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Liu C, Wang YF, Wang P, Guo F, Zhao HY, Wang Q, Shi ZW, Li XF. Predictive value of multiple imaging predictive models for spread through air spaces of lung adenocarcinoma: A systematic review and network meta‑analysis. Oncol Lett 2024; 27:122. [PMID: 38348387 PMCID: PMC10859825 DOI: 10.3892/ol.2024.14255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Spread Through Air Spaces (STAS) is involved in lung adenocarcinoma (LUAD) recurrence, where cancer cells spread into adjacent lung tissue, impacting surgical planning and prognosis assessment. Radiomics-based models show promise in predicting STAS preoperatively, enhancing surgical precision and prognostic evaluations. The present study performed network meta-analysis to assess the predictive efficacy of imaging models for STAS in LUAD. Data were systematically sourced from PubMed, Embase, Scopus, Wiley and Web of Science, according to the Cochrane Handbook for Systematic Reviews of Interventions) and A Measurement Tool to Assess systematic Reviews 2. Using Stata software v17.0 for meta-analysis, surface under the cumulative ranking area (SUCRA) was applied to identify the most effective diagnostic method. Quality assessments were performed using Cochrane Collaboration's risk-of-bias tool and publication bias was assessed using Deeks' funnel plot. The analysis encompassed 14 articles, involving 3,734 patients, and assessed 17 predictive models for STAS in LUAD. According to comprehensive analysis of SUCRA, the machine learning (ML)_Peri_tumour model had the highest accuracy (56.5), the Features_computed tomography (CT) model had the highest sensitivity (51.9) and the positron emission tomography (pet)_CT model had the highest specificity (53.9). ML_Peri_tumour model had the highest predictive performance. The accuracy was as follows: ML_Peri_tumour vs. Features_CT [relative risk (RR)=1.14; 95% confidence interval (CI), 0.99-1.32]; ML_Peri_tumour vs. ML_Tumour (RR=1.04; 95% CI, 0.83-1.30) and ML_Peri_tumour vs. pet_CT (RR=1.04; 95% CI, 0.84-1.29). Comparative analyses revealed heightened predictive accuracy of the ML_Peri_tumour compared with other models. Nonetheless, the field of radiological feature analysis for STAS prediction remains nascent, necessitating improvements in technical reproducibility and comprehensive model evaluation.
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Affiliation(s)
- Cong Liu
- Department of Minimally Invasive Oncology, Xuzhou New Health Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Yu-Feng Wang
- Department of Nuclear Medicine, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Peng Wang
- Department of Nuclear Medicine, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Feng Guo
- Department of Medical Oncology, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Hong-Ying Zhao
- Department of Radiotherapy, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Qiang Wang
- Department of Radiotherapy, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Zhi-Wei Shi
- Department of Radiology, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
| | - Xiao-Feng Li
- Department of Radiology, Xuzhou Cancer Hospital (The Xuzhou Hospital Affiliated to Jiangsu University), Xuzhou, Jiangsu 221000, P.R. China
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Niu Y, Han X, Zeng Y, Nanding A, Bai Q, Guo S, Hou Y, Yu Y, Zhang Q, Li X. The significance of spread through air spaces in the prognostic assessment model of stage I lung adenocarcinoma and the exploration of its invasion mechanism. J Cancer Res Clin Oncol 2023; 149:7125-7138. [PMID: 36881149 DOI: 10.1007/s00432-023-04619-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/27/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Spread through air spaces (STAS) is a crucial invasive mode of lung cancer and has been shown to be associated with early recurrence and metastasis. We aimed to develop a prognostic risk assessment model for stage I lung adenocarcinoma based on STAS and other pathological features and to explore the potential relationship between CXCL-8, Smad2, Snail, and STAS. METHODS 312 patients who underwent surgery at Harbin Medical University Cancer Hospital with pathologically diagnosed stage I lung adenocarcinoma were reviewed in the study. STAS and other pathological features were identified by H&E staining, and a prognostic risk assessment model was established. The expression levels of CXCL8, Smad2, and Snail were determined by immunohistochemistry. RESULTS The nomogram was established based on age, smoking history, STAS, tumor lymphocyte infiltration, tissue subtype, nuclear grade, and tumor size. The C-index for DFS was (training set 0.84 vs validation set 0.77) and for OS was (training set 0.83 vs validation set 0.78). Decision curve analysis showed that the model constructed has a better net benefit than traditional reporting. The prognostic risk score validated the risk stratification value for stage I lung adenocarcinoma. STAS was an important prognostic factor associated with stronger invasiveness and higher expression of CXCL8, Smad2, and Snail. CXCL8 was associated with poorer DFS and OS. CONCLUSIONS We developed and validated a survival risk assessment model and the prognostic risk score formula for stage I lung adenocarcinoma. Additionally, we found that CXCL8 could be used as a potential biomarker for STAS and poor prognosis, and its mechanism may be related to EMT.
