A novel cell-wall polysaccharide derived from the stipe of Agaricus bisporus inhibits mouse melanoma proliferation and metastasis.

Malignant melanoma is an invasive and highly aggressive skin cancer that-if diagnosed-poses a serious threat to the patient's health and life. In this work, a novel purified cell-wall polysaccharide (termed Abwp) was obtained from the discarded stipe of Agaricus bisporus (A. bisporus) and characterized to be a novel homogeneous polysaccharide consisted of a ß-(1 â†’ 4)- glucosyl backbone with ß-(1 â†’ 2) and (1 â†’ 6)-d-glucosyl side-chains. The anti-melanoma effects of Abwp and its associated mechanisms in mice were then explored using in vitro and in vivo approaches. In vitro results showed that Abwp inhibited B16 melanoma cell proliferation and promoted their apoptosis in both time- and dose-dependent manners. In B16 cells induced with tumor necrosis factor (TNF-α), Abwp significantly decreased the protein expression of inflammatory-related signaling pathway (e.g., p38 MAPK and NF-κB) in time-, concentration-, and dose-dependent manners. Moreover, Abwp blocked nuclear entry of NF-κB-p65. In an in vivo mouse model featuring neoplasm transplantation with B16 melanoma cells, Abwp significantly inhibited the growth and proliferation of mouse melanoma. Hematoxylin staining showed that the invasion of melanoma cells into the lung tissue of the Abwp-treated group was significantly reduced. Immunohistochemical analysis showed that the expression of proliferation cell nuclear antigen (PCNA), N-cadherin, MMP-9, and Snail in the lung of mouse was significantly inhibited. Immunofluorescence showed that Abwp significantly interfered with the nuclear transcription of NF-κB-p65 in a dose-dependent manner. Collectively, these results showed that Abwp mediated p38 MAPK and NF-κB signaling pathways to inhibit the inflammatory response and malignant proliferation and metastasis of melanoma in mice.

Neoadjuvant Immunotherapy in Oncogene-Positive Non-Small Cell Lung Cancer: A Multicenter Study.

BACKGROUND: Preoperative immunotherapy has shed light on the management of resectable non-small cell lung cancer (NSCLC). However, whether neoadjuvant immunotherapy benefits patients with oncogene-positive NSCLC remains unknown. METHODS: Data were retrieved from 4 institutions in the period from August 2018 to May 2021. Eligible patients were aged ≥18 years with histologically confirmed stage IIA to stage IIIB (T1-2 N1-2 or T3-4 N0-2) NSCLC that was deemed to be surgically resectable. The neoadjuvant regimen included immune checkpoint inhibitors alone or in combination with platinum-based doublets. Surgical resection was performed 4 to 6 weeks after the first day of the last cycle of treatment. The primary end point was major pathologic response (MPR; ≤10% viable tumor cells). Analyses were categorized according to the patients' oncogene (EGFR, ALK, KRAS, MET, BRAF, ROS1, RET) status. RESULTS: Overall, 137 patients were identified; 46 (33%) patients had nonsquamous cell cancer, and 114 (83%) had stage IIIA/B disease. Oncogene alterations were identified in 22 (16%) patients, of whom only 2 patients (2/22 [9%]) had an MPR compared with 65 (65/115 [56.5%]) in the oncogene-negative population (P < .001). Similar results were retained after propensity score matching for age, sex, smoking status, histologic type, stage, and cycles of neoadjuvant treatment. Squamous cell carcinoma (odds ratio, 2.54; 95% CI, 1.08-5.99) and positive oncogene status (odds ratio, 0.13; 95% CI, 0.03-0.64) were found to be indicators for MPR by logistic regression. The 1-year event-free survival rate was 75.4% in the oncogene-positive group, which was not significantly different from 85.5% in the oncogene-negative population (P = .23). CONCLUSIONS: Patients with stage II-III oncogene-positive NSCLCs respond less than patients with oncogene-negative NSCLCs after neoadjuvant immunotherapy.

Invasiveness assessment by artificial intelligence against intraoperative frozen section for pulmonary nodules ≤ 3 cm.

