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Wang M, Chen G, Luo J, Fan Z, Liu Y, Xie C, Gong Y. Case Report: Genetic profiling of small intestine metastasis from poorly differentiated non-small cell lung cancer: report of 2 cases and literature review of the past 5 years. Front Oncol 2023; 13:1265749. [PMID: 38074661 PMCID: PMC10699439 DOI: 10.3389/fonc.2023.1265749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/24/2023] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Poorly differentiated non-small cell lung cancer (NSCLC) is characteristic of high rate of distant metastasis and late stages at diagnosis. Small intestine metastasis is a rare but severe complication of lung cancer with a high rate of mortality. However, there is currently a lack of genetic profile studies on the small intestine metastasis of lung cancer. CASE PRESENTATIONS We present 2 cases of male patients in their 60s with primary NSCLC of low differentiation, initially with no distant metastasis detected. Biopsy samples were obtained from the primary pulmonary lesions, and both patients received systematic radiotherapy (RT) and chemotherapy. However, both cases presented with abdominal pain and distension, and immunohistochemistry of small intestine biopsy samples obtained by endoscopy confirmed lung cancer metastasis. Next generation sequencing was used to explore the genetic profiles from the biopsy samples of both the primary pulmonary lesions and small intestine metastases. The correlated genes responsible for the small intestine metastasis from poorly differentiated NSCLC in these 2 patients included TP53, LRP1B, and FGFR2. The reports of small intestine metastasis from poorly differentiated NSCLC with the past 5 years were systematically reviewed and summarized subsequently. CONCLUSIONS Poorly differentiated NSCLC with small intestine metastases, while rare, substantially impacts the prognosis and poses major challenges for diagnosis and treatment. Through comparisons of genetic profiles between patients and in the same patient before and after metastasis, we identified the mutations in genes such as TP53, LRP1B, and FGFR2, which were correlated with the occurrence and progression of poorly differentiated NSCLC, as well as its small intestinal metastasis. This discovery has the potential to guide clinicians in developing personalized treatment plans through the manipulation of targeted and radiation therapies.
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Affiliation(s)
- Mengqin Wang
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Gang Chen
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiang Luo
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhipeng Fan
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuying Liu
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Conghua Xie
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Gong
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Tumor Precision Diagnosis and Treatment Technology and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
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Yu W, Zhang Q, Ali M, Chen B, Yang Y, Wang L, Sun Q, Wang Y, Wang D. A nomogram for predicting the recurrence of small bowel obstruction after gastrectomy in patients with gastric cancer. World J Surg Oncol 2023; 21:351. [PMID: 37946228 PMCID: PMC10633924 DOI: 10.1186/s12957-023-03197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND This study aimed to create a nomogram for predicting the recurrence of small bowel obstruction (SBO) after gastrectomy in patients with gastric cancer (GC) in order to provide better guidance for its diagnosis and treatment. METHODS A total of 173 patients undergone gastrectomy and developed SBO from January 2015 to October 2022 were admitted into this case-control study. The risk factors of postoperative recurrent SBO were analyzed by univariate and multivariate regression, and a nomogram for predicting the recurrent SBO after gastrectomy was developed using R Studio. RESULTS Thirty-nine cases of postoperative recurrent SBO occurred among the 173 GC patients who underwent radical gastrectomy, and the percentage of recurrent SBO was 22.54% (39/173). Age [odds ratio (OR) = 0.938, p = 0.026], WBC count (OR = 1.547, p < 0.001), tumor size (OR = 1.383, p = 0.024), postoperative metastasis (OR = 11.792, p = 0.030), and the interval from gastrectomy to first SBO (OR = 1.057, p < 0.001) were all identified as independent risk factors for postoperative recurrent SBO by logistic regression analysis. The receiver operating characteristic curve, the calibration curve, the model consistency index, and the decision curve analysis showed that the nomogram had good predictive performance. CONCLUSION Based on these factors, we created a nomogram to predict the occurrence of postoperative recurrent SBO. This novel nomogram could serve as a crucial early warning indicator that would guide doctors to make informed decisions while managing patients with gastric cancer.
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Grants
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. 81972269 the National Natural Science Foundation of China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. YZ2020159 Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
- No. Bk20221144 the Natural Science Foundation of Jiangsu Province
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Affiliation(s)
- Wenhao Yu
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Medical College of Yangzhou University, Yangzhou, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Medical College of Yangzhou University, Yangzhou, China
| | - Muhammad Ali
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Medical College of Yangzhou University, Yangzhou, China
| | - Bangquan Chen
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Medical College of Yangzhou University, Yangzhou, China
| | - Yapeng Yang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Medical College of Yangzhou University, Yangzhou, China
| | - Liuhua Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
| | - Qiannan Sun
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
| | - Yong Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
| | - Daorong Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98 Nantong West Road, Yangzhou, Jiangsu Province, China.
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China.
- Medical College of Yangzhou University, Yangzhou, China.
