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Aisanjiang M, Dai W, Wu L, Yuan Y, Liu S, Liao G, Li L, Tong X, Zhang H, Chen Y, Liu J, Cheng J, Wang C, Lu Y. Ameliorating lung fibrosis and pulmonary function in diabetic mice: Therapeutic potential of mesenchymal stem cell. Biochem Biophys Res Commun 2024; 737:150495. [PMID: 39126861 DOI: 10.1016/j.bbrc.2024.150495] [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: 05/25/2024] [Revised: 07/27/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
This study aimed to investigate the potential of mesenchymal stem cells (MSCs) in alleviating diabetic lung injury by decreasing inflammation, fibrosis and recovering tissue macrophage homeostasis. To induce pulmonary injuries in an in vivo murine model, we utilized a streptozotocin (STZ), and high-fat diet (HFD) induced diabetic C57 mouse model. Subsequently, human umbilical cord-derived MSCs (hUC-MSCs) were administered through the tail vein on a weekly basis for a duration of 4 weeks. In addition, in vitro experiments involved co-culturing of isolated primary abdominal macrophages from diabetic mice and high glucose-stimulated MLE-12 cells with hUC-MSCs. The objective was to evaluate if hUC-MSCs co-culturing could effectively mitigate cell inflammation and fibrosis. Following hUC-MSCs injection, diabetic mice displayed enhanced pulmonary functional parameters, reduced pulmonary fibrosis, and diminished inflammation. Notably, the dynamic equilibrium of lung macrophages shifted from the M1 phenotype to the M2 phenotype, accompanied by a notable reduction in various indicators associated with inflammation and fibrosis. Results from cell co-culturing experiments further supported this trend, demonstrating a reduction in inflammatory and fibrotic indicators. In conclusion, our findings suggest that hUC-MSCs treatment holds promise in mitigating diabetic pulmonary injury by significantly reducing inflammation, fibrosis and maintain tissue macrophage homeostasis within the lungs. This study sheds light on the therapeutic potential of hUC-MSCs in managing diabetic complications affecting the pulmonary system.
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Affiliation(s)
- Maikeliya Aisanjiang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Wenshu Dai
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Luna Wu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yujia Yuan
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Shuyun Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Guangneng Liao
- Animal experimental center of West China hospital, Sichuan University, Chengdu, China
| | - Lan Li
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Tong
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Heteng Zhang
- Sichuan Neo-Life Stem Cell Biotech Inc., Chengdu, China
| | - Younan Chen
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jingping Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiu Cheng
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Chengshi Wang
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China.
| | - Yanrong Lu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Transplant Engineering and Immunology, NHFPC, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
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Yang Y, Shao X, Li Z, Zhang L, Yang B, Jin B, Hu X, Qu X, Che X, Liu Y. Prognostic heterogeneity of Ki67 in non-small cell lung cancer: A comprehensive reappraisal on immunohistochemistry and transcriptional data. J Cell Mol Med 2024; 28:e18521. [PMID: 39021279 PMCID: PMC11255407 DOI: 10.1111/jcmm.18521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/26/2024] [Accepted: 06/12/2024] [Indexed: 07/20/2024] Open
Abstract
In the present study, the debatable prognostic value of Ki67 in patients with non-small cell lung cancer (NSCLC) was attributed to the heterogeneity between lung adenocarcinoma (LUAD) and lung squamous carcinoma (LUSC). Based on meta-analyses of 29 studies, a retrospective immunohistochemical cohort of 1479 patients from our center, eight transcriptional datasets and a single-cell datasets with 40 patients, we found that high Ki67 expression suggests a poor outcome in LUAD, but conversely, low Ki67 expression indicates worse prognosis in LUSC. Furthermore, low proliferation in LUSC is associated with higher metastatic capacity, which is related to the stronger epithelial-mesenchymal transition potential, immunosuppressive microenvironment and angiogenesis. Finally, nomogram model incorporating clinical risk factors and Ki67 expression outperformed the basic clinical model for the accurate prognostic prediction of LUSC. With the largest prognostic assessment of Ki67 from protein to mRNA level, our study highlights that Ki67 also has an important prognostic value in NSCLC, but separate evaluation of LUAD and LUSC is necessary to provide more valuable information for clinical decision-making in NSCLC.
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Affiliation(s)
- Yujing Yang
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning ProvinceThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
- Department of Oncology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Xinye Shao
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning ProvinceThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
| | - Zhi Li
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
| | - Lingyun Zhang
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
| | - Bowen Yang
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
| | - Bo Jin
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
| | - Xuejun Hu
- Department of Respiratory and Infectious Disease of GeriatricsThe First Hospital of China Medical UniversityShenyangChina
| | - Xiujuan Qu
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning ProvinceThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
| | - Xiaofang Che
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning ProvinceThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
| | - Yunpeng Liu
- Department of Medical OncologyThe First Hospital of China Medical UniversityShenyangChina
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning ProvinceThe First Hospital of China Medical UniversityShenyangChina
- Clinical Cancer Research Center of ShenyangThe First Hospital of China Medical UniversityShenyangChina
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Abbosh C, Hodgson D, Doherty GJ, Gale D, Black JRM, Horn L, Reis-Filho JS, Swanton C. Implementing circulating tumor DNA as a prognostic biomarker in resectable non-small cell lung cancer. Trends Cancer 2024; 10:643-654. [PMID: 38839544 DOI: 10.1016/j.trecan.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/16/2024] [Accepted: 04/24/2024] [Indexed: 06/07/2024]
Abstract
Systemic treatment of resectable non-small cell lung cancer (NSCLC) is evolving with emerging neoadjuvant, perioperative, and adjuvant immunotherapy approaches. Circulating tumor DNA (ctDNA) detection at clinical diagnosis, during neoadjuvant therapy, or after resection may discern high-risk patients who might benefit from therapy escalation or switch. This Review summarizes translational implications of data supporting ctDNA-based risk determination in NSCLC and outstanding questions regarding ctDNA validity/utility as a prognostic biomarker. We discuss emerging ctDNA capabilities to refine clinical tumor-node-metastasis (TNM) staging in lung adenocarcinoma, ctDNA dynamics during neoadjuvant therapy for identifying patients deriving suboptimal benefit, and postoperative molecular residual disease (MRD) detection to escalate systemic therapy. Considering differential relapse characteristics in landmark MRD-negative/MRD-positive patients, we propose how ctDNA might integrate with pathological response data for optimal postoperative risk stratification.
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Affiliation(s)
- Chris Abbosh
- Cancer Biomarker Development, Early Oncology AstraZeneca, Cambridge, UK
| | - Darren Hodgson
- Cancer Biomarker Development, Early Oncology AstraZeneca, Cambridge, UK
| | | | - Davina Gale
- Cancer Biomarker Development, Early Oncology AstraZeneca, Cambridge, UK
| | - James R M Black
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK; Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute and University College London Cancer Institute, London, UK
| | - Leora Horn
- Clinical Development, Late Oncology, AstraZeneca, Nashville, TN, USA
| | - Jorge S Reis-Filho
- Cancer Biomarker Development, Early Oncology, AstraZeneca, Gaithersburg, MD, USA
| | - Charles Swanton
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK; Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute and University College London Cancer Institute, London, UK; Department of Medical Oncology, University College London Hospitals, London, UK.
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Li Z, Liu H, Wang M, Wang X, Pan D, Ma A, Chen Y. Nomogram for the preoperative prediction of Ki-67 expression and prognosis in stage IA lung adenocarcinoma based on clinical and multi-slice spiral computed tomography features. BMC Med Imaging 2024; 24:143. [PMID: 38867154 PMCID: PMC11167796 DOI: 10.1186/s12880-024-01305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/21/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE This study developed and validated a nomogram utilizing clinical and multi-slice spiral computed tomography (MSCT) features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma. Additionally, we assessed the predictive accuracy of Ki-67 expression levels, as determined by our model, in estimating the prognosis of stage IA lung adenocarcinoma. MATERIALS AND METHODS We retrospectively analyzed data from 395 patients with pathologically confirmed stage IA lung adenocarcinoma. A total of 322 patients were divided into training and internal validation groups at a 6:4 ratio, whereas the remaining 73 patients composed the external validation group. According to the pathological results, the patients were classified into high and low Ki-67 labeling index (LI) groups. Clinical and CT features were subjected to statistical analysis. The training group was used to construct a predictive model through logistic regression and to formulate a nomogram. The nomogram's predictive ability and goodness-of-fit were assessed. Internal and external validations were performed, and clinical utility was evaluated. Finally, the recurrence-free survival (RFS) rates were compared. RESULTS In the training group, sex, age, tumor density type, tumor-lung interface, lobulation, spiculation, pleural indentation, and maximum nodule diameter differed significantly between patients with high and low Ki-67 LI. Multivariate logistic regression analysis revealed that sex, tumor density, and maximum nodule diameter were significantly associated with high Ki-67 expression in stage IA lung adenocarcinoma. The calibration curves closely resembled the standard curves, indicating the excellent discrimination and accuracy of the model. Decision curve analysis revealed favorable clinical utility. Patients with a nomogram-predicted high Ki-67 LI exhibited worse RFS. CONCLUSION The nomogram utilizing clinical and CT features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma demonstrated excellent performance, clinical utility, and prognostic significance, suggesting that this nomogram is a noninvasive personalized approach for the preoperative prediction of Ki-67 expression.
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Affiliation(s)
- Zhengteng Li
- Department of Radiology, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Hongmei Liu
- Thyroid and Breast Surgery, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Min Wang
- Department of Radiology, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Xiankai Wang
- Department of Radiology, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Dongmei Pan
- Department of Radiology, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Aidong Ma
- Department of Radiology, Jining No.1 People's Hospital, No. 6 Jiankang Road, Rencheng District, Jining, 272000, China
| | - Yang Chen
- Department of Radiology, Yantai Yeda Hospital, Yantai Economic and Technological Development Zone, No. 11 Taishan Road, Yantai, 264000, China.
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Razmi M, Tajik F, Hashemi F, Yazdanpanah A, Hashemi-Niasari F, Divsalar A. The Prognostic Importance of Ki-67 in Gastrointestinal Carcinomas: A Meta-analysis and Multi-omics Approach. J Gastrointest Cancer 2024; 55:599-624. [PMID: 38411875 DOI: 10.1007/s12029-024-01022-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE This study aimed to determine if Ki-67, a commonly used marker to measure tumor proliferation, is a reliable prognostic factor in various types of gastrointestinal (GI) cancers based on current high-quality multivariable evidence. METHODS A comprehensive search was conducted in PubMed, Embase, Scopus, and ISI Web of Science databases to investigate the association between Ki-67 positivity and overall survival (OS) and disease/recurrence-free survival (DFS/RFS) in GI cancers. Heterogeneity was assessed using Chi-square-based Q and I2 analyses and publication bias using funnel plots and Egger's analysis. In addition, Ki-67 levels in different GI cancers were examined by different platforms. The prognostic capability of Ki-67, gene ontology (GO), and pathway enrichment analysis were obtained from GEPIA2 and STRING. RESULTS Totally, 61 studies, involving 13,034 patients, were deemed eligible for our evaluation. The combined hazard ratios (HRs) demonstrated the prediction ability of overexpressed Ki-67 for a worse OS (HR: 1.67, P < 0.001; HR: 1.37, P = 0.021) and DFS/RFS (HR: 2.06, P < 0.001) in hepatocellular and pancreatic malignancies, respectively, as confirmed by multi-omics databases. However, similar correlation was not found in esophageal, gastric, and colorectal cancers. Furthermore, most of the associations were identified to be robust based on different subcategories and publication bias assessment. Finally, enriched Ki-67-related genes were found to be involved in various important signaling pathways, such as cell cycle, P53 signaling network, and DNA damage responses. CONCLUSION This study supports that Ki-67 can serve as an independent prognostic biomarker for pancreatic and hepatocellular malignancies in clinical settings.
