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Tafenzi HA, Choulli F, Adjade G, Baladi A, Afani L, Fadli ME, Essaadi I, Belbaraka R. Development of a well-defined tool to predict the overall survival in lung cancer patients: an African based cohort. BMC Cancer 2023; 23:1016. [PMID: 37864151 PMCID: PMC10589978 DOI: 10.1186/s12885-023-11355-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/31/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Nomogram is a graphic representation containing the expressed factor of the mathematical formula used to define a particular phenomenon. We aim to build and internally validate a nomogram to predict overall survival (OS) in patients diagnosed with lung cancer (LC). METHODS We included 1200 LC patients from a single institution registry diagnosed from 2013 to 2021. The independent prognostic factors of LC patients were identified via cox proportional hazard regression analysis. Based on the results of multivariate cox analysis, we constructed the nomogram to predict the OS of LC patients. RESULTS We finally included a total of 1104 LC patients. Age, medical urgency at diagnosis, performance status, radiotherapy, and surgery were identified as prognostic factors, and integrated to build the nomogram. The model performance in predicting prognosis was measured by receiver operating characteristic curve. Calibration plots of 6-, 12-, and 24- months OS showed optimal agreement between observations and model predictions. CONCLUSION We have developed and validated a unique predictive tool that can offer patients with LC an individual OS prognosis. This useful prognostic model could aid doctors in making decisions and planning therapeutic trials.
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Affiliation(s)
- Hassan Abdelilah Tafenzi
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco.
- Faculty of Medicine and Pharmacy, Biosciences and Health Laboratory, Cadi Ayyad University, Marrakech, Morocco.
| | - Farah Choulli
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
- Faculty of Medicine and Pharmacy, Biosciences and Health Laboratory, Cadi Ayyad University, Marrakech, Morocco
| | - Ganiou Adjade
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
| | - Anas Baladi
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
| | - Leila Afani
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
| | - Mohammed El Fadli
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
| | - Ismail Essaadi
- Faculty of Medicine and Pharmacy, Biosciences and Health Laboratory, Cadi Ayyad University, Marrakech, Morocco
- Medical Oncology Department, Avicenna Military Hospital of Marrakech, Marrakech, Morocco
| | - Rhizlane Belbaraka
- Medical Oncology Department, Mohammed VI University Hospital of Marrakech, Marrakech, Morocco
- Faculty of Medicine and Pharmacy, Biosciences and Health Laboratory, Cadi Ayyad University, Marrakech, Morocco
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2
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Liu P, Yang S, Wang Z, Dai H, Wang C. Feasibility and Mechanism Analysis of Shenfu Injection in the Treatment of Idiopathic Pulmonary Fibrosis. Front Pharmacol 2021; 12:670146. [PMID: 34393772 PMCID: PMC8356043 DOI: 10.3389/fphar.2021.670146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Idiopathic pulmonary fibrosis (IPF) is disease with high mortality, and its effective treatment is limited. Shenfu injection is a traditional Chinese medicine which can improve circulation and protect cells. In this study, we aimed to investigate the feasibility and mechanism of Shenfu injection in the treatment of IPF. Methods: The components and targets of Shenfu injection were mainly retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database. The targets of Shenfu injection were standardized by UniProt database. The Genecards and OMIM databases was used to search for IPF-related genes. The Venn diagram of gene intersection was drawn using the OmicStudio tools, and the protein-protein interaction network was visualized using the Cytoscape 3.7.2 software. Moreover, the metascape online software was applied to explore the enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and the Cytoscape 3.7.2 software was used to construct the target-pathway network. Molecular docking was used to visualize the interactions between the main active compounds and targeted proteins. Animal experiments were performed to validate the effects and mechanisms of Shenfu injection. Results: We obtained 46 co-targets of Shenfu injection and IPF. Among the hub target genes, several genes with important functions were enriched, including TNF, IL-6, IL-1B, TP53, JUN, CASP3 and CASP8. The pathway enrichment analysis for the hub target genes identified pathways in infection/inflammation, apoptosis and cancer. Molecular docking results showed that the main active compound Ginsenoside Re had high affinity to the core target proteins. These results suggested that Shenfu injection may have a positive effect in the treatment of IPF. Consistent with this finding, animal experiments showed that Shenfu injection significantly reduced pulmonary fibrosis in a mouse model with inhibition of apoptosis and inflammation by downregulating IL-1β, caspase-3 and phosphorylated NF-κB. Conclusion: Our results demonstrated that Shenfu injection efficiently alleviate bleomycin-induced pulmonary fibrosis through multi-targets in inflammation-, apoptosis- and cancer-related pathways, which provided first evidence and reference to the feasibility of Shenfu injection in the treatment of IPF.
