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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Suzuki S, Nishiyama N. Restrictive Ventilatory Impairment as a Poor Prognostic Factor in Patients Who Undergo Surgical Resection for Metachronous Second Primary Lung Cancer. Ann Thorac Cardiovasc Surg 2023; 29:185-191. [PMID: 36740271 PMCID: PMC10466115 DOI: 10.5761/atcs.oa.22-00182] [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: 09/29/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate the prognostic impact of restrictive ventilatory impairment in patients who undergo pulmonary resection of metachronous second primary lung cancer. METHODS The clinical characteristics and surgical outcomes of 70 patients with metachronous second primary lung cancer were analyzed. RESULTS The surgical procedures consisted of wedge resection in 40 patients, segmentectomy in 17, lobectomy in 12, and completion pneumonectomy in one. Patients who underwent ipsilateral pulmonary resection developed more perioperative complications (p = 0.0339). Three-year and 5-year overall survival rates were 78.2% and 69.2%, respectively. In univariate analysis, sex, restrictive ventilatory impairment, and histology of second primary lung cancer were significantly poor prognostic factors (all p <0.05). Multivariate analysis identified restrictive ventilatory impairment to be an independent predictor of a poor prognosis (p = 0.0193). In the 22 patients who died, the cause of death was lung cancer in 11 and other diseases, including pneumonia and respiratory failure, in 11. Death from another disease was significantly more common in patients with restrictive ventilatory impairment (p = 0.0216). CONCLUSION Restrictive ventilatory impairment was an independent predictor of a poor prognosis in patients with a second primary lung cancer. Restrictive ventilatory impairment as a result of repeated thoracic surgery may increase the likelihood of death from another disease.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
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Qu X, Shi Z, Guo J, Guo C, Qiu J, Hua K. Identification of a novel six-gene signature with potential prognostic and therapeutic value in cervical cancer. Cancer Med 2021; 10:6881-6896. [PMID: 34498424 PMCID: PMC8495282 DOI: 10.1002/cam4.4054] [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: 01/18/2021] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Cervical cancer has high mortality, high recurrence and poor prognosis. Although prognostic biomarkers such as clinicopathological features have been proposed, their accuracy and precision are far from satisfactory. Therefore, novel biomarkers are urgently needed for disease surveillance, prognosis prediction and treatment selection. Materials Differentially expressed genes (DEGs) between cervical cancer and normal tissues from three microarray datasets extracted from the Gene Expression Omnibus platform were identified and screened. Based on these DEGs, a six‐gene prognostic signature was constructed using cervical squamous cell carcinoma and endocervical adenocarcinoma data from The Cancer Genome Atlas. Next, the molecular functions and related pathways of the six genes were investigated through gene set enrichment analysis and co‐expression analysis. Additionally, immunophenoscore analysis and the QuartataWeb Server were employed to explore the therapeutic value of the six‐gene signature. Results We discovered 178 overlapping DEGs in three microarray datasets and established a six‐gene (APOC1, GLTP, ISG20, SPP1, SLC24A3 and UPP1) prognostic signature with stable and excellent performance in predicting overall survival in different subgroups. Intriguingly, the six‐gene signature was closely associated with the immune response and tumour immune microenvironment. The six‐gene signature might be used for predicting response to immune checkpoint inhibitors (ICIs) and the six genes may serve as new drug targets for cervical cancer. Conclusion Our study established a novel six‐gene (APOC1, GLTP, ISG20, SPP1, SLC24A3 and UPP1) signature that was closely associated with the immune response and tumour immune microenvironment. The six‐gene signature was indicative of aggressive features of cervical cancer and therefore might serve as a promising biomarker for predicting not only overall survival but also ICI treatment effectiveness. Moreover, three genes (UPP1, ISG20 and GLTP) within the six‐gene signature have the potential to become novel drug targets.