PURPOSE: To investigate the performance of an artificial intelligence (AI) algorithm for assessing the malignancy and invasiveness of pulmonary nodules in a multicenter cohort. METHODS: A previously developed deep learning system based on a 3D convolutional neural network was used to predict tumor malignancy and invasiveness. Dataset of pulmonary nodules no more than 3 cm was integrated with CT images and pathologic information. Receiver operating characteristic curve analysis was used to evaluate the performance of the system. RESULTS: A total of 466 resected pulmonary nodules were included in this study. The areas under the curves (AUCs) of the deep learning system in the prediction of malignancy as compared with pathological reports were 0.80, 0.80, and 0.75 for all, subcentimeter, and solid nodules, respectively. Additionally, the AUC in the AI-assisted prediction of invasive adenocarcinoma (IA) among subsolid lesions (n = 184) was 0.88. Most malignancies that were misdiagnosed by the AI system as benign diseases with a diameter measuring greater than 1 cm (26/250, 10.4%) presented as solid nodules (19/26, 73.1%) on CT. In an exploratory analysis involving nodules underwent intraoperative pathologic examination, the concordance rate in identifying IA between the AI model and frozen section examination was 0.69, with a sensitivity of 0.50 and specificity of 0.97. CONCLUSION: The deep learning system can discriminate malignant diseases for pulmonary nodules measuring no more than 3 cm. The AI model has a high positive predictive value for invasive adenocarcinoma with respect to intraoperative frozen section examination, which might help determine the individualized surgical strategy.

[Effect of different ways of insulin infusion in parenteral nutrition patients on activation and concentration of insulin and blood glucose control:a prospective randomized comparison study].

OBJECTIVE: To compare activation and concentration of insulin, and blood glucose control in patients between insulin added into "all in one" bags and syringes at parenteral nutrition (PN). METHODS: From April 2006 to August 2006, 20 consecutive patients after gastrointestinal operations were recruited and randomized to instillation group and pump group. In instillation group, the insulin was directly added into PN and transfused. In pump group, the insulin was added into syringes and transfused by infusion pump. Activation and concentration of insulin, and blood glucose in patients were measured at beginning infusion, infused 1000 ml, infused 2000 ml, and remained 100 ml daily for the first 3 days after operation. RESULTS: There was a tendency of decrease for the activation and concentration of insulin in both groups with the time. There was no significant difference of activation of insulin between the two groups (P = 0.347). There were no significant differences of blood glucoses between the two groups, and between the four time points in each groups (P > 0.05). There were no complications association with blood glucoses in the two groups. CONCLUSIONS: Both of activation and concentration of insulin at PN decreased gradually and slightly with the time no matter the ways of insulin infusion. Activation of insulin and blood glucoses in patients are no significant differences between the two groups. Insulin can be safely added into "all in one" bags at PN.

Response surface optimization of conditions for culturing Azotobacter chroococcum in Agaricus bisporus industrial wastewater.

In the present study, the conditions for Azotobacter chroococcum fermentation using Agaricus bisporus wastewater as the culture medium were optimized. We analyzed the total number of living A. chroococcum in the fermentation broth, using multispectral imaging flow cytometry. Single-factor experiments were carried out, where a Plackett-Burman design was used to screen out three factors from the original six processing factors wastewater solubility, initial pH, inoculum size, liquid volume, culture temperature, and rotation speed that affected the total number of viable A. chroococcum. The Box-Behnken response surface method was used to optimize the interactions between the three main factors and to predict the optimal fermentation conditions. Factors significantly affecting the total number of viable A. chroococcum, including rotation speed, wastewater solubility, and culture temperature, were investigated. The optimum conditions for A. chroococcum fermentation in A. bisporus wastewater were a rotation speed of 200 rpm, a solubility of 0.25%, a culture temperature of 26°C, an initial pH of 6.8, a 5% inoculation volume, a culture time of 48 h, and a liquid volume of 120 mL in a 250 mL flask. Under these conditions, the concentration of total viable bacteria reached 4.29 ± 0.02 ✕ 107 Obj/mL A. bisporus wastewater can be used for the cultivation of A. chroococcum.