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Affiliation(s)
- Peipei Liu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Shengnan Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Harbin Medical University, Harbin, China
| | - Zai Wang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Center for Respiratory Medicine, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Harbin Medical University, Harbin, China
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3
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Hata A, Nakajima T, Matsusaka K, Fukuyo M, Nakayama M, Morimoto J, Ito Y, Yamamoto T, Sakairi Y, Rahmutulla B, Ota S, Wada H, Suzuki H, Iwata T, Matsubara H, Ohara O, Yoshino I, Kaneda A. Genetic alterations in squamous cell lung cancer associated with idiopathic pulmonary fibrosis. Int J Cancer 2021; 148:3008-3018. [PMID: 33533494 DOI: 10.1002/ijc.33499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 12/21/2022]
Abstract
Patients with idiopathic pulmonary fibrosis (IPF) are at higher risk of developing lung cancers including squamous cell lung carcinoma (SCC), which typically carries a poor prognosis. Although the molecular basis of cancer development subsequent to IPF has not been fully investigated, we recently reported two epigenetic phenotypes characterized by frequent and infrequent DNA hypermethylation in SCC, and an association of the infrequent hypermethylation phenotype with IPF-associated SCCs. Here, we conducted targeted exon sequencing in SCCs with and without IPF using the Human Lung Cancer Panel to investigate the genetic basis of IPF-associated SCC. SCCs with and without IPF displayed comparable numbers of total mutations (137 ± 22 vs 131 ± 27, P = .5), nonsynonymous mutations (72 ± 14 vs 69 ± 16, P = .5), indels (3.0 ± 3.5 vs 3.0 ± 3.9, P = 1) and synonymous mutations (62 ± 9.1 vs 60 ± 12, P = .5). Signature 1 was the predominant signature in SCCs with and without IPF. SETD2 and NFE2L2 mutations were significantly associated with IPF (44% vs 13%, P = .03 for SETD2; 38% vs 10%, P = .04 for NFE2L2). MYC amplification, assessed by copy number variant analysis, was also significantly associated with IPF (18.8% vs 0%, P = .04). Mutations in TP53 and CDKN2A were observed relatively frequently in SCCs with frequent hypermethylation (P = .02 for TP53 and P = .06 for CDKN2A). Survival analysis revealed that the SETD2 mutation was significantly associated with worse prognosis (P = .04). Collectively, we found frequent involvement of SETD2 and NFE2L2 mutations and MYC amplification in SCCs with IPF, and an association of a SETD2 mutation with poorer prognosis.
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Affiliation(s)
- Atsushi Hata
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahiro Nakajima
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keisuke Matsusaka
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Pathology, Chiba University Hospital, Chiba, Japan
| | - Masaki Fukuyo
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Applied Genomics and Development, Kazusa DNA Research Institute, Chiba, Japan
| | - Manabu Nakayama
- Department of Frontier Research and Development, Kazusa DNA Research Institute, Chiba, Japan
| | - Junichi Morimoto
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Ito
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayoshi Yamamoto
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuichi Sakairi
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Bahityar Rahmutulla
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Ota
- Department of Pathology, Chiba University Hospital, Chiba, Japan
| | - Hironobu Wada
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidemi Suzuki
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takekazu Iwata
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Osamu Ohara
- Department of Applied Genomics and Development, Kazusa DNA Research Institute, Chiba, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Atsushi Kaneda
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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4
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Hata A, Nakajima T, Matsusaka K, Fukuyo M, Morimoto J, Yamamoto T, Sakairi Y, Rahmutulla B, Ota S, Wada H, Suzuki H, Matsubara H, Yoshino I, Kaneda A. A low DNA methylation epigenotype in lung squamous cell carcinoma and its association with idiopathic pulmonary fibrosis and poorer prognosis. Int J Cancer 2019; 146:388-399. [PMID: 31241180 DOI: 10.1002/ijc.32532] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/09/2019] [Accepted: 06/14/2019] [Indexed: 12/25/2022]
Abstract
Patients with idiopathic pulmonary fibrosis (IPF) have higher risk of developing lung cancer, for example, squamous cell carcinoma (SCC), and show poor prognosis, while the molecular basis has not been fully investigated. Here we conducted DNA methylome analysis of lung SCC using 20 SCC samples with/without IPF, and noncancerous lung tissue samples from smokers/nonsmokers, using Infinium HumanMethylation 450K array. SCC was clustered into low- and high-methylation epigenotypes by hierarchical clustering analysis. Genes hypermethylated in SCC significantly included genes targeted by polycomb repressive complex in embryonic stem cells, and genes associated with Gene Ontology terms, for example, "transcription" and "cell adhesion," while genes hypermethylated specifically in high-methylation subgroup significantly included genes associated with "negative regulation of growth." Low-methylation subgroup significantly correlated with IPF (78%, vs. 17% in high-methylation subgroup, p = 0.04), and the correlation was validated by additional Infinium analysis of SCC samples (n = 44 in total), and data from The Cancer Genome Atlas (n = 390). The correlation between low-methylation subgroup and IPF was further validated by quantitative methylation analysis of marker genes commonly hypermethylated in SCC (HOXA2, HOXA9 and PCDHGB6), and markers specifically hypermethylated in high-methylation subgroup (DLEC1, CFTR, MT1M, CRIP3 and ALDH7A1) in 77 SCC cases using pyrosequencing (p = 0.003). Furthermore, low-methylation epigenotype significantly correlated with poorer prognosis among all SCC patients, or among patients without IPF. Multivariate analysis showed that low-methylation epigenotype is an independent predictor of poor prognosis. These may suggest that lung SCC could be stratified into molecular subtypes with distinct prognosis, and low-methylation lung SCC that significantly correlates with IPF shows unfavorable outcome.