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Affiliation(s)
- Mahdieh Razmi
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Tajik
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Surgery, University of California, Irvine, CA, USA
| | - Farideh Hashemi
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ayna Yazdanpanah
- Department of Tissue Engineering and Regenerative Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hashemi-Niasari
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Adeleh Divsalar
- Department of Cell and Molecular Sciences, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
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Lu F, Wang E, Liu H. Factors correlating the expression of PD-L1. BMC Cancer 2024; 24:642. [PMID: 38796458 PMCID: PMC11127358 DOI: 10.1186/s12885-024-12400-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
OBJECTIVE PD-L1 was an important biomarker in lung adenocarcinoma. The study was to confirm the most important factor affecting the expression of PD-L1 remains undetermined. METHODS The clinical records of 1045 lung adenocarcinoma patients were retrospectively reviewed. The High-Resolution Computed Tomography (HRCT) scanning images of all the participants were analyzed, and based on the CT characteristics, the adenocarcinomas were categorized according to CT textures. Furthermore, PD-L1 expression and Ki67 index were detected by immunohistochemistry. All patients underwent EGFR mutation detection. RESULTS Multivariate logistic regression analysis revealed that smoking (OR: 1.73, 95% CI: 1.04-2.89, p = 0.004), EGFR wild (OR: 1.52, 95% CI: 1.11-2.07, p = 0.009), micropapillary subtypes (OR: 2.05, 95% CI: 1.46-2.89, p < 0.0001), and high expression of Ki67 (OR: 2.02, 95% CI: 1.44-2.82, p < 0.0001) were independent factors which influence PD-L1 expression. In univariate analysis, tumor size > 3 cm and CT textures of pSD showed a correlation with high expression of PD-L1. Further analysis revealed that smoking, micropapillary subtype, and EGFR wild type were also associated with high Ki67 expression. Moreover, high Ki67 expression was observed more frequently in tumors of size > 3 cm than in tumors with ≤ 3 cm size as well as in CT texture of pSD than lesions with GGO components. In addition, multivariate logistic regression analysis revealed that only lesions with micropapillary components correlated with pSD (OR: 3.96, 95% CI: 2.52-5.37, p < 0.0001). CONCLUSION This study revealed that in lung adenocarcinoma high Ki67 expression significantly influenced PD-L1 expression, an important biomarker for immune checkpoint treatment.
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Affiliation(s)
- Fang Lu
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Ernuo Wang
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Haiquan Liu
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, 200040, China.
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Wang M, Mei T, Gong Y. The quality and clinical translation of radiomics studies based on MRI for predicting Ki-67 levels in patients with breast cancer. Br J Radiol 2023; 96:20230172. [PMID: 37724784 PMCID: PMC10546437 DOI: 10.1259/bjr.20230172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/13/2023] [Accepted: 08/02/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE To evaluate the methodological quality of radiomics literature predicting Ki-67 levels based on MRI in patients with breast cancer (BC) and to propose suggestions for clinical translation. METHODS In this review, we searched PubMed, Embase, and Web of Science for studies published on radiomics in patients with BC. We evaluated the methodological quality of the studies using the Radiomics Quality Score (RQS). The Cochrane Collaboration's software (RevMan 5.4), Meta-DiSc (v. 1.4) and IBM SPSS (v. 26.0) were used for all statistical analyses. RESULTS Eighteen studies met our inclusion criteria, and the average RQS was 10.17 (standard deviation [SD]: 3.54). None of these studies incorporated any of the following items: a phantom study on all scanners, cut-off analyses, prospective study, cost-effectiveness analysis, or open science and data. In the meta-analysis, it showed apparent diffusion coefficient (ADC) played a better role to predict Ki-67 level than dynamic contrast-enhanced (DCE) MRI in the radiomics, with the pooled area under the curve (AUC) of 0.969. CONCLUSION Ki-67 index is a common tumor biomarker with high clinical value. Radiomics is an ever-growing quantitative data-mining method helping predict tumor biomarkers from medical images. However, the quality of the reviewed studies evaluated by the RQS was not so satisfactory and there are ample opportunities for improvement. Open science and data, external validation, phantom study, publicly open radiomics database and standardization in the radiomics practice are what researchers should pay more attention to in the future. ADVANCES IN KNOWLEDGE The RQS tool considered the radiomics used to predict the Ki-67 level was of poor quality. ADC performed better than DCE in radiomic prediction. We propose some measures to facilitate the clinical translation of radiomics.
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Affiliation(s)
- Min Wang
- Division of Thoracic Tumor Multidisciplinary Treatment, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Mei
- Division of Thoracic Tumor Multidisciplinary Treatment, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Youling Gong
- Division of Thoracic Tumor Multidisciplinary Treatment, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Meng N, Zhang M, Ren J, Fu F, Xie B, Wu Y, Li Z, Dai B, Li Y, Feng T, Xu T, Wang M. Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT for the assessment of histological feature of pulmonary lesions. Quant Imaging Med Surg 2023; 13:5579-5592. [PMID: 37711783 PMCID: PMC10498229 DOI: 10.21037/qims-23-186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/30/2023] [Indexed: 09/16/2023]
Abstract
Background To investigate the value of quantitative parameters related to static imaging and fast kinetics imaging of total-body (TB) 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in differentiating benign from malignant pulmonary lesions and squamous cell carcinoma (SCC) from adenocarcinoma (AC) and to analyze the correlation of each parameter with the Ki-67 index. Methods A total of 108 patients with pulmonary lesions from July 2021 to May 2022 in the Henan Provincial People's Hospital, China, were consecutively recruited for TB 18F-FDG PET/CT in this prospective study. Static imaging parameters maximum standardized uptake value (SUVmax) and fast kinetics imaging parameters transport constant (K1), rate constants (k2), time delay (td), and fractional blood volume (vb) were calculated and compared. The area under the receiver operating characteristic (ROC) curve (AUC), Delong test, Logistic regression analyses, and Pearson correlation were used to assess diagnostic efficacy, find independent predictors and analyse correlations respectively. Results Malignant lesions had higher SUVmax and K1 and lower vb than benign lesions, and SCC had higher SUVmax and K1 and lower td and vb than AC (all P<0.05). For the differentiation of benign and malignant lesions, SUVmax, K1, and vb were independent predictors, and AUC (SUVmax + K1+ vb) =0.909 (95% CI: 0.839-0.956), AUC (SUVmax) =0.883 (95% CI: 0.807-0.937), AUC (K1) =0.810 (95% CI: 0.723-0.879), and AUC (vb) =0.746 (95% CI: 0.653-0.825), where AUC (SUVmax + K1+ vb) was significantly different from AUC (K1), AUC (vb) (Z=3.006, 3.965, all P<0.05). For the differentiation of SCC and AC, SUVmax, K1, td, and vb were independent predictors, and AUC (SUVmax + K1+ td + vb) =0.946 (95% CI: 0.840-0.991), AUC (SUVmax) =0.818 (95% CI: 0.680-0.914), AUC (K1) =0.770 (95% CI: 0.626-0.879), AUC (vb) =0.737 (95% CI: 0.590-0.853), and AUC (td) =0.669 (95% CI: 0.510-0.791), where AUC (SUVmax + K1+ td + vb) was significantly different from AUC (SUVmax), AUC (K1), AUC (vb), and AUC (td) (Z=2.269, 2.821, 2.848, and 3.276, all P<0.05). SUVmax and K1 were moderately and mildly positively correlated with the Ki-67 index (r=0.541, 0.452, all P<0.05), respectively. Conclusions Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT can be used to differentiate benign from malignant pulmonary lesions and SCC from AC and to assess Ki-67 expression.
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Affiliation(s)
- Nan Meng
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China
| | - Meng Zhang
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Jipeng Ren
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Beichen Xie
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Zhong Li
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Bo Dai
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Yuxia Li
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Tao Feng
- United Imaging Healthcare America Inc. TX, USA
| | - Tianyi Xu
- United Imaging Healthcare, Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China
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Liu F, Li Q, Xiang Z, Li X, Li F, Huang Y, Zeng Y, Lin H, Fang X, Yang Q. CT radiomics model for predicting the Ki-67 proliferation index of pure-solid non-small cell lung cancer: a multicenter study. Front Oncol 2023; 13:1175010. [PMID: 37706180 PMCID: PMC10497212 DOI: 10.3389/fonc.2023.1175010] [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: 02/27/2023] [Accepted: 08/07/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose This study aimed to explore the efficacy of the computed tomography (CT) radiomics model for predicting the Ki-67 proliferation index (PI) of pure-solid non-small cell lung cancer (NSCLC). Materials and methods This retrospective study included pure-solid NSCLC patients from five centers. The radiomics features were extracted from thin-slice, non-enhanced CT images of the chest. The minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) were used to reduce and select radiomics features. Logistic regression analysis was employed to build predictive models to determine Ki-67-high and Ki-67-low expression levels. Three prediction models were established: the clinical model, the radiomics model, and the nomogram model combining the radiomics signature and clinical features. The prediction efficiency of different models was evaluated using the area under the curve (AUC). Results A total of 211 NSCLC patients with pure-solid nodules or masses were included in the study (N=117 for the training cohort, N=49 for the internal validation cohort, and N=45 for the external validation cohort). The AUC values for the clinical models in the training, internal validation, and external validation cohorts were 0.73 (95% CI: 0.64-0.82), 0.75 (95% CI:0.62-0.89), and 0.72 (95% CI: 0.57-0.86), respectively. The radiomics models showed good predictive ability in diagnosing Ki-67 expression levels in the training cohort (AUC, 0.81 [95% CI: 0.73-0.89]), internal validation cohort (AUC, 0.81 [95% CI: 0.69-0.93]) and external validation cohort (AUC, 0.78 [95% CI: 0.64-0.91]). Compared to the clinical and radiomics models, the nomogram combining both radiomics signatures and clinical features had relatively better diagnostic performance in all three cohorts, with the AUC of 0.83 (95% CI: 0.76-0.90), 0.83 (95% CI: 0.71-0.94), and 0.81 (95% CI: 0.68-0.93), respectively. Conclusion The nomogram combining the radiomics signature and clinical features may be a potential non-invasive method for predicting Ki-67 expression levels in patients with pure-solid NSCLC.
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Affiliation(s)
- Fen Liu
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qingcheng Li
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Zhiqiang Xiang
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiaofang Li
- Department of Radiology, The Affiliated Huaihua Hospital, Hengyang Medical School, University of South China, Huaihua, China
| | - Fangting Li
- Department of Radiology, People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Yingqiong Huang
- Department of Radiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Ye Zeng
- Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Huashan Lin
- Department of Pharmaceutical Diagnosis, GE Healthcare, Changsha, China
| | - Xiangjun Fang
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qinglai Yang
- Center for Molecular Imaging Probe, Hunan Province Key Laboratory of Tumor Cellular and Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Sun H, Zhou P, Chen G, Dai Z, Song P, Yao J. Radiomics nomogram for the prediction of Ki-67 index in advanced non-small cell lung cancer based on dual-phase enhanced computed tomography. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04856-2. [PMID: 37204513 DOI: 10.1007/s00432-023-04856-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/13/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE To develop a radiomics nomogram based on dual-phase enhanced computed tomography (CT) for predicting the Ki-67 index status in patients with advanced non-small cell lung cancer (NSCLC). METHODS 137 patients with NSCLC who had undergone dual-phase enhanced CT scans and Ki-67 examination within 2 weeks were retrospectively enrolled between January 2020 and December 2022. Clinical and laboratory data were collected, and the patients were categorized based on low or high expression of Ki-67 index, with a cut-off value of 40%. The cohort was randomly divided into a training group (n = 95) and a testing group (n = 42) at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) algorithm was employed to select the most valuable radiomics features from the dual-phase enhanced CT images. Subsequently, a nomogram that incorporated the radiomics score and clinical factors associated with Ki-67 index status was established through univariate and multivariate logistic regression analyses. The predictive performance of the nomogram was evaluated using the area under the curve (AUC). RESULTS The AUC values of the radiomics features of artery phase and vein phase CT in the testing group were 0.748 and 0.758, respectively. The AUC of the dual-phase enhanced CT was 0.785, and the AUC of the developed nomogram was 0.859, which was higher than those of the radiomics (AUC, 0.785) and clinical models (AUC, 0.736). CONCLUSIONS The radiomics nomogram based on dual-phase enhanced CT images provides a promising method for predicting the Ki-67 index status in patients with advanced NSCLC.
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Affiliation(s)
- Haitao Sun
- Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China
| | - Peng Zhou
- Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China
| | - Guoyue Chen
- Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China
| | - Zhengjun Dai
- Scientific Research Department of Huiying Medical Technology Co., Ltd, 66 Xixiaokou Road, Haidian District, Beijing, 100192, China
| | - Peiji Song
- Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China
| | - Jian Yao
- Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Lixia District, Jinan, 250013, Shandong, China.
