[The study of pleural effusion supernatant cell-free tumor DNA in tumor mutational burden assessment of advanced lung cancer].

Objective: To evaluate the feasibility of cell-free tumor DNA in pleural effusion supernatant for assessing the tumor mutational burden (TMB) of advanced lung cancers. Methods: From December 2016 to August 2018, 34 lung cancer patients (19 males and 15 females) with pleural effusion were enrolled at Zhongshan Hospital, Fudan University. The median age of the patients was 65 (range, 34-85) years. Before systemic or local antitumor therapy, tumor specific mutations in tumor tissue, pleural effusion supernatant, pleural effusion sediment, and plasma samples from these patients were examined using targeted next-generation sequencing, and TMB levels were calculated respectively. Subgroup analysis was based on smoking history and driver mutation status. Statistical differences were determined using SPSS 16.0 software, and individual groups were compared using the one-way analysis of variance (ANOVA) and LSD-t test. Results: The median TMB level of pleural effusion supernatant was 6.23 mutations/Mb, similar to that of tumor tissue (6.23 vs 6.86 mutations/Mb, t=1.174, P=0.245), but significantly higher than that of pleural effusion sediment (2.49 mutations/Mb, t=3.044, P=0.003) and plasma (2.49 mutations/Mb, t=2.464, P=0.016). Compared with tumor tissue in TMB assessment, pleural effusion supernatant had a positive percentage agreement of 52% (9/17), and a negative percentage agreement of 65% (11/17). Subgroup analysis showed that the TMB level was higher in smokers (n=11) than that in non-smokers (n=23, 14.4 vs 5.4 mutations/Mb, t=3.238, P=0.003). Conclusion: For advanced lung cancer patients with pleural effusion, pleural effusion supernatant is a promising substitute to tumor tissue for TMB assessment, which is a potential biomarker for immunotherapy.

Lnc00908 promotes the development of ovarian cancer by regulating microRNA-495-5p.

OBJECTIVE: The aim of this study was to investigate whether lnc00908 could affect the proliferative and migratory behaviors of ovarian cancer (OC) cells by regulating microRNA-495-5p, thus participating in the development of OC. PATIENTS AND METHODS: Quantitative Real Time-Polymerase Chain Reaction (QRT-PCR) was used to detect the expression levels of lnc00908 and microRNA-495-5p in OC tissues and normal ovarian tissues, as well as OC cell lines. The regulatory effects of lnc00908 and microRNA-495-5p on the proliferative and migration abilities of OC cells were detected by cell counting kit-8 (CCK-8) and transwell assay, respectively. The binding relationship between microRNA-495-5p and ANXA3, as well as miR-495-5p and lnc00908, was examined by luciferase reporter gene assay. Gain-of-function experiments were conducted to verify whether lnc00908 could affect the proliferative and migratory behaviors of OC cells by regulating microRNA-495-5p. RESULTS: Lnc00908 was highly expressed in OC tissues, and its expression was positively correlated with tumor stage. Overexpression of lnc00908 markedly promoted the proliferative and migratory abilities of SKOV3 and OVCAR cells. Luciferase reporter gene assay showed that lnc00908 could bind to microRNA-495-5p. However, microRNA-495-5p was significantly downregulated in OC tissues. Overexpression of microRNA-495-5p reversed the enhanced abilities of proliferation and migration in SKOV3 and OVCAR3 cells by lnc00908 overexpression. ANXA3 was a target gene of microRNA-495-5p. Moreover, overexpression of ANXA3 attenuated the inhibitory effect of miR-495-5p on the proliferative and migratory behaviors of SKOV3 and OVCAR3 cells. CONCLUSIONS: We found that the high expression of lnc00908 can promote the proliferation and migration abilities of OC cells through sponging microRNA-495-5p to regulate ANXA3 expression.

[Clinical analysis of IgG4-related lung disease].

Objective: To improve the understanding and treatment of IgG4-related lung disease (IgG4-RLD) by analyzing the clinical characteristics of patients. Methods: A total of 13 patients with IgG4-related lung disease (IgG4-RLD) diagnosed by pathology at Zhongshan Hospital affiliated to Fudan University during December 2007 to December 2017 were included. The clinical characteristics, chest CT, pathological features, serum IgG4 levels, therapy and prognosis of these 13 patients were analyzed. Results: The 13 patients with IgG4-RLD included 8 men and 5 women, with an average age of (51.1±14.8) years. The clinical manifestations were varied, 10 patients showed respiratory symptoms, mainly including cough (n=9), expectoration (n=6), hemoptysis (n=6), chest tightness (n=2) and breathless (n=2). Multiple organs were involved in 12 cases. Chest CT showed solid lung nodules (n=9), ground glass shadows (n=1), alveolar-interstitial infiltration (n=3), bronchovascular lesions (n=3), and the solid lung nodules was predominant. Enlargement of lymph nodes in the mediastinal and bilateral hilum of the lung were present in 10 cases. Serum IgG4 levels were elevated in all the 13 cases, with an average concentration of (7.92 ±13.98)g/L. Quite amount of lymphocytes, plasma cell infiltration and fibrosis were common pathologic findings. Immunohistochemical staining showed a large number of IgG4 positive plasma cells infiltration with IgG4 positive plasma cells count 10-320/HP in 13 cases. The ratio of IgG4 positive plasma cells to IgG positive plasma cells was higher than 40%. Eight patients received glucocorticoid therapy alone, five received glucocorticoids with immunosuppressant therapy. After treatment, 10 patients were with remission, and disease progressed in 3 patients, but no death. Conclusions: The clinical manifestations and imaging features of IgG4-RLD are diverse, and lesions can often involve multiple organs. The diagnosis could be made based on pathological features and IgG4 serum levels. Glucocorticoid can be used as the first choice for the treatment of IgG4-RLD.