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Affiliation(s)
- YangYang Niu
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - XinHao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Yuan Zeng
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Abiyasi Nanding
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Qiang Bai
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - SaiNan Guo
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - YaLi Hou
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China
| | - Yan Yu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China.
| | - QiuJu Zhang
- Department of Biostatistics, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang Province, People's Republic of China.
| | - XiaoMei Li
- Department of Pathology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang Province, People's Republic of China.
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Zivotic M, Kovacevic S, Nikolic G, Mioljevic A, Filipovic I, Djordjevic M, Jovicic V, Topalovic N, Ilic K, Radojevic Skodric S, Dundjerovic D, Nesovic Ostojic J. SLUG and SNAIL as Potential Immunohistochemical Biomarkers for Renal Cancer Staging and Survival. Int J Mol Sci 2023; 24:12245. [PMID: 37569620 PMCID: PMC10418944 DOI: 10.3390/ijms241512245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Renal cell carcinoma (RCC) is the deadliest urological neoplasm. Up to date, no validated biomarkers are included in clinical guidelines for the screening and follow up of patients suffering from RCC. Slug (Snail2) and Snail (Snail1) belong to the Snail superfamily of zinc finger transcriptional factors that take part in the epithelial-mesenchymal transition, a process important during embryogenesis but also involved in tumor progression. We examined Slug and Snail immunohistochemical expression in patients with different stages of renal cell carcinomas with the aim to investigate their potential role as staging and prognostic factors. A total of 166 samples of malignant renal cell neoplasms were analyzed using tissue microarray and immunohistochemistry. Slug and Snail expressions were evaluated qualitatively (presence or absence), in nuclear and cytoplasmic cell compartments and compared in relation to clinical parameters. The Kaplan-Meier survival analysis showed the impact of the sarcomatoid component and Slug expression on the survival longevity. Cox regression analysis separated Slug as the only independent prognostic factor (p = 0.046). The expression of Snail was associated with higher stages of the disease (p = 0.004), especially observing nuclear Snail expression (p < 0.001). All of the tumors that had metastasized showed nuclear immunoreactivity (p < 0.001). In clear cell RCC, we showed a significant relationship between a high nuclear grade and nuclear Snail expression (p = 0.039). Our results suggest that Slug and Snail could be useful immunohistochemical markers for staging and prognosis in patients suffering from various RCCs, representing potential targets for further therapy strategies of renal cancer.
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Affiliation(s)
- Maja Zivotic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Sanjin Kovacevic
- Department of Pathological Physiology, Faculty of Medicine, University of Belgrade, 9 Dr. Subotic Street, 11000 Belgrade, Serbia;
| | - Gorana Nikolic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Ana Mioljevic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Isidora Filipovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Marija Djordjevic
- Faculty of Organization Sciences, University of Belgrade, 11010 Belgrade, Serbia;
| | - Vladimir Jovicic
- Clinic for Cardiac Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Nikola Topalovic
- Department of Medical Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Kristina Ilic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Sanja Radojevic Skodric
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Dusko Dundjerovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 1 Dr. Subotic Street, 11000 Belgrade, Serbia; (M.Z.); (G.N.); (A.M.); (I.F.); (K.I.); (S.R.S.)
