Enumeration and Molecular Characterization of Circulating Tumor Cell Using an Epithelial Cell Adhesion Molecule/Vimentin/Epidermal Growth Factor Receptor Joint Capture System in Lung Cancer.

Background: Detection rate and isolation yield of circulating tumor cells (CTCs) are low in lung cancer with approaches due to CTC invasiveness and heterogeneity. In this study, on the basis of the epithelial cell adhesion molecule (EpCAM) phenotype, markers of vimentin and epidermal growth factor receptor (EGFR) phenotype were added to jointly construct a precise and efficient CTC capture system for capture of lung cancer CTCs. Methods: A CTC capture system combined with EpCAM lipid magnetic bead (Ep-LMB)/vimentin lipid magnetic bead (Vi-LMB)/EGFR lipid magnetic bead (EG-LMB) was constructed, and its performance was tested. The amount of CTC captured in the blood of patients with lung cancer was detected by immunofluorescence identification and analyzed for clinical relevance. Results: The constructed CTC capture system has low cytotoxicity. The capture efficiency of lung cancer cells in phosphate belanced solution (PBS) system was 95.48%. The capture efficiency in the blood simulation system is 94.55%. The average number of CTCs in the blood of patients with lung cancer was 9.73/2 mL. The quantity distribution of CTCs is significantly correlated with tumor staging and metastasis. The area under the curve (AUC) of CTCs for the diagnosis of lung cancer was 0.9994 (95% CI = 0.9981-1.000, P < .0001). The cutoff value was 4.5/2 mL. The sensitivity was 99.39%, and the specificity was 96.88%. Conclusion: The EpCAM/vimentin/EGFR combined capture system has feasibility and high sensitivity in the detection of lung cancer CTC typing, which can be used as an auxiliary diagnostic indicator for lung cancer and is expected to promote the clinical application of CTCs.

A targeted siRNA-loaded PDL1-exosome and functional evaluation against lung cancer.

BACKGROUND: As an endocytic nanosicle involved in intercellular communication, an exosome can efficiently deliver drugs from one cell to another and deliver therapeutic short interfering RNA (siRNA) to target cells. This is conducive to gene therapy for cancers. In this study, an exosome was used as the siRNA-loaded substrate to prepare a targeted siRNA-loaded PD-L1 exosome and evaluate its function against lung cancer. METHODS: The optimal preparation process and binding ratio of the targeted nanovesicle/siRNA complex was determined by detecting the particle size, potential, and other physical parameters in combination with cell binding and uptake capacity of exosome complexes. The biological cell behavior of targeted exosome nanosicles was evaluated through cytotoxicity, apoptosis, and the cell uptake capacity. RESULTS: A targeted exosome nanovesicle capable of loading siRNA and characterized with low toxicity, high loading rate, and the ability to be used for targeted tumor cell gene therapy was constructed. CONCLUSION: The PD-L1 targeting exosome can be used as an efficient siRNA delivery carrier, which is an efficient and safe nanocarrier for tumor targeted gene therapy.

Survival outcomes for patients with four treatments in stages I-III esophageal squamous cell carcinoma: a SEER analysis.

BACKGROUND: Esophageal cancer (EC) is globally acknowledged as one of the most common malignancies among all gastrointestinal cancers. Furthermore, in Eastern Asia, squamous cell carcinoma is the main pathological type of EC. There are different treatments for esophageal squamous cell carcinoma (ESCC), but there is still a lack of large-sample analysis of prognosis among different treatments, especially for different tumor stages. The analysis of the prognosis of ESCC patients with different treatments may be helpful to choose the treatment methods for different stages ESCC. METHODS: A total of 3,346 patients with pathological ESCC between 1976 and 2016 were derived from the Surveillance, Epidemiology, and End Results (SEER) database. All clinical factors associated with prognosis were collected and analyzed to achieve the difference of prognosis among different treatments in ESCC patients, such as ages, sex, race, tumor grade, anatomic location and so on. Kaplan-Meier and Cox proportional hazard analysis were used to compare survival of different treatments in ESCC patients with stage I-III. RESULTS: The overall survival (OS) in all ESCC patients who had received surgery and surgery plus radiation therapy or/and chemotherapy are superior than that had not received any treatments and radiation therapy or/and chemotherapy. The OS in ESCC patients with stage I who had received surgery and surgery plus radiation therapy or/and chemotherapy are superior than that had not received any treatments and radiation therapy or/and chemotherapy. The OS in ESCC patients with stage II/III who had received surgery and surgery plus radiation therapy or/and chemotherapy are superior than that in other groups. Age, race and grade as an independent predictive factor for survival (P<0.05). A nomogram model was constructed to show surgery group had better 1-, 3- and 5-year OS than radiation therapy or/and chemotherapy group (OS: 78.5% vs. 59.2%, 37.9% vs. 18.4%, 16.9% vs. 6.1%). CONCLUSIONS: Surgery is still the first choice for all ESCC patients with stage I-III. Radiotherapy and chemotherapy could improve the survival rate in ESCC patients with stage II-III who have received surgery.

lncRNA LEF1-AS1 Promotes Malignancy in Non-Small-Cell Lung Cancer by Modulating the miR-489/SOX4 Axis.

