[Comparison of Quality of Life of the Patients Three Months after Uniportal 
and Multiportal Thoracoscopic Lobectomy].

BACKGROUND: The relationship between quality of life at three months after lung cancer surgery and different surgical approaches is remains unclear. This study aimed to compare the quality of life of patients three months after uniportal and multiportal thoracoscopic lobectomy. METHODS: Data from patients who underwent lung surgery at the Department of Thoracic Surgery, Sichuan Cancer Hospital between April 2021 and October 2021 were collected. The European Organization for Research and Treatment of Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Lung Cancer 29 (EORTC QLQ-LC29) were used to collect quality of life data of the patients. Potential confounding factors in the baseline data were included in a multivariate regression model for adjustment, and the quality of life of the two groups three months postoperatively was compared with traditional clinical outcomes. RESULTS: A total of 130 lung cancer patients were included, with 57 males (43.8%) and 73 females (56.2%), and an average age of (57.1±9.5) yr. In the baseline data of the two groups, there was a statistical difference in the number of chest drainage tubes placed (P<0.001). After adjustment with the regression model, at three months postoperatively, there were no significant differences in all symptoms and functional status scores between the two groups (all P>0.05). The multiportal group had longer surgery time (120.0 min vs 85.0 min, P=0.001), postoperative hospital stay (6.0 d vs 4.0 d, P=0.020), and a higher incidence of early ≥ grade 2 complications (39.0% vs 10.1%, P=0.011) compared to the uniportal group. CONCLUSIONS: Patients undergoing uniportal and multiportal thoracoscopic lobectomy have similar quality of life at three months postoperatively. The uniportal group may have certain advantages in terms of traditional clinical outcome indicators such as operation time, postoperative hospital stay, and early postoperative complications.

CircRNA ZKSCAN1 promotes lung adenocarcinoma progression by miR-185-5p/TAGLN2 axis.

BACKGROUND: Circ-ZKSCAN1 has been found to accelerate non-small cell lung cancer (NSCLC) progression; however, the role and mechanism of circ-ZKSCAN1 in lung adenocarcinoma (LUAD) cisplatin (DDP) resistance remain unclear. METHODS: Levels of genes and proteins were examined using qRT-PCR. Functional experiments were performed using CCK-8 assay, flow cytometry, transwell assay and xenograft model assay, respectively. Glucose metabolism was calculated by detecting glucose consumption, lactate production, ATP and HK-2 levels. The interaction between miR-185-5p and circ-ZKSCAN1 or transgelin 2 (TAGLN2) was validated by dual-luciferase reporter assay. RESULTS: Circ-ZKSCAN1 was highly expressed in DDP-resistant LUAD tissues and cell lines, and circ-ZKSCAN1 knockdown weakened DDP resistance and suppressed cell viability, migration, invasion, and glycolysis in LUAD. Circ-ZKSCAN1 acted as a sponge of miR-185-5p, and the regulatory effects of circ-ZKSCAN1 knockdown on LUAD were reversed by miR-185-5p downregulation. Meanwhile, miR-185-5p directly targeted TAGLN2, and performed anticancer effects by regulating TAGLN2. Importantly, silencing of circ-ZKSCAN1 hindered tumor growth and promoted DDP sensitivity in vivo via regulating miR-185-5p and TAGLN2. CONCLUSION: Circ-ZKSCAN1 promoted LUAD tumorigenesis and DDP resistance by regulating miR-185-5p/TAGLN2 axis.

The number and microlocalization of tumor-associated immune cells are associated with patient's survival time in non-small cell lung cancer.

BACKGROUND: Tumor microenvironment is composed of tumor cells, fibroblasts, endothelial cells, and infiltrating immune cells. Tumor-associated immune cells may inhibit or promote tumor growth and progression. This study was conducted to determine whether the number and microlocalization of macrophages, mature dendritic cells and cytotoxic T cells in non-small cell lung cancer are associated with patient's survival time. METHODS: Ninety-nine patients with non-small cell lung cancer (NSCLC) were included in this retrospective study. Paraffin-embedded NSCLC specimens and their clinicopathological data including up to 8-year follow-up information were used. Immunohistochemical staining for CD68 (marker for macrophages), CD83 (marker for mature dendritic cells), and CD8 (marker for cytotoxic T cells) was performed and evaluated in a blinded fashion. The numbers of immune cells in tumor islets and stroma, tumor islets, or tumor stroma were counted under a microscope. Correlation of the cell numbers and patient's survival time was analyzed using the Statistical Package for the Social Sciences (version 13.0). RESULTS: The numbers of macrophages, mature dendritic cells and cytotoxic T cells were significantly more in the tumor stroma than in the tumor islets. The number of macrophages in the tumor islets was positively associated with patient's survival time, whereas the number of macrophages in the tumor stroma was negatively associated with patient's survival time in both univariate and multivariate analyses. The number of mature dendritic cells in the tumor islets and stroma, tumor islets only, or tumor stroma only was positively associated with patient's survival time in a univariate analysis but not in a multivariate analysis. The number of cytotoxic T cells in the tumor islets and stroma was positively associated with patient's survival time in a univariate analysis but not in a multivariate analysis. The number of cytotoxic T cells in the tumor islets only or stroma only was not associated with patient's survival time. CONCLUSIONS: The number of macrophages in the tumor islets or stroma is an independent predictor of survival time in NSCLC patients. Counting macrophages in the tumor islets or stroma is more useful in predicting patient's survival time than counting mature dendritic cells or cytotoxic T cells.

