Knockdown of PTEN promotes colon cancer progression and induces M2 macrophage polarization in the colon cancer cell environment

Objective: This article aims to study the effect of phosphate and tension homolog deleted on chromosome ten (PTEN) knockdown on colon cancer progression and macrophage polarization in the cancer environment. Materials and Methods and Results: The expression of PTEN in colon cancer tissues and colon cancer cells was significantly lower than in precancerous tissues or CCD-18Co cells, and the decrease was most evident in SW620 cells. The expressions of phosphate (p)-p38, c-Jun N-terminal kinase (JNK), activator protein 1 (AP-1), B-cell lymphoma-2 (Bcl-2) protein in colon cancer tissues and cells were significantly higher than in precancerous tissues or CCD-18Co cells (P-values < 0.05). Bcl-2-associated X (Bax) and Caspase-3 expressions in colon cancer tissues and cells were significantly lower than in precancerous tissues or CCD-18Co cells (P-values < 0.05). 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) was applied to measure cell viability. Transwell evaluated the cell migration and invasion ability. Si-PTEN improved the proliferation, migration, and invasion of SW620 cells (P-values < 0.05). The expression levels of arginase-1 (Arg-1), CD163, CD206 in colon cancer tissues were significantly higher than in precancerous tissues (P-values < 0.05). The cell cycle, the number of M1 and M2 double-positive cells were assessed by flow cytometry. Si-PTEN reduced the expression of tumor necrosis factor-alpha (TNF-?), interleukin-1beta (IL-1?), and inducible nitric oxide synthase (iNOS), which upregulated the expression of Arg-1, CD206, CD163, p-p38, JNK, and AP-1 (P-values < 0.05). Conclusion: Si-PTEN promoted colon cancer progression and induced the polarization of M2 tumor-associated macrophages in the colon cancer cell environment.

Interleukin-27 augments the inhibitory effects of sorafenib on bladder cancer cells

Both sorafenib and interleukin-27 (IL-27) are antineoplastic drugs. This study aimed to investigate the synergistic effect of these two drugs on bladder cancer cells. HTB-9 and T24 cells were stimulated with IL-27 (50 ng/mL), sorafenib (2 μM) or the synergistic action of these two drugs. The cells without treatment acted as control. Cell proliferation, apoptosis and invasion were measured by bromodeoxyuridine assay, flow cytometry and modified Boyden chamber, respectively. Simultaneously, both modified Boyden chamber and scratch assay were used to assess cell migration. Finally, the phosphorylation levels of key kinases in the Akt/mechanistic target of rapamycin (mTOR)/mitogen-activated protein kinase (MAPK) pathway, and expression levels of matrix metalloproteinase (MMP)-2 and MMP-9 were detected by western blot analysis. Stimulation with IL-27 or sorafenib repressed proliferation, migration and invasion but promoted apoptosis, and the effects were all enhanced by the combination of these two drugs in HTB-9 cells. The effect of the combined treatment on bladder cancer cells was verified in T24 cells. Additionally, the phosphorylation levels of AKT, mTOR and MAPK as well as the expression levels of MMP-2 and MMP-9 were all decreased by a single treatment of IL-27 or sorafenib, and further decreased by the combined treatment of these two drugs. The combination of IL-27 and sorafenib inhibited proliferation, migration and invasion and promoted apoptosis of bladder cancer cells compared with mono-drug treatment. Additionally, the AKT/mTOR/MAPK pathway might be implicated in the functional effects by down-regulations of MMP-2 and MMP-9.

Artificial pneumothorax for pain relief during microwave ablation of subpleural lung tumors.

BACKGROUND: When microwave ablation (MWA) is used for subpleural lesions, severe pain was the common side effect under the local anesthesia conditions during the procedure and postprocedure. To study the pain relief effect of artificial pneumothorax in the treatment of subpleural lung tumors with MWA. MATERIALS AND METHODS: From February 2012 to October 2014, 37 patients with 40 subpleural lung tumors underwent MWA, including 17 patients of 19 sessions given artificial pneumothorax prior to MWA (group‑I), and 20 patients of 21 sessions without artificial pneumothorax (group‑II). Patient’s pain assessment scores (10‑point visual analog scale [VAS]) at during‑procedure, 6, 12, 24, and 48 h after the MWA procedure and mean 24 h morphine dose were compared between the two groups. Complications of the artificial pneumothorax were also summarized. RESULTS: Pain VAS were 0.53, 0.65, 1.00, 0.24, and 0.18 at during‑procedure, 6, 12, 24, and 48 h for group‑I and 5.53, 2.32, 2.82, 1.21, and 0.21 for group‑II, respectively. Pain VAS in group I was significantly decreased at during‑procedure, 6, 12, and 24 h after the MWA (P < 0.001). No statistical pain VAS difference was observed at 48 h after the MWA between the two groups (P > 0.05). The mean 24 h morphine dose was 5.00 mg in group‑I and 12.63 mg in group‑II (P = 0.000). “Artificial pneumothorax” related complications occurred in two patients from group‑I, including one pleural effusion and one minor hemoptysis. No patient in group‑I and group‑II died during the procedure or in 30 days after MWA. CONCLUSION: Artificial pneumothorax is a safe and effective method for pain relief during MWA of subpleural lung tumors.