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Blaauwgeers H, Lissenberg-Witte BI, Dickhoff C, Duin S, Thunnissen E. Prognostic value of proliferation, PD-L1 and nuclear size in patients with superior sulcus tumours treated with chemoradiotherapy and surgery. J Clin Pathol 2023; 76:111-115. [PMID: 34301798 DOI: 10.1136/jclinpath-2021-207570] [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: 03/23/2021] [Accepted: 07/14/2021] [Indexed: 01/24/2023]
Abstract
AIMS The aim of this study was to determine the relationship between proliferative activity, PD-L1 status and nuclear size changes after preoperative chemoradiotherapy (CRT) and the clinical outcome in patients with superior sulcus tumours. METHODS Proliferative activity (MIB-1) and PD-L1 status were estimated by immunohistochemistry in the tumour cells of resection specimen in a series of 33 patients with residual tumour after trimodality therapy for a sulcus superior tumour between 2005 and 2014. A morphometric analysis of both pretreatment and post-treatment tumour materials was also performed. Results were related to disease-free survival and overall survival. RESULTS Low proliferative activity (<20% MIB-1) was associated with better overall survival: 2-year overall survival of 73% compared with 43% and 25%, respectively, for moderate (MIB-1 20%-50%) and high (MIB-1 >50%) proliferative activity (p=0.016). A negative PD-L1 status (<1% positive tumour cells) was also associated with better overall survival (p=0.021). The mean nuclear size of normal lung tissue pneumocytes was significantly smaller compared with the mean nuclear size of tumour cells of the resection specimens (median difference -38.1; range -115.2 to 16.0; p<0.001). The mean nuclear size of tumour cells did not differ between pretreatment biopsies and resection specimens (median difference -4.6; range -75.2 to 86.7; p=0.14). Nuclear size was not associated with survival (p=0.82). CONCLUSIONS Low proliferative activity determined by MIB-1 as well as a negative PD-L1 expression are significantly associated with better overall survival in patients with residual tumour after CRT for superior sulcus tumour.
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Affiliation(s)
- Hans Blaauwgeers
- Department of Pathology, OLVG LAB BV, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Chris Dickhoff
- Department of Surgery and Cardiothoracic Surgery, Amsterdam UMC - Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Sylvia Duin
- Department of Pathology, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Erik Thunnissen
- Department of Pathology, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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[Correlation Analysis of Ki67 Expression and EGFR Mutation on the Risk of Recurrence and Metastasis in Postoperative Patients with Stage I Lung Adenocarcinoma]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2022; 25:852-861. [PMID: 36617471 PMCID: PMC9845089 DOI: 10.3779/j.issn.1009-3419.2022.101.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The prognosis of stage I non-small cell lung cancer (NSCLC) is generally good. However, some of the stage I NSCLC patients still may have early recurrence and metastasis, and there is no standard method to screen this part of the population. The aim of this study is to investigate the relationship between Ki67 expression as well as epidermal growth factor receptor (EGFR) mutation and the risk of recurrence in postoperative patients with stage I lung adenocarcinoma. METHODS We retrospectively enrolled 118 postoperative patients with stage I lung adenocarcinoma. EGFR mutation was tested using amplification refractory mutation system polymerase chain reaction (ARMS-PCR) , and Ki67 level was detected by immunohistochemistry (IHC), followed by the collection of the patients' clinical characteristics. Kaplan-Meier method, Log-rank test, and Cox proportional hazards regression model were used for the prognostic statistical analysis. RESULTS Among the 118 patients, the rate of high Ki67 expression was 43.22% (51/118), which is related to gender, smoking status, surgical method, differentiation degree, and postoperative stage (P<0.05). Meanwhile, EGFR mutation rate was 61.02% (72/118), of which EGFR exon 19 deletion mutation rate was 19.49% (23/118), and the EGFR exon 21 L858R mutation rate was 41.53% (49/118). However, Ki67 expression was not associated with EGFR mutation status (χ2=1.412, P=0.235). Survival analysis showed that high Ki67 expression was inversely associated with disease-free survival (DFS) and overall survival (OS) in stage I lung adenocarcinoma (P<0.05), but EGFR mutation status was not significantly associated with DFS and OS (P>0.05). In the subgroup analysis, the DFS of the EGFR exon 19 deletion group was significantly decreased compared with the EGFR exon 21 L858R mutation group (P=0.031), but there was no significant difference in OS (P=0.308). Multivariate analysis showed that there was statistical significance between Ki67 expression (P=0.001) and DFS in stage I lung adenocarcinoma; Ki67 expression (P=0.03) and gender (P=0.015) were associated with OS in stage I lung adenocarcinoma. CONCLUSIONS Ki67 expression is an independent influencing factor for postoperative recurrence and OS of stage I lung adenocarcinoma and it is not significantly associated with EGFR mutation. There is no significant difference between EGFR mutation status and the prognostis of stage I lung adenocarcinoma. However, the prognosis differed in EGFR mutation types; the patients with EGFR exon 19 deletion are at higher risk of recurrence than EGFR exon 21 L858R mutation.
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Cabezón-Gutiérrez L, Sereno M, Cervera-Calero R, Mielgo-Rubio X, Higuera O. High tumor burden in non-small-cell lung cancer: A review of the literature. J Clin Transl Res 2022; 8:403-413. [PMID: 36518549 PMCID: PMC9741935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/17/2022] [Accepted: 07/27/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND AND AIM Lung cancer is the leading cause of cancer death worldwide and the majority of the patients have advanced/metastatic disease on presentation. In clinical practice, several biomarkers and clinical factors are taken into account when choosing the best treatment option in advanced non-small-cell lung cancer (NSCLC). One potential marker may be tumor burden (TB). However, this concept is not specifically defined in NSCLC, and usually, it is used as a synonymous for aggressive disease. METHODS A non-systematic literature review was conducted. We searched for eligible randomized controlled trials from PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials with a cutoff at February 2021. The keywords included non-small-cell lung cancer, tumor burden, aggressive disease, prognosis biomarker, predictive biomarker, and immunotherapy. RESULTS AND CONCLUSIONS This review addresses the definition of TB in advanced NSCLC, the pathophysiology of high TB lesions, and the role of TB as a prognosis biomarker. RELEVANCE FOR PATIENTS The concept of aggressive disease, as high tumor burden definition, remains poorly defined and rarely considered in clinical research or clinical practice in oncology. The identification of this subgroup of patients could be interesting for defining and optimizing a more aggressive treatment strategy.
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Affiliation(s)
- Luis Cabezón-Gutiérrez
- Medical Oncology, Hospital Universitario de Torrejón. Universidad Francisco Vitoria. Madrid, Spain
| | - María Sereno
- Medical Oncology, Sofía University Hospital; European University of Madrid. Madrid, Spain
| | | | - Xabier Mielgo-Rubio
- Medical Oncology. Hospital Universitario Fundación de Alcorcón. Alcorcón. Spain
| | - Oliver Higuera
- Medical Oncology, Hospital Universitario La Paz. Madrid, Spain
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Zhang X, Zhang Y, Qiu X, Cai J, Yang Z, Song F. Extracellular Vesicles Derived from Lung Cancer Cells Induce Transformation of Normal Fibroblasts into Lung Cancer-Associated Fibroblasts and Promote Metastasis of Lung Cancer by Delivering lncRNA HOTAIR. Stem Cells Int 2022; 2022:3805013. [PMID: 36267242 PMCID: PMC9578906 DOI: 10.1155/2022/3805013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/11/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Human lung cancer (LC) cells A549/H358, normal lung epithelial cells BEAS-2B, and lung normal fibroblasts (NFs) were cultured, followed by transfection of H358 cells with HOTAIR shRNA. Extracellular vesicles (EVs) extracted from H358 cells were identified. The internalization of Dil-labeled-EVs by NFs was tested, and protein levels of cancer-associated fibroblast (CAF) surface markers, inflammatory cytokines, cell proliferation, invasion, and migration, and lncRNA HOTAIR levels were determined. A549 cells were cultured in an H358-EVs-treated conditioned medium of NFs (NFCM), followed by intravenous injection of A549 cells into nude mice. The lesions and Ki-67-positive cells in lung tissues were measured. The results showed that tumor cell-derived EVs (T-EVs) motivated the transformation of NFs into CAFs. Specifically, EVs can be internalized by NFs, and the protein levels of CAF surface markers and inflammation levels were elevated in H358-EVs-treated NFs. The proliferation, invasion, and migration of A549 cells cultured in T-EVs-treated NFCM were increased. H358-EVs carried HOTAIR into NFs and promoted the transformation of NFs into CAFs. Inhibition of HOTAIR partially reversed the promoting effect of H358-EVs on the transformation of NFs into CAFs and invasion and migration of LC cells. T-EVs promoted metastasis of LC in vivo by transforming NFs into CAFs.
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Affiliation(s)
- Xiaoxuan Zhang
- Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China
- Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing 400016, China
- Department of Cancer Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Yan Zhang
- Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China
- Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing 400016, China
| | - Xin Qiu
- Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China
- Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing 400016, China
| | - Jing Cai
- Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China
- Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing 400016, China
| | - Zhenzhou Yang
- Department of Cancer Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Fangzhou Song
- Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China
- Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing 400016, China
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State of the Art: Lung Cancer Staging Using Updated Imaging Modalities. Bioengineering (Basel) 2022; 9:bioengineering9100493. [PMID: 36290461 PMCID: PMC9598500 DOI: 10.3390/bioengineering9100493] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Lung cancer is among the most common mortality causes worldwide. This scientific article is a comprehensive review of current knowledge regarding screening, subtyping, imaging, staging, and management of treatment response for lung cancer. The traditional imaging modality for screening and initial lung cancer diagnosis is computed tomography (CT). Recently, a dual-energy CT was proven to enhance the categorization of variable pulmonary lesions. The National Comprehensive Cancer Network (NCCN) recommends usage of fluorodeoxyglucose positron emission tomography (FDG PET) in concert with CT to properly stage lung cancer and to prevent fruitless thoracotomies. Diffusion MR is an alternative to FDG PET/CT that is radiation-free and has a comparable diagnostic performance. For response evaluation after treatment, FDG PET/CT is a potent modality which predicts survival better than CT. Updated knowledge of lung cancer genomic abnormalities and treatment regimens helps to improve the radiologists’ skills. Incorporating the radiologic experience is crucial for precise diagnosis, therapy planning, and surveillance of lung cancer.
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Atari M, Imai K, Nanjo H, Wakamatsu Y, Takashima S, Kurihara N, Kuriyama S, Suzuki H, Demura R, Harata Y, Hiroshima Y, Sato Y, Nomura K, Minamiya Y. Rapid intraoperative Ki-67 immunohistochemistry for lung cancer using non-contact alternating current electric field mixing. Lung Cancer 2022; 173:75-82. [PMID: 36156324 DOI: 10.1016/j.lungcan.2022.09.007] [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: 06/03/2022] [Revised: 07/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Locoregional recurrence of non-small cell lung cancer (NSCLC) occurs even among patients with stage I disease, as a result of tumor proliferative activity. The aim of this study was to evaluate the clinical reliability of a new rapid immunohistochemistry (IHC) technique for assessing malignant potential through detection of tumoral Ki-67 expression. MATERIALS AND METHODS The rapid IHC method uses non-contact alternating current (AC) mixing to achieve more rapid/stable staining within 20 min during surgery. First, to investigate the association between clinical outcomes and tumoral Ki-67 labeling with rapid IHC, 21 pairs of surgical patients treated between 2012 and 2020 for pStage IA1-3 NSCLC with/without recurrence were retrospectively reviewed. Second, 40 frozen section (FS) samples in patients with NSCLC for whom radical surgery was planned between April 2021 and February 2022 were deemed eligible for comparison of the clinical performance of conventional IHC and intraoperative rapid Ki-67 IHC with FS. RESULTS Detection of tumoral Ki-67 expression using rapid IHC with formalin-fixed, paraffin-embedded (FFPE) blocks was significantly associated with clinical outcomes in R0 pStage IA NSCLC surgical patients, including overall and recurrence-free survival (P = 0.0043 and P < 0.0001, respectively). Levels of Ki-67 expression among resectable NSCLC patients detected using rapid IHC with FS significantly correlated with those detected using conventional FFPE-IHC (p < 0.001). An intraoperative cut-off of > 7.5 % tumor cell Ki-67 positivity accurately predicted pathological stage more advanced than IA3 [P = 0.0185, Odds ratio = 20.477, 95 % confidence interval (CI): 1.660-252.55]. CONCLUSION Rapid Ki-67 IHC with AC mixing could potentially serve as a clinical tool for intraoperative determination of tumor malignancy status. The present study suggests that segmentectomy for early small NSCLCs is oncologically safe and a reasonable alternative to lobectomy, but only when there is adequate intraoperative selection for primary tumors with low-grade malignancy, which could be verified using intraoperative rapid Ki-67 IHC with FS.
