RESUMEN
BACKGROUND: The majority of lung cancers are adenocarcinomas, with the proportion being 40%. The patients are mostly diagnosed in the middle and late stages with metastasis and easy recurrence, which poses great challenge to the treatment and prognosis. Platinum-based chemotherapy is a primary treatment for adenocarcinoma, which frequently causes drug resistance. As a result, it is important to uncover the mechanisms of the chemoresponse of adenocarcinoma to platinum-based chemotherapy. METHODS: The genes from the dataset GSE7880 were gathered into gene modules with the assistance of weighted gene coexpression network analysis (WGCNA), the gene trait significance absolute value (|GS|), and gene module memberships (MM). The genes from hub gene modules were calculated with a protein-protein interaction (PPI) network analysis in order to obtain a screening map of hub genes. The hub genes with both a high |GS| and MM and a high degree were selected. Furthermore, genes in the hub gene modules also went through a Gene Ontology (GO) functional enrichment analysis. RESULTS: 11 hub genes in four hub gene modules (LY86, ACTR2, CDK2, CKAP4, KPNB1, RBBP4, SMAD4, MYL6, RPS27, TSPAN2, and VAMP2) were chosen as the significant hub genes. Through the GO function enrichment analysis, it was indicated that four modules were abundant in immune system functions (floralwhite), amino acid biosynthetic process (lightpink4), cell chemotaxis (navajowhite2), and targeting protein (paleturquoise). Four hub genes with the highest |GS| were verified by prognostic analysis.
Asunto(s)
Adenocarcinoma del Pulmón , Resistencia a Antineoplásicos , Neoplasias Pulmonares , Compuestos de Platino/farmacología , Proteína 4 de Unión a Retinoblastoma , Adenocarcinoma del Pulmón/genética , Adenocarcinoma del Pulmón/metabolismo , Adenocarcinoma del Pulmón/mortalidad , Antineoplásicos/farmacología , Resistencia a Antineoplásicos/efectos de los fármacos , Resistencia a Antineoplásicos/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/mortalidad , Pronóstico , Mapas de Interacción de Proteínas/efectos de los fármacos , Mapas de Interacción de Proteínas/genética , Proteína 4 de Unión a Retinoblastoma/genética , Proteína 4 de Unión a Retinoblastoma/metabolismo , Transcriptoma/efectos de los fármacos , Transcriptoma/genéticaRESUMEN
The effect of preoperative external radiotherapy (XRT) on head and neck free-flap reconstruction is still controversial. In this study, we aimed to determine the impact of preoperative XRT on the outcomes of head and neck microvascular free-flap reconstruction. A systematic review and meta-analysis was conducted in concordance with the Systematic reviews and Meta-Analyses protocol. We searched several databases (PubMed, EMBASE, Web of Science, and Cochrane Library) to find published papers on the topic. The R program was used for data synthesis and statistical heterogeneity evaluation; then, fixed effect or random effect models were used. A total of 37 studies, involving 12 408 patients with 12 668 flaps, were included in this meta-analysis. The overall flap success rate for all studies was 94.4%. Pooled analysis showed that patients with preoperative XRT were significantly associated with an increased risk of total flap failure (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.45-2.23, P < .001), partial flap failure (OR = 1.90, 95% CI = 1.07-3.38, P = .029), and postoperative complication rates (OR = 2.22, 95% CI = 1.64-2.72, P < .001). Our study suggests that preoperative XRT is associated with an increased risk of developing free-flap failure and an increased postoperative complication rate.