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Affiliation(s)
- Atsushi Hata
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahiro Nakajima
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keisuke Matsusaka
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaki Fukuyo
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Genome Research and Development, Kazusa DNA Research Institute, Chiba, Japan
| | - Junichi Morimoto
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayoshi Yamamoto
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuichi Sakairi
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Bahityar Rahmutulla
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Ota
- Department of Pathology, Chiba University Hospital, Chiba, Japan
| | - Hironobu Wada
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidemi Suzuki
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Atsushi Kaneda
- Department of Molecular Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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5
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Tomita M, Ayabe T, Maeda R, Nakamura K. Serum Carcinoembryonic Antigen Level Predicts Cancer-Specific Outcomes of Resected Non-Small Cell Lung Cancer With Interstitial Pneumonia. World J Oncol 2018; 9:136-140. [PMID: 30524637 PMCID: PMC6279459 DOI: 10.14740/wjon1163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/24/2018] [Indexed: 12/13/2022] Open
Abstract
Background It has been well accepted that the prognosis of non-small cell lung cancer (NSCLC) patients with interstitial pneumonia (IP) is significantly poor. However, there are only a few studies that indicated the prognostic factors, especially tumor markers, among NSCLC patients with IP. Methods Forty-one NSCLC patients with IP who underwent surgery at our institution were included. Patients died of other diseases including postoperative acute exacerbation (AE) of IP were excluded. Univariate and multivariate analyses were calculated by the Cox proportional hazards regression model. Results The 5-year cancer-specific survival of overall and stage I patients were 37.4% and 39.2%, respectively. The 5-year cancer-specific survival of patients with high serum carcinoembryonic antigen (CEA) level was 9.4%, while that with normal serum CEA level was 55.6%. However, serum cytokeratin-19 fragment (CYFRA 21-1) and squamous cell carcinoma-related antigen (SCC) levels were not associated with patients’ survival. Furthermore, serum CEA level was significantly associated with poorer cancer-specific survival in univariate and multivariate analyses. Conclusions This study demonstrated that serum CEA level might serve as an efficient prognostic indicator after surgery in NSCLC with IP.
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Affiliation(s)
- Masaki Tomita
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan
| | - Takanori Ayabe
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan
| | - Ryo Maeda
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan
| | - Kunihide Nakamura
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan
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6
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Naccache JM, Gibiot Q, Monnet I, Antoine M, Wislez M, Chouaid C, Cadranel J. Lung cancer and interstitial lung disease: a literature review. J Thorac Dis 2018; 10:3829-3844. [PMID: 30069384 DOI: 10.21037/jtd.2018.05.75] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The association between lung cancer (LC) and interstitial lung disease (ILD) can be explained by the shared risk factors like smoking and physiopathology of fibrogenesis and cancerogenesis. The relative LC risk is shown to be 3.5- to 7.3-times higher in ILD, with LC occurrence estimated at 10-20% in ILD, with >15% of ILD patients likely to die from LC. ILD incidence upon LC diagnosis varied from 2.4-10.9%. Primary radiological presentations consist of peripheral lesions, mostly in the inferior pulmonary lobes, either close to or within the ILD areas. There is a trend towards inverted proportion of adenocarcinomas and squamous-cell carcinomas, with EGFR mutations very rarely found. ILD negatively impacted LC prognosis, with surgery associated with increased morbidity-mortality, particularly due to acute exacerbation (AE) of ILD. Limited resection reduced this risk, whilst increasing that of cancer mortality. Studies on radiotherapy that can induce AE-ILD are scarce. Chemotherapy was associated with similar response rates to those in LC patients without ILD, yet worse survival. This difference may be accounted for by ILD patients' poorer health and higher risk of drug-induced pneumonitis. Further studies are warranted to better understand cancer physiopathology within the fibrotic areas, along with the therapeutic strategies required.
