Spectral CT for preoperative diagnosis of N2 station lymph node metastasis in solid T1 non-small cell lung cancer.

PURPOSE: To evaluate the diagnostic value of spectral CT for the preoperative diagnosis of N2 station lymph nodes metastasis in solid T1 non-small cell lung cancer (NSCLC). METHOD: For this retrospective study, dual-phase contrast agent-enhanced CT was performed in patients with NSCLC from September 2019 to June 2023. Quantitative spectral CT parameters measurements were performed by 2 radiologists independently. Logistic regression analysis and Delong test were performed. RESULTS: 60 NSCLC patients (mean age, 62.85 years ± 8.49, 44men) were evaluated. A total of 121 lymph nodes (38 with metastasis) were enrolled. There was no significant difference in the slope of the spectral Hounsfield unit curve (λHu) on arterial phase (AP) or venous phase (VP) between primary lesions and metastatic lymph nodes (P > 0.05), but significant difference in VP λHu between primary lesions and non-metastatic lymph nodes (P < 0.001). The CT40KeV, λHu, normalized iodine concentration (nIC), normalized effective atomic number (nZeff) measured during both AP and VP were lower in metastatic lymph nodes than in non-metastatic lymph nodes (all P < 0.05). Short-axis diameter (S) of metastatic lymph nodes was higher than non-metastatic lymph nodes (P < 0.001). Area under the curve (AUC) for S performed the highest (0.788) in diagnosing metastatic lymph nodes. When combined with VP λHu, VP nZeff, AUC increased to 0.871. CONCLUSION: Spectral CT is a complementary means for the preoperative diagnosis of N2 station lymph nodes metastasis in solid T1 NSCLC. The combined parameters have higher diagnostic efficiency.

Lymphopenic condition enhanced the antitumor immunity of PD-1-knockout T cells mediated by CRISPR/Cas9 system in malignant melanoma.

BACKGROUND: Adoptive transfer of PD-1 knockout T cells mediated by CRISPR/Cas9 technology has been used in various cancers and got satisfactory treatment effectiveness. However, the effectiveness was limited due to the low proliferation ability, antigen recognition ability and short lifetime of T cells in vivo. METHOD: In this study, PD-1 knockout T cells mediated by CRISPR/Cas9 system were transferred into lymphopenic mice after sub-lethal dose of total body irradiation. The antitumor effects of PD-1 knockout T cells were comprehensively analyzed by flow cytometry. Moreover, PD-L1 knockout B16 cells were inoculated subcutaneously in lymphopenic mice receiving infusion of naïve T cells to value the role of PD-1/PD-L1 axis on lymphopenia-induced antitumor immunity RESULT: In this study, we found that the PD-1-knockout T cells underwent several rounds of homeostatic proliferation in vivo when they were transferred into lymphopenic mice. The number of IFN-γ-releasing CTL was significantly increased and the tumor growth was remarkably inhibited in lymphopenic mice receiving infusion of PD-1 knockout T cells. The expression of PD-L1 on tumor cells rose smartly in lymphopenic mice undergoing homeostatic proliferation. PD-L1 gene knockout on B16 melanoma cells could effectively enhance the antitumor immunity mediated by the homeostatic proliferation of T cells and significantly inhibited the growth of tumor CONCLUSION: These findings suggested that lymphopenic condition after total body irradiation might be able to create an environment to promote the PD-1 knockout T cells to recognize tumor antigen and undergo homeostatic proliferation, thus induced a more powerful antitumor immunity than adoptively transferring into immunocompetent hosts.

Liquid biopsy using ascitic fluid and pleural effusion supernatants for genomic profiling in gastrointestinal and lung cancers.