Microwave ablation as palliative treatment of locally recurrent colorectal cancer.

BACKGROUND: Patients suffering local recurrence of colorectal cancer which cannot be surgically removed are troubled with severe pain and poor quality of life. The aim of this study is to evaluate the efficacy and safety of computed tomography (CT)‑guided microwave ablation (MWA) as palliative treatment for recurrent unresectable colorectal cancer. MATERIALS AND METHODS: Thirty‑one patients were suffering locally recurrent colorectal cancer underwent MWA with CT guidance. The MWA power was set at 60–80 W, 6–8 min. Effectiveness was evaluated by visual analog scale (VAS) with a follow‑up of 6‑month. Complications were also recorded. RESULTS: Technical success was achieved in all patients. Mean VAS preprocedure was 7.10. Mean VAS postprocedure were as follows: 1 week, 2.65 (P < 0.001); 1 month, 0.81 (P < 0.001); 3 months 0.45 (P < 0.001); and 6 months 0.19 (P < 0.001). No serious complications were observed including intestinal fistulas, bladder fistulas, or peripheral vascular or nerve injury. CONCLUSIONS: CT‑guided MWA as treatment of recurrent colorectal cancer can quickly and effectively relieve pain. It is a minimally invasive, safe, and efficient palliative treatment of recurrent colorectal cancer.

Computed tomography‑guided percutaneous microwave ablation of patients 75 years of age and older with early‑stage nonsmall cell lung cancer.

BACKGROUND: We aimed to assess the clinical outcome of computed tomography (CT)‑guided percutaneous microwave ablation (MWA) in patients 75 years of age and older with early stage peripheral nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS: Twenty‑eight patients, aged ≥75 years, with Stage I and lymph node‑negative IIa peripheral NSCLC underwent CT‑guided percutaneous MWA in our hospital between July 2007 and March 2015. The overall 1‑, 2‑, 3‑, and 4‑year survival rates were estimated using Kaplan–Meier analysis. Adverse events were recorded. RESULTS: The median follow‑up time was 22.5 months. The overall median survival time (MST) was 35 months (95% confidence interval [CI] 22.3–47.7 months), and the cancer‑specific MST was 41.9 months (95% CI 38.8–49.9 months). The 1‑, 2‑, 3‑, and 4‑year overall survival rates were 91.7%, 76.5%, 47.9%, and 47.9%, while the cancer‑specific survival rates were 94.7%, 73.9%, 64.7%, and 64.7%, respectively. Median time to local progression was 28.0 months (95% CI 17.7–38.3 months). Major complications were included pneumothorax (21.4%, requiring drainage), pleural effusions (3.6%, requiring drainage), and pulmonary infection (3.6%). CONCLUSIONS: CT‑guided percutaneous MWA is safe and effective for the treatment of patients 75 years of age and older with medically inoperable early stage peripheral NSCLC.

Bronchopleural fistula after lung ablation: Experience in two cases and literature review.

BACKGROUND: Bronchopleural fistula (BPF) complicating lung tumor ablation is rare but severe. The purpose of this article was to study its characteristics and treatments. MATERIALS AND METHODS: Two of 682 (0.3%) sessions of lung microwave ablation (MWA) were complicated with BPF and documented. Two electronic databases were searched for reported cases of BPF after lung tumor ablation. Case selection and data collection were done by 3 independent reviewers. RESULTS: A 56‑year‑old man and a 61‑year‑old woman developed BPF after MWA and died. Thirteen cases (mean age 63.8, 61.5% male) of BPF with adequate information were identified from 8 articles. Of the 13 cases, 5 (38.5%) had pulmonary co‑morbidity, 3 (23.1%) had a history of pulmonary surgery, 7 (53.8%) had a target tumor adjacent or abutting pulmonary pleura, and 6 (46.2%) developed severe infections. After chest tube placement, pleurodesis, endoscopic therapy, surgery, and other treatments, 12 were cured and 1 died of BPF and pneumonia. CONCLUSION: BPF is a rare but severe complication of lung ablation, and the management needs a multidisciplinary and individualized treatment strategy.