Association between the HER2 Gene Status and the Efficacy of First-line Pemetrexed Combined with Platinum Chemotherapy in Patients with Advanced Lung Adenocarcinoma / 中国肺癌杂志

BACKGROUND@#Human epidermal growth factor receptor 2 (HER2) is one of the driver genes of non-small cell lung cancer (NSCLC). Several studies have shown that the efficacy of pemetrexed in HER2-mutant NSCLC is controversial. The aim of this study is to investigate the efficacy of pemetrexed combined with platinum chemotherapy in patients with HER2-mutant and HER2 wild-type lung adenocarcinoma.@*METHODS@#The clinical data of 106 cases of EGFR, ALK, ROS-1, KRAS, BRAF, RET and MET-negative patients with advanced lung adenocarcinoma patients who diagnosed by histopathology in the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed. The relationships between HER2 gene status, clinical characteristics and response and progression-free survival (PFS) were analyzed.@*RESULTS@#All of the 106 patients' HER2 status were determined. HER2 mutations occurred in 32 cases (30.2%), no mutations in 74 cases (69.8%). HER2 mutations were common in young, non-smoking and female patients. All patients received first-line pemetrexed and platinum-based chemotherapy. The objective response rate (ORR) and disease control rate (DCR) of patients with HER2-mutant lung adenocarcinoma were significantly higher than those without HER2 mutations (40.6% vs 14.9%, χ²=8.464, P=0.004; 93.8% vs 68.9%, χ²=6.327, P=0.012), and the difference was statistically significant. According to univariate analysis, the PFS was significantly associated with the brain metastases, maintenance chemotherapy and HER2 gene status (P0.05). Cox multivariate analysis indicated that HER2 mutation was an independent positive prognostic factor of PFS (P=0.038).@*CONCLUSIONS@#HER2-mutant lung adenocarcinoma patients with first-line pemetrexed combined with platinum chemotherapy have greater clinical benefit than HER2 wild-type patients.

Characteristics of Epidermal Growth Factor Receptor with Rare Mutations in Non-small Cell Lung Cancer and the Effect of EGFR Tyrosine Kinase Inhibitors on Them / 中国肺癌杂志

BACKGROUND@#Adenocarcinoma is the most common type of lung cancer. It has been clinically evaluated that therapiestargeting against the epidermal growth factor receptor (EGFR) as the clinical standard first-line treatment. The response and outcome of EGFR-tyrosine kinase inhibitors (TKIs) in patients harboring common mutations in EGFR kinase domain (deletion in exon19 and L858R in exon 21) has been well demonstrated, but not in rare or complex mutations.@*METHODS@#A total of 150 patients that harbored rare or complex mutations in EGFR diagnosed by histopathology were included in this retrospective study. The clinical-pathological characteristics of all 150 patients as well as the response and progression-free survival (PFS) in 48 patients that received EGFR-TKIs in first/second/third line treatments weredescribed and analyzed.@*RESULTS@#Patients were divided into four groups based on the mutation types: single G719X point mutation in exon 18 (n=46, 30.7%), single L861Q point mutation in exon 21 (n=45, 30.0%), other single rare mutation (n=14, 9.3%) and complex mutations (n=45, 30.0%). The result indicated thatthere was no correlation of EGFR mutation typeswith other parameters such as gender, age, clinical stage, pathology and smoking history. For the 48 patients that received EGFR-TKIs treatment, there were no significant differencesamong 4 groups in terms of objective response rate (ORR) and disease control rate (DCR) (54.5% vs 30.0% vs 0.0% vs 35.7%, χ²=3.200, P=0.34; 90.9% vs 85.0% vs 66.7% vs 92.9%, χ²=2.162, P=0.59). The median progress-free survival (mPFS) was 11.0 months (95%CI: 4.4-17.6), and in each group of different EGFR mutation types are 15.8 months (95%CI: 9.5-22.2), 8.0 months (95%CI: 5.1-11.0), 4.9 months (95%CI: 1.4-8.4) and 23.1 months (95%CI: 15.8-30.4)(χ²=7.876, P=0.049).@*CONCLUSIONS@#The efficiency of targeting EGFR-TKIs on different types of rare or complex mutations was heterogeneous. The PFS may be better in patients that harbored complex mutations than those with single rare mutations. Further studies with larger sample size are necessary. Moreover, to discover novel therapeutic targets and develop new drugs are imminentfor those patientswith no response to the existing treatments.