| | - Jelena Nesovic Ostojic
- Department of Pathological Physiology, Faculty of Medicine, University of Belgrade, 9 Dr. Subotic Street, 11000 Belgrade, Serbia;
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Zhang Z, Fang T, Lv Y. Prognostic and clinicopathological value of Slug protein expression in breast cancer: a systematic review and meta-analysis. World J Surg Oncol 2022; 20:361. [PMID: 36372891 PMCID: PMC9661812 DOI: 10.1186/s12957-022-02825-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022] Open
Abstract
Background Many studies have reported the relationship between prognosis and Slug protein expression in breast cancer patients, but the results are discrepant. Therefore, there is a need for meta-analyses with high statistical power to investigate and further explore their relationship. Methods We used PubMed, Embase, the Cochrane Library, Scopus, MEDLINE, and the Web of Science to find studies on breast cancer and Slug. Overall survival (OS) and disease-free survival (DFS) were the study’s primary endpoints. We pooled hazard ratios (HRs) and odds ratios (ORs) to assess the association between Slug protein expression and prognostic and clinicopathological parameters. This study was performed using STATA version 14.0 for data analysis. (Stata Corporation, TX, USA). Results We conducted a literature search by searching six online databases. Ultimately, we obtained eight studies including 1458 patients through strict exclusion criteria. The results showed that increased Slug protein expression resulted in poorer OS (HR = 2.21; 95% CI = 1.47–3.33; P < 0.001) and DFS (HR = 2.03; 95% CI = 1.26–3.28; P = 0.004) in breast cancer patients. In addition, the results suggested that breast cancer patients with increased Slug protein expression had a higher TNM stage (I–II vs III–IV; OR = 0.42; 95% CI = 0.25–0.70; P = 0.001), a greater tendency to have axillary lymph node metastases (N+ vs N0; OR = 2.16; 95% CI = 1.31–3.56; P = 0.003) and were more prone to estrogen receptor deficiency (positive vs negative; OR = 0.67; 95% CI = 0.45–0.99; P = 0.042). However, Slug protein expression was not associated with age, histological grade, tumor size, progesterone receptor status, or human epidermal growth factor receptor 2 status in breast cancer patients. Conclusion This meta-analysis showed that elevated Slug protein expression may be related to poor outcomes in patients with breast cancer. Therefore, Slug is not only an indicator of patient survival but may also become a new target for breast cancer therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02825-6.
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Zeng Y, Zhou L, Jia D, Pan B, Li X, Yu Y. Comprehensive analysis for clarifying transcriptomics landscapes of spread through air spaces in lung adenocarcinoma. Front Genet 2022; 13:900864. [PMID: 36072669 PMCID: PMC9441605 DOI: 10.3389/fgene.2022.900864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
Patients with spread through air spaces (STAS) have worse postoperative survival and a higher recurrence rate in lung adenocarcinoma, even in the earliest phases of the disease. At present, the molecular pathogenesis of STAS is not well understood. Therefore, to illustrate the underlying pathogenic mechanism of STAS, we accomplished a comprehensive analysis of a microarray dataset of STAS. Differential expression analysis revealed 841 differentially expressed genes (DEGs) between STAS_positive and STAS_negative groups. Additionally, we acquired two hub genes associated with survival. Gene set variation analysis (GSVA) confirmed that the main differential signaling pathways between the two groups were hypoxia VHL targets, PKC, and pyrimidine metabolism pathways. Analysis of immune activity showed that the increased expression of MHC-class-Ⅰ was observed in the STAS_positive group. These findings provided novel insights for a better knowledge of pathogenic mechanisms and potential therapeutic markers for STAS treatment.
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Affiliation(s)
- Yuan Zeng
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lingli Zhou
- Department of Respiratory Medicine, Suizhou Hospital, Hubei University of Medicine, Hubei, China
| | - Dexin Jia
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Bo Pan
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xiaomei Li
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yan Yu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
- *Correspondence: Yan Yu,
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Retrospective analysis of the prognostic implications of tumor spread through air spaces in lung adenocarcinoma patients treated with surgery. ESMO Open 2022; 7:100568. [PMID: 36007450 PMCID: PMC9588883 DOI: 10.1016/j.esmoop.2022.100568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Tumor spread through air spaces (STAS) in lung adenocarcinoma is a novel mechanism of invasion. STAS has been proposed as an independent predictor of poor prognosis. The aim of this study was to evaluate the correlations between STAS status and other clinicopathologic variables and to assess the prognostic implications of STAS and the distance from the edge of the tumor to the farthest STAS in patients with resected lung adenocarcinoma. Material and methods This is a single-institution retrospective observational study. We included all patients with resected lung adenocarcinoma from January 2017 to December 2018 at La Paz University Hospital. The cut-off for the distance from the edge of the tumor to the farthest STAS was 1.5 mm and was assessed by the area under the receiver operating characteristic curve. Results A total of 73 patients were included. STAS was found in 52 patients (71.2%). Histological grade 3 (P = 0.035) and absence of lepidic pattern (P = 0.022) were independently associated with the presence of STAS. The median recurrence-free survival (RFS) was 48.06 months [95% confidence interval (CI) 33.58 months to not reached]. STAS-positive patients had shorter median RFS [39.23 months (95% CI 29.34-49.12 months)] than STAS-negative patients (not reached) (P = 0.04). STAS-positive patients with a distance from the edge of the tumor to the farthest STAS ≥1.5 mm had an even shorter median RFS [37.63 months (95% CI 28.14-47.11 months)]. For every 1 mm increase in distance, the risk of mortality increased by 1.26 times (P = 0.04). Conclusions Histological grade 3 and absence of lepidic pattern were independently associated with the presence of STAS. STAS was associated with a higher risk of recurrence. The distance from the edge of the tumor to the farthest STAS also had an impact on overall survival. Lung adenocarcinoma patients with STAS had higher risk of recurrence. Patients with STAS and a distance from the edge of the tumor to the farthest STAS ≥1.5 mm had an even shorter RFS. The distance from the edge of the tumor to the farthest STAS also had an impact on overall survival.
