树突状细胞在肺腺癌组织中的浸润及其影响

目的：研究肺腺癌组织中树突状细胞（ＤＣ）的浸润程度及对预后的影响。方法将Ｓ－１００蛋白作为ＤＣ特异性标记物,应用免疫组织化学方法检测肺腺癌组织中ＤＣ分布。结果４６例肺腺癌中,ＤＣ显著浸润者１９例,５年生存率６１％,无或轻度浸润者２７例,５年生存率２１％,低分化腺癌２６例,显著浸润者１０例,５年生存率５７％,轻度浸润者１６例,５年生存率１６％。经Ｌｏｇ－ｒａｎｋ检验,在显著浸润和轻度浸润组二者之间差     

最大直径≤2 cm原发性周围型肺腺癌临床病理特征及预后

目的分析手术切除的最大直径≤2.0 cm原发性周围型肺腺癌的临床病理特征及预后影响因素。方法回顾性分析98例最大直径≤2.0 cm周围型肺腺癌的组织学类型、淋巴结转移、胸膜侵犯、手术方式、临床分期、CT征象等临床病理特征及影响预后的因素。结果直径≤1.0 cm 37例,1.1～2.0 cm 61例,1.1～2.0 cm组肺癌与年龄、吸烟、淋巴结转移、胸膜侵犯、组织学类型、临床分期及CT征象显著相关(均P0.05);≤1.0 cm组微小肺癌总生存率显著好于1.1～2.0 cm组(P0.05);多因素分析显示性别、吸烟、脏层胸膜浸润是影响早期肺腺癌患者生存预后的独立危险因素(P0.001)。结论直径≤1.0 cm微小肺癌具有独特的临床特征和更好的临床预后。当肿瘤直径≤1.0 cm、组织类型为原位腺癌或原位腺癌伴微小浸润、CT以磨玻璃结节为主时可避免行淋巴结清扫,性别、吸烟、胸膜侵犯是评价预后的独立危险因素。     

最大直径不超过3cm周围型肺腺癌病人与预后相关的细胞学因素

背景近来，最大直径≤3cm周围型肺腺癌(PLA)通常是由放射学诊断的。本研究的目的是确定哪些细胞学因素与PLA病人的良好及不良预后相关。方法检查了134例PLA病人的特征涂片。16种细胞学因素包括坏死、细胞分布、细胞簇重叠、细胞簇聚集、细胞簇大小、簇浓度、核异常、核大小、核大小变异、多核细胞、核内包涵体、核内包涵体类型、核仁外形、嗜酸性核仁、多核仁和有丝分裂均运用单变量和多变量分析进行评估。运用这种计数方法来判定病人个体的预后。     

非小细胞肺癌脑转移预后影响因素

目的探讨非小细胞肺癌脑转移的生存情况及预后影响因素。方法选取我院2014年6月至2018年12月确诊139例非小细胞肺癌脑转移患者,收集临床资料并随访生存时间。运用Kaplan-Meier法对每个临床因素的不同水平进行生存分析,Log-rank法进行生存曲线的比较。采用单因素、多因素分析方法来筛选非小细胞肺癌脑转移的预后影响因素。结果本研究139例患者中位生存时间为11.2个月,对症支持组、全脑放疗组、靶向治疗组、全脑放疗+靶向治疗组、全脑放疗+化疗+靶向治疗组分别为8.1个月、10.1个月、14.6个月、16.7个月、23.4个月。单因素分析显示病理类型、发生脑转移的时间、EGFR突变的状态、RPA分级以及治疗方式对非小细胞肺癌脑转移的发生有显著影响作用。多因素分析表明KPS评分、RPA分级、治疗方法、发生脑转移的时间及EGFR突变状态是影响生存期的独立预后因素。结论经积极治疗(化疗+全脑放疗+靶向治疗)脑转移瘤患者可以获得更长生存期,高KPS评分、RPA I级、异时性脑转移及EGFR敏感突变型是非小细胞肺癌脑转移的预后良好因素。     

非小细胞肺癌患者临床疗效及预后的影响因素

目的 研究非小细胞肺癌(NSCLC)的临床疗效及相关预后因素.方法 2013年6月-2020年6月,于复旦大学附属华东医院呼吸科治疗的155例NSCLC患者,分为手术组(n=47)和非手术组(n=108).比较2组的临床特征,随访观察患者的中位总生存时间(OS)、中位无进展生存(PFS)及生存率,分析影响NSCLC预后...     