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Affiliation(s)
- Jean-Marc Naccache
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Pneumologie, Paris, France
| | - Quentin Gibiot
- Centre Hospitalier Intercommunal de Creteil, Service de Pneumologie, Creteil, France.,INSERM UMR U955, Faculté de Médecine, Université Paris Est (UPEC), Créteil, France
| | - Isabelle Monnet
- Centre Hospitalier Intercommunal de Creteil, Service de Pneumologie, Creteil, France
| | - Martine Antoine
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service d'Anatomie et Cytologie pathologique, Paris, France
| | - Marie Wislez
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Pneumologie, Paris, France.,Sorbonne Universités, UPMC University Paris VI, Theranoscan, Paris, France
| | - Christos Chouaid
- Centre Hospitalier Intercommunal de Creteil, Service de Pneumologie, Creteil, France.,INSERM UMR U955, Faculté de Médecine, Université Paris Est (UPEC), Créteil, France
| | - Jacques Cadranel
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Pneumologie, Paris, France.,Sorbonne Universités, UPMC University Paris VI, Theranoscan, Paris, France
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7
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Tsubochi H, Shibano T, Endo S. Recommendations for perioperative management of lung cancer patients with comorbidities. Gen Thorac Cardiovasc Surg 2017; 66:71-80. [PMID: 29147917 PMCID: PMC5794844 DOI: 10.1007/s11748-017-0864-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/04/2017] [Indexed: 12/25/2022]
Abstract
Objectives To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. Methods We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery. Articles identified by keyword searches were included in the analysis. Results Significant predictive factors for acute exacerbation of idiopathic pulmonary fibrosis were identified. However, no effective perioperative care was identified for prevention of acute exacerbation of interstitial pneumonia. The timing of coronary revascularization and antithrombotic management for cardiovascular diseases are subjects of ongoing research, and acid–base balance is essential in the management of hemodialysis patients with end-stage renal diseases. Conclusions To improve surgical outcomes for lung cancer patients, future studies should continue to study optimal perioperative management of comorbidities.
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Affiliation(s)
- Hiroyoshi Tsubochi
- Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan
| | - Tomoki Shibano
- Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan
| | - Shunsuke Endo
- Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan.
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Mehta K, Moravcikova E, McFall D, Luketich JD, Pennathur A, Donnenberg AD, Donnenberg VS. The Mesenchymal State Predicts Poor Disease-Free Survival in Resectable Non-Small Cell Lung Cancer. Ann Thorac Surg 2017; 104:321-328. [PMID: 28499650 DOI: 10.1016/j.athoracsur.2017.01.091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/19/2017] [Accepted: 01/25/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND The epithelial-mesenchymal transition (EMT) is thought to contribute to the overall invasiveness of malignant cells. Expression of cluster of differentiation (CD) 44 and CD90 mark the mesenchymal state in multiple epithelial malignancies. Their role in lung cancer remains unclear, however. This study evaluated the prognostic significance of CD44 and CD90 coexpression in patients with resectable primary non-small cell lung cancer (NSCLC). METHODS This was a nonconcurrent cohort study of patients with resectable NSCLC, stratified by the degree of expression of CD44/CD90 double-positive cells in their primary tumor. Flow cytometry was used for immunophenotyping of freshly isolated disaggregated tumor. We analyzed the relationship between expression of CD44/CD90 and relapse-free survival. RESULTS We evaluated 37 patients (18 men; median age, 70 years) with NSCLC. For this group, the geometric mean proportion of cells coexpressing CD44/CD90 was 0.52%. Expression of CD44/CD90 was significantly elevated (24.4%, geometric mean) in 6 patients. The median relapse-free survival for patients with high CD44/CD90 coexpression was 7.7 months (95% confidence interval, 4.2 to 11.7) compared with 40 months (95% confidence interval, 18.2 to 77.8) for the group with low CD44/CD90 coexpression (p = 0.00006 by Mantel log-rank test). The assessment of risk based upon CD44/CD90 expression status was not correlated with pathologic staging (p = 0.073 by χ2). CONCLUSIONS High expression of CD44 and CD90 was associated with significantly reduced relapse-free survival in NSCLC patients. These results suggest that CD44 and CD90 may be important markers of tumor progression in NSCLC.
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Affiliation(s)
- Kunal Mehta
- Department of Cardiothoracic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erika Moravcikova
- Department of Cardiothoracic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - David McFall
- Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Department of Molecular Biology, Princeton University, Princeton, New Jersey
| | - James D Luketich
- Department of Cardiothoracic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Arjun Pennathur
- Department of Cardiothoracic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Albert D Donnenberg
- Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Vera S Donnenberg
- Department of Cardiothoracic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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