Prognostic value and clinicopathological significance of proliferating cell nuclear antigen expression in gastric cancer: a systematic review and meta-analysis

BACKGROUND

The prognostic significance of proliferating cell nuclear antigen (PCNA) expression in gastric cancer has long been assessed, yet results remain controversial. Therefore, we performed a meta-analysis to assess the prognostic value and clinicopathological significance of PCNA in gastric cancer.

METHODS

A systematic literature search of PubMed, EMBASE, and the Cochrane Library databases was conducted. Summary odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to investigate the correlations between PCNA expression and clinicopathological features, overall survival (OS), and disease-free survival (DFS).

RESULTS

A total of 19 studies involving 2,852 participants were included in our analysis. The pooled HR indicated that high PCNA expression was significantly associated with poor OS (HR 1.66, 95% CI 1.32-2.08) and DFS (HR 1.81, 95% CI 1.40-2.36). Subgroup analysis revealed that the association between PCNA and OS was also significant in Asian and European patients. In addition, the pooled ORs showed that high PCNA expression was significantly associated with deeper tumor invasion (OR 2.37, 95% CI 1.71-3.27), lymph node metastasis (OR 2.49, 95% CI 1.85-3.35), and advanced stage cancer (OR 1.89, 95% CI 1.36-2.63).

CONCLUSION

Our meta-analysis indicates that high PCNA expression might be a prognosticator of poor survival and a promising therapeutic target for gastric cancer patients.

By recruiting HDAC1, MORC2 suppresses p21 Waf1/Cip1 in gastric cancer

Microrchidia (MORC) family CW-type zinc-finger 2 (MORC2) regulates chromatin remodeling during the DNA-damage response, represses gene transcription, promotes lipogenesis. Here, we found that MORC2 down-regulated p21 by recruiting HDAC1 to the p21 promoter, in a p53-independent manner. MORC2-mediated down-regulation of p21 in turn promoted cell cycle progression in gastric cancer cells. Furthermore, MORC2 expression correlated negatively with p21 expression in gastric tumors in patients. We suggest that MORC2 may be a potential therapeutic target in cancer.

Bioinformatics analysis of miRNA expression profile between primary and recurrent glioblastoma

OBJECTIVE

Glioblastoma (GBM) is the most malignant brain tumor with rapid relapse. The goal of this study is to identify microRNAs (miRNAs) involved in recurrent GBM.

MATERIALS AND METHODS

miRNA transcription profile data (GSE32466) were downloaded, including 12 primary GBM samples and 12 recurrent GBM samples. Then, limma package was utilized to identify differentially expressed miRNAs (DEMs) with the criteria of false discovery rate < 0.05 and |log2 fold change| ≥ 1. Thereafter, miTarget and TargetScan databases were used to predict the potential target genes of DEMs. Regulatory co-expression network was constructed based on co-expressed genes and potential miRNA-gene pairs, and then, pathway analysis was conducted. Furthermore, database miRWalk was used to screen out known GBM-associated miRNAs from the identified DEMs.

RESULTS

A total of 71 DEMs were identified between primary and recurrent GBM samples, and 2684 potential target genes were found. Besides, regulatory co-expression network was constructed, including 12 DEMs and 81 potential target genes. These genes significantly enriched in ECM-receptor interaction, ribosome, and focal adhesion pathways, and DEMs like hsa-miR-320a, hsa-miR-139-5p, has-miR-128, hsa-miR-140-5p, and hsa-miR-146b-5p had high degree. Notably, 7 DEMs in network were known GBM-associated miRNAs recorded in database miRWalk.

CONCLUSIONS

DEMs like hsa-miR-320a, hsa-miR-139-5p, has-miR-128, hsa-miR-146b-5p, hsa-let-7c, hsa-miR-128, and hsa-let-7a might participate in recurrent GBM. These results would pave ways for further study of recurrent GBM mechanism, and for the prevention and treatment of recurrent GBM. However, more experimental verifications are required to prove these predictions.

Thymic carcinoma patients with myasthenia gravis exhibit better prognoses

BACKGROUND

Thymic carcinoma is an aggressive mediastinal neoplasm with a poor prognosis, but the factors that contribute to its prognosis are not completely understood. Myasthenia gravis (MG) can coexist with thymic carcinoma with low incidence, but the effect MG has on thymic carcinoma prognosis is unknown. Here, we investigated the prognostic factors of thymic carcinoma and the influence of MG on patients with this disease.

METHODS

Between January 1996 and December 2012, 49 patients were diagnosed with thymic carcinoma and surgically treated at our institution. Clinical data and survival information were recorded and systematically reviewed. Kaplan-Meier survival curves were generated, and independent prognostic factors were identified by Cox's proportional hazard model.

