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Lu T, Zhou L, Chu Z, Song Y, Wang Q, Zhao M, Dai C, Chen L, Cheng G, Wang J, Guo Q. Cordyceps sinensis relieves non-small cell lung cancer by inhibiting the MAPK pathway. Chin Med 2024; 19:54. [PMID: 38528546 DOI: 10.1186/s13020-024-00895-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/23/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE To determine the pharmacodynamic mechanism underlying Cordyceps sinensis relief in a murine model of non-small cell lung cancer (NSCLC). METHODS We created a murine model of NSCLC and studied the potential molecular mechanism by which C. sinensis relieved NSCLC using a combination of transcriptomics, proteomics, and experimental validation. RESULTS C. sinensis markedly suppressed the fluorescence values in mice with NSCLC, improved the pathologic morphology of lung tissue, ameliorated inflammatory cytokines (tumor necrosis factor-alpha, interleukin-6, interleukin-10, and the oxidative stress indicators superoxide dismutase, malondialdehyde, and glutathione peroxidase). Transcriptomics results showed that the therapeutic effect of C. sinensis was primarily involved in the differentiation and activation of T cells. Based on the proteomic results, C. sinensis likely exerted a protective effect by recruiting immune cells and suppressing tumor cell proliferation via the MAPK pathway. Finally, the experimental validation results indicated that C. sinensis significantly decreased the VEGF and Ki67 expression, downregulated RhoA, Raf-1, and c-fos expression, which are related to cell migration and invasion, increased the serum concentration of hematopoietic factors (EPO and GM-CSF), and improved the percentage of immune cells (natural killer cells, dendritic cells, and CD4+ and CD8+ lymphocytes), which enhanced immune function. CONCLUSIONS Based on our preclinical study, C. sinensis was shown to exert a protective effect on NSCLC, primarily by inhibiting the MAPK pathway.
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Affiliation(s)
- Tianming Lu
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Lirun Zhou
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Zheng Chu
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yang Song
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Qixin Wang
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Minghong Zhao
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Chuanhao Dai
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Lin Chen
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Guangqing Cheng
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jigang Wang
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Qiuyan Guo
- State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs, Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Prosperi D, Carideo L, Russo VM, Meucci R, Campagna G, Lastoria S, Signore A. A Systematic Review on Combined [ 18F]FDG and 68Ga-SSA PET/CT in Pulmonary Carcinoid. J Clin Med 2023; 12:jcm12113719. [PMID: 37297914 DOI: 10.3390/jcm12113719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/20/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023] Open
Abstract
Pulmonary carcinoids (PCs) are part of a spectrum of well-differentiated neuroendocrine neoplasms (NENs) and are classified as typical carcinoid (TC) and atypical carcinoid (AC). TC differ from AC not only for its histopathological features but also for its "functional imaging pattern" and prognosis. ACs are more undifferentiated and characterized by higher aggressiveness. Positron emission tomography/computed tomography (PET/CT) with somatostatin analogs (SSA) labeled with Gallium-68 (68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE) has widely replaced conventional imaging with gamma camera using 111In- or 99mTc-labelled compounds and represents now the gold standard for diagnosis and management of NENs. In this setting, as already described for gastro-entero-pancreatic NENs, 18F-Fluorodeoxiglucose ([18F]FDG) in addition to 68Ga-SSA can play an important role in clinical practice, particularly for ACs that show a more aggressive behavior compared to TCs. The aim of this systematic review is to analyze all original studies collected from the PubMed and Scopus databases regarding PCs in which both 68Ga-SSA PET/CT and [18F]FDG PET/CT were performed in order to evaluate the clinical impact of each imaging modality. The following keywords were used for the research: "18F, 68Ga and (bronchial carcinoid or carcinoid lung)". A total of 57 papers were found, of which 17 were duplicates, 8 were reviews, 10 were case reports, and 1 was an editorial. Of the remaining 21 papers, 12 were ineligible because they did not focus on PC or did not compare 68Ga-SSA and [18F]FDG. We finally retrieved and analyzed nine papers (245 patients with TCs and 110 patients with ACs), and the results highlight the importance of the combined use of 68Ga-SSA and [18F]FDG PET/CT for the correct management of these neoplasms.
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Affiliation(s)
- Daniela Prosperi
- Nuclear Medicine Unit, University Hospital Sant'Andrea, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Luciano Carideo
- Nuclear Medicine Unit, IRCCS National Cancer Institute, Fondazione Senatore G. Pascale, 80127 Naples, Italy
| | - Vincenzo Marcello Russo
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University, 00184 Rome, Italy
| | - Rosaria Meucci
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University, 00184 Rome, Italy
- U.O.C. Diagnostic Imaging, PTV Policlinico "Tor Vergata" University, Viale Oxford 81, 00133 Rome, Italy
| | - Giuseppe Campagna
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University, 00184 Rome, Italy
| | - Secondo Lastoria
- Nuclear Medicine Unit, IRCCS National Cancer Institute, Fondazione Senatore G. Pascale, 80127 Naples, Italy
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University, 00184 Rome, Italy
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Li T, Xie Q, Fang YY, Sun Y, Wang XM, Luo Z, Yan GL, He JB, Zheng XQ. Prognostic value of CYFRA 21 - 1 and Ki67 in advanced NSCLC patients with wild-type EGFR. BMC Cancer 2023; 23:295. [PMID: 37004004 PMCID: PMC10064697 DOI: 10.1186/s12885-023-10767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND The prognostic value of cytokeratin 19 fragment (CYFRA 21 - 1) and Ki67 in advanced non-small cell lung cancer (NSCLC) patients with wild-type epidermal growth factor receptor (EGFR) remains to be explored. METHODS In this study, 983 primary NSCLC patients from January 2016 to December 2019 were retrospectively reviewed. Finally, 117 advanced NSCLC patients with wild-type EGFR and 37 patients with EGFR mutation were included and prognostic value of CYFRA 21 - 1 and Ki67 were also identified. RESULTS The patients age, smoking history and the Eastern Corporative Oncology Group (ECOG) performance scores were significantly different between CYFRA21-1 positive and negative groups (p < 0.05), while no significant differences were found in Ki67 high and low groups. The results of over survival (OS) demonstrated that patients with CYFRA21-1 positive had markedly shorter survival time than CYFRA21-1 negative (p < 0.001, For whole cohorts; p = 0.002, For wild-type EGFR). Besides, patients with wild-type EGFR also had shorter survival times than Ki67 high group. Moreover, In CYFRA 21 - 1 positive group, patients with Ki67 high had obviously shorter survival time compared to patients with Ki67 low (median: 24vs23.5 months; p = 0.048). However, Ki67 could not be used as an adverse risk factor for patients with EGFR mutation. Multivariate cox analysis showed that age (HR, 1.031; 95%CI, 1.003 ~ 1.006; p = 0.028), Histopathology (HR, 1.760; 95%CI,1.152 ~ 2.690; p = 0.009), CYFRA 21 - 1 (HR, 2.304; 95%CI,1.224 ~ 4.335; p = 0.01) and Ki67 (HR, 2.130; 95%CI,1.242 ~ 3.652; p = 0.006) served as independent prognostic risk factor for advanced NSCLC patients. CONCLUSIONS Our finding indicated that CYFRA 21 - 1 was an independent prognostic factor for advanced NSCLC patients and Ki67 status could be a risk stratification marker for CYFRA 21 - 1 positive NSCLC patients with wild-type EGFR.
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Affiliation(s)
- Tao Li
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Qi Xie
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Yang-Yang Fang
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Yi Sun
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Xiao Ming Wang
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Zhu Luo
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Gui-Ling Yan
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Jian-Bo He
- Department of Respiratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Xiao-Qun Zheng
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China.
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Zhang L, Gong Y, Zhang L, Liang B, Xu H, Hu W, Jin Z, Wu X, Chen X, Li M, Shi L, Shi Y, Li M, Huang Y, Wang Y, Yang L. Gou Qi Zi inhibits proliferation and induces apoptosis through the PI3K/AKT1 signaling pathway in non-small cell lung cancer. Front Oncol 2022; 12:1034750. [PMID: 36591458 PMCID: PMC9796997 DOI: 10.3389/fonc.2022.1034750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Gou Qi Zi (Lycium barbarum) is a traditional herbal medicine with antioxidative effects. Although Gou Qi Zi has been used to prevent premature aging and in the treatment of non-small cell lung cancer (NSCLC), its mechanism of action in NSCLC remains unclear. The present study utilized network pharmacology to assess the potential mechanism of action of Gou Qi Zi in the treatment of NSCLC. Methods The TCMSP, TCMID, SwissTargetPrediction, DrugBank, DisGeNET, GeneCards, OMIM and TTD databases were searched for the active components of Gou Qi Zi and their potential therapeutic targets in NSCLC. Protein-protein interaction networks were identified and the interactions of target proteins were analyzed. Involved pathways were determined by GO enrichment and KEGG pathway analyses using the Metascape database, and molecular docking technology was used to study the interactions between active compounds and potential targets. These results were verified by cell counting kit-8 assays, BrdU labeling, flow cytometry, immunohistochemistry, western blotting, and qRT-PCR. Results Database searches identified 33 active components in Gou Qi Zi, 199 predicted biological targets and 113 NSCLC-related targets. A network of targets of traditional Chinese medicine compounds and potential targets of Gou Qi Zi in NSCLC was constructed. GO enrichment analysis showed that Gou Qi Zi targeting of NSCLC was mainly due to the effect of its associated lipopolysaccharide. KEGG pathway analysis showed that Gou Qi Zi acted mainly through the PI3K/AKT1 signaling pathway in the treatment of NSCLC. Molecular docking experiments showed that the bioactive compounds of Gou Qi Zi could bind to AKT1, C-MYC and TP53. These results were verified by experimental assays. Conclusion Gou Qi Zi induces apoptosis and inhibits proliferation of NSCLC in vitro and in vivo by inhibiting the PI3K/AKT1 signaling pathway.