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Alvarez Moreno JC, Aljamal AA, Bahmad HF, Febres-Aldana CA, Rassaei N, Recine M, Poppiti R. Correlation between spread through air spaces (STAS) and other clinicopathological parameters in lung cancer. Pathol Res Pract 2021; 220:153376. [PMID: 33647868 DOI: 10.1016/j.prp.2021.153376] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND "Spread through airspace" (STAS) is defined as micropapillary clusters, solid nests or single cells of tumor extending beyond the edge of the tumor into the air spaces of the surrounding lung parenchyma. It is associated with reduced overall survival and disease-free survival. Assessment of STAS in lung cancer appears to be necessary to guide clinical interventions. However, data on the correlation between the status of STAS and other lung cancer clinicopathological parameters are scarce. METHODS We reviewed 240 resected lung cancers and investigated the clinical significance of STAS in relation to other relevant lung cancer clinicopathological variables. We performed univariate and multivariate logistic regression analyses with STAS as a dependent variable. RESULTS Of the total 240 patients, STAS was observed in 67 (27.9 %) of them. STAS is highly prevalent in adenocarcinoma with a micropapillary growth pattern (70.0 %) than in other lung cancer growth patterns. STAS was frequently reported in wedge resections (31.0%) than in lobectomy specimens (26.7 %). STAS was significantly associated with advanced pN stage (p < 0.001) and lymphovascular invasion (p = 0.005). In multivariate models, we found that lung cancers in the right lower lobe (RLL) (OR, 2.674; 95 % CI = 1.313-5.448, p = 0.007), micropapillary lung cancer growth pattern (OR = 5.199, 95 % CI = 1.220-22.162, p = 0.026), and pN2 stage (OR = 3.683, 95 % CI = 1.324-10.245, p = 0.013) serve as independent predictors for STAS. CONCLUSION Our findings suggest that the presence of STAS is associated with right lower lobe tumors, micropapillary adenocarcinoma, and pN2 tumor stage. Hence, it could serve as one of the prognostically significant histologic findings in lung cancer. It is thus valid to mandate reporting STAS status in CAP surgical pathology lung cancer case summaries.
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Affiliation(s)
- Juan Carlos Alvarez Moreno
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States.
| | - Abed Alhalim Aljamal
- Department of Internal Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States
| | - Hisham F Bahmad
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States
| | - Christopher A Febres-Aldana
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States
| | - Negar Rassaei
- Department of Pathology and Laboratory Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, United States
| | - Monica Recine
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States; Herbert Wertheim College of Medicine. Florida International University, Miami, FL, United States
| | - Robert Poppiti
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL, United States; Herbert Wertheim College of Medicine. Florida International University, Miami, FL, United States
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Ni L, Li Z, Shi X, Yao C, Sun J, Ai M, Li S, Liu Y, Xu F, Zhou Y, Li J, Qiu L. Rosthorin A inhibits non-small cell lung cancer cell growth and metastasis through repressing epithelial-mesenchymal transition via downregulating Slug. Anticancer Drugs 2020; 31:997-1003. [PMID: 33065690 PMCID: PMC7566306 DOI: 10.1097/cad.0000000000000973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/19/2020] [Indexed: 11/29/2022]
Abstract
Lung cancer always ranks first in the number of cancer deaths every year, accounting for 18.4% of total cancer deaths in 2018. Metastasis is the main cause of death in lung cancer patients. The identification of bioactive components of traditional Chinese medicine is very important for the development of novel reagents against non-small cell lung cancer (NSCLC). Rosthorin A has originated from Rabdosia rosthornii (Diels) Hara which excerpts from 'Chinese materia medica', and is known to have 'clear heat phlegm' properties in the folk. Little is known about the biological functions and mechanisms of Rosthorin A in cancer cells at present. The role of EMT in metastasis of a tumor cell is self-evident. Slug is an important EMT inducer, which is related to the development of lung cancer. Cell growth, clone assay, cell migration, cell invasion, and protein expression, and NSCLC transplanted tumor growth were performed in A549, H1299, and H1975 cells. Rosthorin A significantly inhibited the growth of NSCLC cells, it could prolong the survival of nude mice. Rosthorin A inhibited the migration and invasion of A549, H1299, and H1975 cells. Rosthorin A up-regulated E-cadherin expression level and down-regulated the expression of β-catenin, N-cadherin, vimentin, Slug, and Twist. Rosthorin A could promote the expression of E-cadherin and inhibit the development of EMT by downregulating Slug, to inhibit the development and metastasis of NSCLC cells. In summary, Rosthorin A could be used as a promising candidate for the treatment of NSCLC patients with recurrence and metastasis.