BACKGROUND: Precision medicine highlights the importance of incorporating molecular genetic testing into standard clinical care. Next-generation sequencing can detect cancer-specific gene mutations, and molecular-targeted drugs can be designed to be effective for one or more specific gene mutations. For patients with special site metastases, it is particularly important to use appropriate samples for genetic profiling. This study aimed to determine whether genomic profiling using ASC and PE is effective in detecting genetic mutations. METHODS: Tissues, plasma, ascites (ASC) supernatants, and pleural effusion (PE) samples from gastrointestinal cancer patients with peritoneal metastasis and lung cancer patients with pleural metastasis were collected for comprehensive genomic profiling. The samples were subjected to next-generation sequencing using a panel of 59 or 1021 cancer-relevant genes panel. RESULTS: A total of 156 tissues, 188 plasma samples, 45 ASC supernatants, and 1 PE samples from 304 gastrointestinal cancer patients and 446 PE supernatants, 122 tissues, 389 plasma samples, and 45 PE sediments from 407 lung cancer patients were analyzed. The MSAF was significantly higher in ASC and PE supernatant than that in plasma ctDNA (50.00% vs. 3.00%, p < 0.0001 and 28.5% vs. 1.30%, p < 0.0001, respectively). The ASC supernatant had a higher actionable mutation rate and more actionable alterations than the plasma ctDNA in 26 paired samples. The PE supernatant had a higher total actionable mutation rate than plasma (80.3% vs. 48.4%, p < 0.05). The PE supernatant had a higher frequency of uncommon variations than the plasma regardless of distant organ metastasis. CONCLUSION: ASC and PE supernatants could be better alternative samples when tumor tissues are not available, especially in patients with only peritoneal or pleural metastases.

Intravoxel incoherent motion diffusion-weighted imaging for early assessment of combined anti-angiogenic/chemotherapy for colorectal cancer liver metastases.

Background: To explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the early assessment of colorectal cancer liver metastases (CRLM). Methods: A total of 34 patients with pathologically confirmed unresectable CRLM were enrolled. All participants uniformly received capecitabine and oxaliplatin (CAPOX) plus bevacizumab chemotherapy as standard first-line treatment for advanced colorectal cancer (CRC). Participants underwent 1.5-T conventional magnetic resonance imaging (MRI) and IVIM-DWI sequence scans with 9 b values (0 to 1,000 s/mm2) before treatment and at 3 weeks of treatment, and conventional MRI scans were performed at 6 and 12 weeks after the initial treatment. The IVIM-DWI parameters in the tumor target area were extracted using image post-processing software, including perfusion fraction (f), true diffusion coefficient (D), and false diffusion coefficient (D*). The response assessment was based on the Response Evaluation Criteria in Solid Tumors (RECIST) v. 1.1 by measuring the longest tumor diameter on dynamic contrast-enhanced (DCE) T1-weighted images. Results: According to the RECIST v. 1.1 criteria, the 34 participants were divided into a response group (n=16) and a non-response group (n=18). In the response group, the f value was significantly lowered (P=0.001) and the D value was significantly increased after treatment (P=0.002). In the non-response group, the D value was increased slightly after treatment (P=0.039), and there was no significant difference in the f value and the D* value. In addition, the f value at baseline was significantly greater in the response group than in the non-response group (0.221±0.033 vs. 0.175±0.040; P=0.001). The receiver operating characteristic (ROC) curve analysis showed that the percentage change of the f value obtained the largest area under the curve (AUC =0.797), and the AUC obtained by the Fisher's linear discriminant analysis (FLDA) method (Δf & ΔD combination) was 0.819. Conclusions: The IVIM-DWI parameters (f values and D values) provided effective assessment of the therapeutic effect of CAPOX combined with bevacizumab in patients with CRLM at an early stage, and the f value of the pre-treatment tumor area was shown to be useful for predicting the treatment response of patients.

Development and External Validation of a Nomogram for Predicting Overall Survival in Stomach Cancer: A Population-Based Study.