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Affiliation(s)
- Lingling Zhang
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanju Gong
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Zhang
- School of Medicine, Jianghan University, Wuhan, China
| | - Bing Liang
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Xu
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wangming Hu
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhong Jin
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao Wu
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiongbin Chen
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Li
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liangqin Shi
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yaping Shi
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mingjian Li
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yong Huang
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yong Wang
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lan Yang
- Basic Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Lan Yang, ;
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Hu B, Jin H, Li X, Wu X, Xu J, Gao Y. The predictive value of total-body PET/CT in non-small cell lung cancer for the PD-L1 high expression. Front Oncol 2022; 12:943933. [PMID: 36212409 PMCID: PMC9538674 DOI: 10.3389/fonc.2022.943933] [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: 05/14/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Total-body positron emission tomography/computed tomography (PET/CT) provides faster scanning speed, higher image quality, and lower injected dose. To compensate for the shortcomings of the maximum standard uptake value (SUVmax), we aimed to normalize the values of PET parameters using liver and blood pool SUV (SUR-L and SUR-BP) to predict programmed cell death-ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC) patients. Materials and methods A total of 138 (104 adenocarcinoma and 34 squamous cell carcinoma) primary diagnosed NSCLC patients who underwent 18F-FDG-PET/CT imaging were analyzed retrospectively. Immunohistochemistry (IHC) analysis was performed for PD-L1 expression on tumor cells and tumor-infiltrating immune cells with 22C3 antibody. Positive PD-L1 expression was defined as tumor cells no less than 50% or tumor-infiltrating immune cells no less than 10%. The relationships between PD-L1 expression and PET parameters (SUVmax, SUR-L, and SUR-BP) and clinical variables were analyzed. Statistical analysis included χ2 test, receiver operating characteristic (ROC), and binary logistic regression. Results There were 36 patients (26%) expressing PD-L1 positively. Gender, smoking history, Ki-67, and histologic subtype were related factors. SUVmax, SUR-L, and SUR-BP were significantly higher in the positive subset than those in the negative subset. Among them, the area under the curve (AUC) of SUR-L on the ROC curve was the biggest one. In NSCLC patients, the best cutoff value of SUR-L for PD-L1-positive expression was 4.84 (AUC = 0.702, P = 0.000, sensitivity = 83.3%, specificity = 54.9%). Multivariate analysis confirmed that age and SUR-L were correlated factors in adenocarcinoma (ADC) patients. Conclusion SUVmax, SUR-L, and SUR-BP had utility in predicting PD-L1 high expression, and SUR-L was the most reliable parameter. PET/CT can offer reference to screen patients for first-line atezolizumab therapy.
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Affiliation(s)
| | | | | | | | - Junling Xu
- *Correspondence: Junling Xu, ; Yongju Gao,
| | - Yongju Gao
- *Correspondence: Junling Xu, ; Yongju Gao,
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T1 and ADC histogram parameters may be an in vivo biomarker for predicting the grade, subtype, and proliferative activity of meningioma. Eur Radiol 2022; 33:258-269. [PMID: 35953734 DOI: 10.1007/s00330-022-09026-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/05/2022] [Accepted: 07/09/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the value of histogram analysis of T1 mapping and diffusion-weighted imaging (DWI) in predicting the grade, subtype, and proliferative activity of meningioma. METHODS This prospective study comprised 69 meningioma patients who underwent preoperative MRI including T1 mapping and DWI. The histogram metrics, including mean, median, maximum, minimum, 10th percentiles (C10), 90th percentiles (C90), kurtosis, skewness, and variance, of T1 and apparent diffusion coefficient (ADC) values were extracted from the whole tumour and peritumoural oedema using FeAture Explorer. The Mann-Whitney U test was used for comparison between low- and high-grade tumours. Receiver operating characteristic (ROC) curve and logistic regression analyses were performed to identify the differential diagnostic performance. The Kruskal-Wallis test was used to further classify meningioma subtypes. Spearman's rank correlation coefficients were calculated to analyse the correlations between histogram parameters and Ki-67 expression. RESULTS High-grade meningiomas showed significantly higher mean, maximum, C90, and variance of T1 (p = 0.001-0.009), lower minimum, and C10 of ADC (p = 0.013-0.028), compared to low-grade meningiomas. For all histogram parameters, the highest individual distinctive power was T1 C90 with an AUC of 0.805. The best diagnostic accuracy was obtained by combining the T1 C90 and ADC C10 with an AUC of 0.864. The histogram parameters differentiated 4/6 pairs of subtype pairs. Significant correlations were identified between Ki-67 and histogram parameters of T1 (C90, mean) and ADC (C10, kurtosis, variance). CONCLUSION T1 and ADC histogram parameters may represent an in vivo biomarker for predicting the grade, subtype, and proliferative activity of meningioma. KEY POINTS • The histogram parameter based on T1 mapping and DWI is useful to preoperatively evaluate the grade, subtype, and proliferative activity of meningioma. • The combination of T1 C90 and ADC C10 showed the best performance for differentiating low- and high-grade meningiomas.
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Simionato Perrotta F, Ribeiro U, Mester M, Sobroza de Mello E, Sado HN, Bezerra Pinheiro RB, Tustumi F, Buchpiguel CA, Zilberstein B, Sallum RAA, Ceconello I. Evaluation of the 18F-FDG-PET/CT uptake association with pathological and immunohistochemistry features in esophagogastric adenocarcinoma. Nucl Med Commun 2022; 43:823-833. [PMID: 35506274 DOI: 10.1097/mnm.0000000000001567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The present study aimed to analyze the association between 18F-fluorodeoxyglucose (FDG) uptake and histologic panel in esophagogastric adenocarcinoma. METHODS We retrospectively enrolled 26 patients with histologically confirmed esophageal, gastroesophageal junction and gastric adenocarcinoma that have been submitted to pretreatment FDG-PET/CT. We collected the cancer tissue sample of each patient and performed immunohistochemical analyses of the glucose transport protein 1 (GLUT-1), Ki-67, cysteine aspartate-specific proteinases (Caspase)-3 and hexokinase-1, and evaluated the association of these parameters with FDG uptake. The FDG uptake was measured by tumor standardized uptake value (SUV), metabolic tumor volume (MTV), and Total Lesion Glycolysis (TLG). Besides, we analyzed the association of FDG uptake and tumor location, Lauren's histologic subtype, grade of cellular differentiation and intratumoral inflammatory infiltrate. RESULTS We found a positive association between GLUT-1 with SUV and TLG, Caspase-3 and SUV and inflammation grade with SUV. CONCLUSION Tumor inflammation infiltrate, GLUT-1 and Caspase-3 correlated with 18F-FDG uptake in PET/CT in esophagogastric adenocarcinoma. These findings may help understand the pathologic PET/CT significance in cancer. Understanding the meaning of the 18F-FDG uptake in the field of tumor histologic and immunohistochemistry features is essential to allow the evolution of PET/CT application in esophageal and gastric carcinomas.
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Wei D, Xin Y, Rong Y, Hao Y. Correlation between the Expression of VEGF and Ki67 and Lymph Node Metastasis in Non-small-Cell Lung Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9693746. [PMID: 35800006 PMCID: PMC9256412 DOI: 10.1155/2022/9693746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/18/2022]
Abstract
Background Lymph node metastasis is the most common and important way of metastasis in NSCLC and is also the most important factor affecting lung cancer stage and prognosis. It is very important to analyze the relationship between the expression of vascular endothelial growth factor (VEGF) and Ki67 and lymph node metastasis (LNM) in non-small-cell lung cancer (NSCLC). Methods We searched the PubMed, EMBASE, and Cochrane Library and conducted meta-analyses using the R meta-package. Relative risk (RR) with a 95% confidence interval (95% CI) was the main indicator. Results Totally, 18 studies were considered eligible, with 4521 patients, including 1518 LNM-positive patients and 3033 LNM-negative patients. The incidence of LNM in Ki67-negative patients was lower than that in Ki67-positive patients (RR = 0.66, 95% CI: 0.44, 0.98). The incidence of LNM in VEGF-A-negative patients was lower than that in VEGF-A-positive patients (RR = 0.64, 95% CI: 0.49, 0.83). The incidence of LNM in VEGF-C negative patients was lower than that in VEGF-C positive patients (RR = 0.68, 95% CI: 0.53, 0.88). The incidence of LNM in VEGF-D negative and positive patients were of no significant differences (RR = 0.84, 95% CI: 0.61, 1.14). Conclusion The high expression of Ki67, VEGF-A, and VEGF-C significantly increases the risk of lymph node metastasis in NSCLC, while the VEGF-D expression has no correlation with lymph node metastasis. The expression levels of Ki67, VEGF-A, and VEGF-C show a good potential for lymph node metastasis prediction.
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Affiliation(s)
- Dong Wei
- Department of Thoracic Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Yunchao Xin
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Yu Rong
- Department of Thoracic Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Yanbing Hao
- Department of Thoracic Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
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Ralli GP, Carter RD, McGowan DR, Cheng WC, Liu D, Teoh EJ, Patel N, Gleeson F, Harris AL, Lord SR, Buffa FM, Fenwick JD. Radiogenomic analysis of primary breast cancer reveals [18F]-fluorodeoxglucose dynamic flux-constants are positively associated with immune pathways and outperform static uptake measures in associating with glucose metabolism. Breast Cancer Res 2022; 24:34. [PMID: 35581637 PMCID: PMC9115966 DOI: 10.1186/s13058-022-01529-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/11/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND PET imaging of 18F-fluorodeoxygucose (FDG) is used widely for tumour staging and assessment of treatment response, but the biology associated with FDG uptake is still not fully elucidated. We therefore carried out gene set enrichment analyses (GSEA) of RNA sequencing data to find KEGG pathways associated with FDG uptake in primary breast cancers. METHODS Pre-treatment data were analysed from a window-of-opportunity study in which 30 patients underwent static and dynamic FDG-PET and tumour biopsy. Kinetic models were fitted to dynamic images, and GSEA was performed for enrichment scores reflecting Pearson and Spearman coefficients of correlations between gene expression and imaging. RESULTS A total of 38 pathways were associated with kinetic model flux-constants or static measures of FDG uptake, all positively. The associated pathways included glycolysis/gluconeogenesis ('GLYC-GLUC') which mediates FDG uptake and was associated with model flux-constants but not with static uptake measures, and 28 pathways related to immune-response or inflammation. More pathways, 32, were associated with the flux-constant K of the simple Patlak model than with any other imaging index. Numbers of pathways categorised as being associated with individual micro-parameters of the kinetic models were substantially fewer than numbers associated with flux-constants, and lay around levels expected by chance. CONCLUSIONS In pre-treatment images GLYC-GLUC was associated with FDG kinetic flux-constants including Patlak K, but not with static uptake measures. Immune-related pathways were associated with flux-constants and static uptake. Patlak K was associated with more pathways than were the flux-constants of more complex kinetic models. On the basis of these results Patlak analysis of dynamic FDG-PET scans is advantageous, compared to other kinetic analyses or static imaging, in studies seeking to infer tumour-to-tumour differences in biology from differences in imaging. Trial registration NCT01266486, December 24th 2010.