RESULTS

Complete resection was achieved in 30 patients (61.2 %), and incomplete resection was performed on the other 19 patients (38.8 %). Six of the 49 patients with thymic carcinoma also presented with MG (12.2 %). Interestingly, these 6 patients exhibited much better prognoses when compared to the other 43 patients. Patients with MG also had significantly smaller tumors (P = 0.045), earlier Masaoka stage (P = 0.048), and higher complete resection rates (P = 0.042). However, multivariate analysis demonstrated that complete resection was the only independent predictor for overall survival (OS) (P < 0.001).

CONCLUSIONS

The OS of patients with thymic carcinoma depends on complete resection, but patients with MG also demonstrate improved prognoses. MG patients have higher rates of complete surgical resection, which may account for their better prognoses. Patients with MG have unique features that may aid in the clinical management of these patients.

The inhibition of Cdk5 activity after hypoxia/ischemia injury reduces infarct size and promotes functional recovery in neonatal rats

Recent studies indicate that over-activation of Cdk5 is a crucial pro-death signal and Cdk5 activity inhibition provides neuroprotection in animal stroke models. However, Cdk5 inhibitors are reported to affect physiological functions of Cdk5 and lead to serious side effects. Therefore, targeting Cdk5 or its activators without affecting physiological functions of Cdk5 is a therapeutic strategy for ischemic brain injury. In this study, we examined Cdk5 activity in a rat hypoxia/ischemia (HI) injury model. Cdk5 expression was not changed after HI injury, but Cdk5 activity significantly increased, which was demonstrated by the increased phorsphorylation-phosphorylation of Tau and glucocorticoid receptor (GR), two downstream signals of Cdk5. We further showed that the levels of Cdk5 activators p35 and p39 decreased after HI injury, while p25, which is converted from p35 and has a higher activator activity on Cdk5, increased markedly after HI injury. P5, a 24-residue mimetic peptide of p35, was reported to specifically inhibit the p25/Cdk5 signal pathway in an Alzheimer's disease model. P5-TAT, which can cross the blood-brain barrier and cell membrane facilitated by TAT protein, was used in our study. We found that p5-TAT treatment did not change the levels of p35, p39, and p25, but reduced the phorsphorylation of Tau and GR, suggesting the inhibition of the p25/Cdk5 by the peptide p5-TAT. This was supported by the fact that p5 interacted with Cdk5, but not with Cdk5 activators. In addition, p5-TAT reduced cleaved caspase-3 level, a marker of neuronal apoptosis. We further demonstrated that p5-TAT pre-treatment reduced cerebral infarct volume; even when p5-TAT was delayed to be administered at 24h after HI injury, p5-TAT still promoted long-term functional recovery. Therefore, Cdk5 inhibition by the small peptide p5-TAT or its derivatives is a promising therapeutic strategy for the treatment of ischemic brain injury including hypoxic-ischemic encephalopathy and stroke.

CD29 of human umbilical cord mesenchymal stem cells is required for expansion of CD34(+) cells

OBJECTIVES

Human umbilical cord mesenchymal stem cells (hUCMSCs) play a critical role in expanding haematopoietic stem cells (HSCs) by providing the essential microenvironment for haematopoiesis. In this study, we sought to investigate whether CD29 of hUCMSCs would play a key role in the ability of hUCMSCs to help expand HSCs in vivo and in vitro.

MATERIAL AND METHODS

To investigate whether CD29 of hUCMSCs would play a key role for the ability of hUCMSCs to expand HSCs, soluble anti-CD29 antibody was added to co-cultures of hUCMSCs and cord blood (CB) CD34(+) cells. It significantly blocked expansion of CB CD34(+) cells induced by hUCMSCs. Using CD29-deficient hUCMSCs models, long-term culture-initiating cell and non-obese diabetic/severe combined immunodeficient disease mouse repopulating cell assay, revealed that CB CD34(+) cells co-cultured with CD29-deficient hUCMSCs only retained the capacity of multipotent differentiation for 5 weeks at the most.

RESULTS

Soluble anti-CD29 antibody significantly blocked expansion of CB CD34(+) cells induced by hUCMSCs. CB CD34(+) cells co-cultured with CD29-deficient hUCMSCs only retained the capacity of multipotent differentiation for 5 weeks at the most.

CONCLUSIONS

CB CD34(+) cells co-cultured with CD29-deficient hUCMSCs gave rise to all major haematopoietic lineages, but failed to engraft long term.