Clinical characteristics and prognostic analyses of 87 patients with pulmonary mucoepidermoid carcinoma / 中华肿瘤杂志

Objective@#To investigate the clinicopathological characteristics, therapy and prognosis of patients with pulmonary mucoepidermoid carcinoma.@*Methods@#The clinical data of 87 patients diagnosed as pulmonary mucoepidermoid carcinoma at The First Affiliated Hospital of Zhengzhou University from April 2011 to May 2016 were retrospectively analyzed. The clinicopathological features were summarized and the prognoses were analyzed.@*Results@#Among the 87 patients with lung mucoepidermoid carcinoma, 53 were male and 34 were female, the gender ratio between men and women was 1.56∶1.The ages of patients were from 16 to 79 years and the median age was 52.5 years. Seventeen cases were diagnosed as stage Ⅰ, 28 cases were stage Ⅱ, 26 cases were stage Ⅲ, 16 cases were stage Ⅳ.Thirty-six patients were examined by immunohistochemistry, of which 29 cases were cytokeratin (CK) 5/6 positive, 29 cases were CK7 positive, 10 cases were CK positive, 28 cases were p63 positive, 14 cases were p40 positive, 17 cases were thyroid transcription factor-1 (TTF-1) positive, 11 cases were NapsinA positive, 2 cases were epithelial membrane antigen (EMA) positive, 4 cases were CK8/18 positive, 3 cases were surfactant proteins A (SPA) positive, 1 case was CAM5.2 positive and 1 case was CK14 positive. Among the 87 patients, 34 cases were treated by operation alone, 23 cases were treated by operation combined with chemotherapy, 5 cases were treated by radiotherapy combined with chemotherapy, 14 cases were treated by chemotherapy alone, 2 cases were treated by particle implantation combined with chemotherapy, 2 cases were treated by local radiofrequency hyperthermia combined with chemotherapy, and 7 cases without special treatment.Five patients with brain metastasis were treated with cerebral radiotherapy combined with sequential chemotherapy. The 1-year, 2-year and 5-year survival rates of 87 patients were 90.7%, 81.6% and 46.3%, respectively. The median survival time was 60 months. The prognoses of patients with lung mucoepidermoid carcinoma were related with the clinical stage, smoking and operative therapy (all P<0.05).@*Conclusions@#The age distribution of patients with pulmonary mucoepidermoid is a wide range, the incidence of male is higher than that of female. The diagnosis of pulmonary mucoepidermoid carcinoma mainly relies on the morphological diagnosis and the immunohistochemical detection is non-specific. The prognoses of patients with lung mucoepidermoid carcinoma are related with clinical stage, smoking and operative therapy. For patients who are inoperable and with single distant metastasis, local radiotherapy, other local treatment and chemotherapy can significantly improve their prognoses.

Prognostic values of NLR and platelet count before and after chemotherapy in patients with advanced non-small cell lung cancer / 国际肿瘤学杂志

Objective To investigate the prognostic values of neutrophil to lymphocyte ratio (NLR) and platelet count before and after chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).Methods From October 2011 to December 2012,70 patients with advanced NSCLC in Anyang Cancer Hospital of Henan Province were collected.NLR and platelet were calculated from complete blood counts in laboratory test before and after 2 cycles of chemotherapy.The patients were divided into two groups according to the NLR and platelet count:low NLR group (≤3.43)and high NLR group (>3.43);normal group (100 ×109 /L

The impact of hepatitis B virus infection on patients outcome following resection for intrahepatic cholangiocarcinoma / 中华普通外科杂志

Objective To evaluate the impact of chronic hepatitis B virus (HBV) infection on the outcome following resection for intrahepatic cholangiocarcinoma (ICC) patients.Methods The clinicpathological data of 60 consecutive operated ICC patients were collected.These patients were divided into group A with HBV infection,represented by serum positive hepatitis B surface antigen (HBsAg),group B with hepatitis B surface antibody (HBsAb) positive,and group C with all serum marker of HBV negative.The overall survival rate was evaluated.Results The 1-and 3-year overall survival rate and median survival of three groups were 50％ vs 53％ vs 29％ ; 22％ vs 18％ vs O; and 12.0 m vs 12.0 m vs 6 m,respectively.The difference was statistically significant(P =0.037).Multivariate analyses revealed that the preoperative serum level of TIBL,tumor location,HBV infection or injection of hepatitis B vaccine,hepatolithiasis and adjuvant chemotherapy were related to the prognosis.Conclusions HBV infection or injection of hepatitis B vaccine is favorable independent factor for prognosis of patients with intrahepatic cholangiocarcinoma after resection.

Pathology of primary neuroectodermal tumor and its prognostic factors:A report of 35 cases / 第三军医大学学报

Objective To study the pathology of primary neuroectodermal tumor (PNET),and its diagnostic standards and prognostic factors.Methods Expression of CD99,FLI-1,Syn,NSE,S-100,NF,and Vim was detected in PNET tissues stained with HE and immmunohistochemistry (En Vision method).Survival rate of 33 PNET patients with complete clinical information was analyzed with COX regression analysis method.Results The positive expression rate of CD99,FLI-1,Vim,Syn,NSE and s-100 was 88.57%,51.43%,91.42%,48.57%,45.71%,and 22.86%,respectively.The sensitivity of combined CD99 and FLI-1 was 100%.However,NF was not expressed in all PNET tissues.When other factors were unchanged,no difference was found in the effect of age on the survival rate of patients.However,a significant difference was observed in the effect of PNET site and its treatment modalities on the survival rate of patients (P