1
|
Liu Y, Ma H, Zhou R, Chen Y, Zhu Y, Chang X, Chen J, Zhang H. Nomogram-based prognostic tool for stage IIIB/IV non-small cell lung cancer patients undergoing traditional Chinese medicine treatment. Heliyon 2024; 10:e31449. [PMID: 38818171 PMCID: PMC11137507 DOI: 10.1016/j.heliyon.2024.e31449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
Objective Given the significant impact of long-term traditional Chinese medicine (TCM) treatment on the prognosis of patients with non-small cell lung cancer (NSCLC), we aimed to develop nomograms, with or without consideration of TCM treatment duration, to accurately predict the overall survival (OS) of patients with stage IIIB/IV NSCLC treated with TCM. Methods Nomograms were developed from a training cohort comprised of 292 patients diagnosed with NSCLC, using univariate and multivariate Cox regression analyses to screen for various prognostic factors with and without TCM treatment. The nomograms were evaluated using the concordance index (C-index), calibration curve, and decision curve analysis (DCA), after which they were validated, using the bootstrap self-sampling method for internal validation, and a validation cohort comprised of 175 patients for external validation. Bootstrap validation is a resampling technique that involves randomly selecting and replacing data from the original dataset to make statistical inferences, thereby circumventing the issue of sample reduction that can arise from cross-validation. Results We identified seven significant prognostic factors for OS. For nomogram A (excluding TCM treatment time), the C-indexes (95 % confidence interval [CI]) were 0.674 (0.635-0.712) and 0.660 (0.596-0.724) for the training and validation cohorts, respectively. For nomogram B (including TCM treatment time), the C-indices (95 % CI) were 0.846 (0.822-0.870) and 0.783 (0.730-0.894), for the training and validation cohorts, respectively, indicating that nomogram B was superior to nomogram A. Both the calibration curves and DCA results exhibited favorable clinical concordance and usefulness. Conclusion The nomogram B yielded precise prognostic predictions for patients with advanced NSCLC treated with TCM.
Collapse
Affiliation(s)
- Yihong Liu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Haochuan Ma
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Hospital of Chinese Medicine Postdoctoral Research Workstation, Guangzhou, Guangdong, China
| | - Rui Zhou
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yadong Chen
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yanjuan Zhu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xuesong Chang
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jicai Chen
- Department of Thoracic Surgery, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Haibo Zhang
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Jiang H, Bu L. Progress in the treatment of lung adenocarcinoma by integrated traditional Chinese and Western medicine. Front Med (Lausanne) 2024; 10:1323344. [PMID: 38259856 PMCID: PMC10802683 DOI: 10.3389/fmed.2023.1323344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) overwhelmingly represents the predominant histological subtype of lung cancer, with lung adenocarcinoma emerging as the most prevalent form. Conventional Western medical treatments encompass a spectrum of modalities, including surgical interventions, cytotoxic chemotherapy, radiotherapy, targeted pharmacotherapy, and immunotherapy. In contrast, Traditional Chinese Medicine (TCM) methodologies encompass traditional Chinese medicine treatments, acupuncture therapies, and tuina treatments. While conventional Western medicine has made remarkable strides in the treatment of lung cancer, it is important to acknowledge the limitations inherent in singular treatment approaches. Consequently, the quest for a more comprehensive and integrative therapeutic paradigm becomes imperative. A deficiency of evaluation criteria specific to lung adenocarcinoma treatment in the realm of TCM represents an outstanding challenge in need of resolution. Nonetheless, in the backdrop of the continuous evolution of lung adenocarcinoma treatment modalities, the amalgamation of Chinese and Western medical approaches for treating this condition has exhibited a promising trajectory. It not only contributes to mitigating toxicity and augmenting efficacy but also serves to reduce a spectrum of postoperative complications, thereby enhancing the quality of patients' survival and extending life expectancy. This article furnishes a comprehensive survey of the research advancements in the integration of Chinese and Western medical approaches for treating lung adenocarcinoma. It elucidates the merits and demerits of individual and combined therapeutic strategies, surmounts current limitations, underscores the virtues of amalgamating Chinese and Western medical paradigms, and offers a more holistic, integrated, and efficacious treatment blueprint.
