with MTT assay 20 and 120 min after transfection. The effect of PRL-2 on the invasive migration of CL-2 cells was evaluated according to the number of cells penetrating the Matrigel layer of polycarbonate membrane of Boyden chamber. RESULTS: RT-PCR yielded a fragment of 504 bp and the inserted PRL-2 sequence was verified by sequence analysis. The subclones were identified by restriction endonuclease digestion, and a G418-resistant clone, PRL-2-CL1, was obtained after 8 weeks of selection. RT-PCR showed stable expression of PRL-2 mRNA, and Western blotting confirmed overexpression of PRL-2 protein in the transfected cells. PRL-2 increased the adhesion rate of CL-1 cells to fibronectin at 20 min and 120 min after transfection (P<0.05), and also the number of CL-1 cells penetrating the polycarbonate membrane from 10.0+/-3.7 to 44.8+/-2.6 (P<0.05). CONCLUSION: An eukaryotic expression vector of PRL-2 has been successfully constructed, which allows stable and efficient expression in CL-1 cell line. PRL-2 can promote cell adhesion and invasion activity of human hepatocellular carcinoma cells.

[Association of XAGE-1b gene expression with clinical characteristics of non-small cell lung cancer].

OBJECTIVE: To explore the association between XAGE-1b gene expression and the clinical characteristics of non-small cell lung cancer (NSCLC). METHODS: Tumor tissue and adjacent normal lung tissue specimens were obtained surgically from 30 patients with resectable NSCLC, from which the total RNA was extracted for RT-PCR to amplify full-length XAGE-1b gene. The products of RT-PCR were identified by electrophoresis and sequencing. The expression of XAGE-1b gene and its association with the clinical characteristics of the patients were analyzed. RESULTS: In the 30 tumor tissue specimens, the expression rate of XAGE-1b gene was 40%, but none of the normal lung tissues expressed this gene. The gene expression was not related to the patients' age, gender, tumor differentiation or clinical stages, but showed significant correlation to their pathological classification. The expression rate of XAGE-1b gene in adenocarcinoma was much higher than that in tumors of other pathological types (61.1% vs 8.3%, P=0.015). XAGE-1b gene expression tended to increase with the TNM stages, which, however, failed to find statistical data support (P>0.05). CONCLUSIONS: XAGE-1b gene is highly expressed in lung adenocarcinoma, and can be an ideal target for tumor immunotherapy.

The epidermal growth factor receptor intron1 (CA) n microsatellite polymorphism is a potential predictor of treatment outcome in patients with advanced lung cancer treated with Gefitinib.

The goal of our study was to assess the association between R497K and intron1 (CA) n repeat genetic polymorphisms of the EGF (epidermal growth factor) receptor and the clinical outcome of patients with advanced non-small cell lung cancer treated with EGF receptor tyrosine kinase inhibitor. We determined the genotypes for R497K and intron1 (CA) n repeat genetic polymorphisms of 70 Chinese patients with advanced non-small cell lung cancer. Genetic polymorphisms were correlated with the clinical outcome of treatment with EGF receptor tyrosine kinase inhibitor. In a subgroup of patients whose tumor tissues were available for mutation analysis and IHC (immunohistochemistry) assay, the associations between the EGF receptor mutations, the EGF receptor protein expression levels and EGF receptor polymorphisms were analyzed. The results indicated that patients with a lower number of EGF receptor CA repeats (any allele < or =16 CA) were more likely to have higher EGF receptor protein expression levels, better response, and longer survival time than were patients with a higher number of CA repeats (both alleles >16 CA) after therapy targeted at the EGF receptor (P=0.021; P=0.014; P=0.0392, respectively). In contrast, the R497K polymorphism had no relationship with EGF receptor protein expression levels or the clinical outcome of the patients treated with EGF receptor tyrosine kinase inhibitor (P=0.49; P=0.452, respectively), and there were no associations between the two polymorphisms and somatic mutations (P=0.916; P=0.562, respectively). Overall, our data suggest that the intron1 (CA) n polymorphism of the EGF receptor gene may be associated with the sensitivity to and the prognosis of non-small cell lung cancer after EGF receptor targeted inhibitor treatment.

KDR expression is associated with the stage and cigarette smoking of the patients with lung cancer.