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Affiliation(s)
- Lulu Ni
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Zhongjie Li
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi
| | - Xuelin Shi
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi
| | - Chao Yao
- Laboratory of Integrative Medicine, School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai
| | - Jiangnan Sun
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Min Ai
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Shuangshuang Li
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Yixiao Liu
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Fei Xu
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Yuetao Zhou
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
| | - Jiangan Li
- Emergency Department, Wuxi No.2 Hospital Affiliated to Nanjing Medical University, Wuxi, PR China
| | - Liying Qiu
- Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University
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Liu A, Sun X, Xu J, Xuan Y, Zhao Y, Qiu T, Hou F, Qin Y, Wang Y, Lu T, Wo Y, Li Y, Xing X, Jiao W. Relevance and prognostic ability of Twist, Slug and tumor spread through air spaces in lung adenocarcinoma. Cancer Med 2020; 9:1986-1998. [PMID: 31970942 PMCID: PMC7064118 DOI: 10.1002/cam4.2858] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/28/2019] [Accepted: 01/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tumor spread through air spaces (STAS) is a novel pathologic characteristic in lung adenocarcinomas that indicates invasive tumor behavior. We aimed to explore the relationship between Twist, Slug and STAS in lung adenocarcinoma and to investigate the potential relationship between epithelial-mesenchymal transition (EMT) and STAS. MATERIALS AND METHODS Our study retrospectively analyzed 115 patients with resected lung adenocarcinomas to evaluate the relationship between Twist, Slug and STAS. STAS was diagnosed using hematoxylin-eosin (H&E) staining. Immunohistochemistry was used to evaluate the expression levels of Slug and Twist. RESULTS In this study, 56 (48.7%) patients had STAS, 40 (34.8%) patients had Slug overexpression, and 28 (24.3%) patients had Twist overexpression. Patients with either STAS or Slug and Twist overexpression experienced poor recurrence-free survival (RFS) and overall survival (OS). There were significant associations between Twist overexpression, Slug overexpression and the presence of STAS. The logistic model further revealed that pathological stage, Twist overexpression and Slug overexpression were independent risk factors for STAS. A multivariate analysis that contained Twist, Slug, pathologic stage and STAS, showed that pathologic stage and STAS were independent prognostic factors for poor RFS and OS. Another multivariate model that contained Twist, Slug and pathologic stage, showed that pathologic stage, Twist overexpression and Slug overexpression were independent risk factors for poor RFS and OS. In the cohort with STAS, the multivariate analysis showed that pathologic stage and Twist overexpression were independent risk factors for poor survival. The subgroup analysis showed that patients with both Slug overexpression and Twist overexpression with STAS received a poor prognosis. CONCLUSIONS STAS, Slug and Twist were correlated with poor RFS and OS in resected lung adenocarcinomas. Additionally, STAS was correlated with the overexpression of Twist and Slug, which could potentially provide information on the mechanism of STAS.
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Affiliation(s)
- Ao Liu
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Xiao Sun
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jin Xu
- Department of PathologyAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yunpeng Xuan
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yandong Zhao
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Tong Qiu
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Feng Hou
- Department of PathologyAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yi Qin
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yuanyong Wang
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Tong Lu
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yang Wo
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yujun Li
- Department of PathologyAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Xiaoming Xing
- Department of PathologyAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Wenjie Jiao
- Department of Thoracic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
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