Collapse
Affiliation(s)
- Hongxin Jiang
- The College of Life Sciences, Northwest University, Xi’an, Shaanxi, China
| | - Lina Bu
- Department of Respiratory and Critical Care Medicine, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, China
| |
Collapse
|
3
|
Kwag E, Kim SD, Shin SH, Oak C, Park SJ, Choi JY, Hoon Yoon S, Kang IC, Jeong MK, Woo Lee H, Bang SH, Son JW, Lee S, Kim SJ, Yoo HS. A Randomized, Multi-Center, Open Label Study to Compare the Safety and Efficacy between Afatinib Monotherapy and Combination Therapy with HAD-B1 for the Locally Advanced or Metastatic NSCLC Patients with EGFR Mutations. Integr Cancer Ther 2024; 23:15347354241268231. [PMID: 39103991 DOI: 10.1177/15347354241268231] [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] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Lung cancer, especially non-small cell lung cancer (NSCLC), poses a significant health challenge globally due to its high mortality. Afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has shown superior efficacy over traditional chemotherapy in NSCLC treatment. However, issues like secondary resistance and adverse effects call for alternative therapies. HAD-B1, comprising 4 herbal medicines, has shown promise in lung cancer treatment in both preclinical and clinical settings. This study assesses the combination of HAD-B1 and Afatinib in advanced NSCLC patients to potentially improve outcomes by addressing the limitations of current EGFR-TKI therapies. METHOD A randomized, open-label trial evaluated the efficacy and safety of HAD-B1 with Afatinib in 90 EGFR-mutation-positive NSCLC patients. Participants were divided into treatment and control groups, receiving Afatinib with or without HAD-B1. The study focused on the initial dose maintenance rate and disease control rate (DCR) of Afatinib, alongside secondary outcomes like survival rates and quality of life, under continuous safety monitoring. RESULTS Among the 90 participants, no significant difference was found in initial dose maintenance (60.98% in the treatment group vs 52.50% in the control, P = .4414) or DCR (80.49% vs 90.00%, P = .2283). Secondary outcomes like PFS, TTP, and OS showed no notable differences. However, physical functioning significantly improved in the treatment group (P = .0475, PPS group). The control group experienced higher rates of adverse events of special interest and adverse drug reactions (P = .01), suggesting HAD-B1 with Afatinib might enhance physical function without increasing adverse effects. CONCLUSION Combining HAD-B1 with Afatinib potentially improves quality of life and reduces adverse events in advanced NSCLC patients. Further research is necessary to confirm the long-term benefits of this combination therapy, aiming to advance NSCLC treatment outcomes. TRIAL REGISTRATION Clinical Research Information Service (CRIS) of the Republic of Korea, https://cris.nih.go.kr/ (ID: KCT0005414).
Collapse
Affiliation(s)
- Eunbin Kwag
- East West Cancer Center, Daejeon Korean Medicine Hospital, Daejeon University, Daejeon 35235, Republic of Korea
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Soo-Dam Kim
- East West Cancer Center, Daejeon Korean Medicine Hospital, Daejeon University, Daejeon 35235, Republic of Korea
- Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Seong-Hoon Shin
- Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Chulho Oak
- Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - So-Jung Park
- School of Korean Medicine and Korean Medicine Hospital, Pusan National University, Yangsan 50612, Republic of Korea
| | - Jun-Yong Choi
- School of Korean Medicine and Korean Medicine Hospital, Pusan National University, Yangsan 50612, Republic of Korea
| | - Seong Hoon Yoon
- School of Medicine, Pusan National University Yangsan Hospital, Pusan National University, Yangsan 50612, Republic of Korea
| | - In-Cheol Kang
- College of Life and Health Sciences and BioChip Research Center, Hoseo University, Asan‑si, Chungcheongnam‑do 336‑795, Republic of Korea
| | - Mi-Kyung Jeong
- Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Hyun Woo Lee
- Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Sun-Hwi Bang
- Hwirim Korean Medicine Hospital, Busan 48942, Republic of Korea
| | - Ji Woong Son
- Konyang University Hospital, Daejeon 35365, Republic of Korea
| | - Sanghun Lee
- Dankook University, Gyeonggi-do 16890, Republic of Korea
| | - Seung Joon Kim
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hwa-Seung Yoo
- East West Cancer Center, Daejeon Korean Medicine Hospital, Daejeon University, Daejeon 35235, Republic of Korea
| |
Collapse
|
4
|
Song X, Cao L, Ni B, Wang J, Qin X, Sun X, Xu B, Wang X, Li J. Challenges of EGFR-TKIs in NSCLC and the potential role of herbs and active compounds: From mechanism to clinical practice. Front Pharmacol 2023; 14:1090500. [PMID: 37089959 PMCID: PMC10120859 DOI: 10.3389/fphar.2023.1090500] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/28/2023] [Indexed: 04/25/2023] Open