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Affiliation(s)
- Maiko Atari
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Kazuhiro Imai
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan.
| | - Hiroshi Nanjo
- Department of Pathology, Akita University Graduate School of Medicine, Japan
| | - Yuki Wakamatsu
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Shinogu Takashima
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Nobuyasu Kurihara
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Shoji Kuriyama
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Haruka Suzuki
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Ryo Demura
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Yuzu Harata
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Yuko Hiroshima
- Department of Pathology, Akita University Graduate School of Medicine, Japan
| | - Yusuke Sato
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
| | - Kyoko Nomura
- Department of Health Environmental Science and Public Health, Akita University Graduate School of Medicine, Japan
| | - Yoshihiro Minamiya
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Japan
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Luo Y, Jiang H, Meng N, Huang Z, Li Z, Feng P, Fang T, Fu F, Yuan J, Wang Z, Yang Y, Wang M. A comparison study of monoexponential and fractional order calculus diffusion models and 18F-FDG PET in differentiating benign and malignant solitary pulmonary lesions and their pathological types. Front Oncol 2022; 12:907860. [PMID: 35936757 PMCID: PMC9351313 DOI: 10.3389/fonc.2022.907860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the application value of monoexponential, fractional order calculus (FROC) diffusion models and PET imaging to distinguish between benign and malignant solitary pulmonary lesions (SPLs) and malignant SPLs with different pathological types and explore the correlation between each parameter and Ki67 expression. Methods A total of 112 patients were enrolled in this study. Prior to treatment, all patients underwent a dedicated thoracic 18F-FDG PET/MR examination. Five parameters [including apparent diffusion coefficient (ADC) derived from the monoexponential model; diffusion coefficient (D), a microstructural quantity (μ), and fractional order parameter (β) derived from the FROC model and maximum standardized uptake value (SUVmax) derived from PET] were compared between benign and malignant SPLs and different pathological types of malignant SPLs. Independent sample t test, Mann-Whitney U test, DeLong test and receiver operating characteristic (ROC) curve analysis were used for statistical evaluation. Pearson correlation analysis was used to calculate the correlations between Ki-67 and ADC, D, μ, β, and SUVmax. Results The ADC and D values were significantly higher and the μ and SUVmax values were significantly lower in the benign group [1.57 (1.37, 2.05) μm2/ms, 1.59 (1.52, 1.72) μm2/ms, 5.06 (3.76, 5.66) μm, 5.15 ± 2.60] than in the malignant group [1.32 (1.03, 1.51) μm2/ms, 1.43 (1.29, 1.52) μm2/ms, 7.06 (5.87, 9.45) μm, 9.85 ± 4.95]. The ADC, D and β values were significantly lower and the μ and SUVmax values were significantly higher in the squamous cell carcinoma (SCC) group [1.29 (0.66, 1.42) μm2/ms, 1.32 (1.02, 1.42) μm2/ms, 0.63 ± 0.10, 9.40 (7.76, 15.38) μm, 11.70 ± 5.98] than in the adenocarcinoma (AC) group [1.40 (1.28, 1.67) μm2/ms, 1.52 (1.44, 1.64) μm2/ms, 0.70 ± 0.10, 5.99 (4.54, 6.87) μm, 8.76 ± 4.18]. ROC curve analysis showed that for a single parameter, μ exhibited the best AUC value in discriminating between benign and malignant SPLs groups and AC and SCC groups (AUC = 0.824 and 0.911, respectively). Importantly, the combination of monoexponential, FROC models and PET imaging can further improve diagnostic performance (AUC = 0.872 and 0.922, respectively). The Pearson correlation analysis showed that Ki67 was positively correlated with μ value and negatively correlated with ADC and D values (r = 0.402, -0.346, -0.450, respectively). Conclusion The parameters D and μ derived from the FROC model were superior to ADC and SUVmax in distinguishing benign from malignant SPLs and adenocarcinoma from squamous cell carcinoma, in addition, the combination of multiple parameters can further improve diagnostic performance. The non-Gaussian FROC diffusion model is expected to become a noninvasive quantitative imaging technique for identifying SPLs.
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Affiliation(s)
- Yu Luo
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Han Jiang
- Department of Medical Imaging, Xinxiang Medical University & Henan Provincial People’s Hospital, Xinxiang, Henan, China
| | - Nan Meng
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhun Huang
- Department of Medical Imaging, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ziqiang Li
- Department of Medical Imaging, Xinxiang Medical University & Henan Provincial People’s Hospital, Xinxiang, Henan, China
| | - Pengyang Feng
- Department of Medical Imaging, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ting Fang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Fangfang Fu
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Zhe Wang
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Meiyun Wang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Meiyun Wang,
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Dong H, Yin L, Lou C, Yang J, Wang X, Qiu Y. Correlation of computed tomography quantitative parameters with tumor invasion and Ki-67 expression in early lung adenocarcinoma. Medicine (Baltimore) 2022; 101:e29373. [PMID: 35758369 PMCID: PMC9276291 DOI: 10.1097/md.0000000000029373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/11/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of the study is to investigate the correlation of computed tomography (CT) quantitative parameters with tumor invasion and Ki-67 expression in early lung adenocarcinoma.The study involved 141 lesions in 141 patients with early lung adenocarcinoma. According to the degree of tumor invasion, the lesions were assigned into (adenocarcinoma in situ + minimally invasive adenocarcinoma) group and invasive adenocarcinoma (IAC) group. Artificial intelligence-assisted diagnostic software was used to automatically outline the lesions and extract corresponding quantitative parameters on CT images. Statistical analysis was performed to explore the correlation of these parameters with tumor invasion and Ki-67 expression.The results of logistic regression analysis showed that the short diameter of the lesion and the average CT value were independent predictors of IAC. Receiver operating characteristic curve analysis identified the average CT value as an independent predictor of IAC with the best performance, with the area under the receiver operating characteristic curve of 0.893 (P < .001), and the threshold of -450 HU. Besides, the predicted probability of logistic regression analysis model was detected to have the area under the curve of 0.931 (P < .001). The results of Spearman correlation analysis showed that the expression level of Ki-67 had the highest correlation with the average CT value of the lesion (r = 0.403, P < .001).The short diameter of the lesion and the average CT value are independent predictors of IAC, and the average CT value is significantly positively correlated with the expression of tumor Ki-67.
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Affiliation(s)
- Hao Dong
- Department of Radiology, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Lekang Yin
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cuncheng Lou
- Department of Radiology, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Junjie Yang
- Department of Pathology, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Xinbin Wang
- Department of Radiology, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Yonggang Qiu
- Department of Radiology, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
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19
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Chatzopoulos GS, Koidou VP, Wolff LF. Expression of Wnt signaling agonists and antagonists in periodontitis and healthy subjects, before and after non-surgical periodontal treatment: A systematic review. J Periodontal Res 2022; 57:698-710. [PMID: 35719081 DOI: 10.1111/jre.13029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022]
Abstract
Periodontitis is a preventable and treatable multifactorial chronic inflammatory disease that can lead to irreversible periodontal destruction and tooth loss. Wnt signaling and its regulators play an important role in periodontal inflammation, destruction, regeneration, and reconstruction. This systematic review aimed at investigating the involvement of Wnt signaling agonists and antagonists in periodontitis and healthy subjects, before and after periodontal treatment. Electronic searches were carried out using MEDLINE/PubMed, EMBASE, and Cochrane Library databases in addition to hand searches. Studies having different designs assessing the levels of Wnt signaling antagonist and agonist levels in gingival crevicular fluid, serum, and tissue in patients diagnosed with periodontitis or gingivitis, compared with healthy individuals were included. In addition, studies compared these levels in periodontitis patients before and after non-surgical periodontal therapy were also eligible. Sixteen studies met the eligibility criteria. Sclerostin (SOST) has been mainly investigated in the literature (8 publications). Sclerostin (5 studies), Wnt-5a (2 studies), secreted frizzled-related protein 1 (SFRP1) (3 studies), and β-catenin (3 studies) show increased levels in periodontitis compared with periodontal health. Strong correlations between marker levels and periodontal clinical parameters were identified for SOST (5 studies), SFRP1 (2 studies), and β-catenin (2 studies). SOST (3 studies) and SFRP1 (1 study) levels significantly decrease following non-surgical periodontal treatment. The present systematic review demonstrated an association between Wnt signaling agonist and antagonist levels and periodontitis. Wnt agonists and antagonists may serve as valuable diagnostic and prognostic markers for periodontitis onset and progression. Further case-control and longitudinal studies should be conducted for different Wnt signaling agonists and antagonists.
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Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki P Koidou
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.,Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - Larry F Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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20
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Dong Y, Jiang Z, Li C, Dong S, Zhang S, Lv Y, Sun F, Liu S. Development and validation of novel radiomics-based nomograms for the prediction of EGFR mutations and Ki-67 proliferation index in non-small cell lung cancer. Quant Imaging Med Surg 2022; 12:2658-2671. [PMID: 35502390 PMCID: PMC9014164 DOI: 10.21037/qims-21-980] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/20/2022] [Indexed: 07/30/2023]
Abstract
BACKGROUND We developed and validated novel radiomics-based nomograms to identify epidermal growth factor receptor (EGFR) mutations and the Ki-67 proliferation index of non-small cell lung cancer. METHODS We enrolled 132 patients with histologically verified non-small cell lung cancer from four hospital institutions who underwent computed tomography (CT) scans. EGFR mutations and the Ki-67 proliferation index were measured from tumor tissues. A total of 1,287 radiomic features were extracted, and a three-stage feature selection method was implemented to acquire the most valuable radiomic features. Finally, the radiomic scores and nomograms of the two tasks were established and tested. Receiver operating characteristic curves, calibration curves, and decision curves were used to evaluate their prediction performance and clinical utility. RESULTS In task [1], smoking status and histological type were significantly associated with EGFR mutations. After feature selection, 10 features were used to establish radiomic score, which showed good performance [area under the curve (AUC) =0.800] in the validation cohort. The radiomic nomogram had an AUC of 0.798 (95% CI: 0.664 to 0.931) with a C-index of 0.798 in the validation cohort. In task [2], gender, smoking status, histological type, and stage showed a significant correlation with Ki-67 proliferation index expression. A total of 28 features were selected to develop a radiomic score, with an AUC of 0.820 in the validation cohort. The final nomogram showed an AUC of 0.828 (95% CI: 0.703 to 0.953) with a C-index of 0.828 in the validation cohort. CONCLUSIONS EGFR mutations and Ki-67 proliferation index in non-small cell lung cancer can be predicted efficiently by the novel radiomic scores and nomograms.