手术切除肺腺癌患者免疫细胞浸润分析及预后关系

目的探究肺腺癌手术患者免疫细胞浸润模式及预后关系。方法基于GSE68465数据集,利用CIBERSORT软件包,对442例样本中22种免疫细胞进行定量分析,利用Survival包,Kaplan-Meier法分析22种免疫细胞含量与总生存率关系,利用Cox多变量回归分析构建肺腺癌手术患者免疫细胞预后风险模型,根据风险评分中位数,分为高风险组和低风险组,绘制Kaplan-Meier生存曲线和ROC曲线,评估模型的预测效果。结果肺腺癌组织浸润的免疫细胞主要有浆细胞、M2巨噬细胞和M0巨噬细胞,肺腺癌组织与正常组织免疫浸润存在显著差异。静息NK细胞与预后关系显著(P<0.05)。基于5种免疫细胞构建预后风险模型(Risk Score=8.156×静息NK细胞+9.059×活化CD4+记忆T细胞+3.899×活化肥大细胞+2.452×M0巨噬细胞+5.575×活化树突状细胞),高风险组较低风险组预后显著较差(P<0.0001),ROC曲线提示该风险模型具有较好的预后预测效果。结论免疫细胞浸润风险评分模型可以有效预测肺腺癌手术患者预后。     

影响局部晚期非小细胞肺癌适形放疗的预后因素分析

目的 探讨非小细胞肺癌三维适形放疗的疗效及其预后因素.方法 选择在本院行三维适形放疗的32例非小细胞肺癌患者的临床资料,所有病例行三维适形低分割照射,由CT扫描测量肿瘤最大直径和体积,对相关指标进行单因素、多因素分析,并用预后指数模型综合评价放疗疗效.结果 有效率(CR PR)为78.1%(25/32),元变化加病变进展率(NC PD)为21.9%(7/32).中位生存时间为14个月,1年生存率为53%,多因素分析提示卡氏评分(KPS)是独立的生存预后因素.结论 KPS有可能成为三维适形放疗治疗非小细胞肺癌的独立影响因素.     

手术治疗非小细胞肺癌患者预后的影响因素

<正>非小细胞肺癌(NSCLC)约占肺癌总数的80%~85%〔1〕。NSCLCⅠ期、Ⅱ期及部分ⅢA期患者治疗仍以手术治疗为主,关于NSCLC手术治疗预后情况各报道不一,而且对于预后的影响因素报道也不完全一致〔2〕。本文探索影响NSCLC患者预后的危险因素。1资料与方法1.1临床资料2006年1月至2007年6月我院手术治疗的NSCLC患者136例,均经病理学或细胞学确诊,临床资料和随     

肺腺癌T1N0M0的预后因素分析

目的：探讨肺腺癌T1N0M0患预后的病理因素与生存率的关系。方法：回顾1994年－1997年经手术治疗的肺腺癌T1N0M0 34例。观察病理学特征并随访。结果：34例病例术后平均随访时间为5．1年，5年生存率为67．7％。肿瘤直径2－3cm；中心性纤维化＞30％；有淋巴管腔的侵犯；细胞核Ⅲ级与肿瘤坏死＞50％，明显降低5年生存率。结论：研究有利于检测出转移风险较大的患，使其及时接受辅助性系统治疗。     

Promoter hypermethylation of the CFTR gene and clinical/pathological features associated with non-small cell lung cancer