Abstract
Epidermal growth factor receptor (EGFR) mutations are the most common oncogenic driver in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are widely used in the treatment of lung cancer, especially in the first-line treatment of advanced NSCLC, and EGFR-TKIs monotherapy has achieved better efficacy and tolerability compared with standard chemotherapy. However, acquired resistance to EGFR-TKIs and associated adverse events pose a significant obstacle to targeted lung cancer therapy. Therefore, there is an urgent need to seek effective interventions to overcome these limitations. Natural medicines have shown potential therapeutic advantages in reversing acquired resistance to EGFR-TKIs and reducing adverse events, bringing new options and directions for EGFR-TKIs combination therapy. In this paper, we systematically demonstrated the resistance mechanism of EGFR-TKIs, the clinical strategy of each generation of EGFR-TKIs in the synergistic treatment of NSCLC, the treatment-related adverse events of EGFR-TKIs, and the potential role of traditional Chinese medicine in overcoming the resistance and adverse reactions of EGFR-TKIs. Herbs and active compounds have the potential to act synergistically through multiple pathways and multiple mechanisms of overall regulation, combined with targeted therapy, and are expected to be an innovative model for NSCLC treatment.
Collapse
Affiliation(s)
- Xiaotong Song
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Luchang Cao
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baoyi Ni
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jia Wang
- Department of Respiratory, Hongqi Hospital Affiliated to Mudanjiang Medical College, Mudanjiang, China
| | - Xiaoyan Qin
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoyue Sun
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bowen Xu
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinmiao Wang
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Li
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
5
|
Shi J, Hao S, Liu X, Li Y, Zheng X. Feiyiliu Mixture sensitizes EGFR Del19/T790M/C797S mutant non-small cell lung cancer to osimertinib by attenuating the PRC1/Wnt/EGFR pathway. Front Pharmacol 2023; 14:1093017. [PMID: 36744262 PMCID: PMC9892466 DOI: 10.3389/fphar.2023.1093017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction: Osimertinib is a potent epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for the treatment of patients with EGFR-mutant non-small cell lung cancer (NSCLC). However, the emergence of acquired resistance due to the EGFR-Del19/T790M/C797S mutation limits the clinical application of osimertinib. Feiyiliu Mixture (FYLM), a clinical experience formula of Chinese medicine, was used to treat lung cancer with good clinical efficacy. In this study, we aimed to investigate the mechanism by which Feiyiliu Mixture delays osimertinib resistance in EGFR-mutant cell lines and EGFR-mutant cell tumor-bearing mice. Methods: The osimertinib-resistant cell models were established in mouse Lewis lung carcinoma (LLC) cells transfected with EGFR-Del19/T790M/C797S mutant lentivirus. In cell experiments, after 48 h of treatment with Feiyiliu Mixture-containing serum, MTT assay was used to detect the relative cell viability, and western blotting was used to detect EGFR protein phosphorylation expression. In animal experiments, C57BL/6J mice were subcutaneously injected with Lewis lung carcinoma cells stably expressing EGFR-Del19/T790M/C797S mutations to construct a xenograft model. After 2 weeks of Feiyiliu Mixture and/or osimertinib treatment, the expression of proliferation-related, apoptosis-related and PRC1/Wnt/EGFR pathway markers was detected by real-time qPCR, western blotting and immunohistochemistry. Results: The results showed that when combined with osimertinib, Feiyiliu Mixture synergistically reduces proliferation and increases apoptosis to improve drug resistance. In vitro, Feiyiliu Mixture-containing serum reduced the EGFR phosphorylation. In vivo, Feiyiliu Mixture downregulated the expression of cyclin B1 and Bcl-2 while upregulating the level of cleaved Caspase-3 protein, indicating that Feiyiliu Mixture promotes apoptosis. Furthermore, Feiyiliu Mixture reduced the expression of p-EGFR, p-Akt, PRC1 and Wnt pathway-related proteins such as β-catenin, c-Myc and c-Jun. Conclusion: The present study identified that Feiyiliu Mixture inhibited PRC1/Wnt/EGFR pathway activation, reduced proliferation, and promoted apoptosis, thereby increasing the sensitivity of EGFR-mutant non-small cell lung cancer to osimertinib. Our study provided a new idea for Chinese medicine to play a role in enhancing efficacy and reducing toxicity in the treatment of non-small cell lung cancer.