PURPOSE: Kinase insert domain-containing receptor (KDR) is one of the molecular targets used in cancer therapy. We studied the KDR expression characteristics and the relationship with the clinical parameters of the patients with lung cancer, to give the basic evidence and clue for tailoring therapy. METHODS: Reverse transcriptase and real-time PCR were used to evaluate the KDR mRNA expression levels in 222 tissue samples (106 tumor tissues, 106 matched normal tissues obtained from the same patients with lung cancer, and 10 normal lung specimens from individuals without lung cancer). The KDR mRNA expression level and clinical parameters were analyzed by paired-sample t test, ANOVA and linear regression, respectively. The Kaplan-Meier method and the log-rank test were used for survival analysis. Expression of KDR protein was also examined immunohistochemically in 15 tumor samples and 15 matched normal lung specimens. RESULTS: The KDR mRNA expression levels were significantly higher in normal tissues (mean 4.50 +/- 0.51) than that in the carcinoma tissues (mean 4.12 +/- 0.50, P < 0.0005). KDR expression in tumor tissues is associated with the histological status, tumor stage, cigarette smoking, and N stage of the patients with lung cancer (P < 0.05) analyzed by using ANOVA methods. Multivariate analysis showed that tumor stages and cigarette smoking status were the two most important independent predictors for the KDR expression levels in tumor tissues (R = 0.415, R (2) = 0.172, F = 10.694, P < 0.0005). Tumors with KDR mRNA expression levels above the mean had a shorter survival (466 +/- 313 days) than did patients with KDR expression levels below the mean (671 +/- 264 days), whereas Kaplan-Meier analysis and log-rank test showed no significant difference in the overall survival between the patients (P = 0.2055). All the 15 normal lung tissues detected showed scale 2 KDR immunostaining. The intensity of immunostaining for KDR in tumor specimens varied from negative (scale 0) to strongest (scale 3) staining. CONCLUSIONS: Locally advanced and non-cigarette smoking patients with lung cancer may be the two valuable surrogate markers for KDR mRNA higher levels. Non-squamous lung cancer, N 2 stage may be the secondary markers for that. The KDR expression level in normal lung tissue is stable, but varied in tumor tissues. Targeting KDR therapy in lung cancer might considerate these clinical and KDR expression information. Further confirmation study must be needed.

[Expression of NY-ESO-1 and LAGE-1 cancer-testis antigens in hepatocellular carcinoma].

OBJECTIVE: To study the role of NY-ESO-1 and LAGE-1 cancer-testis antigens as targets for immunotherapy and the relationship between corresponding gene expression and biologic behavior of hepatocellular carcinoma (HCC). METHODS: The expression of NY-ESO-1 and LAGE-1 was studied in frozen tumor tissues from 30 cases of HCC by reverse transcriptase-polymerase chain reaction and immunohistochemistry. NY-ESO-1 expression and its distribution were further studied by immunohistochemistry in a tissue array contained 191 cases of HCC. RESULTS: NY-ESO-1 and LAGE-1 mRNAs were expressed in 33.3% (10/30) and 16.7% (5/30) of HCC respectively. Either NY-ESO-1 or LAGE-1 was expressed in 36.7% (11/30) cases. NY-ESO-1 was expressed mainly in the cytoplasm of tumor cells. It was positive in 13.8% (24/174) cases of HCC. There was an increased expression of NY-ESO-1 from 6.8%, 3/44 in small HCC, 16.2%, 21/130 in advanced HCC and 23.1%, 12/52 in metastatic HCC. The expression in the non-metastatic group was 9.8% (12/122). The differences between the metastatic group and non-metastatic group (< 0.05) and between normal liver tissue and HCC (< 0.01) were statistically significant. There was no relationship between NY-ESO-1 expression and tumor size. NY-ESO-1 and LAGE-1 were not detected in adjacent normal liver tissue. CONCLUSIONS: NY-ESO-1 and LAGE-1 are expressed in a high percentage of HCC, especially in cases with metastasis. It is thus possible that NY-ESO-1/LAGE-1 can serve as targets for antigen-specific immunotherapy in HCC and NY-ESO-1 peptide vaccination may be of use for patients with advanced HCC.

[Correlation of NY-ESO-1 gene and protein expression to metastasis and clinicopathologic features of hepatocellular carcinoma].

BACKGROUND & OBJECTIVE: NY-ESO-1 belongs to cancer-testis antigen family. It can inspire both cellular and humoral immune responses in tumor patients, and is regarded as the strongest tumor antigen. This study was to investigate the expression of NY-ESO-1 gene and its correlation with clinicopathologic features of hepatocellular carcinoma (HCC). METHODS: NY-ESO-1 mRNA expression was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 62 specimens of HCC and adjacent liver tissue. NY-ESO-1 protein expression and its distribution were detected by immunohistochemistry (IHC) in a tissue microarray contained 132 eligible cases of HCC. RESULTS: Positive rate of NY-ESO-1 mRNA was 27.4% in HCC; it was higher in HCC with tumor embolus of portal vein than in HCC without tumor embolism (40.0% vs. 18.9%). Positive rate of NY-ESO-1 protein was 18.9% in HCC tissue microarray; it was significantly higher in HCC with metastasis than in HCC without metastasis (29.6% vs. 11.5%, P < 0.05). NY-ESO-1 protein mainly located in cytoplasm of HCC cells. Positive rates of NY-ESO-1 mRNA and protein were 28.3% and 19.1% respectively in HBsAg positive HCC, and were 29.5% and 20.7% respectively in HCC with alpha fetoprotein (AFP) of > 20 ng/ml. Both NY-ESO-1 mRNA and protein were not detected in adjacent normal liver tissue. CONCLUSIONS: NY-ESO-1 gene specifically expresses in HCC, and may correlates with progress and metastasis of HCC. It may be a candidate target for antigen-specific immunotherapy for HCC with metastatic lesion. NY-ESO-1 expression has no correlation with HBsAg/AFP status of HCC.

