Relationship between hepatitis B virus infection and hepatic metastasis in non-small cell lung cancer

Objective： The purpose of the study was to explore the relationship between hepatitis B virus （HBV） infec tion and hepatic metastasis in non-small cell lung cancer （NSCLC）. Methods： Four hundred and eighty cases of NSCLC were retrospectively analyzed from January 2003 to January 2010, and the prevalence of hepatic metastasis of NSCLC in patients with and without hepatitis B virus infection were compared. Results： In the HBV carriers＇ group, the prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis were 13.2% and 5.9%, respectively. Meanwhile in the non-HBV group, those were 21.6% and 9.5% respectively. A significant difference between the two groups was found （P 〈 0.05）. Conclusion： The prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis in non-small cell lung cancer with HBV infection are lower than those in non-HBV infection group. Hepatic metastasis is infrequent in HBV infected cases of NSCLC.     

Gefitinib in the treatment of 41 cases with refractory non-small cell lung cancer

Objective： We observe the curative effect, median survival time, time to progression, quality of life and adverse effect of patients with advanced refractory non-small cell lung cancer （NSCLC） after gefitinib （Iressa） treatment. Methods： Forty-one patients with grade Ⅲb to Ⅳ NSCLC previously treated with two chemotherapy including 85.4% of patients after second line therapy were chosen. The regimen was oral intake of gefitinib 250 mg once daily until the disease progression or toxic reaction has become intolerable. The patients were required to receive tumor evaluation before the treatment, one month, two month and every three months after Iressa administration. Results： All of 41 patients were evaluable for therapeutic effect. Without complete regression being observed, partial response rate （PR）, stable disease （SD） and progression of disease （PD） were 43.9% （18/41）, 34.1% （14/41） and 22.1% （9/41）, respectively. The overall response rate was 43.9% （18141） and disease control rate （PR ＋ SD） was 78% （32/41）. The response rate in male was 42.1%, while it in female was 45.5% （P 〉 0.05）. Twenty-two of them （53.7%, 22/41） were still alive with 10.1 months of MST when the follow-up ended in November 2006. TTP and MST of patients who died was 2.7 and 5.0 months, respectively. The rate of symptom improvement was 78% of all patients with 13 months of MST of PR patients. The Karnofsky enhanced 20 ＋ 5 after 28 days treatment without 3-4 degree of reactive toxicity. Conclusion： Iressa has significant antitumor activity in advanced NSCLC patients who have previously failed in second or third line chemotherapy. Iressa is effective and safe for patients with poor performance status.     

The value and association of CC chemokine receptor 7 expression in non-small cell lung cancer with lymph nodes metastasis

Objective： The aim of this study was to analyze the expression of CC chemokine receptor 7 （CCR7） in pulmonary tumor tissue and metastasized lymph nodes of non-small cell lung cancer （NSCLC）, explore the relationship between the expressions of CCR7 in pulmonary tumor tissue and metastasized lymph nodes, and discuss the significance. Methods： SABC immunohistochemical staining was used to investigate the expression of CCR7 by rabbit anti-human CCR7 monoclonal antibody, and the specimens were 17 cases of adenocarcinoma, 17 cases of squamous cell carcinoma, 12 cases of adenosquamous carcinoma, 4 cases of large cell carcinoma and 28 cases of metastasized lymph nodes of lung cancer. Negative control sections used 5 cases of inflammatory pseudotumor and 20 cases of normal lung tissue. Two independent pathologists observed all the specimens in the high power field （x 400） of microscope by double blind method. Results： （1） The expression of CCR7 in pulmonary tumor tissue was stronger than normal lung tissue （P 〈 0.005）; （2） The expressions of CCR7 in pulmonary tumor tissues and metastasized lymph nodes had no significant differences （P = 0.177）; （3） The expression of CCR7 had correlation with lymph nodes metastasis, and the expression in lymph nodes metastasis group was more than that of no lymph nodes metastasis group （P = 0.016）; （4） Along with the increment of clinical stage, the CCR7 expression had a tendency to increase （P = 0.003）. Conclusion： CCR7 has rich expression in carcinoma cell nests and lymph node metastasis. It demonstrates that CCR7 may be related to the development of lymph node metastasis in NSCLC.     

Effects of weekly dose docetaxel monotherapy schedule for elderly patients with non-small cell lung cancer

Objective： To investigate the clinical efficacy and toxicity of weekly dose docetaxel monotherapy schedule in elderly with advanced non-small cell lung cancer （NSCLC）. Methods： 28 patients aged over 65 with advanced NSCLC were received with docetaxel （Aisu） 35 mg/m^2 on days 1, 8 and 15 every 28 days. A clinical evaluation on effectiveness, quality of life and toxicities was performed. Results： 28 patients were given 86 cycles＇ chemotherapy altogether. The overall response rate was 35.7% （10/28）. The clinical beneficial rate was 64.3% （18/28）. Mean KPS was increased from 75.5 at baseline to 87.7 after chemotherapy （P 〈 0.01）; lung cancer symptom scale （LCSS） scores of cough, hemoptysis, chest pain and dyspnea were increased from 64, 65, 62 and 65 to 90, 92, 87 and 88, respectively （P 〈 0.01）. The median time to progression （TTP） was 5.3 months; median survival time （MST） was 8.5 months. The main toxicities were fatigue, leukopenia and decrease of hemoglobin with well tolerance. Conclusion： Weekly dose docetaxel monotherapy schedule is a feasible, well-tolerated, and active scheme in the treatment of the elderly patients with advanced NSCLC.     