Hypothesis on the source, transmission and characteristics of infection of avian influenza A (H7N9) virus--based on analysis of field epidemiological investigation and gene sequence analysis

On 31 March 2013, the National Health and Family Planning Commission announced that human infections with influenza A (H7N9) virus had occurred in Shanghai and Anhui provinces, China. H7N9 cases were later detected in Jiangsu and Zhejiang provinces. It was estimated that the virus first spread northward along the route taken by migratory birds and then spread to neighbouring provinces with the sale of poultry. Epidemiological studies were carried out on samples from the external environment of infected cases, transmission routes, farmers markets and live poultry markets. Phylogenetic study of viral sequences from human and avian infections in Zhejiang showed that those from Shanghai and Jiangsu provinces along Taihu Lake were highly homologous with those from the external environment. This suggests that avian viruses carried by waterfowl combined with the virus carried by migratory birds, giving rise to avian influenza virus H7N9, which is highly pathogenic to humans. It is possible that the virus was transmitted by local wildfowl to domestic poultry and then to humans, or spread further by means of trading in wholesale poultry markets. As the weather has turned warm, and with measures adopted to terminate poultry trade and facilitate health communication, the epidemic in the first half of the year has been kept under control. However, the infection source in the triangular area around Taihu Lake still remains. The H7N9 epidemic will probably hit the area later in the year and next spring when the migratory birds return and may even spread to other areas. Great importance should therefore be attached to the wildfowl in Taihu Lake as the repository and disseminator of the virus: investigation and study of this population is essential.

Prediction of peritoneal recurrence by the mRNA level of CEA and MMP-7 in peritoneal lavage of gastric cancer patients

A number of tumor markers had been reported to be useful in detecting free cancer cells in the peritoneal cavity and predict peritoneal recurrence in gastric cancer patients. The objective of this study was to compare the clinical impact of different tumor markers in peritoneal lavage fluid using the real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) technique and to screen the most effective ones from them. The peritoneal lavage fluid of 116 patients with gastric cancer was sampled at laparotomy. After RNA extraction and reverse transcription, real-time quantitative polymerase chain reaction (PCR) was performed using the primers and probes for carcinoembryonic antigen (CEA), cytokeratin-20, matrix metalloproteinase-7 (MMP-7), carbohydrate antigen 125, and transforming growth factor-beta-1. Among the 116 patients, 45 (38.8%) were confirmed to have peritoneal recurrence. Any of the PCR-positive results of the five tumor markers could predict peritoneal recurrence in the univariate analysis (P < 0.001). In the multivariate analysis, the PCR results of CEA (P = 0.003) and MMP-7 (P = 0.028) were found to be independent prognostic factors. A real-time quantitative RT-PCR analysis of the CEA and MMP-7 transcripts in peritoneal lavage fluid could effectively predict peritoneal recurrence in advanced gastric cancer patients who underwent a potentially curative resection.

PAK4 kinase-mediated SCG10 phosphorylation involved in gastric cancer metastasis

Superior cervical ganglia 10 (SCG10), as a microtubule (MT) destabilizer, maintains MT homeostasis and has a critical role in neuronal development, but its function in tumorigenesis has not been characterized. In the present study, we demonstrated that p21-activated kinase 4 (PAK4)-mediated SCG10 phosphorylation regulates MT homeostasis in metastatic gastric cancer. Our results indicate that SCG10 is a physiological substrate of PAK4, which is phosphorylated on serine 50 (Ser50) in a PAK4-dependent manner. Phosphorylated SCG10 regulated MT dynamics to promote gastric cancer cell migration and invasion in vitro and metastasis in a xenograft mouse models. Inhibiting PAK4, either by LCH-7749944 or RNA interference, resulted in the inhibition of Ser50 phosphorylation and a blockade to cell invasion, suggesting that PAK4-SCG10 signaling occurs in gastric cancer cell invasion. Moreover, we demonstrated a strong positive correlation between PAK4 and phospho-Ser50 SCG10 expression in gastric cancer samples. We also showed that high expression of SCG10 phospho-Ser50 is highly correlated to an aggressive phenotype of clinical gastric cancer. These findings revealed a novel function of SCG10 in promoting invasive potential of gastric cancer cells, suggesting that blocking PAK4-mediated SCG10 phosphorylation might be a potential therapeutic strategy for metastasis of gastric cancer.

