Primary tumor location in lung cancer: the evaluation and administration.

ABSTRACT: Lung cancer continues to be the leading cause of cancer-related death in the world, which is classically subgrouped into two major histological types: Non-small cell lung cancer (NSCLC) (85% of patients) and small-cell lung cancer (SCLC) (15%). Tumor location has been reported to be associated with the prognosis of various solid tumors. Several types of cancer often occur in a specific region and are more prone to spread to predilection locations, including colorectal cancer, prostate cancer, gastric cancer, ovarian cancer, cervical cancer, bladder cancer, lung tumor, and so on. Besides, tumor location is also considered as a risk factor for lung neoplasm with chronic obstructive pulmonary disease/emphysema. Additionally, the primary lung cancer location is associated with specific lymph node metastasis. And the recent analysis has shown that the primary location may affect metastasis pattern in metastatic NSCLC based on a large population. Numerous studies have enrolled the "location" factor in the risk model. Anatomy location and lobe-specific location are both important in prognosis. Therefore, it is important for us to clarify the characteristics about tumor location according to various definitions. However, the inconsistent definitions about tumor location among different articles are controversial. It is also a significant guidance in multimode therapy in the present time. In this review, we mainly aim to provide a new insight about tumor location, including anatomy, clinicopathology, and prognosis in patients with lung neoplasm.

The distribution of SIgA and IgG antibody-secreting cells in the palatine tonsils of Bactrian camels (Camelus bactrianus) of different ages.

Secretory immunoglobulin A (SIgA) antibody-secreting cells (ASCs) are the major effector cells of mucosal immunity, and immunoglobulin G (IgG) ASCs are also associated with mucosal immunity. This study aimed to explore the distribution of these 2 ASC populations in the palatine tonsils of Bactrian camels of different ages. Eighteen Bactrian camels were divided into the following three age groups: pubertal (3-5 years), middle-aged (6-16 years) and old (17-20 years). SIgA and IgG ASCs within different sites of the palatine tonsils were observed through histological and immunohistochemical techniques, and their densities were analyzed using statistical methods. The results from all age groups showed that both the SIgA and IgG ASCs were primarily distributed in the subepithelial compartments of the reticulated crypt epithelium and secondarily distributed in the subepithelial compartments of the stratified surface squamous epithelium, with a few ASCs located in the extrafollicular region. Their densities in these three areas were significantly decreased in turn (P<0.05). However, the densities of SIgA ASCs were significantly higher than IgG ASCs in the same regions (P<0.05), and the densities of both ASC populations decreased with age. The results confirmed that Bactrian camel palatine tonsils are the primary mucosal immune organ producing SIgA ASCs, and the subepithelial compartment of the reticulated crypt epithelium is the primary region for the colonization and functional activity of SIgA and IgG ASCs.

Sequential Serum Let-7 Is a Novel Biomarker to Predict Accelerated Reproliferation During Fractional Radiotherapy in Lung Cancer.

BACKGROUND: Accelerated reproliferation, usually deemed to occur late during the course of radiation therapy, is an important factor resulting in radiotherapy failure. The identification of strategies that accurately reflect accelerated reproliferation might help to determine radiotherapy strategy, and thus implementation of individualized treatment. PATIENTS AND METHODS: Patients with lung cancer were enrolled from Shandong Cancer Hospital and Institute in China between March 2014 and March 2015. Tumor tissue and sequential peripheral blood samples were obtained before treatment and during radiotherapy to detect Ki-67 and let-7 expression. RESULTS: We found a strong correlation between serum let-7 and tissue Ki-67 before treatment (r = -0.773; P = .003). Patients with a high level of baseline serum let-7 expression level had significantly better overall survival (the overall survival were 100% and 27.3%, respectively; P = .024). For patients with a relatively low expression level of baseline serum let-7, there was a peak of expression levels at week 4 (the mean expression levels were 1.40, 5.01, and 1.36, respectively). However, for patients with relatively high expression levels of baseline serum let-7, the expression levels were constantly downregulated at week 4 and 6 compared with the original (the mean expression levels were 6.16 vs. 1.34 vs. 0.80, respectively). CONCLUSION: The study showed that serum let-7 expression level could reflect the proliferation of tumor tissue reliably in patients with lung cancer. Furthermore, the study might change conventional views of accelerated reproliferation. We showed that initial accelerated proliferation exists in patients with a relatively slow proliferation rate before radiotherapy, and late course accelerated reproliferation exists in patients with relatively fast proliferation before radiotherapy.

Therapeutic value of transcatheter arterial chemoembolization combined with portal vein embolization for primary hepatocellular carcinoma with portal vein tumor thrombus: a pilot study.