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Affiliation(s)
- G P Ralli
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - R D Carter
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Doctoral Training Centre, University of Oxford, Keble Road, Oxford, OX1 3NP, UK
- Department of Physiology, Anatomy and Genetics, University of Oxford, Sherrington Road, Oxford, OX1 3PT, UK
| | - D R McGowan
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK.
- Department of Medical Physics and Clinical Engineering, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, OX3 7LE, UK.
| | - W-C Cheng
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - D Liu
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - E J Teoh
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Department of Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, OX3 7LE, UK
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DS, UK
| | - N Patel
- Department of Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, OX3 7LE, UK
| | - F Gleeson
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Department of Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, OX3 7LE, UK
| | - A L Harris
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DS, UK
| | - S R Lord
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DS, UK
| | - F M Buffa
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - J D Fenwick
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Daulby Street, Liverpool, L69 3GA, UK
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10
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Bu L, Tu N, Wang K, Zhou Y, Xie X, Han X, Lin H, Feng H. Relationship between 18F-FDG PET/CT Semi-Quantitative Parameters and International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society Classification in Lung Adenocarcinomas. Korean J Radiol 2022; 23:112-123. [PMID: 34983098 PMCID: PMC8743143 DOI: 10.3348/kjr.2021.0455] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/30/2021] [Accepted: 09/26/2021] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate the relationship between 18F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. Materials and Methods This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years; age range, 23.0–84.0 years) who had undergone surgical removal of stage IA–IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semi-quantitative parameters were compared between the tumor subtypes using the Mann–Whitney U test or the Kruskal–Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman’s correlation. Statistical significance was set at p < 0.05. Results SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. Conclusion As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.
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Affiliation(s)
- Lihong Bu
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ning Tu
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Wang
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ying Zhou
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinli Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xingmin Han
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiqin Lin
- Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongyan Feng
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China.
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11
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Huang Z, Li X, Wang Z, Meng N, Fu F, Han H, Li D, Bai Y, Wei W, Fang T, Feng P, Yuan J, Yang Y, Wang M. Application of Simultaneous 18 F-FDG PET With Monoexponential, Biexponential, and Stretched Exponential Model-Based Diffusion-Weighted MR Imaging in Assessing the Proliferation Status of Lung Adenocarcinoma. J Magn Reson Imaging 2021; 56:63-74. [PMID: 34888990 DOI: 10.1002/jmri.28010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ki-67 proliferation index (PI) is important for providing information on tumor behavior, treatment response, and prognosis. Integrated positron emission tomography/magnetic resonance (PET/MR) may have the potential to assess Ki-67 PI in patients with lung adenocarcinoma. PURPOSE To explore the value of simultaneous 18 F-fluorodeoxyglucose (18 F-FDG) PET/MR-derived parameters in assessing the proliferation status of lung adenocarcinoma and to determine the best combination of parameters. STUDY TYPE Prospective. POPULATION Seventy-eight patients with lung adenocarcinoma and with Ki-67 PI. FIELD STRENGTH/SEQUENCE 3.0 T, simultaneous PET/MRI including diffusion-weighted imaging (DWI) and 18 F-FDG PET. ASSESSMENT DWI-derived parameters, namely, apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), diffusion heterogeneity index (α), and distributed diffusion coefficient (DDC); and PET-derived parameters, namely, maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), and total lesion glycolytic volume (TLG), were calculated and compared between the high (>25%) and low (≤25%) Ki-67 PI groups. The correlations between PET-derived parameters and DWI-derived parameters were analyzed. STATISTICAL TESTS Student's t-test, Mann-Whitney U test, chi-square test, and receiver operating characteristic (ROC) curves. A P-value <0.05 was considered statistically significant. RESULTS The SUVmax , MTV, TLG, ADC, D, and DDC values were significantly different between the high (N = 35) and low Ki-67 PI groups (N = 43). D, SUVmax , and MTV independently predicted the Ki-67 PI status. The combination of D, SUVmax , and MTV had the largest area under the ROC curve (AUC = 0.900), which was significantly larger than the AUC alone of DDC (AUC = 0.725), SUVmax (AUC = 0.815), MTV (AUC = 0.774), or TLG (AUC = 0.783). The perfusion fraction did not correlate with SUVmax , MTV, or TLG (r = -0.03, -0.11, and -0.04, respectively; P = 0.786, 0.348, and 0.733). DATA CONCLUSION The combination of D, SUVmax , and MTV may predict Ki-67 PI status. No correlation was observed between perfusion parameters and metabolic parameters. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhun Huang
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China
| | - Xiaochen Li
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhixue Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Nan Meng
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Fangfang Fu
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dujuan Li
- Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Yan Bai
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Wei Wei
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Ting Fang
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Pengyang Feng
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, UIH Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
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12
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Gu W, Hu M, Xu L, Ren Y, Mei J, Wang W, Wang C. The Ki-67 Proliferation Index-Related Nomogram to Predict the Response of First-Line Tyrosine Kinase Inhibitors or Chemotherapy in Non-small Cell Lung Cancer Patients With Epidermal Growth Factor Receptor-Mutant Status. Front Med (Lausanne) 2021; 8:728575. [PMID: 34805200 PMCID: PMC8602562 DOI: 10.3389/fmed.2021.728575] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The correlation between Ki-67 and epidermal growth factor receptor (EGFR)- or Kristen rat sarcoma viral oncogene homolog (KRAS)-mutant status in advanced or postoperative-recurrent non-small cell lung cancer (NSCLC) has fewer studies reported, and the prognostic role of Ki-67 with first-line EGFR-tyrosine kinase inhibitors (TKIs) or chemotherapy remains controversial. Methods: A total of 295 patients were tested for EGFR-mutant status in advanced or postoperative-recurrent NSCLC and received first-line EGFR-TKIs or chemotherapy for treatment. Ki-67 expression was retrospectively analyzed by immunohistochemistry. The Kaplan-Meier method was used to calculate survival rates. The multivariate Cox proportional hazards model was used to generate a nomogram. The established nomogram was validated using the calibration plots. Results: The expression levels of Ki-67 were divided into low (<60%, n = 186) and high (≥60%, n = 109) groups, based on the receiver operating characteristic curve. The expression levels of Ki-67 were found to be higher in patients with KRAS mutations when compared to KRAS wildtype, and EGFR wildtype was higher than EGFR mutations. The median overall survival (OS) of the low Ki-67 expression group was significantly longer than that of the high Ki-67 group, no matter in all NSCLC, EGFR mutations, EGFR wildtype, KRAS-mutant status, EGFR-TKIs, or chemotherapy of patients (P < 0.05). Subgroup analysis showed that the KRAS wildtype or EGFR mutations combine with low Ki-67 expression group had the longest median OS than KRAS mutations or EGFR wildtype combine with Ki-67 high expression group (P < 0.05). In the training cohort, the multivariate Cox analysis identified age, serum lactate dehydrogenase (LDH), serum Cyfra211, EGFR mutations, and Ki-67 as independent prognostic factors, and a nomogram was developed based on these covariates. The calibration curve for predicting the 12-, 24-, and 30-month OS showed an optimal agreement between the predicted and actual observed outcomes. Conclusions: The Ki-67 expression-based nomogram can well predict the efficacy of first-line therapy in NSCLC patients with EGFR- or KRAS-mutant status, high expression levels of Ki-67 correlated with a poor prognosis.
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Affiliation(s)
- Weiguo Gu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingbin Hu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linlin Xu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Institute of Molecular Pathology, Nanchang University, Nanchang, China
| | - Yuanhui Ren
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinhong Mei
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Institute of Molecular Pathology, Nanchang University, Nanchang, China
| | - Weijia Wang
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chunliang Wang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
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13
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Song J, Yu Z, Dong B, Zhu M, Guo X, Ma Y, Zhao S, Yang T. Clinical significance of circulating tumour cells and Ki-67 in renal cell carcinoma. World J Surg Oncol 2021; 19:156. [PMID: 34034739 PMCID: PMC8152311 DOI: 10.1186/s12957-021-02268-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/18/2021] [Indexed: 12/27/2022] Open
Abstract
Background Renal cell carcinoma (RCC) is a common malignant tumour of the genitourinary system. We aimed to analyse the potential value of metastasis-related biomarkers, circulating tumour cells (CTCs) and the proliferative marker Ki-67 in the diagnosis of RCC. Methods Data from 24 laparoscopic radical nephrectomies (RNs) and 17 laparoscopic partial nephrectomies (PNs) were collected in 2018. The numbers and positive rates of CTCs and circulating tumour microemboli (CTM) in the peripheral blood were obtained at three different time points: just before surgery, immediately after surgery and 1 week after surgery. Ki-67 protein expression was evaluated in the RCC tissue by immunohistochemistry. Results Except for the statistically significant association between the preoperative CTC counts and tumour size, no association between the number and positive rate of perioperative CTCs and clinicopathological features was found. The CTC counts gradually decreased during the perioperative period, and at 1 week after surgery, they were significantly lower than those before surgery. High Ki-67 expression was significantly positively correlated with preoperative CTC counts. In addition, Ki-67 expression was higher in the high CTC group (≥ 5 CTCs). Conclusion Our results suggest that surgical nephrectomy is associated with a decrease in CTC counts in RCC patients. CTCs can act as a potential biomarker for the diagnosis and prognosis of RCC. A careful and sufficient long-term follow-up is needed for patients with high preoperative CTC counts. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02268-5.