[Prokaryotic expression vector construction, expression and polyclonal antibody preparation of the fusion protein of glutathione S-transferase and peroxisome proliferator-activated receptor-gamma coactivator-1].

OBJECTIVE: To express the fusion protein of glutathione S-transferase (GST) and peroxisome proliferator-activated receptor-gamma coactivator-1 (PPARgammaC1) in E. coli. and prepare the polyclonal antibody against PPARgammaC1. METHODS: The coding sequence of PPARgammaC1 gene was amplified by reverse transcriptase-PCR (RT-PCR) from the total RNA of Hep G2 cells and inserted into pGEX-4T-1 vector. The recombinant vector was identified by restriction endonuclease digestion analysis and the fusion protein GST-PPARgammaC1 was expressed in E. coli. via IPTG induction. The expressed fusion protein was purified by glutathione-agarose affinity chromatography and used to immunize the egg-laying hens for preparing the polyclonal antibody against GST-PPARgammaC1. RESULTS: Restriction endonuclease digestion analysis demonstrated that the PPARgammaC1 gene had been correctly inserted into pGEX-4T-1 vector, and the expressed fusion protein had a relative molecular mass of approximately 39,000 as shown by SDS-PAGE. The polyclonal antibody obtained from the egg yolk immunoglobulins was found to specifically bind to purified PPARgammaC1 in Western blot analysis. CONCLUSION: The successfully prepared polyclonal antibody against PPARgammaC1 peptide provides a useful reagent for PPARgammaC1 detection.

[Expressions of inducible nitric oxide synthase and vascular endothelial growth factor and their relationship with microvessel density in hepatocellular carcinoma].

BACKGROUND & OBJECTIVE: Inducible nitric oxide synthase (iNOS), and vascular endothelial growth factor (VEGF) are recognized as key factors required for angiogenesis of tumors. They can influence pathologic development and prognosis of tumors. This study was to investigate the correlation of expressions of iNOS and VEGF to angiogenesis of hepatocellular carcinoma (HCC). METHODS: Tissue microarray of 147 specimens of HCC was prepared, VEGF and microvessel density (MVD) were detected using immunohistochemistry, iNOS mRNA was detected by in situ hybridization. RESULTS: Positive rates of iNOS, and VEGF in HCC tissues were higher than those in adjacent noncancerous tissues (86.39% vs. 33.33%, 78.91% vs. 40.82%). Expression levels of iNOS, and VEGF in HCC tissues were significantly higher than those in adjacent noncancerous tissues (P<0.01). MVD in HCC tissues was significantly higher than that in adjacent noncancerous tissues (56.5+/-12.8 vs. 8.4+/-3.6, P<0.01). Expression of iNOS was related with tumor size, and surface antigen of hepatitis B (HBsAg) (P<0.05), but didn't relate with metastasis, and differentiation of the cancer (P>0.05). Expression of VEGF, and MVD were correlated to tumor size, and metastasis (P<0.05), not to HbsAg, and tumor differentiation (P>0.05). In cancer tissues, MVD was positively correlated with expressions of VEGF and iNOS (P<0.01), expression of VEGF was positively correlated with that of iNOS (P<0.01). CONCLUSION: iNOS and VEGF may play important roles in angiogenesis of HCC. Expression levels of iNOS and VEGF, and MVD in HCC tissues were higher than those in adjacent noncancerous tissues.

[Expression of GST-PRL-2 fusion protein in prokaryotic cells and preparation of Hen egg yolk immunoglobulin (IgY) against PRL-2].

AIM: To express phosphatase 2 of regenerating liver (PRL-2) fusion protein in E.coli and to prepare specific hen egg yolk immunoglobulin(IgY) against PRL-2. METHODS: A full-length human PRL-2 gene coding sequence was cloned into expression vectors pGEX-4T-2 and pET21a, then transformed into E.coli. Fusion protein GST-PRL-2 was expressed in E.coli via IPTG induction. The expressed proteins were purified from lysates through Glutathione Sepharose 4B and the Ni-NTA agarose columns, respectively. Egg-laying hens were immunized using the purified GST-PRL-2 with Freund's complete or incomplete adjuvant. The specificity of the resulting antibody was identified by Western blot. RESULTS: A high level of expression of target protein was detected by Western blot after IPTG induction and purified protein was obtained through Glutathione Sepharose 4B and the Ni-NTA affinity chromatography agarose columns, respectively. Western blot analysis showed that the anti-PRL-2 polyclonal antibody can recognize 6 x His-PRL-2 fusion protein. CONCLUSION: The hen egg yolk immunoglobulin(IgY) against PRL-2 expressed in E.coli has good specificity which provides an useful reagent for the detection of PRL-2.