AIM: To compare clinical outcome and safety of transcatheter arterial chemoembolization (TACE) + portal vein embolization (PVE) with TACE alone in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). METHODS: We retrospectively collected patients of HCC with PVTT treated with TACE (5-FU, oxaliplatin and mitomycin) or TACE + PVE (doxorubicin) between October 2000 and July 2008. Outcomes evaluated include overall survival, response to treatment and side effects. RESULTS: One hundred and sixteen patients were assessed. The median follow-up of TACE group and TACE + PVE group was 83 and 85 months, respectively. The tumor response rates were respectively 48/64 and 49/52. The 1-, 3- and 5-year overall survival rates for the TACE and TACE + PVE groups were 39/64, 16/64, 0/64 and 42/52, 19/52, 6/52 respectively (P = 0.015, 0.046 and 0.002, respectively). Three factors were shown as the risk factors which affect the survival of patients: treated by TACE + PVE or TACE; type of PVTT; and absence of cirrhosis. CONCLUSION: TACE + PVE may be better than TACE alone to treat primary HCC with PVTT.

CXCR4 Signaling Induced Epithelial-Mesenchymal Transition by PI3K/AKT and ERK Pathways in Glioblastoma.

Stromal cell-derived factor 1 (SDF-1) and its receptor, CXCR4, play an important role in tumor progression. Epithelial-mesenchymal transition (EMT) process is linked to disease pathophysiology. This study aimed to investigate the roles and underlying mechanisms of SDF-1/CXCR4 axis in EMT process of glioblastoma. In the present study, CXCR4 activation and inhibition in U87 were induced with exogenous SDF-1 and with CXCR4 small interfering RNA (siRNA), respectively. CXCR4 downstream signal molecules AKT, ERK, and EMT biomarkers (vementin, snail, N-cadherin, and E-cadherin) were tested using the Western blot. Our results showed that SDF-1 can induce AKT and ERK phosphorylation in a dose-dependent manner, and endogenous CXCR4 can be blocked thoroughly by CXCR4 siRNA in U87. Notably SDF-1 alone treatment can induce the upregulation of vementin, snail, and N-cadherin of U87; besides, the downregulation of E-cadherin also occurred. On the contrary, CXCR4 siRNA significantly prohibited SDF-1-induced AKT and ERK phosphorylation, at the same time, EMT biomarker changes were not observed. Function analysis revealed that CXCR4 siRNA obviously interfered with U87 cell migration and proliferation, according to wound healing assay. In conclusion, this study suggested that EMT process can be triggered by the SDF-1/CXCR4 axis in glioblastoma, and then involved in the tumor cell invasion and proliferation via activation of PI3K/AKT and ERK pathway. Our study lays a new foundation for the treatment of glioblastoma through antagonizing CXCR4.

The histological characteristics of the aggregated lymphoid nodules area in abomasum of Bactrian camels (Camelus bactrianus) of different ages.

The aggregated lymphoid nodules area (ALNA) in abomasum of Bactrian camels is a special immune structure discovered only in Bactrian camels in recent years (2003). The anatomy research found that there was a close relationship between degree of development, anatomical characteristics and age. To further establish the relationship between histological characteristics of this special structure and animal age, 24 Alashan Bactrian camels of the following four age groups were studied: young (1-2 years), pubertal (3-5 years), middle-aged (6-16 years) and old (17-20 years). Mucosal-associated lymphoid tissue (MALT) of ALNA in abomasum was particularly observed and analyzed by histology, histochemistry and statistical methods. The results showed that the average number of lymphoid nodules in reticular mucosal folds region of ALNA in abomasum from young group to old group was in order of 26.8, 32.7, 17.6 and 7.8, and in longitudinal mucosal folds region was 20.1, 26.0, 10.3 and 5.1. The number of lymphoid nodules in the four experimental groups first increased and then decreased with increasing age (P<0.01). In young and pubertal camels lymphoid nodules were distributed evenly on both sides of the axis of mucosal folds and mostly displayed round, oval or wedge shape. The number of lymphoid nodules, follicle-associated epithelium (FAE), reticular fibers and plasmocytes in mucosal folds gradually increased from 1 to 2 years and peaked at puberty. There were up to 37 visible lymphoid nodules in a mucosal fold. However, ALNA of middle-aged and old camels gradually degenerated as aging. Lymphoid nodules were unevenly distributed on both sides of the axis of mucosal folds, which mostly displayed oval or irregular shape. Lymphoid tissue in old camels mostly existed as diffuse form. Although germinal centers of the lymphoid nodules were still obvious, the number of reticular fiber and plasmocyte and lymphoid nodules gradually decreased. The results indicated that in accord with the anatomical results, there was a close relationship between histology characteristics of lymphoid tissue of ALNA in abomasum and animal age. In summary, the lymphoid tissue of ALNA in abomasums gradually increased from young to pubertal groups with increasing age, peaked in 3-5 year-old camels, and subsequently declined with age and when 17-20 years old this immunity structure had severely atrophied.