Collapse
Affiliation(s)
- Jingjing Shi
- College of First Clinical Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
- Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser Hospital), Qingdao, China
| | - Shaoyu Hao
- Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xiantao Liu
- Department of Respiratory Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yingying Li
- College of First Clinical Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xin Zheng
- Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser Hospital), Qingdao, China
| |
Collapse
|
6
|
Yang J, Lu H, Jing N, Wang B, Guo H, Sun S, Zhang Y. Traditional Chinese Medicine Syndromes are Associated with Driver Gene Mutations and Clinical Characteristics in Patients with Lung Adenocarcinoma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9905868. [PMID: 36248421 PMCID: PMC9568290 DOI: 10.1155/2022/9905868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/09/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate the associations between traditional Chinese medicine (TCM) syndromes and driver gene mutations as well as the clinical characteristics of patients with lung adenocarcinoma. We performed a cross-sectional study in patients with lung adenocarcinoma between June 2020 and October 2021. The patient characteristics, such as age, sex, smoking history, clinical stage, metastasis, driver gene mutations, and the type of traditional Chinese medicine syndrome/element, were collected. The associations between each TCM syndrome and sex, smoking history, clinical stage, metastasis, and driver gene mutations were analyzed. The present study included 127 patients. The most frequent TCM syndromes were Qi and Yin deficiency (39, 30.7%) and lung-spleen Qi deficiency (32, 25.2%). Eighty-one (63.8%) patients had mutations in driver genes, especially in the EGFR gene (64, 79.0%). There was a statistically significant association between a driver gene mutation and TCM syndrome (P < 0.05). Genetic mutations presented more frequently in patients with Qi and Yin deficiency (37.0%), lung-spleen Qi deficiency (30.0%), or the cold element (59.3%). Male patients were more likely to have Qi stagnation and blood stasis, whereas female patients were more likely to have lung-spleen Qi deficiency or Qi and Yin deficiency. The patients with lung-spleen Qi deficiency were usually younger than those with Qi and Yin deficiency or Qi stagnation and blood stasis (P < 0.05). Compared with the patients with other TCM syndromes, the patients with Yin and Yang deficiency were more likely to have bone metastasis. TCM syndromes were associated with driver gene mutations, sex, age, and bone metastasis in patients with lung adenocarcinoma.