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Affiliation(s)
- Xinyu Qu
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Zhiwen Shi
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China
| | - Jingjing Guo
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Chenyan Guo
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Junjun Qiu
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Keqin Hua
- Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Surgical outcomes of primary lung cancers following esophagectomy for primary esophageal carcinoma. Jpn J Clin Oncol 2021; 51:786-792. [PMID: 33442741 DOI: 10.1093/jjco/hyaa254] [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: 09/23/2020] [Revised: 10/22/2020] [Accepted: 12/06/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this retrospective study is to evaluate the perioperative complications and prognosis of patients with a history of resected esophageal carcinoma who subsequently underwent pulmonary resection of a primary lung cancer. METHODS The study cohort comprised 23 patients who had undergone curative resection of a primary lung cancer following esophagectomy for a primary esophageal carcinoma. Clinical characteristics and surgical outcomes were analyzed. RESULTS The initial treatment for esophageal carcinoma was esophagectomy by thoracotomy in 10 patients and video assisted thoracoscopic surgery in 13. The treatments for lung cancer comprised wedge resection in three patients, segmentectomy in seven and lobectomy in 13. The pulmonary resections were performed by thoracotomy in six and video assisted thoracoscopic surgery in 17. The average operating time for the lung cancer surgeries was 202 min and average blood loss 122 ml. There were no perioperative deaths or severe complications. Three- and Five-year overall survival rates were 78.0% and 68.2%. According to univariate survival analysis, age, restrictive ventilatory impairment and histology of lung cancer were significant predictors of poor prognosis (all P < 0.05). Significantly more of the patients with than without restrictive ventilatory impairment died of other diseases (P = 0.0036). CONCLUSIONS Pulmonary resection for primary lung cancers following esophagectomy for esophageal carcinoma is acceptable in selected patients. Such surgery requires caution concerning intrathoracic adhesions and postoperative prolonged air leakage. Patients with restrictive ventilatory impairment had a poorer prognosis, and the indication for surgery in these patients should be carefully considered.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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Tang X, Liu S, Ding Y, Guo C, Guo J, Hua K, Qiu J. Serum Circular FoxO3a Serves as a Novel Prognostic Biomarker in Squamous Cervical Cancer. Cancer Manag Res 2020; 12:2531-2540. [PMID: 32308490 PMCID: PMC7154007 DOI: 10.2147/cmar.s243329] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/27/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Circular RNAs (circRNAs) are novel type of noncoding RNAs that play important roles and serve as noninvasive biomarkers in various cancers. In the present study, we focused on circFoxO3a and aimed to investigate its prognostic value as a novel serum biomarker for squamous cervical cancer (SCC). Patients and Methods Our study included 103 SCC patients from Obstetrics and Gynecology Hospital of Fudan University. Expression levels of circFoxO3a in the serum of patients with SCC were examined by reverse transcription‑quantitative PCR (RT‑qPCR). The correlation between serum circFoxO3a expression and clinicopathologic factors was analyzed. The Kaplan–Meier method and multivariate Cox regression analysis were applied to evaluate the independent prognostic factors for SCC. A prognostic predictive nomogram was constructed using R software. Results Levels of serum circFoxO3a were decreased in SCC patients compared with controls. Low expression of circFoxO3a was correlated with deeper stromal invasion and positive lymph node metastasis. Moreover, SCC patients with lower expression of serum circFoxO3a showed poorer prognosis, including both overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox analysis indicated low serum circFoxO3a levels to be an unfavorable prognostic factor for both OS and RFS, independent of positive lymph node metastasis. Notably, the predictive nomogram we established further confirmed that serum circFoxO3a is a useful tool for predicting survival in SCC. Conclusion Altogether, our findings demonstrated that serum circFoxO3a could serve as a potential novel noninvasive predictive prognostic biomarker and therapeutic target for SCC.
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Affiliation(s)
- Xiaoyan Tang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
| | - Songping Liu
- Department of Obstetrics and Gynecology, Zhenjiang Maternal and Child Health Hospital, Zhenjiang, Jiangsu 212001, People's Republic of China
| | - Yan Ding
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
| | - Chenyan Guo
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
| | - Jingjing Guo
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
| | - Keqin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
| | - Junjun Qiu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People's Republic of China.,Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People's Republic of China
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Serum SCCA levels in patients suffering cancers or other diseases. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 162:165-175. [PMID: 30905447 DOI: 10.1016/bs.pmbts.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Increased serum squamous cell carcinoma antigen (SCCA) levels are clinically used diagnostic or prognostic biomarker for squamous cell carcinomas. According to recently published studies, increased serum SCCA levels are also observed in adenocarcinomas, hepatocarcinomas, kidney, and other inflammatory diseases, indicating squamous cell carcinoma is not the production source of serum SCCA in these diseases. However, serum SCCA levels in patients suffering different types of diseases have not been systematically measured and compared. Thus, in our current study, serum SCCA levels from 21,608 patients with 39 clinically defined diseases were collected and measured by the clinical laboratory in the Affiliated Hospital of Qingdao University over the past 5 years in addition to 232 serum samples from individuals who attend their annual physical examination as the healthy controls. According to the median, mean, and -log10p values, we found that patients with uremia, azotemia, diabetic nephropathy, and nephritic syndrome had the highest serum SCCA levels among all 39 different types of diseases including patients suffering squamous cell carcinomas. Moreover, patients suffering lung cancer, cervical cancer, esophagus cancer, or chronic pulmonary disease had lower median and interquartile range values but higher or comparable mean values and significantly higher SD values than that of the healthy controls. Furthermore, patients with endometrial cancer, pancreatitis, osteoporosis, and some other diseases had lower serum SCCA levels than that of the healthy controls. These results demonstrated that serum SCCA can not only be used in diagnosis and prognosis of squamous cell carcinomas but also as biomarkers for uremia, azotemia, diabetic nephropathy, and nephritic syndrome.
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