CARMA3 overexpression accelerates cell proliferation and inhibits paclitaxel-induced apoptosis through NF-κB regulation in breast cancer cells

CARMA3 was recently reported to be overexpressed in several cancers and associated with malignant behavior of cancer cells. However, the expression pattern and biological roles of CARMA3 in breast cancer have not been reported. In the present study, we found that CARMA3 was overexpressed in 41.9 % of breast cancer specimens. Significant association was observed between CARMA3 overexpression and TNM stage (p = 0.0223), tumor size (p = 0.0227), and ErbB-2 status (p = 0.0049). Furthermore, knockdown of CARMA3 expression in MDA-MB-435 cells with high endogenous expression decreased cell proliferation and sensitized cell to paclitaxel-induced apoptosis, while overexpression of CARMA3 in MDA-MB-231 cell line promoted cell proliferation and inhibited apoptosis. Further analysis showed that CARMA3 depletion downregulated, and its overexpression upregulated cyclin D1, Bcl-2, and p-IκB levels. In conclusion, our study demonstrated that CARMA3 is overexpressed in breast cancers. CARMA3 facilitates proliferation and inhibits apoptosis through nuclear factor-kappaB signaling.

Sulfate reduction in groundwater: characterization and applications for remediation

Sulfate is ubiquitous in groundwater, with both natural and anthropogenic sources. Sulfate reduction reactions play a significant role in mediating redox conditions and biogeochemical processes for subsurface systems. They also serve as the basis for innovative in situ methods for groundwater remediation. An overview of sulfate reduction in subsurface environments is provided, along with a brief discussion of characterization methods and applications for addressing acid mine drainage. We then focus on two innovative, in situ methods for remediating sulfate-contaminated groundwater, the use of zero-valent iron and the addition of electron-donor substrates. The advantages and limitations associated with the methods are discussed, with examples of prior applications.

Sulfate reduction in groundwater: characterization and applications for remediation

Sulfate is ubiquitous in groundwater, with both natural and anthropogenic sources. Sulfate reduction reactions play a significant role in mediating redox conditions and biogeochemical processes for subsurface systems. They also serve as the basis for innovative in situ methods for groundwater remediation. An overview of sulfate reduction in subsurface environments is provided, along with a brief discussion of characterization methods and applications for addressing acid mine drainage. We then focus on two innovative, in situ methods for remediating sulfate-contaminated groundwater, the use of zero-valent iron and the addition of electron-donor substrates. The advantages and limitations associated with the methods are discussed, with examples of prior applications.

βig-h3 supports gastric cancer cell adhesion, migration and proliferation in peritoneal carcinomatosis

βig-h3 is an extracellular matrix protein and its expression is highly induced by transforming growth factor (TGF-β). It has also been suggested to play an important role in the growth and invasion of colon and pancreatic cancers. In the present study, we demonstrated that βig-h3 is expressed in mesothelial cells, especially in patients with advanced gastric cancer. The positive rate of βig-h3 was significantly higher in cases with a more invasive and advanced serous-type, with visible peritoneal metastasis, and in peritoneal lavage cytological examination (PLC) (+) and peritoneal lavage fluid CEA mRNA(+) subgroups (p<0.05). Our study also showed that the expression of βig-h3 gradually increased with increasing TGF-β1 concentrations in vitro in a time-dependant manner. In addition, βig-h3 also induced human gastric carcinoma cell line (SGC-7901) cell adhesion in a dose-dependent manner and significantly increased cell migration and proliferation. The results suggest that βig-h3 expression in peritoneal mesothelial cells in gastric cancer patients is a marker of the biological behavior of gastric cancer and plays an important role in the process of peritoneal carcinomatosis.

MicroRNA-335 acts as a metastasis suppressor in gastric cancer by targeting Bcl-w and specificity protein 1

Aberrant expression of miR-335 has been frequently reported in cancer studies, suggesting that there is a close correlation between miR-335 and cancer during its development, progression, metastasis and prognosis. The expression of miR-335 in gastric cancer and its effects are not known. Relative expression of miR-335 in 4 gastric cancer cell lines and in 70 gastric cancer tissues was confirmed by real-time quantitative reverse transcriptase-PCR compared with controls. Transwell cell migration and Matrigel invasion assay in vitro and metastasis formation assay in vivo were used to examine the effects of miR-335 expression on gastric cancer cell invasion and metastasis. The effect of miR-335 expression on gastric cancer cell proliferation was estimated by the 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay. Luciferase reporter assay and western blot were used to examine the potential target genes and related pathways. Gene silencing with small-interfering RNA was used to examine the effects of target genes on gastric cancer cell invasion. miR-335 was dramatically downregulated in gastric cancer cell lines than in the normal gastric cell line GES-1. Low expression of miR-335 was significantly associated with lymph-node metastasis, poor pT stage, poor pN stage and invasion of lymphatic vessels. Overexpression of miR-335 suppressed gastric cancer cell invasion and metastasis in vitro and in vivo, but has no significant effects on cell proliferation. Furthermore, miR-335 might suppress gastric cancer invasion and metastasis by targeting Bcl-w and specificity protein 1 (SP1). Taken together, our results provide evidence that miR-335 might function as a metastasis suppressor in gastric cancer by targeting SP1 directly and indirectly through the Bcl-w-induced phosphoinositide 3-kinase-Akt-Sp1 pathway. miR-335 showing altered expression at different stages of gastric cancer could be a target for gastric cancer therapies and could be further developed as a potential prognostic factor.

