Risk Factors of Venous Thromboembolism in Patients With Lung Cancer Before Surgery: A Case Control Study.

OBJECTIVE: This study aimed to investigate the risk factors of venous thromboembolism (VTE) in admitted patients with lung carcinoma before surgery. METHODS: We conducted a retrospective case-control study of 94 preoperative lung cancer patients with VTE between January 2017 to December 2020. Each VTE patients was randomly matched with 2 control patients according to residence and gender. The clinical characteristics and related laboratory test results between the groups were compared by univariate analysis, while the risk factors of VTE in preoperative patients with lung cancer were analyzed using multivariate logistic regression analysis. RESULTS: Patients aged ≥60 years, a history of arrhythmia, homocysteine>15ummol/L, Fibrinogen (FIB) >4 g/L and D-dimer>500 ng/mL were found to be associated with an increased risk of VTE by univariate analysis. The multivariate logistic regression analysis revealed that age ≥60 years (OR=10.985), FIB >4 g/L (OR=8.861) and D-Dimer >500 ng/mL (OR=6.613) were independent risk factors for VTE in patients with lung carcinoma before surgery (P<.05). CONCLUSION: For preoperative patients with lung cancer, the independent risk factors of VTE included age ≥60 years, FIB >4 g/L and D-Dimer >500 ng/mL. As for these patients, prophylactic anticoagulant therapy should be considered before surgery.

CITED4 enhances the metastatic potential of lung adenocarcinoma.

BACKGROUND: CITED4 belongs to the CBP/p300-interacting transactivator with glutamic acid and aspartic acid-rich tail (CITED) family which is induced by various cytokines and participates in cytokine-induced proliferation and differentiation. CITED4 is induced by HB-EGF in lung cancer cells. However, it is unclear whether and how CITED4 contributes to the invasion and metastasis of lung adenocarcinoma (ADC). METHODS: CITED4 expression in lung adenocarcinoma and its association with disease-free survival (DFS) and overall survival were analyzed based on a cohort of 261 patients. The roles of CITED4 were validated via loss-of-function and gain-of-function experiments. The relationship between CITED4 and CLDN3 was validated by immunohistochemistry, Western blotting, and luciferase reporter assays. The function of the CITED4-CTNNB1-CLDN3 complex was fully validated and described. RESULTS: CITED4 expression was significantly upregulated in ADC tissues and cells and a predictor for DFS. Downregulation of CITED4 attenuated the proliferation and invasion, whereas CITED4 overexpression enhanced these effects. Overexpression and knockdown of CITED4 resulted in the upregulation and downregulation of CLDN3, respectively. Moreover, CITED4 downregulation suppressed CLDN3-mediated ADC cell metastasis in vivo. CITED4 was highly expressed and positively correlated with CLDN3. Mechanistically, CITED4 interacted with CTNNB1 and functioned synergistically to enhance CLDN3 transcription. Importantly, CITED4 induced ADC invasion via a CLDN3-dependent pathway. CITED4 determined the level of CLDN3, which in turn affected the sensitivity of tumors to Clostridium perfringens enterotoxin treatment. CONCLUSIONS: The CITED4-CTNNB1-CLDN3 axis plays a key role in the invasion and metastasis of ADC and provides a novel therapeutic target for lung cancer treatment.

Assessing the nutritional status of elderly Chinese lung cancer patients using the Mini-Nutritional Assessment (MNA(®)) tool.

PURPOSE: This study assessed the nutritional status of elderly Chinese lung cancer inpatients using a revised version of the Mini-Nutritional Assessment (MNA(®)) tool. PATIENTS AND METHODS: The revised version of the MNA tool was used to assess the nutritional status of 180 elderly Chinese lung cancer inpatients prior to their scheduled surgery between June 2010 and July 2011. Patients' demographic data, anthropometric parameters, and biochemical markers were collected and analyzed. RESULTS: Among the 180 inpatients who underwent the MNA, 9% were malnourished (MNA score < 19), 33% were at risk of malnutrition (MNA score 19-23), and 58% were well nourished (MNA score ≥ 24). There was significant correlation between the MNA scores of patients who were malnourished, at risk of malnutrition, and well nourished (P < 0.001), as well as between total MNA score and most MNA questions. The three patient groups with different nutritional statuses differed significantly in their responses to anthropometrics and global, diet, and subjective assessments. CONCLUSION: Incidence rates of malnutrition prior to surgery are high among elderly Chinese lung cancer inpatients. The revised MNA is a valid and reliable tool that can be used to assess and prevent malnutrition among these inpatients.