[Injuries after lobectomy: a prospective randomized comparison of video-assisted thoracoscopic surgery and mini-thoracotomy].

OBJECTIVE: To compare the differences of injuries and recovery between video-assisted thoracoscopic surgery (VATS) and mini-thoracotomy (MT) in patients with clinical early stage non-small cell lung cancer (NSCLC) after lobectomy. METHODS: From March 2004 to December 2006, 47 consecutive patients with early stage NSCLC with a diameter of tumor less than 6 cm were recruited and randomized to VATS group and MT group. Incision length, duration of operation and intraoperative blood loss were recorded. Postoperative pain was assessed using a visual analogue scale before operation and daily for the first 7 days after operation. The serum levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured by cytometric bead array before operation and at 4, 24, and 48 h after operation. Karnofsky performance status (KPS) was assessed before operation and daily for the first 7 days after operation. RESULTS: Incision length was (6.0 +/- 0. 9) cm in the VATS group and (12.5 +/- 1.5) cm in the MT group. There was no significant difference in duration of operation and intraoperative blood loss between the VATS group and the MT group. Postoperative pain was significantly less in the VATS group in the 5th to 7th day postoperatively (P < 0.05). There was no significant difference of serum concentrations of IL-6 and IL-10 between the VATS group and the MT group at 4, 24, and 48 h after operation. KPS score was significantly higher in the VATS group on 2nd to 7th day postoperatively (P < 0.05). CONCLUSION: Compared with MT, VATS for lobectomy has less postoperative pain, faster recovery, but can't reduce postoperative release of cytokines.

Giant liposarcoma of the esophagus: A case report.

Liposarcomas rarely develop in the aerodigestive tract. Here, we present a primary esophageal liposarcoma that was discovered between the T3 and T7 levels of the esophagus during right pleural exploration of a 51-year-old male patient. The patient had presented with non-specific symptoms, including progressive dysphagia over the previous 6 mo, without complaints of chest or epigastric pain, regurgitation, or weight loss. A radical three-hole esophagectomy was performed. The tumor was extremely large (14 cm × 7.0 cm × 6.5 cm), but completely encapsulated. Upon histological examination, the tumor was diagnosed as a giant, well-differentiated esophageal liposarcoma with a dedifferentiated component. Non-specific radiological and endoscopic results during the clinical work-up delayed diagnosis until post-operative histology was performed. In this report, the clinical, radiological and endoscopic diagnostic challenges specific to the case are discussed, as well as the surgical and pathological findings.

[Diagnosis and therapeutics of 24 cases of pulmonary sclerosing hemangioma].

BACKGROUND & OBJECTIVE: Pulmonary sclerosing hemangioma (PSH) is an uncommon benign lung tumor. The study was to investigate the clinical features, diagnosis, treatment, and prognosis of PSH in order to promote the recognition of this disease. METHODS: Data of 24 pathologically confirmed PSH patients treated in Sun Yat-sen University Cancer Center from Jan. 1999 to Jul. 2007 were reviewed. The clinical features, diagnosis, treatment, and prognosis were summarized. RESULTS: Of the 24 patients, two (8.3%) were males, and 22 (91.7%) were females. The median age of the patients was 54.5 years old, ranging from 21 to 76 years old. Ten (41.7%) patients were detected upon routine medical examination, while 14 (58.3%) patients presented clinical symptoms, including cough, hemoptysis, chest pain, chest distress and tachypnea. The imaging examination revealed isolated round or similar round nodules with distinct margins and homogeneous density. No calcification and aerial semilunar sign appeared. All the patients received surgical resection without complications and mortality. Eight patients underwent lobectomy, 13 underwent wedge resection, two underwent tumor resection and one underwent segmentectomy. There was no recurrence or metastasis during follow-ups. CONCLUSIONS: Clinical and radiological characteristics of PSH are nonspecific. Thus, accurate diagnosis of PSH before operation is difficult. Confirmation of PSH depends on pathological examination. Surgical resection is an effective treatment for PSH, among which lobectomy or limited resection is advisable, while systematic lymph node dissection is not recommended.