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Affiliation(s)
- Yinjun Dong
- Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
- Postdoctoral Research Workstation, Liaocheng People’s Hospital, Liaocheng, China
| | - Zekun Jiang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Chaowei Li
- Department of Clinical Drug Research, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shuai Dong
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shengdong Zhang
- Department of Radiology, Yinan Branch of Qilu Hospital of Shandong University, Yinan County People’s Hospital, Linyi, China
| | - Yunhong Lv
- Department of Mathematics and Information Technology, Xingtai University, Xingtai, China
- Department of Mathematics and Statistics, University of Windsor, Windsor, Ontario, Canada
| | - Fenghao Sun
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuguang Liu
- Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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21
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Yu D, Sun Y, McNutt MA, Xu S. CEA-Ki-67- Pathologic Subtype: An Adjunct Factor for Refining Prognosis in Stage I Pulmonary Adenocarcinoma. Front Surg 2022; 9:853363. [PMID: 35548181 PMCID: PMC9082601 DOI: 10.3389/fsurg.2022.853363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The prognosis for stage I pulmonary adenocarcinoma is generally good. However, some patients with stage I pulmonary adenocarcinoma have an unexpectedly poor outcome. This warrants consideration of adjunct markers. In this study, we analyze carcinoembryonic antigen, Ki-67, and a pathologic subtype in combination for prognostic evaluation of stage I pulmonary adenocarcinoma. These factors were selected for study as they have been shown to be individually associated with prognosis in many studies. Methods A total of 650 patients with stage I pulmonary adenocarcinoma were investigated retrospectively. Each patient was re-staged using standard TNM criteria. Carcinoembryonic antigen (CEA) values were obtained from preoperative blood samples, and Ki-67 was evaluated with tumor tissue immunohistochemistry. Patient clinicopathologic characteristics, survival status, and date of death were obtained from medical records and telephone follow-up. Results CEA > 4.4 ng/ml, Ki-67 > 13%, and a solid-micropapillary tumor growth pattern were each independent adverse prognostic markers for 5-year disease specific survival in stage I pulmonary adenocarcinoma. However, in combination, these 3 factors yielded a prognostic value (designated “CEA-Ki-67-pathologic subtype” value). Stage I pulmonary adenocarcinoma of low-risk CEA-Ki-67-pathologic subtype (CKP) value show biologic behavior similar to TNM stage IA1 tumors, while stage I tumors of high-risk CKP value are similar in prognosis to TNM stage II. Conclusion The CKP value may be used as an adjunct to the TNM classification, which may yield a more accurately defined prognosis for cases of stage I pulmonary adenocarcinoma. CKP value may identify patients at higher risk who may benefit from adjuvant chemotherapy. Conversely, lower risk CKP values may support avoidance of chemotherapy.
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Affiliation(s)
- Dongzhi Yu
- Department of General Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanbin Sun
- Department of General Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Michael A. McNutt
- Department of Pathology and Molecular Biology, School of Medicine and Research Institute, Peking University, Beijing, China
| | - Shun Xu
- Department of General Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Shun Xu
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22
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Zhu M, Yang Z, Zhao W, Wang M, Shi W, Cheng Z, Ye C, Zhu Q, Liu L, Liang Z, Chen L. Predicting Ki-67 labeling index level in early-stage lung adenocarcinomas manifesting as ground-glass opacity nodules using intra-nodular and peri-nodular radiomic features. Cancer Med 2022; 11:3982-3992. [PMID: 35332684 PMCID: PMC9636499 DOI: 10.1002/cam4.4719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 12/19/2022] Open
Abstract
Objectives To explore the diagnostic value of radiomics in differentiating between lung adenocarcinomas appearing as ground‐glass opacity nodules (GGO) with high‐ and low Ki‐67 expression levels. Materials and Methods From January 2018 to January 2021, patients with pulmonary GGO who received lung resection were evaluated for potential enrollment. The included GGOs were then randomly divided into a training cohort and a validation cohort with a ratio of 7:3. Logistic regression (LR), decision tree (DT), support vector machines (SVM), and adaboost (AB) were applied for radiomic model construction. Area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the established models. Results Seven hundred and sixty‐nine patients with 769 GGOs were included in this study. Two hundred and forty‐five GGOs were confirmed to be of high Ki‐67 labeling index (LI). In the training cohort, gender, age, spiculation sign, pleural indentation sign, bubble sign, and maximum 2D diameter of the nodule were found to be significantly different between high‐ and low Ki‐67 LI groups (p < 0.05), and spiculation sign and maximum 2D diameter of the nodule were further confirmed to be risk factors for Ki‐67 LI. The radiomic model established using SVM exhibited an AUC of 0.731 in the validation cohort, which was higher than that of the clinical‐radiographic model (AUC = 0.675). Moreover, radiomic model combining both intra‐ and peri‐nodular features showed better diagnostic efficacy than using intra‐nodular features alone (AUC = 0.731 and 0.720, respectively). Conclusions The established radiomic model exhibited good diagnostic efficacy in differentiating between lung adenocarcinoma GGOs with high and low Ki‐67 LI, which was higher than the clinical‐radiographic model. Peri‐nodular radiomic features showed added benefits to the radiomic model. As a novel noninvasive method, radiomics have the potential to be applied in the preliminary classification of Ki‐67 expression level in lung adenocarcinoma GGOs.
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Affiliation(s)
- Minghui Zhu
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhen Yang
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wei Zhao
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Miaoyu Wang
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wenjia Shi
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhenshun Cheng
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Cheng Ye
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Qiang Zhu
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Lu Liu
- Department of Nutrition, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhixin Liang
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Liangan Chen
- Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China
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23
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Duan L, Perez RE, Calhoun S, Maki CG. RBL2/DREAM-mediated repression of the Aurora kinase A/B pathway determines therapy responsiveness and outcome in p53 WT NSCLC. Sci Rep 2022; 12:1049. [PMID: 35058503 PMCID: PMC8776870 DOI: 10.1038/s41598-022-05013-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/28/2021] [Indexed: 01/03/2023] Open
Abstract
Wild-type p53 is a stress-responsive transcription factor and potent tumor suppressor. P53 activates or represses genes involved in cell cycle progression or apoptosis in order to arrest the cell cycle or induce cell death. Transcription repression by p53 is indirect and requires repressive members of the RB-family (RB1, RBL1, RBL2) and formation of repressor complexes of RB1-E2F and RBL1/RBL2-DREAM. Many aurora kinase A/B (AURKA/B) pathway genes are repressed in a p53-DREAM-dependent manner. We found heightened expression of RBL2 and reduced expression of AURKA/B pathway genes is associated with improved outcomes in p53 wild-type but not p53 mutant non-small cell lung cancer (NSCLC) patients. Knockdown of p53, RBL2, or the DREAM component LIN37 increased AURKA/B pathway gene expression and reduced paclitaxel and radiation toxicity in NSCLC cells. In contrast, pharmacologic inhibition of AURKA/B or knockdown of AURKA/B pathway components increased paclitaxel and IR sensitivity. The results support a model in which p53-RBL2-DREAM-mediated repression of the AURKA/B pathway contributes to tumor suppression, improved tumor therapy responses, and better outcomes in p53 wild-type NSCLCs.
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Affiliation(s)
- Lei Duan
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Ave, AcFac 507, Chicago, IL, 60612, USA. .,Rush University Medical Center, Chicago, IL, 60612, USA.
| | - Ricardo E Perez
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Sarah Calhoun
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Ave, AcFac 507, Chicago, IL, 60612, USA.,Rush University Medical Center, Chicago, IL, 60612, USA
| | - Carl G Maki
- Department of Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Ave, AcFac 507, Chicago, IL, 60612, USA. .,Rush University Medical Center, Chicago, IL, 60612, USA.
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24
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Ali SA, Kadry MO, Hammam O, Hassan SA, Abdel-Megeed RM. Ki-67 pulmonary immunoreactivity in silver nanoparticles toxicity: Size-rate dependent genotoxic impact. Toxicol Rep 2022; 9:1813-1822. [DOI: 10.1016/j.toxrep.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/04/2022] [Accepted: 09/19/2022] [Indexed: 12/08/2022] Open
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25
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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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26
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Ren H, Ma J, Wang J. Correlation between apparent diffusion coefficient and Ki-67 in different pathological types of lung cancer. Transl Cancer Res 2021; 10:5364-5371. [PMID: 35116383 PMCID: PMC8798236 DOI: 10.21037/tcr-21-2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Computed tomography (CT) is common and valuable non-invasive method to evaluate proliferative activity in lung cancer; however, magnetic resonance (MR) is rarely used in lung cancer. To evaluate whether there were different expression levels of Ki-67 in different pathological types of lung cancer and the correlation between Ki-67 index and apparent diffusion coefficient (ADC) value. METHODS The clinical and pathological data of 165 patients with lung cancer confirmed by needle biopsy or surgery were retrospectively evaluated, among whom 54 underwent MR examination. The level of Ki-67 was tested using the international standard IHC 2-step method. Kruskal-Wallis H test was used to compare the different expression level of Ki-67 index of adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, and the least significant difference (LSD) method was used for pair-group comparison. Spearman correlation coefficient was used to analyze the correlation between Ki-67 index and ADC value. All statistical tests were bilateral, and P<0.05 was considered statistically significant. RESULTS The median of Ki-67 index in adenocarcinoma, squamous cell carcinoma, and small cell carcinoma were 20 (10, 30), 40 (40, 60), and 70 (60, 80), respectively. There was a statistical difference in the expression level of Ki-67 index in the 3 different pathological types of lung cancer (H=103.762, P=0.000). In 54 cases of lung cancer with MR examination, there was a significant negative correlation between average ADC value and expression level of Ki-67 index (r=-0.506, P=0.000), while there was no correlation between ADC value and Ki-67 index in distinguishing different pathological types of lung cancer. CONCLUSIONS The expression level of Ki-67 index was different among different pathological types of lung cancer. The ADC value is correlated with Ki-67 index in lung cancer, which can be used to evaluate the proliferative activity of lung cancer.
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Affiliation(s)
- Hongna Ren
- Department of Radiology, the First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Jianbing Ma
- Department of Radiology, the First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Jia Wang
- Department of Radiology, the First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, China
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27
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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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Aydos U, Ünal ER, Özçelik M, Akdemir D, Ekinci Ö, Taştepe Aİ, Memiş L, Atay LÖ, Akdemir ÜÖ. Texture features of primary tumor on 18F-FDG PET images in non-small cell lung cancer: The relationship between imaging and histopathological parameters. Rev Esp Med Nucl Imagen Mol 2021; 40:343-350. [PMID: 34752367 DOI: 10.1016/j.remnie.2020.09.012] [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: 05/04/2020] [Accepted: 06/19/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aims of this study were to evaluate the relationships between textural features of the primary tumor on FDG PET images and clinical-histopathological parameters which are useful in predicting prognosis in newly diagnosed non-small cell lung cancer (NSCLC) patients. METHODS PET/CT images of ninety (90) patients with NSCLC prior to surgery were analyzed retrospectively. All patients had resectable tumors. From the images we acquired data related to metabolism (SUVmax, MTV, TLG) and texture features of primary tumors. Histopathological tumor types and subgroups, degree of Ki-67 expression and necrosis rates of the primary tumor, mediastinal lymph node (MLN) status and nodal stages were recorded. RESULTS Among the two histologic tumor types (adenocarcinoma and squamous cell carcinoma) significant differences were present regarding metabolic parameters, Ki-67 index with higher values and kurtosis with lower values in the latter group. Textural heterogeneity was found to be higher in poorly differentiated tumors compared to moderately differentiated tumors in patients with adenocarcinoma. While Ki-67 index had significant correlations with metabolic parameters and kurtosis, tumor necrosis rate was only significantly correlated with textural features. By univariate and multivariate analyses of the imaging and histopathological factors examined, only gradient variance was significant predictive factor for the presence of MLN metastasis. CONCLUSIONS Textural features had significant associations with histologic tumor types, degree of pathological differentiation, tumor proliferation and necrosis rates. Texture analysis has potential to differentiate tumor types and subtypes and to predict MLN metastasis in patients with NSCLC.