OBJECTIVE: The study was to develop and externally validate a prognostic nomogram to effectively predict the overall survival of patients with stomach cancer. METHODS: Demographic and clinical variables of patients with stomach cancer in the Surveillance, Epidemiology, and End Results (SEER) database from 2007-2016 were retrospectively collected. Patients were then divided into the Training Group (n = 4,456) for model development and the Testing Group (n = 4,541) for external validation. Univariate and multivariate Cox regressions were used to explore prognostic factors. The concordance index (C-index) and the Kolmogorov-Smirnov (KS) value were used to measure the discrimination, and the calibration curve was used to assess the calibration of the nomogram. RESULTS: Prognostic factors including age, race, marital status, TNM stage, surgery, chemotherapy, grade, and the number of regional nodes positive were used to construct a nomogram. The C-index was 0.790 and the KS value was 0.45 for the Training Group, and the C-index was 0.789 for the Testing Group, all suggesting the good performance of the nomogram. CONCLUSION: We have developed an effective nomogram with ten easily acquired prognostic factors. The nomogram could accurately predict the overall survival of patients with stomach cancer and performed well on external validation, which would help improve the individualized survival prediction and decision-making, thereby improving the outcome and survival of stomach cancer.

Association of genetic and immuno-characteristics with clinical outcomes in patients with RET-rearranged non-small cell lung cancer: a retrospective multicenter study.

BACKGROUND: Rearranged during transfection (RET) has been proven to be a tumorigenic target in non-small cell lung cancers (NSCLCs). In RET-rearranged NSCLCs, molecular features and their impact on prognosis were not well illustrated, and the activity of mainstay therapeutics has not currently been well compared. METHODS: Patients diagnosed with NSCLCs with RET rearrangements were analyzed for concomitant mutations, tumor mutation burden (TMB), PD-L1 expression, T cell receptor repertoire and clinical outcomes with chemotherapy, immune checkpoint inhibitors (ICIs), and multikinase inhibitors (MKIs). RESULTS: Among 129 patients with RET-rearranged NSCLC who were analyzed, 41.1% (53/129) had co-occurring genetic alterations by next-generation sequencing, and concomitant TP53 mutation appeared most frequently (20/53, 37.7%). Patients with concurrent TP53 mutation (n = 15) had shorter overall survival than those without (n = 30; median, 18.4 months [95% CI, 8.6-39.1] vs 24.8 months [95% CI, 11.7-52.8]; P < 0.05). Patients with lower peripheral blood TCR diversity (n = 5) had superior overall survival compared with those with higher diversity (n = 6; median, 18.4 months [95% CI, 16.9-19.9] vs 4.8 months [95% CI, 4.5-5.3]; P = 0.035). An association with overall survival was not observed for PD-L1 expression nor for tumor mutation burden level. Median progression-free survival was not significantly different across chemotherapy, ICIs, and MKIs (median, 3.5 vs 2.5 vs 3.8 months). For patients treated with ICIs, the disease control rate was 60% (6/10) and the objective response rate was 20% (2/10). CONCLUSIONS: RET-rearranged lung cancers can be heterogeneous in terms of concomitant genetic alterations. Patients with concurrent TP53 mutation or high peripheral blood TCR repertoire diversity have relatively inferior overall survival in this series. Outcomes with traditional systemic therapies in general are suboptimal.

Deubiquitinase PSMD14 enhances hepatocellular carcinoma growth and metastasis by stabilizing GRB2.