[Quality of life after lobectomy for early stage non-small cell lung cancer--video-assisted thoracoscopic surgery versus minimal incision thoracotomy].

BACKGROUND & OBJECTIVE: Quality of life (QOL) after video-assisted thoracoscopic surgery (VATS) lobectomy for clinical early stage non-small cell lung cancer (NSCLC) has seldom been systematically studied. This study was to compare the QOL in patients with clinical early stage NSCLC after VATS or minimal incision thoracotomy (MIT) lobectomy, and to explore the characteristic of QOL after VATS lobectomy. METHODS: A prospective randomized controlled trial was conducted. From Mar. 2004 to Mar. 2005, 32 consecutive patients with early stage NSCLC and tumor size of < or =6 cm diagnosed by CT scan were recruited and randomized to VATS group (17 patients) and MIT group(15 patients). Two patients in VAYS group were excluded for conversion to posterolateral thoracotomy because of uncontrolled bleeding and dense pleural adhesion. QOL was assessed using Lung Cancer Symptom Scale (LCSS) before operation and at 1, 3 and 6 months after operation. RESULTS: There were no significant differences between the 2 groups in age, sex, tumor pathologic stage, tumor size, and postoperative complications. One month after operation, the scores of dyspnea and pain were significantly lower in VATS group than in MIT group (10.9+/-7.4 vs. 17.4+/-9.6, P=0.047; 13.7+/-9.5 vs. 23.0+/-12.2, P=0.028). The score of overall symptom was slightly lower in VATS group than in MIT group (9.7+/-7.2 vs. 16.2+/-10.9, P=0.066). Five major symptoms (appetite, fatigue, cough, dyspnea, and pain) at the VATS group were deteriorated after operation. Appetite, fatigue and cough were deteriorated significantly at 1 month after operation (P<0.05), but returned to nearly preoperative levels at 3 months after operation (P>0.05) except appetite, and all returned to baseline levels at 6 months after operation (P>0.05). CONCLUSIONS: Compared with MIT lobectomy, VATS will lead to better QOL for the patients with early stage NSCLC. It takes 6 months for the patients to return to preoperative QOL levels after VATS lobectomy.

[Influence of unexpected simultaneous splenectomy on postoperative complications and prognosis of patients undergoing radical esophagectomy for esophageal carcinoma].

BACKGROUND & OBJECTIVE: Unexpected splenectomy is sometimes performed simultaneously with radical esophagectomy for esophageal carcinoma because of spleen injury or anatomical abnormity. This study was to investigate the influence of unexpected simultaneous splenectomy on postoperative complications and prognosis of patients undergoing radical esophagectomy for esophageal carcinoma. METHODS: Clinical data of 843 esophageal carcinoma patients, underwent esophagectomy (R0 resection) at Cancer Center of Sun Yat-sen University from Aug. 1999 to Jul. 2002, were analyzed. Of these patients, 39 (4.6%) underwent splenectomy. The clinicopathologic parameters and prognosis of the patients in splenectomy group and non-splenectomy group were compared. RESULTS: The amount of intraoperative blood loss was significantly higher in splenectomy group than in non-splenectomy group [(380+/-113) ml vs. (305+/-85) ml, P<0.001]. However, there were no significant differences in clinicopathologic characteristics, intraoperative or postoperative complications between the 2 groups (P>0.05). The occurrence rate of pulmonary complications was higher in splenectomy group than in non-splenectomy group (17.9% vs. 8.5%, P>0.05). The median survival time was shorter in splenectomy group than in non-splenectomy group (18.4 months vs. 21 months, P>0.05). CONCLUSION: Unexpected simultaneous splenectomy had no effect on the long-term survival of patients who underwent radical esophagectomy for esophageal carcinoma, but it may result in more intraoperative blood loss and pulmonary complications.

[Cytokine responses after lobectomy: a prospective randomized comparison of video-assisted thoracoscopic surgery and minimal incision thoracotomy].