Partial cancerous changes eventually developing into superficial spreading cancer over 18 months

In this report, we describe a patient presenting with the superficial spreading type of early gastric cancer (egc) accompanied by cancerous ulcers. Disease progression and treatment outcome are discussed. After symptoms persisted for more than 1 year, the patient underwent total gastrectomy with D2 lymph node dissection. The patient was diagnosed with superficial spreading cancer (ssc), accompanied by an extensive iic lesions. The progression of this patient suggests that the co-occurrence of cancerous ulcers may contribute to egc development to some extent. As is known, egc often develops into advanced gastric cancer with time. However, in our case, we observed a process during which partial cancerous changes developed into ssc over 18 months. Superficial spreading cancer should be considered an egc variant, which may have the ability to spread superficially along the stomach wall without invading the muscularis propria. But we speculate that, if gene expression changes for some reason, the malignant ssc cells may acquire the ability to grow deeply into the stomach wall. Eventually, Borrmann type iv gastric cancer may develop.

REP-PCR tracking of the origin and spread of airborne Staphylococcus aureus in and around chicken house

Staphylococcus aureus was used as an indicator to study the origin and spread of microbial aerosol in and around chicken houses. Air samples indoor, upwind (10 and 50 m), and downwind (10, 50, 100, 200, and 400 m) of four chicken houses were collected using Andersen-6 stages sampler. The concentrations of S. aureus were determined for every sample site. Isolation of S. aureus from chicken feces was performed according to the standard method. The genetic relationship among the isolates was determined by profiles of PCR-amplified repetitive extragenic palindromic (REP-PCR) elements. The results showed that the concentrations of S. aureus indoor of four chicken houses were higher than those upwind and downwind sites (P < 0.05 or P < 0.01), but there were no significant concentration differences among downwind sites (P > 0.05). The fingerprints and the phylogenetic tree indicated that a part of the S. aureus (55.6%, 10/18) isolates from indoor air had the same REP-PCR fingerprints as feces isolates. Consequently, most isolates (57.1%, 20/35) from downwind 10, 50, 100, 200, even 400 m had the same REP-PCR fingerprints as those from indoor or feces. These data indicated that some isolates from downwind and indoor originated from the chicken feces. However, those isolates from upwind had low similarity (similarity index 0.6-0.87) to those from indoor or feces. Therefore, the isolates upwind were not from the chicken feces or indoor. These results suggest that microbes in chicken feces can be aerosolized and spread indoor and outdoor, especially to downwind of the chicken houses. It should have an important epidemiological and public health significance.

PRACTICAL IMPLICATIONS

Thus, the use of S. aureus as an indicator to study the origin and spread of airborne pathogens from chicken houses is potentially useful for enhancing public health and understanding the airborne epidemiology of this pathogen. Meanwhile it can provide evidence for studying the spreading model of airborne pathogens.

Treatment and outcome of intracranial hemorrhage after carotid artery stenting. A ten year single center experience

SUMMARY

Intracranial hemorrhage following carotid artery stenting (CAS) is a rare but potentially devastating complication. The present study reviewed intracranial hemorrhage cases from patients undergoing CAS in ten years to find the methods to rescue patients from this fatal complication. Patients with postoperative intracranial hemorrhage following CAS were retrospectively selected, and clinical features, treatments and outcomes were studied. Ten patients with intracranial hemorrhage were identified. The mean onset time of hemorrhage was 6.1-/+7.1h. Intracerebral hemorrhage occurred in eight patients and SAH in two patients. The patients were treated by stopping anti-platelet and anticoagulant for at least three days, and surgical drainage of the hematoma/ventricle drainage or conservative treatment. Six patients survived, two had left moderate paralysis, four had a good recovery at four week follow-up, and four patients died. No patients underwent thrombosis in stent after withdrawing of antiplatelet and anticoagulant. Intracranial hemorrhage after CAS occurs usually in a few hours and leads to catastrophic results. Once patients have intracranial hemorrhage, good neurocritical care may help to save them. Stopping antiplatelet and anticoagulant for at least three days may avoid thrombosis in the stenting site.