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Affiliation(s)
- Jinbo Song
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Zhe Yu
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Bingqi Dong
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Mingkai Zhu
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xiaofeng Guo
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yongkang Ma
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Shiming Zhao
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Tiejun Yang
- Department of Urology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
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14
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Hendriks AM, Brouwers AH, Giannopoulos P, Lefrandt JD, Timens W, Groen HJM, de Bock GH, Jalving M. 18F-FDG PET/CT Scans Can Identify Sub-Groups of NSCLC Patients with High Glucose Uptake in the Majority of Their Tumor Lesions. J Cancer 2021; 12:562-570. [PMID: 33391452 PMCID: PMC7738988 DOI: 10.7150/jca.45899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Reprogrammed glucose metabolism is a hallmark of cancer making it an attractive therapeutic target, especially in cancers with high glucose uptake such as non-small cell lung cancer (NSCLC). Tools to select patients with high glucose uptake in the majority of tumor lesions are essential in the development of anti-cancer drugs targeting glucose metabolism. Type 2 diabetes mellitus (T2DM) patients may have tumors highly dependent on glucose uptake. Surprisingly, this has not been systematically studied. Therefore, we aimed to determine which patient and tumor characteristics, including concurrent T2DM, are related to high glucose uptake in the majority of tumor lesions in NSCLC patients as measured by 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) scans. Methods: Routine primary diagnostic 18F-FDG PET/CT scans of consecutive NSCLC patients were included. Mean standardized uptake value (SUVmean) of 18F-FDG was determined for all evaluable tumor lesions and corrected for serum glucose levels according to the European Association of Nuclear Medicine Research Ltd guidelines. Patient characteristics potentially determining degree of tumor lesion glucose uptake in the majority of tumor lesions per patient were investigated. Results: The cohort consisted of 102 patients, 28 with T2DM and 74 without T2DM. The median SUVmean per patient ranged from 0.8 to 35.2 (median 4.2). T2DM patients had higher median glucose uptake in individual tumor lesions and per patient compared to non-diabetic NSCLC patients (SUVmean 4.3 vs 2.8, P < 0.001 and SUVmean 5.4 vs 3.7, P = 0.009, respectively). However, in multivariable analysis, high tumor lesion glucose uptake was only independently determined by number of tumor lesions ≥1 mL per patient (odds ratio 0.8, 95% confidence interval 0.7-0.9). Conclusions:18F-FDG PET/CT scans can identify sub-groups of NSCLC patients with high glucose uptake in the majority of their tumor lesions. T2DM patients had higher tumor lesion glucose uptake than non-diabetic patients. However, this was not independent of other factors such as the histological subtype and number of tumor lesions per patient.
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Affiliation(s)
- Anne M Hendriks
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
| | - Adrienne H Brouwers
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Nuclear Medicine and Molecular Imaging
| | - Panagiotis Giannopoulos
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
| | - Joop D Lefrandt
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Internal Medicine
| | - Wim Timens
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Pathology
| | - Harry J M Groen
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Pulmonary Diseases
| | - Geertruida H de Bock
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Epidemiology
| | - Mathilde Jalving
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Department of Medical Oncology
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15
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Boggio F, Del Gobbo A, Croci G, Barella M, Ferrero S. Early stage lung cancer: pathologist's perspective. J Thorac Dis 2020; 12:3343-3348. [PMID: 32642258 PMCID: PMC7330767 DOI: 10.21037/jtd.2019.12.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Francesca Boggio
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Del Gobbo
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Croci
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Barella
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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16
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Correlation between Skip N2 Metastases and SUV max, Long Diameter of Tumor, and Ki67 Expression in Patients with Non-Small-Cell Lung Cancer. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9298358. [PMID: 32420384 PMCID: PMC7201773 DOI: 10.1155/2020/9298358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/09/2020] [Accepted: 03/31/2020] [Indexed: 01/05/2023]
Abstract
Background We aim at investigating the correlation between skip N2 metastases (SN2) and SUVmax, long diameter of tumor mass after 18F-FDG PET/CT, and pathological Ki67 expression in patients with non-small-cell lung cancer (NSCLC). Methods and Results We retrospectively analyzed the factors that might affect the pathogenesis of SN2 in these patients. The clinical SN2 symptoms in patients with squamous carcinoma or adenocarcinoma were investigated. The work curve was utilized to analyze the optimal cutoff value for the SUVmax and long diameter of tumor. Multivariate analysis revealed that high expression of Ki67 was a risk factor for mediastinal SN2 (OR = 1.042, 95% CI: 1.009-1.076). Subgroup analysis indicated that the SUVmax of the non-SN2 group was significantly higher than that of the SN2 group in patients with squamous carcinoma (16.3 ± 6.0 vs. 10.7 ± 5.6, P = 0.026). In the patients with adenocarcinoma, the long diameter of tumor in the SN2 group was significantly longer than that of the non-SN2 group (43.8 ± 16.3 mm vs. 30.1 ± 13.8 mm, P = 0.032). The Ki67 expression in the SN2 group was significantly higher than that of the non-SN2 group (51.7 ± 24.0 vs. 30.0 ± 19.2, P = 0.028). Conclusions The differences of clinical features of the patients in the SN2 group and non-SN2 group in the NSCLC patients were associated with the pathological subtypes, which were featured by lower SUVmax in the SN2 of the squamous carcinoma, and longer diameter of SN2 in the adenocarcinoma patients.
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17
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Histological Grade of Meningioma: Prediction by Intravoxel Incoherent Motion Histogram Parameters. Acad Radiol 2020; 27:342-353. [PMID: 31151902 DOI: 10.1016/j.acra.2019.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/08/2019] [Accepted: 04/16/2019] [Indexed: 11/23/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the usefulness of intravoxel incoherent motion (IVIM) histogram analysis for differentiating low-grade meningiomas (LGMs) and high-grade meningiomas (HGMs). MATERIALS AND METHODS Fifty-nine patients with pathologically confirmed meningiomas (45 LGMs and 14 HGMs) underwent IVIM MR imaging. Maps of IVIM parameters (perfusion fraction, f; true diffusion coefficient, D; and pseudo diffusion coefficient, D*), as well as of the apparent diffusion coefficient (ADC), were generated. Histogram analysis was performed using parametric values from all voxels in regions-of-interest manually drawn to encompass the whole tumor. The histogram results of ADC and IVIM parameters were compared using the Mann-Whitney U test. Area under the receiver operating characteristic curve (AUC) values were generated to evaluate how well each parameter could differentiate LGMs from HGMs. Spearman's rank correlation coefficients were used to evaluate correlations between histogram parameters and Ki-67 expression. RESULTS Compared to LGM, HGM showed significantly higher standard deviation (SD), variance, and coefficient of variation (CV) of ADC (p< 0.006-0.028; AUC, 0.693-0.748), D (p< 0.004-0.032; AUC, 0.670-0.752), and significantly higher CV of f (p< 0.005-0.024; AUC = 0.737). Means and percentiles of ADC and IVIM parameters did not differ significantly between LGM and HGM. Significant positive correlations were identified between Ki-67 and histogram parameters of ADC (SD, variance, kurtosis, skewness, and CV) and D (SD, variance, kurtosis, and CV), whereas no significant correlation with Ki-67 was shown for mean or percentiles of ADC and IVIM parameters. CONCLUSION Heterogeneity histogram parameters of ADC, D, and f may be useful for differentiating LGMs from HGMs.
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18
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Konert T, Everitt S, La Fontaine MD, van de Kamer JB, MacManus MP, Vogel WV, Callahan J, Sonke JJ. Robust, independent and relevant prognostic 18F-fluorodeoxyglucose positron emission tomography radiomics features in non-small cell lung cancer: Are there any? PLoS One 2020; 15:e0228793. [PMID: 32097418 PMCID: PMC7041813 DOI: 10.1371/journal.pone.0228793] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 01/22/2020] [Indexed: 12/14/2022] Open
Abstract
In locally advanced lung cancer, established baseline clinical variables show limited prognostic accuracy and 18F-fluorodeoxyglucose positron emission tomography (FDG PET) radiomics features may increase accuracy for optimal treatment selection. Their robustness and added value relative to current clinical factors are unknown. Hence, we identify robust and independent PET radiomics features that may have complementary value in predicting survival endpoints. A 4D PET dataset (n = 70) was used for assessing the repeatability (Bland-Altman analysis) and independence of PET radiomics features (Spearman rank: |ρ|<0.5). Two 3D PET datasets combined (n = 252) were used for training and validation of an elastic net regularized generalized logistic regression model (GLM) based on a selection of clinical and robust independent PET radiomics features (GLMall). The fitted model performance was externally validated (n = 40). The performance of GLMall (measured with area under the receiver operating characteristic curve, AUC) was highest in predicting 2-year overall survival (0.66±0.07). No significant improvement was observed for GLMall compared to a model containing only PET radiomics features or only clinical variables for any clinical endpoint. External validation of GLMall led to AUC values no higher than 0.55 for any clinical endpoint. In this study, robust independent FDG PET radiomics features did not have complementary value in predicting survival endpoints in lung cancer patients. Improving risk stratification and clinical decision making based on clinical variables and PET radiomics features has still been proven difficult in locally advanced lung cancer patients.
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Affiliation(s)
- Tom Konert
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sarah Everitt
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Matthew D. La Fontaine
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen B. van de Kamer
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael P. MacManus
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Wouter V. Vogel
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jason Callahan
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jan-Jakob Sonke
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- * E-mail:
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19
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Briganti V, Cuccurullo V, Berti V, Di Stasio GD, Linguanti F, Mungai F, Mansi L. 99mTc-EDDA/HYNIC-TOC is a New Opportunity in Neuroendocrine Tumors of the Lung (and in other Malignant and Benign Pulmonary Diseases). Curr Radiopharm 2020; 13:166-176. [PMID: 31886756 PMCID: PMC8193811 DOI: 10.2174/1874471013666191230143610] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/11/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022]
Abstract
Neuroendocrine tumors (NETs) consist of a relatively rare spectrum of malignancies that can arise from neuroendocrine cells; lung NETs (L-NETs) represent about 25% of primary lung neoplasm and 10% of all carcinoid tumors. Diagnostic algorithm usually takes into consideration chest Xray, contrast-enhanced CT and MRI. Nuclear medicine plays a crucial role in the detection and correct assessment of neoplastic functional status as it provides in vivo metabolic data related to the overexpression of Somatostatin Receptors (SSTRs) and also predicting response to peptide receptor radionuclide therapy (PRRT). 111In-Pentreotide (Octreoscan®) is commercially available for imaging of neuroendocrine tumors, their metastases and the management of patients with NETs. More recently, 99mTc-EDDA/HYNIC-TOC(Tektrotyd®) was introduced into the market and its use has been approved for imaging of patients with L-NETs and other SSTR-positive tumors. 99mTc-EDDA/HYNIC-TOC could also represent a good alternative to 68Ga-DOTA-peptides (DOTA-TOC, DOTA-NOC, DOTATATE) in hospitals or centers where PET/CT or 68Ge/68Ga generators are not available. When compared to 111In-Pentetreotide, Tektrotyd® showed slightly higher sensitivity, in the presence of higher imaging quality and lower radiation exposure for patients. Interesting perspectives depending on the kinetic analysis allowed by Tektrotyd® may be obtained in differential diagnosis of non-small cells lung cancer (NSCLC) versus small cells lung cancer (SCLC) and NETs. An interesting perspective could be also associated with a surgery radio-guided by Tektrotyd® in operable lung tumors, including either NETs and NSCLC.