Impact of resveratrol on the expression of apoptosis related gene survivin and bax in human cancer cells

Objective： We explored the mechanism of apoptosis in human esophageal cancer Ecal09 cells by resveratrol. Methods： The suppressive ratio of resveratrol on Ecal09 cells proliferation was evaluated by MTT colorimetric assay and morphology was observed by transmission electron microscope. The expression of survivin and bax was analyzed by RT-PCR and Flow Cytometry （FCM）. Results： Resveratrol inhibited the growth of Ecal09 calls in a dose-and time-dependent man- ner, and the suppressive ratio arrived at 76.42%. Morphological apoptosis could be observed after treated with resveratrol.The bulk of some drug-treated cells turned small and the nuclear chromatin became condensed and rnarginated. The results determined by RT-PCR and FCM showed that resveratrol could down-regulate surviving, while up-regulate bax. Conclusion： Resveratrol could induce the apoptosis of human esophageal cancer Ecal09 cells, and its possible molecular mechanisms might be related to modulation the expression of survivin and bax.     

Improvements of quality of life in patients with advanced non-small cell lung cancer treated with gefitinib

Objective： The aim of this study was to evaluate the effect of gefitinib on improvement of quality of life （QoL） of patients with advanced non-small cell lung cancer （NSCLC）. Methods： There were 70 patients with advanced NSCLC. One oral gefitinib tablet （250 mg） was administered every day without interruption unless disease progression or unacceptable toxicity occurred. The impact of treatment on disease-related symptoms and QoL was evaluated with the Chinese versions of European Organization for Research and Treatment of Cancer Quality of Life Questionnaires （EORTC QLQ-C30 and QLQ- LC13）. Results： Fifty-eight patients had finished the questionnaires. The mean scores of five functioning scales （physical, role, emotional, cognitional and social） were 62.64, 56.03, 68.41, 64.67, 60.63 respectively after eight weeks of treatment, which were 52.30, 49.43, 64.39, 59.79, 52.30 respectively before treatment, and the mean score of global QoL after and before treatment was 60.17 and 52.70 respectively. There was statistical difference in five functioning scales and global QoL （P 〈 0.05）. Mean scores of main general symptoms （fatigue and appetite loss） were 57.66 and 48.08 respectively after eight weeks of treatment, which were 61.11 and 51.72 respectively before treatment, and mean scores of disease-related symptoms （dyspnoea, coughing, empsyxis, pain in chest）were 48.66, 47.13, 26.82, 24.71 respectively after eight weeks of treatment, which were 54.98, 53.64, 27.78, 28.54 respectively before treatment. There was statistical difference in fatigue, dyspnoea, cough and pain in chest （P 〈 0.05）. Response rate of five functioning and global QoL were all more than 50% after gefitinib treatment. Response rate of main general symptoms and disease-related symptoms were all more than 40%. QoL and symptom response correlated with disease control. The patients with better QoL had longer survival. Conclusion： gefitinib treatment can improve the QoL and symptoms of advanced NSCLC patient     

Relationship between the expression of ERCC-1, survivin and both efficiency and prognosis of cisplatin contained first-line chemotherapy in advanced lung adenocarcinoma

Objective： We analyzed the relationship between the expression of ERCC-1 （excisition repair cross complement- 1）, survivin and sensitivity and prognosis of cisplatin contained regimens first-line chemotherapy in advanced lung adenocarcinoma. Methods： Immunohistochemical （IHC） method was used to evaluate the expression of ERCC-1 and survivin in 80 pathologically confirmed advanced lung adenocarcinoma patients given cisplatin-contained regimens first-line chemotherapy. The response rate and survival time were analyzed according to the expression of ERCC-1 and survivin. Results： Only 77 patients could be reviewed by IHC staining. The expression rates of ERCC-1 and survivin were 33.77% and 53.25 % respectively. The worse response rate and shorter TTP/PFS could be identified in ERCC-1 positive group. Patients with positive expression of survivin had worse survival time. Conclusion： Expression of ERCC-1 may be a molecular marker of cispla- tincontained regimens first-line chemotherapy resistance and poor prognosis in advanced lung adenocarcinoma patients. Positive expression of survivin predicates poor prognosis for patients with advanced lung adenocarcinoma.     

Vasculogenic mimicry in non-small cell lung cancer and its relationship with tumor stage

Objective： The purpose of the study was to study the mechanism of vasculogenic mimicry （VM） and its relationship with tumor stage in non-small cell lung cancer （NSCLC）. Methods： Forty-two patients with NSCLC were collected, 19 belonged to the early stage （stages Ⅰ ＋Ⅱ） while 23 were late stage （stages Ⅲ ＋ Ⅳ）. Moreover, 20 patients got surgical treat ment and 22 got chemotherapy. We studied the relationship of VM with stage, chemotherapeutic effect, HIF-la, microves sel density （MVD） and clinicopathologic features. Results： VM in patients of early stages were significantly more than late stages （68.4% vs 26.1%, P = 0.006）, and the positive rate of VM was proportional to HIF-la （P = 0.034）. But no correlation was found between VM and chemotherapeutic effect （14.3% vs 26.7%, P = 1.00） or MVD （P 〉 0.05）. Furthermore, we found VM also showed a negative correlation with distant metastases and lymph nodes metastases （P 〈 0.05） while no correlation was found with other clinicopathologic. Conclusion： VM was generated during the early stage in NSCLC and correlated with lymph nodes metastases. As the disease progressed, VM may be replaced by vascular endothelial cells, so the late-stage patients especially people with distant metastases had fewer VM. As the main factor produced by hypoxia, HIF-la may make a difference in VM formation. Thus we inferred VM might be a new target for targeted therapy, and could provide help for clinical staging and treatment.