Background and objective: The exact role of the cystic fibrosis transmembrane conductance regulator (CFTR) in pathophysiology, and the mechanisms regulating its expression are poorly understood. The CFTR gene is known to be genetically or epigenetically associated with several cancers. In the present study, the methylation status of the promoter region of the CFTR gene and its expression in primary non‐small cell lung cancer (NSCLC) were investigated. Methods: The methylation status of the promoter region of the CFTR gene in NSCLC tissue was assessed by pyrosequencing and methylation‐specific PCR. Expression of the CFTR gene was analysed by real‐time PCR, and CFTR gene reactivation was investigated using 5‐aza‐2′‐deoxycytidine. The correlation between methylation of the CFTR gene and the clinical features of the patients was assessed. Results: Methylation of the CFTR gene in NSCLC was quantitatively high by pyrosequencing analysis and qualitatively frequent by methylation‐specific PCR analysis. Expression of the CFTR gene was significantly lower in NSCLC compared with normal lung tissue. In addition, the demethylating agent 5‐aza‐2′‐deoxycytidine increased CFTR gene expression. Methylation of the CFTR gene was significantly greater in squamous cell carcinomas than in adenocarcinomas. CFTR gene methylation was associated with significantly poorer survival in young patients, but not in elderly patients. Conclusions: These findings suggest that DNA methylation may be important for downregulation of CFTR gene expression in lung cancer. Promoter hypermethylation of the CFTR gene may be an important prognostic factor in younger patients with NSCLC.     

非小细胞肺癌化疗患者营养状况评估及其对患者预后的影响

目的 非小细胞肺癌化疗患者营养状况评估及其对患者预后的影响.方法 选择2015年6月至2016年6月于我院首次确诊的中晚期NSCLC患者124例,随访至2020年6月,记录患者治疗前1 d化验血清白蛋白及外周血淋巴细胞计数,计算预后营养指数(PNI),应用Kaplan-Meier法计算生存曲线,采用Cox风险模型进行多...     

High SNRPA1 expression leads to poor prognosis in patients with lung adenocarcinoma

Objective

SNRPA1, a subunit of spliceosome complex, has been implicated in diverse cancers, while its biological effect in LUAD remains elusive. Therefore, we sought to decipher the relationship between SNRPA1 expression and the prognosis of patients with LUAD and reveal the underlying molecular mechanism.

Materials and methods

Based on the clinical data from TCGA databases, the multivariate Cox model was constructed to screen the prognostic value of SNRPA1. qRT-PCR and immunohistochemical staining were used to examine SNRPA1 mRNA and protein expression in LUAD. The effect of SNRPA1 on LUAD cell proliferation, migration, and epithelial mesenchymal transformation were examined using colony formation assays, wound healing, and western blot assays, respectively. Finally, the influence of SNRPA1 on LUAD immune microenvironment were validated from the Tumor Immune Estimation Resource database.

Results

SNRPA1 was significantly upregulated in both LUAD tissues and cell lines, and highly expressed SNRPA1 contributed to poor prognosis of LUAD patients. In vitro, SNRPA1 knockdown inhibited the proliferation and migration, as well as delayed the EMT differentiation of LUAD cells. Lastly, SNRPA1 was found to be positively associated with immune infiltration and some immune-check-point markers.

Conclusions

Our findings indicate that SNRPA1 may be a new biomarker for prognostic prediction and a potential therapeutic target in the treatment of LUAD.     

电视胸腔镜治疗非小细胞肺癌的疗效及影响因素

目的研究电视胸腔镜治疗非小细胞肺癌的疗效及其影响因素。方法选取本院2013年4月-2015年4月收治90例原发性非小细胞肺癌患者作为研究对象,随机分为对照组和观察组各45例患者。观察组使用胸腔镜辅助下小切口肺叶切除术,对照组采用传统的开胸肺叶切除术。再采取Log-rank检验和Kaplan-Meier法估计两组患者的中位生存时间和生存率,采用Cox比例风险回归模型分析胸腔镜微创治疗效果的影响因素。结果两组患者的总体生存时间分布之间无显著性差异(χ~2=0.335,P=0.846);患者的肿瘤分期(χ~2=46.593,P0.001)与患者的预后之间的关系密切,而患者的年龄(χ~2=1.229,P=0.268)、性别(χ~2=0.389,P=0.533)和吸烟史(χ~2=1.491,P=0.222)与患者的预后之间没有直接联系;患者清扫的淋巴结个数和肿瘤分期是影响非小细胞肺癌患者治疗的独立因子。而组织分化、是否辅助化疗、病灶长度以及支气管切缘的情况是影响非小细胞肺癌患者治疗的非独立因子,考虑这些因素协同作用对患者疗效的影响。结论使用电视胸腔镜治疗非小细胞肺癌和传统的手术方法疗效差异不大,且肿瘤分期和淋巴结的清扫个数是影响患者预后的独立因素。     