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Affiliation(s)
| | - Vincenzo Cuccurullo
- Address correspondence to this author at the Medicina Nucleare, Università della Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Napoli, Italy; E-mail:
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20
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Wen Q, Zhan Y, Zheng H, Zang H, Luo J, Zhang Y, Wang W, Feng J, Lu J, Chen L, Fan S. Elevated expression of mcl-1 inhibits apoptosis and predicts poor prognosis in patients with surgically resected non-small cell lung cancer. Diagn Pathol 2019; 14:108. [PMID: 31601252 PMCID: PMC6788105 DOI: 10.1186/s13000-019-0884-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/04/2019] [Indexed: 12/16/2022] Open
Abstract
Background Mcl-1, an anti-apoptotic member of bcl-2 family, together with cleaved poly (ADC-ribose) polymerase (c-PARP) can serve as a marker of cell apoptosis. Previously we reported that treatment of Mnk inhibitor CGP57380 resulted in decreased Mcl-1 expression while increased c-PARP expression in non-small cell lung cancer (NSCLC) cells. In this study, we aimed to investigate association between Mcl-1 expression and clinicopathological features of NSCLC, and their correlation between Mcl-1 and both proliferation index (PI) and apoptotic index (AI) in NSCLC patients. Methods Tissue microarrays (TMA) including 350 cases of surgically resected NSCLC were utilize and stained with Mcl-1, Ki-67 and c-PARP antibodies, PI and AI were then evaluated, respectively. Results Higher Mcl-1 expression and PI were observed in NSCLC compared with non-cancerous lung tissues (non-CLT), while AI was significantly lower in lung adenocarcinoma (ADC) compared with non-CLT. Additionally, Mcl-1 expression in lung ADC was evidently higher than that of in lung squamous cell carcinoma (SCC). The elevated Mcl-1 expression was associated with PI, and inversely related to AI in NSCLC. NSCLC patients with elevated Mcl-1 expression and high PI, or with high Mcl-1 expression and low AI had remarkably shorter overall survival time than these patients with low Mcl-1 expression. Conclusions Elevated expression of Mcl-1 might be inversely proportional to disease progression of NSCLC patients by promoting cell proliferation and inhibiting apoptosis, and Mcl-1 might serve as novel biomarker of poor prognosis for NSCLC patients. Supplementary information Supplementary information accompanies this paper at (10.1186/s13000-019-0884-3).
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Affiliation(s)
- Qiuyuan Wen
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Yuting Zhan
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Hongmei Zheng
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Hongjing Zang
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Jiadi Luo
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Yuting Zhang
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Weiyuan Wang
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Juan Feng
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Junmi Lu
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Lingjiao Chen
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Songqing Fan
- Department of Pathology, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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21
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Cuccurullo V, Di Stasio GD, Mansi L. Physiopathological Premises to Nuclear Medicine Imaging of Pancreatic Neuroendocrine Tumours. Curr Radiopharm 2019; 12:98-106. [DOI: 10.2174/1874471012666190206094555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/19/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
Background:
Pancreatic Neuroendocrine Tumors (P-NETs) are a challenge in terms of both
diagnosis and therapy; morphological studies need to be frequently implemented with nonstandard
techniques such as Endoscopic Ultrasounds, Dynamic CT, and functional Magnetic Resonance.
Discussion:
The role of nuclear medicine, being scarcely sensitive F-18 Fluorodeoxyglucose, is mainly
based on the over-expression of Somatostatin Receptors (SSTR) on neuroendocrine tumor cells surface.
Therefore, SSTR can be used as a target for both diagnosis, using radiotracers labeled with gamma or
positron emitters, and therapy. SSTRs subtypes are capable of homo and heterodimerization in specific
combinations that alter both the response to ligand activation and receptor internalization.
Conclusion:
Although agonists usually provide efficient internalization, also somatostatin antagonists
(SS-ANTs) could be used for imaging and therapy. Peptide Receptor Radionuclide Therapy (PRRT)
represents the most successful option for targeted therapy. The theranostic model based on SSTR does
not work in insulinoma, in which different radiotracers such as F-18 FluoroDOPA or tracers for the
glucagon-like peptide-1 receptor have to be preferred.
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Affiliation(s)
- Vincenzo Cuccurullo
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Giuseppe Danilo Di Stasio
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Luigi Mansi
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
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22
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Giordano F, Vaira V, Cortinovis D, Bonomo S, Goedmakers J, Brena F, Cialdella A, Ianzano L, Forno I, Cerrito MG, Giovannoni R, Ferri GL, Tasciotti E, Vicent S, Damarco F, Bosari S, Lavitrano M, Grassilli E. p65BTK is a novel potential actionable target in KRAS-mutated/EGFR-wild type lung adenocarcinoma. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:260. [PMID: 31200752 PMCID: PMC6570906 DOI: 10.1186/s13046-019-1199-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/29/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lung cancer is still the main cause of cancer death worldwide despite the availability of targeted therapies and immune-checkpoint inhibitors combined with chemotherapy. Cancer cell heterogeneity and primary or acquired resistance mechanisms cause the elusive behaviour of this cancer and new biomarkers and active drugs are urgently needed to overcome these limitations. p65BTK, a novel isoform of the Bruton Tyrosine Kinase may represent a new actionable target in non-small cell lung cancer (NSCLC). METHODS p65BTK expression was evaluated by immunohistochemistry in 382 NSCLC patients with complete clinico-pathological records including smoking habit, ALK and EGFR status, and in metastatic lymph nodes of 30 NSCLC patients. NSCLC cell lines mutated for p53 and/or a component of the RAS/MAPK pathway and primary lung cancer-derived cells from Kras/Trp53 null mice were used as a preclinical model. The effects of p65BTK inhibition by BTK Tyrosine Kinase Inhibitors (TKIs) (Ibrutinib, AVL-292, RN486) and first-generation EGFR-TKIs (Gefitinib, Erlotinib) on cell viability were evaluated by MTT. The effects of BTK-TKIs on cell growth and clonogenicity were assessed by crystal violet and colony assays, respectively. Cell toxicity assays were performed to study the effect of the combination of non-toxic concentrations of BTK-TKIs with EGFR-TKIs and standard-of-care (SOC) chemotherapy (Cisplatin, Gemcitabine, Pemetrexed). RESULTS p65BTK was significantly over-expressed in EGFR-wild type (wt) adenocarcinomas (AdC) from non-smoker patients and its expression was also preserved at the metastatic site. p65BTK was also over-expressed in cell lines mutated for KRAS or for a component of the RAS/MAPK pathway and in tumors from Kras/Trp53 null mice. BTK-TKIs were more effective than EGFR-TKIs in decreasing cancer cell viability and significantly impaired cell proliferation and clonogenicity. Moreover, non-toxic doses of BTK-TKIs re-sensitized drug-resistant NSCLC cell lines to both target- and SOC therapy, independently from EGFR/KRAS status. CONCLUSIONS p65BTK results as an emerging actionable target in non-smoking EGFR-wt AdC, also at advanced stages of disease. Notably, these patients are not eligible for EGFR-TKIs-based therapy due to a lack of EGFR mutation. The combination of BTK-TKIs with EGFR-TKIs is cytotoxic for EGFR-wt/KRAS-mutant/p53-null tumors and BTK-TKIs re-sensitizes drug-resistant NSCLC to SOC chemotherapy. Therefore, our data suggest that adding BTK-TKIs to SOC chemotherapy and EGFR-targeted therapy may open new avenues for clinical trials in currently untreatable NSCLC.
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Affiliation(s)
- Federica Giordano
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Sara Bonomo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Joyce Goedmakers
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federica Brena
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Annamaria Cialdella
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Leonarda Ianzano
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Irene Forno
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Roberto Giovannoni
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Present address: Department of Biology, University of Pisa, Pisa, Italy
| | - Gian Luca Ferri
- Department of Biomedical Science, NEF-Laboratory, University of Cagliari, Cagliari, Italy
| | - Ennio Tasciotti
- Center for Biomimetic Medicine, Houston Methodist Research Institute, Houston, TX, USA.,Houston Methodist Orthopedic and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Silve Vicent
- Center for Applied Medical Research, Program in Solid Tumors and Biomarkers, University of Navarra, Pamplona, Spain.,Department of Pathology, Anatomy and Physiology, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Francesco Damarco
- Division of Thoracic Surgery and Lung Tranplantation, Fondazione IRCCS Ca' Granda Ospedale maggiore Policlinico Milano, Milano, Italy
| | - Silvano Bosari
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Emanuela Grassilli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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23
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Pace E, Di Vincenzo S, Di Salvo E, Genovese S, Dino P, Sangiorgi C, Ferraro M, Gangemi S. MiR-21 upregulation increases IL-8 expression and tumorigenesis program in airway epithelial cells exposed to cigarette smoke. J Cell Physiol 2019; 234:22183-22194. [PMID: 31054160 DOI: 10.1002/jcp.28786] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cigarette smoke exposure, increasing Toll-like receptor 4 (TLR4) and reactive oxygen species (ROS), promotes inflammatory responses in airway epithelial cells. Chronic inflammation, microRNA (miRNA), and oxidative stress are associated with cancer development. AIMS The present study was aimed to explore whether cigarette smoke exposure, altering miR-21 expression, promoted inflammatory responses and tumorigenesis processes in airway epithelial cells. METHODS Airway normal and cancer epithelial cells (16HBE and A549) were exposed to cigarette smoke extracts (CSE) or with/without agomiR-21, and then it was assessed: a) miR-21 expression; b) signal transducer and activator of transcription 3 (STAT3) nuclear protein expression and ERK1/2 activation; c) IL-8 gene expression and protein release. An antagonist of TLR4 (CLI-095) and the antioxidant flavonoid, apigenin, were also included to evaluate miR-21 expression in CSE exposed cells. RESULTS It was demonstrated that: a) A549 cells constitutively expressed higher levels of miR-21 and IL-8; b) CSE increased STAT3 nuclear expression in 16HBE; c) in both cell lines, CSE and agomiR-21 increased: miR-21 expression; ERK1/2 activation and IL-8 gene expression and protein release; d) TLR4 inhibition counteracted the effects of CSE on miR-21 in A549; e) apigenin reduced miR-21 and IL-8 gene expression in both cell lines. CONCLUSIONS Data herein provided identified for the first time new mechanisms supporting the crucial role of cigarette smoke-induced miR-21 expression in the amplification of inflammatory responses and in tumorigenesis processes within the airways.