Hepatocellular carcinoma (HCC) has emerged as one of the most common malignancies worldwide. It is associated with a high mortality rate, as evident from its increasing incidence and extremely poor prognosis. The deubiquitinating enzyme 26S proteasome non-ATPase regulatory subunit 14 (PSMD14) has been reported to act as an oncogene in several human cancers. The present study aimed to reveal the functional significance of PSMD14 in HCC progression and the underlying mechanisms. We found that PSMD14 was significantly upregulated in HCC tissues. Overexpression of PSMD14 correlated with vascular invasion, tumor number, tumor recurrence, and poor tumor-free and overall survival of patients with HCC. Knockdown and overexpression experiments demonstrated that PSMD14 promoted proliferation, migration, and invasion in HCC cells in vitro, and facilitated tumor growth and metastasis in vivo. Mechanistically, we identified PSMD14 as a novel post-translational regulator of GRB2. PSMD14 inhibits degradation of GRB2 via deubiquitinating this oncoprotein in HCC cells. Furthermore, pharmacological inhibition of PSMD14 with O-phenanthroline (OPA) suppressed the malignant behavior of HCC cells in vitro and in vivo. In conclusion, our findings suggest that PSMD14 could serve as a novel promising therapeutic candidate for HCC.

The oncoprotein HBXIP facilitates metastasis of hepatocellular carcinoma cells by activation of MMP15 expression.

Background: Due to the high recurrence and metastasis rate, the clinical outcomes of patients with hepatocellular carcinoma (HCC) are still unsatisfactory. Hepatitis B virus X-interacting protein (HBXIP) has been reported to play crucial roles in carcinogenesis. Purpose: We aimed to reveal the functional significance and underlying mechanism of HBXIP in HCC metastasis. Methods: Cell transwell assay, in vivo metastasis model, real-time PCR, western blot analysis, luciferase reporter and chromatin immunoprecipitation assays were applied. Results: Here, we detected the HBXIP expression level and determined its clinical significance in HCC. We found that HBXIP was significantly upregulated in HCC tissues, and correlated with vascular invasion, tumor metastasis and worse prognosis of HCC patients. HBXIP enhanced cell migration and invasion in vitro, and promoted the metastasis of HCC in vivo. Furthermore, we confirmed that HBXIP increased MMP15 expression through association with proto-oncogene c-myc. Depletion of c-myc abolished HBXIP-mediated MMP-15 upregulation. We also observed a positive correlation between HBXIP and MMP15 expression in HCC tissues. Conclusion: Our results establish a novel function for HBXIP-MMP15 regulation in HCC metastasis and suggest its candidacy as a new prognostic biomarker and therapeutic target for HCC metastasis.

LAPTM4B facilitates tumor growth and induces autophagy in hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers and the third leading cause of cancer-related deaths. It has been reported that lysosomal associated transmembrane protein LAPTM4B expression is significantly upregulated in human cancers and closely associated with tumor initiation and progression. Purpose: We aimed to reveal the relevance of LAPTM4B and the pathogenesis of HCC. Methods: Cell viability assessment, colony formation assay, in vivo xenograrft model, microarray, real-time PCR, immunofluorescence and western blot analysis were applied. Results: Our results demonstrated that LAPTM4B promoted HCC cell proliferation in vitro and tumorigenesis in vivo. Additionally, upon starvation conditions, LAPTM4B facilitated cell survival, inhibited apoptosis and induced autophagic flux. Expression profiling coupled with gene ontology (GO) analysis revealed that 159 gene downregulated by LAPTM4B silencing was significantly enriched in response to nutrient and some metabolic processes. Moreover, LAPTM4B activated ATG3 transcription to modulate HCC cell apoptosis and autophagy. Conclusion: Our findings demonstrate that LAPTM4B acts as an oncogene that promotes HCC tumorigenesis and autophagy, and indicate that LAPTM4B may be used as a novel therapeutic target for HCC treatment.