EGFR和K-ras基因表达突变与非小细胞肺癌预后的关联分析

目的探讨EGFR和K-ras基因表达突变与非小细胞肺癌(NSCLC)预后的关系。方法纳入126例NSCLC患者,使用免疫组织化学染色和基因测序检测其肿瘤组织EGFR和K-ras基因的表达突变情况,按NCCN指南对患者进行标准治疗和随访,采用Kaplan-Meier曲线、Log rank检验和Cox比例风险模型分析不同基因表达突变患者的中位生存期、5年总生存率和生存期的影响因素。结果 EGFR基因的阳性表达率为49.21%,突变率为28.57%,K-ras基因的阳性表达率为42.06%,突变率为2.38%;K-ras(+)的中位生存期和5年总生存率均显著低于K-ras(-)患者(χ2=4.348,Log-rank P=0.037),EGFR(突变)的中位生存期和5年总生存率均显著高于EGFR(野生)患者(χ2=11.518,Log-rank P=0.001);双基因阳性(P=0.027,HR=2.584,95%CI:1.113~6.002)和远处转移(P=0.046,HR=2.104,95%CI:1.013~4.369)是影响NSCLC患者生存期的危险因素,使用靶向药物治疗是生存期的保护因素(P0.001,HR=0.293,95%CI:0.149~0.574)。结论 EGFR和K-ras基因的表达突变与NSCLC患者的预后密切相关,双基因阳性可降低患者生存时间,它们是患者个体化用药和预后判断的重要指标。     

Construction and validation of a robust ferroptosis-associated gene signature predictive of prognosis in lung adenocarcinoma

To construct and validate a ferroptosis-associated signature predictive of prognosis in lung adenocarcinoma (LUAD), and systematically evaluate the underlying molecular connections in cancer biology.We retrieved mRNAs sequencing profiles of LUAD from the cancer genome atlas (TCGA) data portal and clinical information from the cBio Cancer Genomics Portal. The differentially expressed ferroptosis-associated genes (DEFAGs) were screened between normal samples and LUAD by packages “limma” in R. Then the total TCGA cohort was randomly divided into training set and testing set. Based on the training set, a DEFAG signature was built and further validated in the test set, the total TCGA cohort and other independent cohorts from the gene expression omnibus data portal. A nomogram was constructed and validated, and the correlation between high-risk group and cancer biology was further evaluated.We initially identified 68 DEFAGs from TCGA cohort. A 6 DEFAG signature was built and further validated in the test set, the total TCGA cohort and other 2 independent cohorts including {"type":"entrez-geo","attrs":{"text":"GSE31210","term_id":"31210"}}GSE31210 and {"type":"entrez-geo","attrs":{"text":"GSE72094","term_id":"72094"}}GSE72094 from gene expression omnibus data portal. Further exploration indicated that high-risk group combined with TP53 mutation harbored the most unfavorable prognosis while low-risk group with TP53 wild-type status had the most favorable survival advantage over other groups. Moreover, high-risk group was associated with higher cancer stemness, tumor mutation burden, and CD274 (programmed cell death 1 ligand 1) expression.We constructed a robust ferroptosis-associated gene signature and a nomogram predictive of prognosis in LUAD, and provided a new perspective on associations between ferroptosis and cancer.     

紫杉醇联合化疗治疗晚期非小细胞肺癌43例疗效观察

目的 评价紫杉醇联合顺铂或卡铂对晚期非小细胞肺癌的疗效和毒副作用。方法 43例晚期非小细胞肺癌应用紫杉醇175mg/m^2和顺铂80mg/m^2或卡铂350mg/m^2联合化疗,每3－4周一次,2－3周期为一疗程。结果 43例总有效率39．5％,紫杉醇加顺铂29例,有效率44．8％;紫杉醇加卡铂14例,有效率为28．6％。复治病例14例,有效率42．9％。主要毒副作用是骨髓抑制、脱发、手足麻木、关节肌肉瘤、心脏毒性反应。结论 紫杉醇联合顺铂或卡铂是治疗晚期非小细胞肺癌的有效方案,安全且耐受。