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Affiliation(s)
- Uğuray Aydos
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turkey.
| | - Emel Rodoplu Ünal
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turkey
| | - Mahsun Özçelik
- Yüzüncü Yıl University, Faculty of Medicine, Department of Nuclear Medicine, Van, Turkey
| | - Deniz Akdemir
- Michigan State University, Department of Epidemiology and Biostatistics, East Lansing, MI, USA
| | - Özgür Ekinci
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turkey
| | - Abdullah İrfan Taştepe
- Gazi University, Faculty of Medicine, Department of Thoracic Surgery, Beşevler/Ankara, Turkey
| | - Leyla Memiş
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turkey
| | - Lütfiye Özlem Atay
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turkey
| | - Ümit Özgür Akdemir
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turkey
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29
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Huang Z, Lyu M, Ai Z, Chen Y, Liang Y, Xiang Z. Pre-operative Prediction of Ki-67 Expression in Various Histological Subtypes of Lung Adenocarcinoma Based on CT Radiomic Features. Front Surg 2021; 8:736737. [PMID: 34733879 PMCID: PMC8558627 DOI: 10.3389/fsurg.2021.736737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/09/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose: The aims of this study were to combine CT images with Ki-67 expression to distinguish various subtypes of lung adenocarcinoma and to pre-operatively predict the Ki-67 expression level based on CT radiomic features. Methods: Data from 215 patients with 237 pathologically proven lung adenocarcinoma lesions who underwent CT and immunohistochemical Ki-67 from January 2019 to April 2021 were retrospectively analyzed. The receiver operating curve (ROC) identified the Ki-67 cut-off value for differentiating subtypes of lung adenocarcinoma. A chi-square test or t-test analyzed the differences in the CT images between the negative expression group (n = 132) and the positive expression group (n = 105), and then the risk factors affecting the expression level of Ki-67 were evaluated. Patients were randomly divided into a training dataset (n = 165) and a validation dataset (n = 72) in a ratio of 7:3. A total of 1,316 quantitative radiomic features were extracted from the Analysis Kinetics (A.K.) software. Radiomic feature selection and radiomic classifier were generated through a least absolute shrinkage and selection operator (LASSO) regression and logistic regression analysis model. The predictive capacity of the radiomic classifiers for the Ki-67 levels was investigated through the ROC curves in the training and testing groups. Results: The cut-off value of the Ki-67 to distinguish subtypes of lung adenocarcinoma was 5%. A comparison of clinical data and imaging features between the two groups showed that histopathological subtypes and air bronchograms could be used as risk factors to evaluate the expression of Ki-67 in lung adenocarcinoma (p = 0.005, p = 0.045, respectively). Through radiomic feature selection, eight top-class features constructed the radiomic model to pre-operatively predict the expression of Ki-67, and the area under the ROC curves of the training group and the testing group were 0.871 and 0.8, respectively. Conclusion: Ki-67 expression level with a cut-off value of 5% could be used to differentiate non-invasive lung adenocarcinomas from invasive lung adenocarcinomas. It is feasible and reliable to pre-operatively predict the expression level of Ki-67 in lung adenocarcinomas based on CT radiomic features, as a non-invasive biomarker to predict the degree of malignant invasion of lung adenocarcinoma, and to evaluate the prognosis of the tumor.
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Affiliation(s)
- Zhiwei Huang
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Mo Lyu
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China.,School of Life Sciences, South China Normal University, Guangzhou, China
| | - Zhu Ai
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Yirong Chen
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Yuying Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Zhiming Xiang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
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30
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Šutić M, Vukić A, Baranašić J, Försti A, Džubur F, Samaržija M, Jakopović M, Brčić L, Knežević J. Diagnostic, Predictive, and Prognostic Biomarkers in Non-Small Cell Lung Cancer (NSCLC) Management. J Pers Med 2021; 11:1102. [PMID: 34834454 PMCID: PMC8624402 DOI: 10.3390/jpm11111102] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide. Despite growing efforts for its early detection by screening populations at risk, the majority of lung cancer patients are still diagnosed in an advanced stage. The management of lung cancer has dramatically improved in the last decade and is no longer based on the "one-fits-all" paradigm or the general histological classification of non-small cell versus small cell lung cancer. Emerging options of targeted therapies and immunotherapies have shifted the management of lung cancer to a more personalized treatment approach, significantly influencing the clinical course and outcome of the disease. Molecular biomarkers have emerged as valuable tools in the prognosis and prediction of therapy response. In this review, we discuss the relevant biomarkers used in the clinical management of lung tumors, from diagnosis to prognosis. We also discuss promising new biomarkers, focusing on non-small cell lung cancer as the most abundant type of lung cancer.
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Affiliation(s)
- Maja Šutić
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (M.Š.); (A.V.); (J.B.)
| | - Ana Vukić
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (M.Š.); (A.V.); (J.B.)
| | - Jurica Baranašić
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (M.Š.); (A.V.); (J.B.)
| | - Asta Försti
- Hopp Children’s Cancer Center (KiTZ), 69120 Heidelberg, Germany;
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Feđa Džubur
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany; (F.D.); (M.S.); (M.J.)
- Clinical Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Miroslav Samaržija
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany; (F.D.); (M.S.); (M.J.)
- Clinical Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Jakopović
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany; (F.D.); (M.S.); (M.J.)
- Clinical Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Brčić
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria;
| | - Jelena Knežević
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (M.Š.); (A.V.); (J.B.)
- Faculties for Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia
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A Novel Strategy for the Diagnosis of Pulmonary High-Grade Neuroendocrine Tumor. Diagnostics (Basel) 2021; 11:diagnostics11111945. [PMID: 34829292 PMCID: PMC8625242 DOI: 10.3390/diagnostics11111945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 01/04/2023] Open
Abstract
Correctly diagnosing a histologic type of lung cancer is important for selecting the appropriate treatment because the aggressiveness, chemotherapy regimen, surgical approach, and prognosis vary significantly among histologic types. Pulmonary NETs, which are characterized by neuroendocrine morphologies, represent approximately 20% of all lung cancers. In particular, high-grade neuroendocrine tumors (small cell lung cancer and large cell neuroendocrine tumor) are highly proliferative cancers that have a poorer prognosis than other non-small cell lung cancers. The combination of hematoxylin and eosin staining, Ki-67, and immunostaining of classic neuroendocrine markers, such as chromogranin A, CD56, and synaptophysin, are normally used to diagnose high-grade neuroendocrine tumors; however, they are frequently heterogeneous. This article reviews the diagnostic methods of lung cancer diagnosis focused on immunostaining. In particular, we describe the usefulness of immunostaining by Stathmin-1, which is a cytosolic phosphoprotein and a key regulator of cell division due to its microtubule depolymerization in a phosphorylation-dependent manner, for the diagnosis of high-grade neuroendocrine tumors.
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32
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Diehl V, Wegner M, Grumati P, Husnjak K, Schaubeck S, Gubas A, Shah V, Polat I, Langschied F, Prieto-Garcia C, Müller K, Kalousi A, Ebersberger I, Brandts C, Dikic I, Kaulich M. Minimized combinatorial CRISPR screens identify genetic interactions in autophagy. Nucleic Acids Res 2021; 49:5684-5704. [PMID: 33956155 PMCID: PMC8191801 DOI: 10.1093/nar/gkab309] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Combinatorial CRISPR-Cas screens have advanced the mapping of genetic interactions, but their experimental scale limits the number of targetable gene combinations. Here, we describe 3Cs multiplexing, a rapid and scalable method to generate highly diverse and uniformly distributed combinatorial CRISPR libraries. We demonstrate that the library distribution skew is the critical determinant of its required screening coverage. By circumventing iterative cloning of PCR-amplified oligonucleotides, 3Cs multiplexing facilitates the generation of combinatorial CRISPR libraries with low distribution skews. We show that combinatorial 3Cs libraries can be screened with minimal coverages, reducing associated efforts and costs at least 10-fold. We apply a 3Cs multiplexing library targeting 12,736 autophagy gene combinations with 247,032 paired gRNAs in viability and reporter-based enrichment screens. In the viability screen, we identify, among others, the synthetic lethal WDR45B-PIK3R4 and the proliferation-enhancing ATG7-KEAP1 genetic interactions. In the reporter-based screen, we identify over 1,570 essential genetic interactions for autophagy flux, including interactions among paralogous genes, namely ATG2A-ATG2B, GABARAP-MAP1LC3B and GABARAP-GABARAPL2. However, we only observe few genetic interactions within paralogous gene families of more than two members, indicating functional compensation between them. This work establishes 3Cs multiplexing as a platform for genetic interaction screens at scale.
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Affiliation(s)
- Valentina Diehl
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Martin Wegner
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Paolo Grumati
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Koraljka Husnjak
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Simone Schaubeck
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Andrea Gubas
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Varun Jayeshkumar Shah
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ibrahim H Polat
- Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, 60590 Frankfurt am Main, Germany
| | - Felix Langschied
- Applied Bioinformatics Group, Institute of Cell Biology and Neuroscience, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - Cristian Prieto-Garcia
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Konstantin Müller
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Alkmini Kalousi
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ingo Ebersberger
- Applied Bioinformatics Group, Institute of Cell Biology and Neuroscience, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
- Senckenberg Biodiversity and Climate Research Centre (S-BIK-F), Frankfurt am Main, Germany
- LOEWE Centre for Translational Biodiversity Genomics (TBG), Frankfurt am Main, Germany
| | - Christian H Brandts
- Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, 60590 Frankfurt am Main, Germany
- Frankfurt Cancer Institute, 60596 Frankfurt am Main, Germany
- University Cancer Center Frankfurt (UCT), University Hospital, Goethe University, Frankfurt, Germany
| | - Ivan Dikic
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Frankfurt Cancer Institute, 60596 Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, 60590 Frankfurt am Main, Germany
- Buchmann Institute for Molecular Life Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - Manuel Kaulich
- Institute of Biochemistry II, Faculty of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Frankfurt Cancer Institute, 60596 Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, 60590 Frankfurt am Main, Germany
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33
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Ma X, Zhou S, Huang L, Zhao P, Wang Y, Hu Q, Xia L. Assessment of relationships among clinicopathological characteristics, morphological computer tomography features, and tumor cell proliferation in stage I lung adenocarcinoma. J Thorac Dis 2021; 13:2844-2857. [PMID: 34164176 PMCID: PMC8182526 DOI: 10.21037/jtd-21-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Surgically resected stage I lung adenocarcinoma (ADC) has wide variation in prognosis. It is significant to identify high-risk patients and optimize therapeutic strategy. This study aimed to investigate the relationships among histological grade, serum tumor marker index (TMI), morphological computer tomography (CT) features, and a well-established prognosticator cell proliferation (Ki-67) in stage I ADC. Methods Preoperative CT was performed in 182 patients with stage I ADC confirmed by pathology. The Ki-67 expression was acquired by immunohistochemistry. TMI was the square root of standardized serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragments (CYFRA 21-1) values. Tumor shadow disappearance rate (TDR) and other morphological CT features were interpreted by two radiologists. Histological grade, TMI, CT features were statistically evaluated to explore the associations with Ki-67 expression. Results In univariate analysis, gender, smoking history, pack-year, histological grade, TNM stage (IA and IB), serum CEA and CYFRA 21-1 status, TMI status, as well as TDR, long-axis diameter, short-axis diameter, lobulation, spiculation, attenuation types, vacuolation, vascular invasion, vascular convergence, thickened bronchovascular bundles, pleural attachment and peripheral fibrosis were significantly associated with Ki-67 expression (all P<0.05). Solid-predominant ADC had the highest Ki-67 expression, followed by micropapillary, papillary and acinar-predominant ADC, while lepidic-predominant ADC had the lowest Ki-67 expression (P<0.001). TDR was negatively correlated with Ki-67 (r =−0.478, P<0.001). Multivariate logistic regression analysis revealed that gender, histological grade, TDR and attenuation types were independent factors associated with Ki-67 expression. Conclusions Ki-67 expression differed distinctly according to ADC histological subtypes. High Ki-67 expression is independently associated with male patients of stage I ADC with worse differentiation, lower TDR and solid tumors, which might be of prognostic value for poor prognosis in stage I ADC.
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Affiliation(s)
- Xiaoling Ma
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuchang Zhou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peijun Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yujin Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiongjie Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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34
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Aydos U, Ünal ER, Özçelik M, Akdemir D, Ekinci Ö, Taştepe AI, Memiş L, Atay LÖ, Akdemir ÜÖ. Texture features of primary tumor on 18F-FDG PET images in non-small cell lung cancer: The relationship between imaging and histopathological parameters. Rev Esp Med Nucl Imagen Mol 2021; 40:S2253-654X(20)30134-7. [PMID: 33785321 DOI: 10.1016/j.remn.2020.06.025] [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: 05/04/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate the relationships between textural features of the primary tumor on FDG PET images and clinical-histopathological parameters which are useful in predicting prognosis in newly diagnosed non-small cell lung cancer (NSCLC) patients. MATERIAL AND METHODS PET/CT images of ninety (90) patients with NSCLC prior to surgery were analyzed retrospectively. All patients had resectable tumors. From the images we acquired data related to metabolism (SUVmax, metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) and texture features of primary tumors. Histopathological tumor types and subgroups, degree of Ki-67 expression and necrosis rates of the primary tumor, mediastinal lymph node (MLN) status and nodal stages were recorded. RESULTS Among the 2histologic tumor types (adenocarcinoma and squamous cell carcinoma) significant differences were present regarding metabolic parameters, Ki-67 index with higher values and kurtosis with lower values in the latter group. Textural heterogeneity was found to be higher in poorly differentiated tumors compared to moderately differentiated tumors in patients with adenocarcinoma. While Ki-67 index had significant correlations with metabolic parameters and kurtosis, tumor necrosis rate was only significantly correlated with textural features. By univariate and multivariate analyses of the imaging and histopathological factors examined, only gradient variance was significant predictive factor for the presence of MLN metastasis. CONCLUSIONS Textural features had significant associations with histologic tumor types, degree of pathological differentiation, tumor proliferation and necrosis rates. Texture analysis has potential to differentiate tumor types and subtypes and to predict MLN metastasis in patients with NSCLC.