Increasing evidence has indicated that long noncoding RNAs (lncRNAs) could participate in diverse cancers. Among these, lymphoid enhancer-binding factor 1 antisense RNA 1 (LEF1-AS1) was recently identified as an oncogenic lncRNA, but little is known about its function in non-small-cell lung cancer (NSCLC). In the present study, we found that LEF1-AS1 was markedly upregulated in lung cancer tissues and could promote NSCLC cell proliferation and migration in vivo and in vitro. LEF1-AS1 could bind with miR-489 and further negatively regulate miR-489 to promote SRY-related HMG box transcription factor 4 (SOX4) expression. In conclusion, these data suggested that LEF1-AS1 promoted NSCLC tumorigenesis dependent on the miR-489-SOX4 axis and implicated the potential application of LEF1-AS1 for the prognosis and treatment of NSCLC.

18F-FDG PET-CT metabolic findings can predict the short-term curative effects in esophageal cancer.

OBJECTIVE: 18F-FDG PET-CT is a noninvasive approach extensively used to assess the therapeutic results and give a prognosis for esophageal cancer. This study is focused on examining the predictive value of metabolic tumor volume (MTV) and pre-treatment maximal standardized uptake value (SUVmax) of short-term curative effects demonstrated in patients with esophageal cancer. METHODS: This study carried out a retrospective analysis of 98 patients diagnosed with esophageal cancer who received treatment by radiotherapy or a combination of chemotherapy and radiotherapy in the Second Affiliated Hospital of Fujian Medical University. 18F-FDG PET-CT scan was carried out prior to the treatment. PET/CT images before treatment were evaluated by two high-level professional doctors as a double-blind method. MTV and SUVmax values were averaged and confirmed. In 1 to 3 months after the treatment, a deputy director of PET/CT center with much experience and a radiotherapist assessed the curative effect of all patients in line with the Response Evaluation Criteria in Solid Tumor (RECIST). RESULTS: No considerable difference in SUVmax and MTV was observed between the two groups in cancer site, gender, age, or differential extent. In addition, there was a significant correlation between SUVmax and lesion length, lymph node metastasis, depth of invasion, and clinical stage. SUVmax was positively correlated to depth of invasion, lymph node metastasis, MTV, lesion length, and clinical stage. The value of effective rate was up to 67.3% (66/98). There was a negative correlation between MTV as well as SUVmax, and curative effects in the short term, whereas the curative effects of MTV exceeded that of SUVmax. CONCLUSION: MTV and SUVmax before treatment serve to forecast curative effects in the short term of radiotherapy or combination of chemotherapy and radiotherapy for patients with esophageal cancer. MTV had a greater predictive effect than SUVmax.

Unilateral video-assisted thoracoscopic extended thymectomy offers long-term outcomes equivalent to that of the bilateral approach in the treatment of non-thymomatous myasthenia gravis.

OBJECTIVES: Video-assisted thoracoscopic extended thymectomy (VATET) is commonly performed bilaterally to remove all the thymic tissue in the mediastinum for the surgical treatment of myasthenia gravis. We hypothesize that the therapeutic efficacy of unilateral thoracoscopic thymectomy (right-sided) is comparable to that of bilateral VATET. METHODS: We retrospectively reviewed 103 consecutive patients who received VATET for non-thymomatous myasthenia gravis (NTMG), with a minimum follow-up period of 36 months. RESULTS: Bilateral VATET was performed in the first 31 patients and right-sided VATET in the following 72. No patients died perioperatively. The operating time in the right-sided VATET group was significantly shorter than that in the bilateral VATET group (169.3 ± 19.3 vs 152.6 ± 20.7 min, P<0.001). There were no significant differences between groups, in terms of blood loss, pain severity, drainage time, ICU stay, hospital stay and postoperative morbidity. The median follow-up was 5.2 years. Forty-eight patients achieved complete stable remission (CSR). The 5-year CSR rate, calculated by Life-table analysis, was 52% in the bilateral VATET group and 47% in the right-sided VATET group. These two operative methods did not differ significantly with respect to CSR by Kaplan-Meier analysis. Multivariate analysis identified shorter disease duration (<12 months) (P = 0.021, HR = 0.50) and thymic hyperplasia (P = 0.038, HR = 0.48) as independent predictors of higher CSR rates in patients who underwent thymectomy. CONCLUSIONS: The long-term outcome of right-sided VATET in the surgical treatment of NTMG, in terms of CSR, is comparable to that of bilateral VATET.