The M1 form of tumor-associated macrophages in non-small cell lung cancer is positively associated with survival time.

BACKGROUND: Tumor-associated macrophages (TAMs) play an important role in growth, progression and metastasis of tumors. In non-small cell lung cancer (NSCLC), TAMs' anti-tumor or pro-tumor role is not determined. Macrophages are polarized into M1 (with anti-tumor function) and M2 (with pro-tumor function) forms. This study was conducted to determine whether the M1 and M2 macrophage densities in NSCLC are associated with patient's survival time. METHODS: Fifty patients with an average of 1-year survival (short survival group) and 50 patients with an average of 5-year survival (long survival group) were included in this retrospective study. Paraffin-embedded NSCLC specimens and their clinicopathological data including up to 8-year follow-up information were used. Immunohistochemical double-staining of CD68/HLA-DR (markers for M1 macrophages) and CD68/CD163 (markers for M2 macrophages) was performed and evaluated in a blinded fashion. The M1 and M2 macrophage densities in the tumor islets, stroma, or islets and stroma were determined using computer-aided microscopy. Correlation of the macrophage densities and patient's survival time was analyzed using the Statistical Package for the Social Sciences. RESULTS: Approximately 70% of TAMs were M2 macrophages and the remaining 30% were M1 macrophages in NSCLC. The M2 macrophage densities (approximately 78 to 113 per mm2) in the tumor islets, stroma, or islets and stroma were not significantly different between the long survival and short survival groups. The M1 macrophage densities in the tumor islets (approximately 70/mm2) and stroma (approximately 34/mm2) of the long survival group were significantly higher than the M1 macrophage densities in the tumor islets (approximately 7/mm2) and stroma (13/mm2) of the short survival group (P < 0.001 and P < 0.05, respectively). The M2 macrophage densities were not associated with patient's survival time. The M1 macrophage densities in the tumor islets, stroma, or islets and stroma were positively associated with patient's survival time in a univariate analysis (P < 0.01 or 0.001). In a multivariate Cox proportional hazards analysis, the M1 macrophage density in the tumor islets was an independent predictor of patient's survival time. CONCLUSIONS: The M1 macrophage density in the tumor islets is an independent predictor of survival time in NSCLC patients.

[Expression and their significance of ezrin and E-cadherin in non-small cell lung cancer].

BACKGROUND: It has been proven that ezrin protein may interact with E-cadherin protein and take part in metastasis of tumors. The aim of this study is to detect the expression of ezrin and E-cadherin and their significance in non-small cell lung cancer (NSCLC) with tissue microarray technique. METHODS: Ezrin and E-cadherin proteins were detected in 25 cases of benign pulmonary tissues, 287 cases of NSCLC tissues and 120 cases of metastatic lymph nodes by LSAB method of immunohistochemical staining. All patients were followed up. RESULTS: The overexpression rate of ezrin in primary NSCLC tissues and metastatic lymph nodes was 57.8% and 83.3% respectively (P=0.000). The abnormal expression rate of E-cadherin in primary NSCLC tissues and metastatic lymph nodes was 82.6% and 98.3% respectively (P=0.000). The overexpression rate of ezrin was significantly related to grading (P=0.005) and metastasis (P=0.032). The abnormal expression rate of E-cadherin was closely related to grading (P=0.024), metastasis (P=0.015) and TNM stages (P=0.037). There was a negative correlation between expression of ezrin and E-cadherin (P=0.029). Grading, metastasis of NSCLC, TNM stages, overexpression of ezrin and abnormal expression of E-cadherin were independent prognostic factors of NSCLC (P < 0.05). CONCLUSIONS: Overexpression of ezrin and abnormal expression of E-cadherin may promote tumor metastasis. Ezrin and E-cadherin may be useful prognostic markers for patients with advanced NSCLC.