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Affiliation(s)
- U Aydos
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía.
| | - E R Ünal
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - M Özçelik
- Yüzüncü Yıl University, Faculty of Medicine, Department of Nuclear Medicine, Van, Turquía
| | - D Akdemir
- Michigan State University, Department of Epidemiology and Biostatistics, East Lansing, MI, Estados Unidos
| | - Ö Ekinci
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - A I Taştepe
- Gazi University, Faculty of Medicine, Department of Thoracic Surgery, Beşevler/Ankara, Turquía
| | - L Memiş
- Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turquía
| | - L Ö Atay
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía
| | - Ü Ö Akdemir
- Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turquía
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35
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Evaluation of polyhexamethylene guanidine-induced lung injuries by chest CT, pathologic examination, and RNA sequencing in a rat model. Sci Rep 2021; 11:6318. [PMID: 33737587 PMCID: PMC7973781 DOI: 10.1038/s41598-021-85662-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/04/2021] [Indexed: 12/19/2022] Open
Abstract
Our aim was to correlate chest CT and pathologic findings of polyhexamethylene guanidine phosphate (PHMG)-induced lung injuries in a rat model, to determine whether PHMG exposure causes lung tumors, and to explore genetic alterations according to PHMG exposure under the guidance of CT. A PHMG solution was intratracheally administrated to 40 male rats. Chest CT was carried out in all rats and both lungs were collected for histopathologic evaluation. At 4- and 8-weeks post-instillation, one lobe of the right lung from 3 rats was subjected to RNA sequencing. At least one abnormal CT finding was found in all rats at all weeks. The major CT findings were inflammation, fibrosis, and tumors in the pathologic analysis, where significant changes were observed over time. The lung lesions remained persistent after 8 weeks of PHMG exposure. In the pathologic analysis, the extent/severity of inflammation did not show statistically significant changes over time, whereas the extent/severity of fibrosis increased continuously up to 6 weeks after PHMG exposure and then decreased significantly at 8 weeks. Bronchiolar-alveolar adenomas which have malignant potential were found in 50% of rats at 6 and 8 weeks after PHMG exposure. Also, several genes associated with lung cancer, acute lung injury, and pulmonary fibrosis were detected. Our study revealed that PHMG-induced lung injury and its changes according to the number of weeks after exposure were demonstrated using chest CT and pathologic evaluation. In addition, we showed that PHMG exposure caused lung tumors and genetic alterations according to PHMG exposure under the guidance of CT.
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36
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Wang Y, Zheng C, Lu W, Wang D, Cheng Y, Chen Y, Hou K, Qi J, Liu Y, Che X, Hu X. Bioinformatics-Based Identification of HDAC Inhibitors as Potential Drugs to Target EGFR Wild-Type Non-Small-Cell Lung Cancer. Front Oncol 2021; 11:620154. [PMID: 33763356 PMCID: PMC7982742 DOI: 10.3389/fonc.2021.620154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/26/2021] [Indexed: 11/13/2022] Open
Abstract
Patients with EGFR-mutant non-small-cell lung cancer (NSCLC) greatly benefit from EGFR-tyrosine kinase inhibitors (EGFR-TKIs) while the prognosis of patients who lack EGFR-sensitive mutations (EGFR wild type, EGFR-WT) remains poor due to a lack of effective therapeutic strategies. There is an urgent need to explore the key genes that affect the prognosis and develop potentially effective drugs in EGFR-WT NSCLC patients. In this study, we clustered functional modules related to the survival traits of EGFR-WT patients using weighted gene co-expression network analysis (WGCNA). We used these data to establish a two-gene prognostic signature based on the expression of CYP11B1 and DNALI1 by combining the least absolute shrinkage and selection operator (LASSO) algorithms and Cox proportional hazards regression analysis. Following the calculation of risk score (RS) based on the two-gene signature, patients with high RSs showed a worse prognosis. We further explored targeted drugs that could be effective in patients with a high RS by the connectivity map (CMap). Surprisingly, multiple HDAC inhibitors (HDACis) such as trichostatin A (TSA) and vorinostat (SAHA) that may have efficacy were identified. Also, we proved that HDACis could inhibit the proliferation and metastasis of NSCLC cells in vitro. Taken together, our study identified prognostic biomarkers for patients with EGFR-WT NSCLC and confirmed a novel potential role for HDACis in the clinical management of EGFR-WT patients.
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Affiliation(s)
- Yizhe Wang
- Department of Respiratory and Infectious Disease of Geriatrics, The First Hospital of China Medical University, Shenyang, China
| | - Chunlei Zheng
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Wenqing Lu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Duo Wang
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Yang Cheng
- Department of Respiratory and Infectious Disease of Geriatrics, The First Hospital of China Medical University, Shenyang, China
| | - Yang Chen
- Department of Respiratory and Infectious Disease of Geriatrics, The First Hospital of China Medical University, Shenyang, China
| | - Kezuo Hou
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Jianfei Qi
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Baltimore, MD, United States
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Xiaofang Che
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.,Liaoning Province Clinical Research Center for Cancer, Shenyang, China
| | - Xuejun Hu
- Department of Respiratory and Infectious Disease of Geriatrics, The First Hospital of China Medical University, Shenyang, China
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Zheng Y, Huang W, Zhang X, Lu C, Fu C, Li S, Lin G. A Noninvasive Assessment of Tumor Proliferation in Lung cancer Patients using Intravoxel Incoherent Motion Magnetic Resonance Imaging. J Cancer 2021; 12:190-197. [PMID: 33391415 PMCID: PMC7738818 DOI: 10.7150/jca.48589] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/26/2020] [Indexed: 12/15/2022] Open
Abstract
Ki-67 is a nuclear antigen widely used in routine pathologic analyses as a tumor cell proliferation marker for lung cancer. However, Ki-67 expression analyses using immunohistochemistry (IHC) are invasive and frequently influenced by tissue sampling quality. In this study, we assessed the feasibility of noninvasive magnetic resonance imaging (MRI) in predicting the Ki-67 labeling indices (LIs). A total of 51 lung cancer patients, including 42 non-small cell lung cancer (NSCLC) cases and nine small cell lung cancer (SCLC) cases, were enrolled in this study. Quantitative MRI parameters from conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) were obtained, and their correlations with tumor tissue Ki-67 expression were analyzed. We found that the true diffusion coefficient (D value) from IVIM was negatively correlated with Ki-67 expression (Spearman r = -0.76, P < 0.001). The D values in the high Ki-67 group were significantly lower than those in the low Ki-67 group (0.90 ± 0.21 × 10-3 mm2/s vs. 1.22 ± 0.30 × 10-3 mm2/s). Among three MRI techniques used, D values from IVIM showed the best performance for distinguishing the high Ki-67 group from low Ki-67 group in receiver operating characteristic (ROC) analysis with an area under the ROC curve (AUROC) of 0.85 (95% CI: 0.73-0.97, P < 0.05). Moreover, D values performed well for differentiating SCLC from NSCLC with an AUROC of 0.82 (95% CI: 0.68-0.90), Youden index of 0.72, and F1 score of 0.81. In conclusion, D values were negatively correlated with Ki-67 expression in lung cancer tissues and can be used to distinguish high from low proliferation statuses, as well as SCLC from NSCLC.
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Affiliation(s)
- Yu Zheng
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Wenjun Huang
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Xuelin Zhang
- Department of Thoracic Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Chen Lu
- Department of Pathology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Caixia Fu
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, Guangdong Province, 518057, China
| | - Shihong Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Guangwu Lin
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
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Ma H, Liu T, Xu Y, Wang X, Wang J, Liu X. MiR-519d and miR-328-3p Combinatorially Suppress Breast Cancer Progression. Onco Targets Ther 2020; 13:12987-12997. [PMID: 33376348 PMCID: PMC7755341 DOI: 10.2147/ott.s281962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background MiR-519d and miR-328-3p had tumor-regulatory properties in different cancers, but their combinatorial effects and potential common target in breast cancer had not been fully reported. This research targeted to study the underlying mechanism of how miR-519d and miR-328-3p cooperatively suppressed breast cancer. Methods MiR-519d and miR-328-3p expressions in breast cancer tissues and cells were assessed and Ki-67 expression was also checked. DLR assay was executed to verify whether Ki-67 was a common target of miR-519d and miR-328-3p. Western blot, flow cytometry, colony formation, wound healing and transwell assays were applied to examine the inhibitory roles of these two miRNAs on the malignant behaviors of breast cancer cells and the potential molecular mechanism. Results Impeded miR-519d and miR-328-3p expressions and enhanced Ki-67 expression were detected in breast cancer tissues and cells. Ki-67 was confirmed as a target of these two miRNAs. MiR-519d and miR-328-3p hampered cell proliferation and blocked cell cycle via binding to Ki-67 and they also suppressed migration and invasion. The combinatorial effects of two miRNAs were much stronger than a single miRNA. Conclusion Our findings proved that miR-519d and miR-328-3p played combinatorial anti-cancer roles in breast cancer by directly targeting a common target Ki-67. Our study suggested that these two miRNAs might own the potential to become novel therapeutic biomarkers involved in the diagnosis and therapy of breast cancer.
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Affiliation(s)
- Haiming Ma
- Department of Oncology, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
| | - Tao Liu
- Department of General Surgery, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
| | - Yanhua Xu
- Department of Anesthesiology, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
| | - Xinying Wang
- Department of Pathology, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
| | - Jin Wang
- Department of Oncology, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
| | - Xiaokang Liu
- Department of Oncology, Guangrao County People's Hospital, Dongying City, Shandong Province 257300, People's Republic of China
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Okudela K, Woo T, Saigusa Y, Arai H, Matsumura M, Mitsui H, Sugiyama M, Sekiya M, Ishikawa Y, Oshiro H, Kameda Y, Ohashi K. A method to obtain reproducible Ki-67 indices in lung adenocarcinoma. Histopathology 2020; 78:414-423. [PMID: 32813926 DOI: 10.1111/his.14234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/12/2020] [Indexed: 12/27/2022]
Abstract
AIMS Proliferative activity, evaluated from the Ki-67 index, is a strong prognostic factor in lung adenocarcinoma (LADC). Here, we optimised a procedure to measure the Ki-67 index and establish the best cut-off value. METHODS AND RESULTS We examined 342 stage I LADCs for the immunohistochemical expression of Ki-67 using different antibodies, MIB1 and SP6. The results revealed the superior specificity of SP6; therefore, SP6 was used in subsequent analyses. Slides were scanned with a virtual slide system. Using software, tumour cells were counted in a whole tumour. Thereafter, the tumour was evenly subdivided into 0.25-mm2 tiles. The frequency of positive cells was counted in each tile of an invasive area or the whole tumour. We calculated the number of tumour cells required to produce a 95% confidence interval (CI) <0.05. Additionally, we calculated coverage probabilities (CP) using two different methods, counting any number or 200 cells per tile. The results showed that we could meet our goal by counting 2000 cells from 10 random tiles (200 cells each) in invasive areas. CONCLUSIONS We successfully developed an optimal procedure for determination of the Ki-67 labelling index using an SP6 antibody, which provided CP > 70% and CI of <0.05 in more than 90% of cases. Furthermore, we identified an optimal cut-off value of 0.12 with an alternative of 0.15, based on disease recurrence. This procedure and the cut-off values may be used in the routine pathological diagnosis of LADC.
