Lung adenocarcinoma stem cell phenotypes and their correlation with patient prognosis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the cancer stem cells and to evaluate their prognostic implication in patients with lung adenocarcinoma.</p><p><b>METHODS</b>Three phenotypic markers of cancer stem cells (SP-C, CCSP and OCT4) in lung adenocarcinoma were detected by immunofluorecence staining. The correlation among the clinicopathological parameters and phenotypes of cancer stem cells as well as survival were analyzed by Cox proportional hazard method.</p><p><b>RESULTS</b>Of the 57 cases, cancer stem cells were detected in 52, including OCT4(+) bronchioloalveolar stem cell (BASC) phenotype (SP-C(+) CCSP(+) OCT4(+)) in 40 cases and OCT4(-) BASC phenotype (SP-C(+) CCSP(+) OCT4(-)) in 12 cases. Statistical analysis revealed that the phenotype of cancer stem cells was related with the cellular differentiation, i.e. the OCT4(+) BASC phenotype occurred more frequently in the well-differentiated tumors, while the OCT4(-) BASC phenotype usually presented in most of the poorly-differentiated ones. Cox analysis showed that the OCT4(+) BASC phenotype was one of prognostic factors.</p><p><b>CONCLUSION</b>The lung adenocarcinoma stem cells have phenotypic features of bronchioalveolar stem cells (SP-C(+) CCSP(+)). The expression of self-renewal regulatory gene OCT4 in these cells indicates an aggressive nature and unfavorable prognosis.</p>

Epidermal growth factor receptor mutation in serum circulating DNA and selective targeting therapy against lung cancer / 肿瘤

Objective: To detect somatic mutations in epidermial growth factor receptor (EGFR) in the serum circulating DNA, screen the EGFR-mutated lung cancer patients, and evaluate the clinical effects of the genetically targeted drug gefitinib. Methods: DNA was extracted from the serum specimens of patients and amplified by PCR. The EGFR mutations in PCR product were detected by direct sequence analysis. Results: Somatic mutations of EGFR were identified in serum from 46 of the 116 cases (39.7%), including 30 cases (65.2%) in exon 19 and 16 cases (34.8%) in exon 21. Female patients and those patients with adenocarcinoma (including adenosquamous carcinoma) had an increased frequency of mutations. Further analysis on 20 lung cancer patients demonstrated that the EGFR mutation in serum was consistant with that detected in tumor tissues, suggesting that the EGFR mutations in serum originated from the primary tumor. Based on the screening assay, 19 patients with EGFR mutations who failed prior chemotherapy were treated with gefitinib. The response rate was 52.6% and the disease-controlling rate was 89.5%. The median progression-free survival time was 8 months, the median overall survival time was 12 months, and 2-year survival rate was 33.3%. Conclusions: The EGFR mutations in serum circulating DNA are consistant with the mutation in lung cancer tissue. Gefitinib treatment has significant effects on the advanced lung cancer based on the screening results of EGFR mutation.

Analysis of EGFR mutations in 176 cases of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the incidence and profile of mutations in epidermal growth factor receptor (EGFR) in Chinese patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 176 cases of NSCLC tissue was enrolled in this study, among which 123 normal lung samples were also included. The tissue DNA was extracted and the EGFR gene in exon 19 to 21 was subjected for PCR amplification and direct sequencing.</p><p><b>RESULTS</b>The EGFR gene in exon 19-21 was of wild type in all normal lung tissues detected. Mutations were found in 57 cases of 176 lung cancer samples, with an incidence of 32. 4%. Mutations were mainly detected in the exon 19 (37/57 cases, 64. 9% ) and exon 21 (18/57 cases, 31. 6% ) , while that in the exon 20 was rare (2/57 cases, 3. 5% ). There were 7 types of EGFR mutation in the exon 19, resulting in the deletion of codon 746 to 753. A missense mutation was detected in exon 20, dealing with codon 789 to 793. The mutation in exon 21 belonged to the single missense substitution in codon 858. The EGFR mutations were more frequent in female patients than male ones, in adenocarcinoma and adenosquamous cell carcinoma versus cancer of other histologies.</p><p><b>CONCLUSION</b>EGFR mutation is a tumor-specific somatic abnormality. Some one third of Chinese NSCLC tumors harbor EGFR mutations, especially in exons 19 and 21. These mutations are more frequently detected in female, adenocarcinoma and adenosquamous cell carcinoma.</p>

Implication of micrometastatic cancer cells in the peripheral blood on prognosis of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the relationship of micrometastatic cancer cells in the blood and prognosis of patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Blood samples were collected from peripheral vein perioperatively and from the pulmonary vein intraoperatively in NSCLC patients. Cancer cells were detected by flow cytometry, as described previously. The patients were followed up and analyzed statistically.</p><p><b>RESULTS</b>Cancer cells in blood samples were detected in 20 of 58 patients (34.5%). Patients under 57 years of age or with stage III/IV lesions had higher positive findings than those over 57 years or with stage I/II lesions (P = 0.000 and 0.006, respectively). On the basis of 40 month follow-up data, the 2- and 3-year survival rates of patients with positive and negative results were 30.0% vs 20.0%, and 52.6% vs 50.0%, respectively. There was significant difference between the overall survival curves which favored patients with negative findings (P = 0.0291 and 0.0092, respectively).</p><p><b>CONCLUSION</b>This study indicates that cancer cells can be detected in the blood perioperatively from NSCLC patients which means poor prognosis.</p>