UBE2C functions as a potential oncogene by enhancing cell proliferation, migration, invasion, and drug resistance in hepatocellular carcinoma cells.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide. Recently, ubiquitin-conjugating enzyme E2C (UBE2C) has been reported to be overexpressed in human cancers and act as a potential oncogene. However, little is known about the functional roles of UBE2C in HCC progression. In the present study, analysis of UBE2C mRNA expression in The Cancer Genome Atlas (TCGA) dataset reveals that significantly higher UBE2C mRNA levels was found in HCC tissues and associated with higher HCC grade. Elevated UBE2C mRNA levels in HCC indicated worsened survival probabilities. Through performing loss-of-function assays, we demonstrated that knockdown of UBE2C expression obviously suppressed proliferation, migration, and invasion of HCC cells in vitro Moreover, HCC cells with UBE2C knockdown showed higher sensitivity for the treatment of chemotherapeutic drug, including adriamycin (ADR) and 5-fluorouracil (5-FU). Silencing of UBE2C also increased the sensitivity of HCC cells to sorafenib, an approved treatment for patients with advanced-stage HCC. Our findings strongly suggest that UBE2C emerges as a marker for prognosis in HCC, and blocking UBE2C may be a novel strategy for HCC therapies.

The tumor suppressor DLC1 inhibits cancer progression and oncogenic autophagy in hepatocellular carcinoma.

Downregulation of deleted in liver cancer 1 (DLC1) is associated with poor prognosis of various cancers, but its functional mechanisms in hepatocellular carcinoma (HCC) remains unclear. In the present study, we investigated the roles of DLC1 in tumor progression and autophagy of HCC. We found that DLC1 was frequently downregulated in HCC tissues. Underexpression of DLC1 correlated with AFP level, vascular invasion, poor differentiation, and poor prognosis. In vitro assays revealed that DLC1 not only suppressed the proliferation, migration, and invasion of HCC cells, but also inhibited autophagy of HCC cells. Mechanistic investigation revealed that DLC1 decreased TCF4 expression and the interaction between ß-catenin and TCF4, then inactivated Wnt/ß-catenin signaling. Additionally, DLC1 suppressed the ROCK1 activity and the dissociation of the Beclin1-Bcl2 complex, thereby inhibiting autophagy of HCC cells. In conclusion, our findings imply that loss of DLC1 contributes to the progression and oncogenic autophagy of HCC.

The long noncoding RNA lncPARP1 contributes to progression of hepatocellular carcinoma through up-regulation of PARP1.

Hepatocellular carcinoma (HCC) accounts for a large proportion of cancer-associated mortality worldwide. The functional impact of long noncoding RNAs (lncRNAs) in human cancer is not fully understood. Here, we identified a novel oncogenic lncRNA termed as lncPARP1, which was significantly up-regulated in HCC. Increase in lncPARP1 expression was associated with age, α-fetoprotein (AFP) levels, tumor size, recurrence, and poor prognosis of HCC patients. Loss-of-function approaches showed that knockdown of lncPARP1 inhibited proliferation, migration, and invasion, while induced apoptosis in HCC cells. Moreover, mechanistic investigation demonstrated that PARP1 was an underlying target of lncPARP1 in HCC. In summary, we provide the first evidence that lncPARP1 exerts an oncogene to promote HCC development and progression, at least in part, by affecting poly (ADP-ribose) (PAR) polymerase 1 (PARP1) expression.

VEGF and cortactin expression are independent predictors of tumor recurrence following curative resection of gastric cancer.

INTRODUCTION: To investigate the clinicopathological role of expression of vascular endothelial growth factor (VEGF) and cortactin, as well as whether their expression are independent predictors of tumor recurrence following curative resection of gastric cancer. METHODS: One hundred twenty-eight patients with gastric cancer were included in this study. Formalin-fixed paraffin-embedded specimens were stained for VEGF and cortactin, and the correlation between the staining, clinicopathological parameters and prognostic power were analyzed. RESULTS: Of the 128 patients studied, 58 (45.3%) and 71 (55.5%) cases were strongly positive for VEGF and cortactin, respectively. VEGF expression correlated with Lauren classification (P < 0.001), pathological tumor stage (P < 0.001), and pathological tumor node metastasis (TNM) stage (P = 0.003). Cortactin expression correlated with pathological lymph node stage (P = 0.018), pathological TNM stage (P < 0.001), and degree of differentiation (P < 0.001). There were statistically significant associations between tumor recurrence and VEGF expression (P = 0.023), and cortactin expression (P < 0.001). In multivariate analysis, pathological TNM stage, VEGF expression, and cortactin expression were independent prognostic influence on disease-free survival (P < 0.001, 0.022, and 0.034, respectively). CONCLUSIONS: VEGF and cortactin may be a good biomarker to be applied in clinic to predict the prognosis of patients with curatively resected gastric cancer.