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Affiliation(s)
- Koji Okudela
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tetsukan Woo
- Department of General Thoracic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yusuke Saigusa
- Department of Biostatics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiromasa Arai
- Division of General Thoracic Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Kanagawa, Japan
| | - Mai Matsumura
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Mitsui
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Misaki Sugiyama
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Kanagawa, Japan
| | - Motoki Sekiya
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Kanagawa, Japan
| | - Yoshihiro Ishikawa
- Department of General Thoracic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hisashi Oshiro
- Department of Pathology, Jichi Medical University, Tochigi, Japan
| | - Yoichi Kameda
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Kanagawa, Japan
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Mestrum SGC, de Wit NCJ, Drent RJM, Hopman AHN, Ramaekers FCS, Leers MPG. Proliferative activity is disturbed in myeloproliferative neoplasms (MPN), myelodysplastic syndrome (MDS), and MDS/MPN diseases. Differences between MDS and MDS/MPN. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:322-330. [PMID: 32857909 PMCID: PMC8247351 DOI: 10.1002/cyto.b.21946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 12/20/2022]
Abstract
The proliferation marker Ki-67 is widely used within the field of diagnostic histopathology as a prognostic marker for solid cancers. However, Ki-67 is hardly used for prognostic and diagnostic purposes in flow cytometric analyses of hematologic neoplasms. In the present study, we investigated to what extent the proliferative activity, as determined by Ki-67 expression, is disturbed in myeloproliferative neoplasms (MPN), myelodysplastic syndrome (MDS), and MDS/MPN diseases. Bone marrow aspirates from 74 patients suffering from MPN, MDS, or MDS/MPN, and aspirates from 50 non-malignant cases were analyzed by flow cytometry for Ki-67 expression in the erythro-, myelo-, and monopoiesis. Ki-67 expression was used to investigate the proliferative activity during the various maturation steps within these hematopoietic cell lineages. In the MPN patient cohort, the proliferative activity of all cell lineages is significantly higher during almost all maturation stages compared to those of the benign control cohort. In the MDS and MDS/MPN cohort, a significantly lower proliferative activity is observed in the early maturation stages. In the MDS/MPN patient cohort, increased proliferative activity is seen in the later stages of the maturation. MDS and MDS/MPN display a distinct pattern in the proliferating fraction of maturing hematopoietic cells. This could become of added value in order to classify these malignancies based on their biological background and behavior, as well as in gaining a better understanding into the pathobiology of these malignancies.
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Affiliation(s)
- Stefan G C Mestrum
- Department of Molecular Cell Biology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Norbert C J de Wit
- Central Diagnostic Laboratory (CDL), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Roosmarie J M Drent
- Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Anton H N Hopman
- Department of Molecular Cell Biology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frans C S Ramaekers
- Department of Molecular Cell Biology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.,Nordic-MUbio, Susteren, The Netherlands
| | - Math P G Leers
- Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
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Tong G, Zhang G, Liu J, Zheng Z, Chen Y, Niu P, Xu X. Cutoff of 25% for Ki67 expression is a good classification tool for prognosis in colorectal cancer in the AJCC‑8 stratification. Oncol Rep 2020; 43:1187-1198. [PMID: 32323802 PMCID: PMC7058009 DOI: 10.3892/or.2020.7511] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 02/04/2020] [Indexed: 12/13/2022] Open
Abstract
Ki‑67 expression has been widely used in clinical practice as an index to evaluate the proliferative activity of tumor cells. The cutoff for Ki67 expression in order to increase the prognostic value of Ki67 expression in colorectal cancer varies. The present study assessed the relationship between the 25% cutoff for Ki67 expression and prognosis in colorectal cancer in the AJCC‑8 (American Joint Committee on Cancer 8 edition) stratification. The current trial included 1,090 colorectal cancer patients enrolled from 2006 to 2012 at Huzhou Central Hospital. Ki67 expression was classified according to 25% intervals, dividing the patients into four groups. Measurement data were analyzed by ANOVA, and count data by Crosstabs. Bivariate correlation analysis was performed to assess clinicopathological indicators based on Ki67 expression. Disease‑free survival (DFS) and overall survival (OS) based on Ki67 levels were analyzed by the Kaplan‑Meier method. A total of 1,090 patients of the 2,080 enrolled CRC cases were evaluated (52.4%). Invasive depth, tumor differentiation, tumor size, AJCC‑8, positive number of lymph nodes and chemotherapy status showed significant differences in the various Ki67 expression groups (all P<0.05), with significant correlations (Spearman rho: 0.170, 0.456, 0.22, 0.195, 0.514 and ‑0.201, respectively, all P<0.001). DFS and OS for the different Ki67 level groups based on AJCC‑8 stratification were analyzed, and no significance was found in stage IV (P=0.334). DFS and OS survival rates were assessed at different Ki67 expression levels, and no significant differences were found (all P>0.05). Cox regression analysis showed that invasive depth, lymph node metastasis, tumor differentiation, AJCC‑8 and Ki67 were independent factors affecting colorectal cancer (P=0.030, all others P<0.001). In conclusion, a cutoff of 25% for Ki67 expression is a good classification tool. High Ki67 has a close association with poor prognosis in colorectal cancer and independently predicts prognosis in the AJCC‑8 stratification.
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Affiliation(s)
- Guojun Tong
- Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Guiyang Zhang
- Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Jian Liu
- Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Zhaozheng Zheng
- Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Yan Chen
- Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Pingping Niu
- Central Laboratory, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
| | - Xuting Xu
- Central Laboratory, Huzhou Central Hospital, Huzhou, Zhejiang 313000, P.R. China
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Mitchell KG, Parra ER, Nelson DB, Zhang J, Wistuba II, Fujimoto J, Roth JA, Antonoff MB. Tumor cellular proliferation is associated with enhanced immune checkpoint expression in stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 2019; 158:911-919.e6. [PMID: 31235357 PMCID: PMC8073227 DOI: 10.1016/j.jtcvs.2019.04.084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/17/2019] [Accepted: 04/21/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Ki67 is a marker for tumor proliferative activity and is known to have prognostic significance in multiple solid malignancies. We sought to characterize the relationships among Ki67 expression, immune cell infiltration, and immune checkpoint expression in patients with resected non-small cell lung cancer. METHODS Specimens of patients undergoing resection of stage I to III non-small cell lung cancer (1997-2012) were analyzed using tissue microarrays. Proliferative index was quantified as the percentage of malignant cells expressing Ki67. Checkpoints expressed on malignant cells (programmed death ligand 1, B7H3, B7H4, indoleamine 2,3-dioxygenase 1) and lymphocytes (T-cell immunoglobulin and mucin-domain containing 3, V-domain suppressor of T-cell activation, tumor necrosis factor receptor superfamily member 4, lymphocyte activation gene 3, inducible T-cell co-stimulator) were analyzed in intratumoral and stromal compartments, respectively. Immune cell densities were quantified in intratumoral and peritumoral compartments in a representative subset. RESULTS A total of 190 patients met inclusion criteria. Higher Ki67 expression was noted in squamous cell carcinoma (median 31.4% positive malignant cells vs 15.2% adenocarcinoma, P < .001), advanced-stage tumors (25.7% stages II/III vs 20.8% stage I, P = .013), and poorly differentiated tumors (28.8% vs 15.4% well/moderately, P < .001). Ki67 was positively correlated with intratumoral expression of programmed death ligand 1, B7-H3, and indoleamine 2,3-dioxygenase 1, and elevated stromal expression of lymphocyte activation gene 3 and inducible T-cell co-stimulator. Ki67 expression was inversely associated with intratumoral densities of CD57+ and CD4+ cells. The relationship between Ki67 and checkpoint expression was strongest in stage I tumors. Among patients with stage I, increased Ki67 was independently associated with worse overall survival. CONCLUSIONS Increased Ki67 expression is associated with biologically aggressive non-small cell lung cancer, enhanced immune checkpoint expression, and reduced intratumoral immune cell infiltration. These findings were strongest in early-stage disease and warrant further investigation in the context of novel therapeutic agents.
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Affiliation(s)
- Kyle G Mitchell
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Edwin R Parra
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - David B Nelson
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Jiexin Zhang
- Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Junya Fujimoto
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Jack A Roth
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
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Xiong DD, Zeng CM, Jiang L, Luo DZ, Chen G. Ki-67/MKI67 as a Predictive Biomarker for Clinical Outcome in Gastric Cancer Patients: an Updated Meta-analysis and Systematic Review involving 53 Studies and 7078 Patients. J Cancer 2019; 10:5339-5354. [PMID: 31632479 PMCID: PMC6775696 DOI: 10.7150/jca.30074] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 06/12/2019] [Indexed: 12/18/2022] Open
Abstract
Gastric cancer (GC) threatens human health worldwide and we performed this meta-analysis to evaluate the clinical value of Ki-67/MKI67 in patients with GC. The combined hazard ratio (HR), odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationships of Ki-67/MKI67 expression with prognoses and clinicopathological characteristics. Genes co-expressed with MKI67 were collected for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and protein-protein interaction (PPI) network analyses. In total, 53 studies with 7078 patients were included in this study. The pooled HRs indicated that an elevated expression of Ki-67/MKI67 predicted an unfavorable overall survival (HR: 1.54, 95% CI: 1.33-1.78, P<0.0001) and disease-free survival (HR: 2.28, 95% CI: 1.43-3.64, P<0.0001) in GC patients. Additionally, in patients with advanced GC, a high Ki-67/MKI67 expression was also significantly connected with OS (HR: 1.37, 95% CI: 1.18-1.60, P<0.0001). The combined ORs showed that Ki-67/MKI67 expression was related to TNM stage (stage III/IV versus stage I/II: OR=1.93, 95% CI=1.34-2.78, P<0.0001), tumor differentiation (poor versus well/moderate: OR=1.94, 95% CI=1.32-2.85, P=0.001), lymph node metastasis (yes versus no: OR=1.67, 95% CI=1.23-2.25, P=0.001), distant metastasis (yes versus no: OR=1.67, 95% CI=1.24-2.26, P=0.001) and tumor invasion depth (T3/T4 versus Tis/T1/T2: OR=1.98, 95% CI=1.60-2.44, P<0.0001). The results of GO, KEGG pathway and PPI network analyses indicated that Ki-67/MKI67 may be involved in the development of GC via influencing P53 signaling pathway. Ki-67/MKI67 could be a potential indicator to predict the prognosis of patients with GC and identify high-risk cases. Detecting Ki-67/MKI67 expression in clinic may be helpful in optimizing individual treatment and further improving the survival expectancy of patients with GC.
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Affiliation(s)
- Dan-Dan Xiong
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
| | - Chu-Mei Zeng
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
| | - Ling Jiang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
| | - Dian-Zhong Luo
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
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Can peritumoral radiomics increase the efficiency of the prediction for lymph node metastasis in clinical stage T1 lung adenocarcinoma on CT? Eur Radiol 2019; 29:6049-6058. [PMID: 30887209 DOI: 10.1007/s00330-019-06084-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/07/2019] [Accepted: 02/08/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the efficiency of radiomics model on CT images of intratumoral and peritumoral lung parenchyma for preoperative prediction of lymph node (LN) metastasis in clinical stage T1 peripheral lung adenocarcinoma patients. METHODS Three hundred sixty-six peripheral lung adenocarcinoma patients with clinical stage T1 were evaluated using five CT scanners. For each patient, two volumes of interest (VOIs) on CT were defined as the gross tumor volume (GTV) and the peritumoral volume (PTV, 1.5 cm around the tumor). One thousand nine hundred forty-six radiomic features were obtained from each VOI, and then refined for reproducibility and redundancy. The refined features were investigated for usefulness in building radiomic signatures by mRMR feature ranking method and LASSO classifier. Multivariable logistic regression analysis was used to develop a radiomic nomogram incorporating the radiomic signature and clinical parameters. The prediction performance was evaluated on the validation cohort. RESULTS The radiomic signatures using the features of GTV and PTV showed a good ability in predicting LN metastasis with an AUC of 0.829 (95% CI, 0.745-0.913) and 0.825 (95% CI, 0.733-0.918), respectively. By incorporating the features of GTV and PTV, the AUC of radiomic signature increased to 0.843 (95% CI, 0.770-0.916). The AUC of radiomic nomogram was 0.869 (95% CI, 0.800-0.938). CONCLUSIONS Radiomic signatures of GTV and PTV both had a good prediction ability in the prediction of LN metastasis, and there is no significant difference of AUC between the two groups. The proposed nomogram can be conveniently used to facilitate the preoperative prediction of LN metastasis in T1 peripheral lung adenocarcinomas. KEY POINTS • Radiomics from peritumoral lung parenchyma increase the efficiency of the prediction for lymph node metastasis in clinical stage T1 lung adenocarcinoma on CT. • A radiomic nomogram was developed and validated to predict LN metastasis. • Different scan parameters on CT showed that radiomics signature had good predictive performance.
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