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Affiliation(s)
- Elisabetta Pace
- Institute of Biomedicine and Molecular Immunology "A. Monroy" (IBIM), National Research Council of Italy (CNR), Palermo, Italy
| | - Serena Di Vincenzo
- Institute of Biomedicine and Molecular Immunology "A. Monroy" (IBIM), National Research Council of Italy (CNR), Palermo, Italy
| | - Eleonora Di Salvo
- Institute of Biological Resources and Marine Biotechnology (IRBIM), CNR of Messina, Messina, Italy.,Institute of Applied Sciences & Intelligent Systems "Eduardo Caianiello" (ISASI)-CNR of Messina, Messina, Italy
| | - Sara Genovese
- Institute for Marine and Coastal Environment (IAMC-CNR), National Research Council of Italy (CNR), Messina, Italy
| | - Paola Dino
- Institute of Biomedicine and Molecular Immunology "A. Monroy" (IBIM), National Research Council of Italy (CNR), Palermo, Italy
| | - Claudia Sangiorgi
- Institute of Biomedicine and Molecular Immunology "A. Monroy" (IBIM), National Research Council of Italy (CNR), Palermo, Italy
| | - Maria Ferraro
- Institute of Biomedicine and Molecular Immunology "A. Monroy" (IBIM), National Research Council of Italy (CNR), Palermo, Italy
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, School and Division of Allergy and Clinical Immunology, University of Messina, Messina, Italy
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24
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18F-FDG and 11C-choline uptake in proliferating tumor cells is dependent on the cell cycle in vitro. Ann Nucl Med 2018; 33:237-243. [PMID: 30588580 PMCID: PMC6450840 DOI: 10.1007/s12149-018-01325-6] [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: 10/03/2018] [Accepted: 12/19/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Among different PET tracers, 18F-fludeoxyglucose (FDG) and 11C-choline are known to have a high tumor uptake correlated with a high mitotic index of tumor cells. Thus, the uptake of 18F-FDG and 11C-choline may be dependent on the cell cycle. In the present study, we examined the uptake of 18F-FDG and 11C-choline in cancer cell lines by cell cycle synchronization to clarify the biological properties of cancer cells with respect to each tracer. METHODS HeLa S3 Cells were synchronized by the double thymidine (TdR) block methods. 18F-FDG and 11C-choline were administered to synchronized cells, and the radioactivity per cell was measured to compare the cellular uptake of the tracers during S, G2/M, and G1 phases. Flow cytometry (FCM) was performed to measure the proportion of cells in G1, S, and G2/M phases. Furthermore, the levels of glucose transporter 1 (GLUT1) and choline transporter-like protein 1 (CTL1) in the cell were evaluated by FCM. RESULTS The uptake of 18F-FDG was the highest in S to G2/M phases, and markedly decreased in G1 phase. The uptake of 11C-choline reached its peak in G2/M, and decreased in G1 phase. The level of GLUT1 expression was similar to that of 18F-FDG uptake during the cell cycle, and the level of CTL1 expression was similar to that of 11C-choline uptake throughout the cell cycle. CONCLUSIONS In this in vitro study, we demonstrated that 18F-FDG and 11C-choline had the highest uptake in S to G2/M phases and in G2/M phase, respectively, with a rapid decrease in G1 phase. These findings suggest that 18F-FDG and 11C-choline have a high accumulation in tumor cells with a high mitotic index. Furthermore, our study suggests that the expression of GLUT1 and CTL1 has cell cycle dependence, and the changes of 18F-FDG and 11C-choline accumulation seem to be caused by the above properties of these transporters.
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25
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Molecular and Immunohistochemical Markers with Prognostic and Predictive Significance in Liver Metastases from Colorectal Carcinoma. Int J Mol Sci 2018; 19:ijms19103014. [PMID: 30282914 PMCID: PMC6213422 DOI: 10.3390/ijms19103014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 12/17/2022] Open
Abstract
Despite the significant recent achievements in the diagnosis and treatment of colorectal cancer (CRC), the prognosis of these patients has currently plateaued. During the past few years, the opportunity to consider multiple treatment modalities (including surgery and other locoregional treatments, systemic therapy, and targeted therapy) led to the research of novel prognostic and predictive biomarkers in CRC liver metastases (CRCLM) patients. In this review, we seek to describe the current state of knowledge of CRCLM biomarkers and to outline impending clinical perspectives, in particular focusing on the cutting-edge tools available for their characterization.
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26
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Wei DM, Chen WJ, Meng RM, Zhao N, Zhang XY, Liao DY, Chen G. Augmented expression of Ki-67 is correlated with clinicopathological characteristics and prognosis for lung cancer patients: an up-dated systematic review and meta-analysis with 108 studies and 14,732 patients. Respir Res 2018; 19:150. [PMID: 30103737 PMCID: PMC6088431 DOI: 10.1186/s12931-018-0843-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/13/2018] [Indexed: 02/08/2023] Open
Abstract
Background Lung cancer ranks as the leading cause of cancer-related deaths worldwide and we performed this meta-analysis to investigate eligible studies and determine the prognostic effect of Ki-67. Methods In total, 108 studies in 95 articles with 14,732 patients were found to be eligible, of which 96 studies reported on overall survival (OS) and 19 studies reported on disease-free survival (DFS) with relation to Ki-67 expression in lung cancer patients. Results The pooled hazard ratio (HR) indicated that a high Ki-67 level could be a valuable prognostic factor for lung cancer (HR = 1.122 for OS, P < 0.001 and HR = 1.894 for DFS, P < 0.001). Subsequently, the results revealed that a high Ki-67 level was significantly associated with clinical parameters of lung cancer including age (odd ratio, OR = 1.246 for older patients, P = 0.018), gender (OR = 1.874 for males, P < 0.001) and smoking status (OR = 3.087 for smokers, P < 0.001). Additionally, significant positive correlations were found between Ki-67 overexpression and poorer differentiation (OR = 1.993, P = 0.003), larger tumor size (OR = 1.436, P = 0.003), and higher pathologic stages (OR = 1.867 for III-IV, P < 0.001). Furthermore, high expression of Ki-67 was found to be a valuable predictive factor for lymph node metastasis positive (OR = 1.653, P < 0.001) and advanced TNM stages (OR = 1.497 for stage III-IV, P = 0.024). Finally, no publication bias was detected in any of the analyses. Conclusions This study highlights that the high expression of Ki-67 is clinically relevant in terms of the prognostic and clinicopathological characteristics for lung cancer. Nevertheless, more prospective well-designed studies are warranted to validate these findings. Electronic supplementary material The online version of this article (10.1186/s12931-018-0843-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan-Ming Wei
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Wen-Jie Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Rong-Mei Meng
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Na Zhao
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Xiang-Yu Zhang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Dan-Yu Liao
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
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27
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Konert T, van de Kamer JB, Sonke JJ, Vogel WV. The developing role of FDG PET imaging for prognostication and radiotherapy target volume delineation in non-small cell lung cancer. J Thorac Dis 2018; 10:S2508-S2521. [PMID: 30206495 DOI: 10.21037/jtd.2018.07.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Advancements in functional imaging technology have allowed new possibilities in contouring of target volumes, monitoring therapy, and predicting treatment outcome in non-small cell lung cancer (NSCLC). Consequently, the role of 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has expanded in the last decades from a stand-alone diagnostic tool to a versatile instrument integrated with computed tomography (CT), with a prominent role in lung cancer radiotherapy. This review outlines the most recent literature on developments in FDG PET imaging for prognostication and radiotherapy target volume delineation (TVD) in NSCLC. We also describe the challenges facing the clinical implementation of these developments and present new ideas for future research.
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Affiliation(s)
- Tom Konert
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen B van de Kamer
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan-Jakob Sonke
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wouter V Vogel
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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28
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Liu S, Feng Z, Wen H, Jiang Z, Pan H, Deng Y, Zhang L, Ju X, Chen X, Wu X. 18F-FDG PET/CT can predict chemosensitivity and proliferation of epithelial ovarian cancer via SUVmax value. Jpn J Radiol 2018; 36:544-550. [PMID: 29943313 DOI: 10.1007/s11604-018-0755-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/10/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to explore the clinical and prognostic significance of 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in epithelial ovarian cancer (EOC). METHODS We retrospectively investigated 48 EOC patients who underwent preoperative 18F-FDG PET/CT and primary cytoreductive surgery at our hospital between January 2010 and June 2015. None of these patients received neoadjuvant chemotherapy. PET/CT parameters including the maximum and average standardized uptake value (SUVmax, SUVavg), the metabolic tumor volume (MTV) were measured. Tumor proliferation marker Ki67 was evaluated using immunohistochemistry. The relationships between the PET/CT parameters and chemosensitivity, tumor proliferation, and overall survival (OS) were analyzed, respectively. RESULTS The median (range) SUVmax, SUVavg, and MTV values were 11.42 (3.14-20.20), 4.8 (2.55-9.47), and 150.11 (0.19-792.46), respectively. Overall, 93.8% (45/48) of patients had high-grade serous ovarian cancer. The SUVmax value had a positive correlation with the Ki67 index (P = 0.030, r = 0.314), and a higher SUVmax level was associated with chemosensitivity (P = 0.026). However, neither SUVavg nor MTV had associations with the patients' clinicopathological parameters. None of these three PET/CT parameters were found to be potential predictors of OS. CONCLUSIONS Preoperative 18F-FDG PET/CT had a predictive value on chemosensitivity and proliferation after primary debulking surgery in EOC patients noninvasively.