The inhibitory effects of rh-endostatin (YH-16) in combination with radiotherapy on lung adenocarcinoma A549 in mice and the underlying mechanisms.

In order to investigate the inhibitory effects of Endostar (rh-endostatin, YH-16) in combination with radiotherapy on lung adenocarcinoma A549 in mice and the interaction mechanisms of combined therapy, the transplantation tumor models of A549 lung adenocarcinoma were established. When the largest diameter of tumor reached 1.0 cm, all nude mice were randomly divided into 4 groups: Endostar group, radiotherapy group, radiotherapy plus Endostar (combined treatment) group, and control group (n=6 in each group). The largest diameter and the vertical diameter of tumor were measured at different time points. At the 16th day, mice were executed, and the tumors were applied to analysis of rate of tumor cell apoptosis, and the expression levels of basic fibroblast growth factor (bFGF) mRNA were detected by reverse transcription-polymerase chain reaction (RT-PCR) and those of vascular endothelial growth factor (VEGF) by immunohistochemistry. The results demonstrated that the rate of tumor inhibition in combined treatment group was higher than that in other groups. And the rate of tumor cell apoptosis in combined treatment group was also higher than that in other groups. Meanwhile, the levels of bFGF mRNA and VEGF expression in combined treatment group were lower than those in other groups. It was concluded that Endostar obviously enhanced the curative effectiveness of radiotherapy on lung adenocarcinoma A549 in mice. The underlying mechanisms may involve the down-regulation of bFGF mRNA and VEGF expression to inhibit angiogenesis by Endostar and the cooperative effect of Endostar and radiotherapy to synergistically promote tumor cell apoptosis. And Endostar inhibits angiogenesis by down-regulating the expression of bFGF mRNA and VEGF.

The Inhibitory Effects of Rh-endostatin(YH-16)in Combination with Radiotherapy on Lung Adenocarcinoma A549 in Mice and the Underlying Mechanisms / 华中科技大学学报（医学）（英德文版）

In order to investigate the inhibitory effects of Endostar(rh-endostatin,YH-16)in combination with radiotherapy on lung adenocarcinoma A549 in mice and the interaction mechanisms of combined therapy,the transplantation tumor models of A549 lung adcnocarcinoma were established.When the largest diameter of tumor reached 1.0 cm,all nude mice were randomly divided into 4 groups: Endostar group,radiotherapy group,radiotherapy plus Endostar(combined treatment)group,and control group(n=6 in each group).The largest diameter and the vertical diameter of tumor were measured at different time points.At the 16th day,mice were executed,and the tumors were applied to analysis of rate of tumor cell apoptosis,and the expression levels of basic fibroblast growth factor(bFGF)mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR)and those of vascular endothelial growth factor(VEGF)by immunohistochemistry.The results demonstrated that the rate of tumor inhibition in combined treatment group was higher than that in other groups.And the rate of tumor cell apoptosis in combined treatment group was also higher than that in other groups.Meanwhile,the levels of bFGF mRNA and VEGF expression in combined treatment group were lower than those in other groups.It was concluded that Endostar obviously enhanced the curative effectiveness of radiotherapy on lung adenocarcinoma A549 in mice.The underlying mechanisms may involve the down-regulation of bFGF mRNA and VEGF expression to inhibit angiogenesis by Endostar and the cooperative effect of Endostar and radiotherapy to synergistically promote tumor cell apoptosis.And Endostar inhibits angiogenesis by down-regulating the expression of bFGF mRNA and VEGF.