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Zhong Y, Tang X, Deng B. Capsule Endoscopy-Based Diagnosis of Lung Squamous Cell Carcinoma Associated with Abdominal Pain and Metastasis to Small Intestine: A Case Report. Case Rep Oncol 2023; 16:102-108. [PMID: 36824988 PMCID: PMC9941851 DOI: 10.1159/000529060] [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: 09/28/2022] [Accepted: 01/02/2023] [Indexed: 02/22/2023] Open
Abstract
Gastrointestinal metastases of lung cancer are relatively uncommon, yet occur at a higher frequency than would be expected among patients that exhibit a longer survival interval. Metastases that arise in the small intestines are often associated with no or few symptoms such that their early diagnosis can be challenging. In this report, we describe an extremely rare case of a lung squamous cell carcinoma that had metastasized to the small intestine and was associated with symptoms of abdominal pain. The patient underwent capsule endoscopy which detected an irregular mass in the distal ileum that was hemorrhagic, after which laparoscopic ileal resection and anastomosis in parallel with partial bladder resection were performed. Subsequent pathological biopsy confirmed that the intestinal mass was consistent with metastatic squamous cell carcinoma. With surgery and subsequent maintenance therapy with targeted drugs, the survival of the patient was more than 6 months. As a noninvasive testing strategy, capsule endoscopy can be easily performed to support etiological diagnostic efforts in cases where other diagnostic options are lacking. Early diagnosis and therapeutic intervention can contribute to better prognostic outcomes for GMLC patients.
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Affiliation(s)
- Yihua Zhong
- Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xianjun Tang
- Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Bowen Deng
- Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
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The Clinical Characteristics and Treatments for Large Cell Carcinoma Patients Older than 65 Years Old: A Population-Based Study. Cancers (Basel) 2022; 14:cancers14215231. [PMID: 36358648 PMCID: PMC9658669 DOI: 10.3390/cancers14215231] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Pulmonary large cell carcinoma, a type of non-small cell lung cancer (NSCLC), is a rare neoplasm with poor prognosis. In this study, our aim was to investigate the impact of radiation sequences with surgery for stage III/IV LCC patients between different age groups, especially in the elderly patients. Patients and Methods: The patients with LCC and other types of NSCLC in the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015 were retrospectively analyzed. Then we divided the LCC patients into two age groups: <65 years old group and ≥65 years old group. Propensity score method (PSM) was used to control potential differences between different groups. The overall survival (OS) of LCC patients and other types of NSCLC patients were evaluated by Kaplan−Meier analysis. Univariate and multivariate Cox regression analysis were employed to explore the independent risk factors of OS. The forest plots of HRs for OS were generated to show the above outcomes more visually. Results: In total, 11,349 LCC patients and 129,118 other types of NSCLC patients were enrolled in this study. We divided LCC patients into <65 years old group (4300) and ≥65 years old group (7049). LCC patients was more common in whites (81.4%), males (58.3%), elderly (≥65 years old: 62.1%), east regions (52.7%), upper lobe (51.6%), right-origin of primary (55.4%), with advanced grade (54.2%) or stage (76.7%). After PSM, Kaplan−Meier analysis and multivariate Cox analysis showed significantly worse survival prognosis for LCC patients compared to other types of NSCLC, especially in the group ≥65 years old (HR: 1.230; 95% CI: 1.171−1.291; p < 0.001). For LCC patients, there were some risk survival factors including whites, males, not upper lobe, advanced stage, elder age at diagnosis, bone metastasis, liver metastasis, singled status, no lymphadenectomy, no surgery, and no chemotherapy (p < 0.05). In LCC patients ≥65 years old, radiation after surgery had significantly better impact on overall survival outcomes (HR: 0.863, 95% CI: 0.765−0.973, p = 0.016), whereas radiation prior to surgery (HR: 1.425, 95% CI: 1.059−1.916, p = 0.019) had significantly worse impact on prognosis of patients. In LCC patients <65 years old, radiation sequences with surgery had no significant impact on the OS of patients (p = 0.580), but ≥4 LNRs had significantly survival benefits to prognosis (HR:0.707, 95% CI: 0.584−0.855). Elderly LCC patients had worse malignant tumors than young patients, of which the majority were diagnosed as stage III/IV tumors. Conclusions: Postoperative radiotherapy may achieve a better prognosis for stage III/IV LCC patients older than 65 years old compared to other radiation sequences with surgery.
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Li Z, Liu Z, Yu Z. Application Effect of Somatostatin Combined with Transnasal Ileus Catheterization in Patients with Acute Intestinal Obstruction and Advanced Gastric Cancer. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:9747880. [PMID: 35726291 PMCID: PMC9206574 DOI: 10.1155/2022/9747880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022]
Abstract
Objective: To explore the application of somatostatin combined with nasal plug catheterization in patients with advanced gastric cancer and acute intestinal obstruction. Methods. This study included 94 cases of patients with acute intestinal obstruction and advanced gastric cancer, and according to the length of hospital stay, the patients were randomly divided into two groups: the control group and the study group, with 47 cases in each group. Based on the observations made by the team in the control group given somatostatin combined treatment, we observed two groups of patients with gastrointestinal function, serum index, quality of life, therapeutic effect, and adverse reactions. Results. Abdominal distention, abdominal pain duration, and normal exhaust time were significantly shorter in the study group than in the control group. The study group was higher than the control group in terms of gastrointestinal decompression volume, drainage volume, and abdominal circumference reduction within 24 hours (P < 0.05). After treatment, the levels of CRP, IgA, LPS, and FABP were lower than before, and the levels of CRP, IgA, LPS, and FABP in the former group were much lower than those in the latter group (P < 0.05). Compared with before treatment, the former GIQLI scale score was significantly higher than the latter (P < 0.05). After treatment, the efficiency is much higher than the latter (P < 0.05). After treatment, the former significantly lowers the incidence of postoperative complications of the latter (P < 0.05). Conclusion. For patients with advanced gastric cancer and acute intestinal obstruction, it is safe and feasible to use somatostatin combined with transnasal intestinal obstruction catheterization to restore gastrointestinal function, improve inflammatory response, and promote the improvement of quality of life with high safety and feasibility.
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Affiliation(s)
- Zhenlu Li
- Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Zhen Liu
- Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Zongping Yu
- Department of Emergency Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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