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Affiliation(s)
- Shuai Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Center for Biomedical Imaging, Fudan University, Shanghai, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zheng Feng
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China
| | - Hao Wen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China
| | - Zhaoxia Jiang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Herong Pan
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Center for Biomedical Imaging, Fudan University, Shanghai, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu Deng
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lei Zhang
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xingzhu Ju
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China
| | - Xiaojun Chen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China
| | - Xiaohua Wu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. .,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.
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Standardized Uptake Values Derived from 18F-FDG PET May Predict Lung Cancer Microvessel Density and Expression of KI 67, VEGF, and HIF-1 α but Not Expression of Cyclin D1, PCNA, EGFR, PD L1, and p53. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:9257929. [PMID: 29983647 PMCID: PMC6011144 DOI: 10.1155/2018/9257929] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/26/2018] [Indexed: 12/19/2022]
Abstract
Background Our purpose was to provide data regarding relationships between 18F-FDG PET and histopathological parameters in lung cancer. Methods MEDLINE library was screened for associations between PET parameters and histopathological features in lung cancer up to December 2017. Only papers containing correlation coefficients between PET parameters and histopathological findings were acquired for the analysis. Overall, 40 publications were identified. Results Associations between SUV and KI 67 were reported in 23 studies (1362 patients). The pooled correlation coefficient was 0.44. In 2 studies (180 patients), relationships between SUV and expression of cyclin D1 were analyzed (pooled correlation coefficient = 0.05). Correlation between SUV and HIF-1α was investigated in 3 studies (288 patients), and the pooled correlation coefficient was 0.42. In 5 studies (310 patients), associations between SUV and MVD were investigated (pooled correlation coefficient = 0.54). In 6 studies (305 patients), relationships between SUV and p53 were analyzed (pooled correlation coefficient = 0.30). In 6 studies (415 patients), associations between SUV and VEGF expression were investigated (pooled correlation coefficient = 0.44). In 5 studies (202 patients), associations between SUV and PCNA were investigated (pooled correlation coefficient = 0.32). In 3 studies (718 patients), associations between SUV and expression of PD L1 were analyzed (pooled correlation coefficient = 0.36). Finally, in 5 studies (409 patients), associations between SUV and EGFR were investigated (pooled correlation coefficient = 0.38). Conclusion SUV may predict microvessel density and expression of VEGF, KI 67, and HIF-1α in lung cancer.
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Kidd M, Modlin IM, Drozdov I, Aslanian H, Bodei L, Matar S, Chung KM. A liquid biopsy for bronchopulmonary/lung carcinoid diagnosis. Oncotarget 2017; 9:7182-7196. [PMID: 29467960 PMCID: PMC5805546 DOI: 10.18632/oncotarget.23820] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/15/2017] [Indexed: 01/31/2023] Open
Abstract
No effective blood biomarker exists to detect and clinically manage bronchopulmonary (BP) neuroendocrine tumors (NET). We developed a blood-based 51 NET-specific transcript set for diagnosis and monitoring and evaluated clinical performance metrics. It accurately diagnosed the tumor and differentiated stable from progressive disease as determined by RECIST criteria. Gene expression was evaluated in: a) publicly available BPNET transcriptomes (GSE35679); b) two BPNET cell-lines; and c) BPNET tissue with paired blood (n = 7). Blood gene expression was assessed in 194 samples including controls, benign lung diseases, malignant lung diseases and small bowel NETs. A separate validation study in 25 age- and gender-matched BPNETs/controls was performed. Gene expression measured by real-time PCR was scored (0–100%; normal: < 14%). Regression analyses, Principal Component Analysis (PCA), hierarchical clustering, Fisher's and non-parametric evaluations were undertaken. All 51 genes were identified in BPNET transcriptomes, tumor samples and cell-lines. Significant correlations were evident between paired tumor and blood (R2:0.63–0.91, p < 0.001). PCA and hierarchical clustering identified blood gene expression was significantly different between lung cancers and benign diseases, including BPNETs. Gene expression was highly correlated (R2: 0.91, p = 1.7 × 10-15) between small bowel and BPNET. For validation, all 25 BPNETs were positive compared to 20% controls (p < 0.0001). Scores were significantly elevated (p < 0.0001) in BPNETs (57 ± 28%) compared to controls (4 ± 5%). BPNETs with progressive disease (85 ± 11%) exhibited higher scores than stable disease (32 ± 7%, p < 0.0001). Blood measurements accurately diagnosed bronchopulmonary carcinoids, distinguishing stable from progressive disease. This marker panel will have clinical utility as a diagnostic liquid biopsy able to define disease activity and progression in real-time.
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Affiliation(s)
- Mark Kidd
- Wren Laboratories, Brandford, CT, USA
| | | | | | | | - Lisa Bodei
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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31
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Massironi S, Del Gobbo A, Cavalcoli F, Fiori S, Conte D, Pellegrinelli A, Milione M, Ferrero S. IMP3 expression in small-intestine neuroendocrine neoplasms: a new predictor of recurrence. Endocrine 2017; 58:360-367. [PMID: 28210937 DOI: 10.1007/s12020-017-1249-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/20/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Small-intestine neuroendocrine neoplasms are heterogeneous neoplasms arising from endocrine cells of the intestinal mucosa. Ki-67 is the main determinant of prognosis in neuroendocrine neoplasms. However, the search for new prognostic makers represents a key point with regard to small-intestine neuroendocrine neoplasms. The oncofetal protein IMP3 plays a role in cell growth and its expression has a prognostic value in lung neoplasms. METHODS From January 1998 to August 2015, all the consecutive small-intestine neuroendocrine neoplasms patients suitable for surgery were included: 51 patients (32 males, median age 68 years) had small-intestine neuroendocrine neoplasms classified according to the WHO 2010 classification. In all the cases IMP3 expression was evaluated on primary tumors and, when available, on nodal and distant metastases. The medical records and pathological slides of these patients were used to determine the clinical characteristics, pathological diagnoses, and outcome information. RESULTS The overall 5-year and 10-year survival rate were 53.9 and 42% respectively. At Cox proportional hazards regression grading was the major factor influencing both OS and progression-free survival at univariate (p = 0.0002 and 0.0051, respectively) and multivariate analysis (p = 0.0004 and 0.0043, respectively). Also IMP3 expression at the nodal metastases resulted a factor significantly associated with progression-free survival at both univariate (p = 0.0066) and multivariate analysis (p = 0.0059, HR 3.58). IMP3 expression did not correlate with the Ki-67 (p = n.s.). CONCLUSIONS In this study, IMP3 at the nodal site resulted to be associated with low progression-free survival in small-intestine neuroendocrine neoplasms, independently of the Ki-67 index. We suggest that the integration of IMP3 and Ki-67 would help better stratify the risk of progression in small-intestine neuroendocrine neoplasms.
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Affiliation(s)
- Sara Massironi
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy.
| | - Alessandro Del Gobbo
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Cavalcoli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
- Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
| | - Stefano Fiori
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
| | - Dario Conte
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
- Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
| | - Alessio Pellegrinelli
- Anatomic Pathology 1, Department of Pathology and Laboratory Medicine, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Massimo Milione
- Anatomic Pathology 1, Department of Pathology and Laboratory Medicine, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Mao Y, Xu R, Liu X, Shi W, Han Y. Elevated fibrous sheath interacting protein 1 levels are associated with poor prognosis in non-small cell lung cancer patients. Oncotarget 2017; 8:12186-12193. [PMID: 28086239 PMCID: PMC5355335 DOI: 10.18632/oncotarget.14575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/09/2016] [Indexed: 12/20/2022] Open
Abstract
In this study, we examined the expression and prognostic value of fibrous sheath interacting protein 1 (FSIP1) in 202 non-small cell lung cancer (NSCLC) patients who underwent lung cancer resection at Shengjing Hospital of China Medical University. FSIP1 mRNA and protein expression were measured in NSCLC tissues and non-tumor adjacent tissues (NATs), and Harrell's concordance index (c-index) was used to evaluate the ability of FSIP1 to predict prognosis. FSIP1 mRNA and protein expression was higher in NSCLC tissues than in NATs. Survival analysis revealed the 5-year overall survival rate to be 35.4% in the FSIP1-positive group and 56.3% in the FSIP1-negative group, and FSIP1-positive status was an independent prognostic factor for poor overall survival. The c-index value of FSIP1 for overall survival was greater than that of Ki67, and the addition of FSIP1 status increased the c-index value of the TNM staging system. These results suggest that evaluating FSIP1 status in addition to TNM stage during routine pathological examinations could improve prognostic predictions in NSCLC patients.
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Affiliation(s)
- Yuqiang Mao
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ran Xu
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xiaoying Liu
- Department of Plastic Surgery, The First Hospital of China Medical University, Shenyang 110001, China
| | - Wenjun Shi
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yun Han
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Immunohistochemical Markers as Predictors of Histopathologic Response and Prognosis in Rectal Cancer Treated with Preoperative Adjuvant Therapy: State of the Art. Gastroenterol Res Pract 2017; 2017:2808235. [PMID: 28326100 PMCID: PMC5343286 DOI: 10.1155/2017/2808235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/23/2017] [Indexed: 01/18/2023] Open
Abstract
We explain the state of the art of the immunohistochemical markers of response in rectal cancers treated with neoadjuvant medical therapies and its implication with prognosis. Neoadjuvant chemoradiotherapy is widely used to improve the outcome of patients with locally advanced rectal cancer, and the evaluation of the effects of medical therapy is to date based on histomorphological examination by applying four grading systems of response to therapy (tumor regression grade (TRG)). The need to identify immunohistochemical markers that could ensure a better assessment of response and possibly provide additional prognostic information has emerged. We identified p53, p27kip1, Ki67, matrix metalloprotease-9, survivin, Ki67 proliferative index, CD133, COX2, CD44v6, thymidylate synthase, thymidine phosphorylase, and dihydropyrimidine dehydrogenase as the most common markers studied in literature to date, and we explained their prognostic potential and their implications in the evaluation of the response to preoperative therapies in rectal cancers.