BACKGROUND & OBJECTIVE: The cytokine network plays a pivotal role in inducing acute-phase inflammatory and immunologic responses to surgical trauma. Whether lesser release of cytokines by mini-invasive operation can reduce acute-phase responses and better preserve immune functions needs to be explored. This prospective randomized study was to compare the effects of video-assisted thoracoscopic surgery (VATS) and minimal incision thoracotomy (MIT) on serum levels of cytokines after lobectomy for clinical early stage non-small cell lung cancer (NSCLC). METHODS: From Mar. 2004 to Dec. 2006, 47 consecutive patients with early stage NSCLC (tumor size was

[Influence of perioperative hypertension on postoperative cardiovascular complications in chest cancer patients].

BACKGROUND & OBJECTIVE: The incidence of perioperative hypertension is increasing in recent decades. Hypertension increases the risk of anaesthesia and surgical operation, and also affects the prognosis of patients apparently. This study was to investigate the influence of perioperative hypertension on postoperative cardiovascular complications in chest cancer patients. METHODS: Clinical data of 464 chest cancer patients, received thoracotomy in Cancer Center of Sun Yat-sen University between Aug. 2005 and Dec. 2005, were analyzed. Of the 464 patients, 152 had perioperative hypertension, and 312 did not. Postoperative cardiovascular complications of the 2 groups were compared with Chi-square test. RESULTS: The 2 groups had no significant differences in age, sex, tumor type, preoperative chronic disease, and preoperative cardiovascular disease (P>0.05). Postoperative cardiovascular complications were developed in 54 patients in perioperative hypertension group (including 41 cases of arrhythmia, 8 cases of hypotension, 3 cases of heart failure, and 2 cases of cardiac ischemia) and in 53 patients in perioperative non-hypertension group (including 41 cases of arrhythmia, 9 cases of hypotension, 2 cases of heart failure, and 1 case of cardiac ischemia). The occurrence rate of postoperative cardiovascular complications was significantly higher in perioperative hypertension group than in perioperative non-hypertension group (35.53% vs. 16.99%, P<0.05). CONCLUSION: Perioperative hypertension obviously increases the incidence of postoperative cardiovascular complications in chest cancer patients after thoracotomy.

[Surgical treatment efficacy of bronchioloalveolar carcinoma: a retrospective analysis of 130 patients].

BACKGROUND & OBJECTIVE: Bronchioloalveolar carcinoma (BAC) is a well-differentiated lung adenocarcinoma occurring in the periphery of the lung and growing along an intact interstitial framework. There are controversies about the surgical treatment efficacy of BAC. This study was to explore the surgical treatment efficacy of BAC. METHODS: Data were collected from 130 patients with BAC, hospitalized in the department of Thoracic Surgery, Cancer Center of Sun Yat-sen University, diagnosed by postoperative pathology from 1985 to 2000. Clinical and histological features, approaches and outcomes of surgical treatment according to different TNM stages and clinical patterns were studied retrospectively. RESULTS: Of the 130 patients, 56.1% were men, 42.9% were women. The ratio of smoker to non-smoker was 1:1.55. Ninety-eight patients underwent complete resection and 32 underwent incomplete resection. Patients in stage I (n=54), stage II (n=15), stage III B (2/11), and stage IV (1/19) underwent complete resection, of whom the 5-year survival rates were 60.7%, 33.3%, 13.6%, and 14.0%, respectively. Patients of unifocal (96/113), multifocal (1/12), and pneumonic (1/19) patterns underwent complete resection, of whom the median survival time was 46.3, 20.6, and 5 months. The 1-, 3-, and 5-year survival rates were 96.4%, 58.6%, and 41.2% for the unifocal pattern, 91.2%, 41.7%, and 33.3% for the multifocal pattern, 20%, 0, and 0 for the pneumonic pattern. CONCLUSION: Complete surgical resection can achieve favorable survival rates for BAC in stage I/II and multifocal BAC in stage III/IV, whereas relatively poorer prognosis for pneumonic BAC.