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Zhang L, Wang Y, Zhang X, Wei X, Xiong X, Zhou S. Enzyme and Redox Dual-Triggered Intracellular Release from Actively Targeted Polymeric Micelles. ACS APPLIED MATERIALS & INTERFACES 2017; 9:3388-3399. [PMID: 28071889 DOI: 10.1021/acsami.6b14078] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Highly effective delivery of therapeutic agents into target cells using nanocarriers and subsequently rapid intracellular release are of great importance in cancer treatment. Here, we developed an enzyme and redox dual-responsive polymeric micelle with active targeting abilities to achieve rapid intracellular drug release. To overcome both its poor solubility in water and instability in the blood circulation, camptothecin (CPT) was chemically conjugated to monomethyl poly(ethylene glycol) (mPEG) via a redox-responsive linker to form polymeric prodrugs. The enzyme-responsive function is achieved by connecting hydrophobic polycaprolactone segments and hydrophilic PEG segments with azo bonds. Additionally, the end of the PEG segment was decorated with phenylboronic acid (PBA), endowing the nanocarriers with active targeting abilities. The dual-responsive targeting polymeric micelles can be generated by self-assembly of a mixture of the polymeric prodrug and enzyme-responsive copolymer. The in vitro drug release profile revealed that CPT was rapidly released from the micelles under a simulated condition similar to the tumor cell microenvironment. In vivo and ex vivo fluorescence imaging indicated that these micelles possess excellent specificity to target hepatoma carcinoma cells. The antitumor effect in mice liver cancer cells (H22) in tumor-bearing Kunming (KM) mice demonstrated that this nanocarrier exhibits high therapeutic efficiency in artificial solid tumors and low toxicity to normal tissues, with a survival rate of approximately 100% after 160 days of treatment.
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Affiliation(s)
- Lei Zhang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
| | - Yi Wang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
| | - Xiaobin Zhang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
| | - Xiao Wei
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
| | - Xiang Xiong
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
| | - Shaobing Zhou
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University , Chengdu 610031, China
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Wang M, Wang Q, Peng WJ, Hu JF, Wang ZY, Liu H, Huang LN. Testin is a tumor suppressor in non-small cell lung cancer. Oncol Rep 2016; 37:1027-1035. [PMID: 28000866 DOI: 10.3892/or.2016.5316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/14/2016] [Indexed: 11/05/2022] Open
Abstract
The Testin gene was previously identified in the fragile chromosomal region FRA7G at 7q31.2. It has been implicated in several types of cancers including prostate, ovarian, breast and gastric cancer. In the present study, we investigated the function of the candidate tumor-suppressor Testin gene in non-small cell lung cancer (NSCLC). In NSCLC cell lines, we observed lower expression of Testin compared to that noted in normal human bronchial epithelial cells. MTT assays, flow cytometry, clonogenic assay and invasion assay showed that the overexpression of the Testin gene inhibited cancer cell proliferation, invasion and colony formation. In tumor xenograft models, Testin markedly inhibited lung cancer cell xenograft formation and growth in athymic nude mice. Taken together, these data suggest that Testin plays an important role in the development and progression of NSCLC. Testin may be an effective novel target in NSCLC prevention and treatment.
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Affiliation(s)
- Ming Wang
- Department of Respiratory and Critical Care Medicine, Anhui Provincial Key Laboratory of Clinical Basic Research on Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Qian Wang
- Department of Respiration, The People's Hospital of Lingbi, Suzhou, Anhui 234000, P.R. China
| | - Wen-Jia Peng
- Department of Epidemiology and Health Statistics, Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Jun-Feng Hu
- Department of Respiratory and Critical Care Medicine, Anhui Provincial Key Laboratory of Clinical Basic Research on Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Zu-Yi Wang
- Department of Cardiothoracic Surgery of the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Hao Liu
- Department of Pharmacy, Engineering Technology Research Center of Biochemical Pharmaceuticals, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Li-Nian Huang
- Department of Respiratory and Critical Care Medicine, Anhui Provincial Key Laboratory of Clinical Basic Research on Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
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Gu S, Zhang R, Gu J, Li X, Lv L, Jiang J, Xu Z, Wang S, Shi C, Wang DP, Wu C. HES5 promotes cellular proliferation of non-small cell lung cancer through STAT3 signaling. Oncol Rep 2016; 37:474-482. [DOI: 10.3892/or.2016.5268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/31/2016] [Indexed: 11/05/2022] Open
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37
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Obeid JM, Wages NA, Hu Y, Deacon DH, Slingluff CL. Heterogeneity of CD8 + tumor-infiltrating lymphocytes in non-small-cell lung cancer: impact on patient prognostic assessments and comparison of quantification by different sampling strategies. Cancer Immunol Immunother 2016; 66:33-43. [PMID: 27770170 DOI: 10.1007/s00262-016-1908-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/27/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Infiltration of non-small-cell lung cancer (NSCLC) by CD8+ T lymphocytes predicts improved patient survival; however, heterogeneity of intratumoral localization complicates this assessment. Strategies for tumor sampling may not accurately represent the whole tumor. We hypothesized that sampling strategies may alter the identification of tumors with high CD8 density and affect the prognostic significance. PATIENTS AND METHODS Twenty-three primary NSCLC tumors were immunohistochemically stained for CD8 and were assessed using automated software with eight different sampling strategies or the whole tumor. Results of all sampling strategies were compared to the whole tumor counts (paired t tests, Pearson's r). Associations between CD8 densities and overall survival were assessed (log-rank test). RESULTS Counts from all eight sampling strategies significantly correlated with whole tumor counts (p ≤ 0.001). However, the magnitude of CD8+ cell counts and categorization into high vs low infiltrate groups were affected by the sampling strategy. The most concordant values were derived from random sampling of 20 % of the tumor, a simulated core biopsy, or from sampling the tumor center. TIL infiltration was associated with survival when sampling the center (p = 0.038), but not the invasive margin (p > 0.2) or other strategies. CONCLUSION Different tumor sampling strategies may yield discordant TIL density results and different stratification for risk assessment. Small biopsies may be particularly unrepresentative. Random sampling of larger tumor areas is recommended. Enumerating CD8+ T cells in the tumor center may have prognostic value.
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Affiliation(s)
- Joseph M Obeid
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Nolan A Wages
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Yinin Hu
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Donna H Deacon
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Craig L Slingluff
- Department of Surgery, University of Virginia, Charlottesville, VA, USA.
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Apostolova I, Ego K, Steffen IG, Buchert R, Wertzel H, Achenbach HJ, Riedel S, Schreiber J, Schultz M, Furth C, Derlin T, Amthauer H, Hofheinz F, Kalinski T. The asphericity of the metabolic tumour volume in NSCLC: correlation with histopathology and molecular markers. Eur J Nucl Med Mol Imaging 2016; 43:2360-2373. [PMID: 27470327 DOI: 10.1007/s00259-016-3452-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/22/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE Asphericity (ASP) is a tumour shape descriptor based on the PET image. It quantitates the deviation from spherical of the shape of the metabolic tumour volume (MTV). In order to identify its biological correlates, we investigated the relationship between ASP and clinically relevant histopathological and molecular signatures in non-small-cell lung cancer (NSCLC). METHODS The study included 83 consecutive patients (18 women, aged 66.4 ± 8.9 years) with newly diagnosed NSCLC in whom PET/CT with 18F-FDG had been performed prior to therapy. Primary tumour resection specimens and core biopsies were used for basic histopathology and determination of the Ki-67 proliferation index. EGFR status, VEGF, p53 and ALK expression were obtained in a subgroup of 44 patients. The FDG PET images of the primary tumours were delineated using an automatic algorithm based on adaptive thresholding taking into account local background. In addition to ASP, SUVmax, MTV and some further descriptors of shape and intratumour heterogeneity were assessed as semiquantitative PET measures. RESULTS SUVmax, MTV and ASP were associated with pathological T stage (Kruskal-Wallis, p = 0.001, p < 0.0005 and p < 0.0005, respectively) and N stage (p = 0.017, p = 0.003 and p = 0.002, respectively). Only ASP was associated with M stage (p = 0.026). SUVmax, MTV and ASP were correlated with Ki-67 index (Spearman's rho = 0.326/p = 0.003, rho = 0.302/p = 0.006 and rho = 0.271/p = 0.015, respectively). The latter correlations were considerably stronger in adenocarcinomas than in squamous cell carcinomas. ASP, but not SUVmax or MTV, showed a tendency for a significant association with the extent of VEGF expression (p = 0.058). In multivariate Cox regression analysis, ASP (p < 0.0005) and the presence of distant metastases (p = 0.023) were significantly associated with progression-free survival. ASP (p = 0.006), the presence of distant metastases (p = 0.010), and Ki-67 index (p = 0.062) were significantly associated with overall survival. CONCLUSION The ASP of primary NSCLCs on FDG PET images is associated with tumour dimensions and molecular markers of proliferation and angiogenesis.
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Affiliation(s)
- Ivayla Apostolova
- Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
| | - Kilian Ego
- Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Ingo G Steffen
- Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Ralph Buchert
- Clinic of Nuclear Medicine, University Medicine Charité, Berlin, Germany
| | | | | | - Sandra Riedel
- Clinic of Pneumology, University Hospital, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Jens Schreiber
- Clinic of Pneumology, University Hospital, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Meinald Schultz
- Institute of Pathology Stendal, Straße der Demokratie 1, Stendal, Germany
| | - Christian Furth
- Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.,Clinic of Nuclear Medicine, University Medicine Charité, Berlin, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Holger Amthauer
- Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.,Clinic of Nuclear Medicine, University Medicine Charité, Berlin, Germany
| | | | - Thomas Kalinski
- Institute for Pathology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,Institute for Pathology Lademannbogen, Hamburg, Germany
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