Collapse
Affiliation(s)
- Jili Yang
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| | - Haiyan Lu
- Changchun University of Traditional Chinese Medicine, Changchun 130117, China
| | - Niancai Jing
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| | - Bo Wang
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| | - Huanyu Guo
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| | - Shoukun Sun
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| | - Yue Zhang
- Department of Integrative Medicine, Jilin Provincial Cancer Hospital, Changchun 130012, China
| |
Collapse
|
7
|
Wu X, Xia J, Wang Z, Xu Z, Liu K, Fu X, Deng H. Feiyanning downregulating CXCLs/CXCR2 axis to suppress TANs infiltration in the prevention of lung cancer metastasis. JOURNAL OF ETHNOPHARMACOLOGY 2022; 295:115277. [PMID: 35427725 DOI: 10.1016/j.jep.2022.115277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/26/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tumor-associated neutrophils (TANs) play an important role in tumor metastasis. The Traditional Chinese medicine (TCM) Feiyanning (FYN) has been clinically proven to effectively prevent the recurrence and metastasis of lung cancer, improve immunity, and prolong the survival period of lung cancer patients. However, its anti-metastatic immune mechanism has not been fully elucidated. To this end, we studied the mechanism of FYN's regulation of neutrophils infiltration in the tumor microenvironment (TME). AIM OF THE STUDY To explore the anti-metastatic mechanism of FYN from the perspective of anti-immunosuppressive phenotype neutrophils infiltration in the TME. MATERIALS AND METHODS TCM network pharmacological analysis was used to predict Feiyanning effective target. Flow cytometry was used to detect the proportion of immune cell subsets in the TME. Lung metastases were investigated in C57 mice by tail vein injection. Protein expression was evaluated by immunohistochemistry and Western blot. Gene expression was evaluated by qRT-PCR. RESULTS FYN could reshape the tumor immune microenvironment. It prevents Tregs, M2 macrophages, and neutrophils infiltration, as well as recruits T cells, NK cells, and DCs, and improves DCs activation. In addition, FYN could regulate the polarization of TANs, inhibit the infiltration of neutrophils with an immunosuppressive phenotype, downregulate CXCLs/CXCR2 axis and inhibitory factors like Arg-1 and TGF-β, and up-regulate the immune effector molecule ICAM-1. Furthermore, FYN increases anti-tumor immune effects in the TME to prevent tumor cells from spreading to the lungs. CONCLUSION This study clarifies the potential mechanism of FYN in regulating neutrophils infiltration and anti-metastasis. FYN may regulate neutrophils infiltration in the TME by regulating CXCLs/CXCR2 axis.
Collapse
Affiliation(s)
- Xinhong Wu
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Jinli Xia
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Zhongqi Wang
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Zhenye Xu
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Kaile Liu
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Xiaojie Fu
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| | - Haibin Deng
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China.
| |
Collapse
|
8
|
Zhou Y, Dong X, Zhang L. Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery. Thorac Cardiovasc Surg 2022; 71:197-205. [PMID: 35042243 DOI: 10.1055/s-0041-1740558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Lung cancer is a primary cause of cancer death. This study assessed the action of dexmedetomidine (DEX) on oxidative stress (OS) and microRNA 10a (miR-10a) in patients with lung cancer. METHODS Patients were given 1 µg/kg DEX before anesthesia and control patients were given saline. The duration of intraoperative one-lung ventilation (OLV) and fluid intake were determined, and mean arterial pressure, heart rate and bispectral index were observed at the time of before anesthesia (T0), immediately after endotracheal intubation (T1), 1 hour after OLV (T2), and 10 minutes before the end of surgery (T3). The expressions and correlations of miR-10a, inflammation and OS levels in the serum were analyzed. The effects of DEX intervention and miR-10a level on pulmonary complications were analyzed. RESULTS Patients with DEX intervention had lower levels of inflammation and OS during perioperative period than the controls. DEX intervention reduced miR-10a levels in patients during perioperative period. miR-10a in serum of patients with DEX intervention after surgery was positively-correlated with the concentrations of malondialdehyde, and inflammatory factors, while negatively-correlated with superoxide dismutase. The total incidence of postoperative pulmonary complications after DEX intervention was lowered. Patients with high miR-10a expression had a higher cumulative incidence of pulmonary complications than those with low miR-10a expression. CONCLUSION DEX can reduce postoperative OS and plasma miR-10a level in patients with lung cancer, and high expression of miR-10a predicts a high incidence of postoperative pulmonary complications.
Collapse
Affiliation(s)
- Yan Zhou
- Department of Anesthesiology, The First People's Hospital of Jinan, Jinan, Shandong Province, China
| | - Xia Dong
- Department of Anesthesiology, Shizhong District People's Hospital of Jinan, Jinan, Shandong Province, China
| | - Lei Zhang
- Department of Operating Room, The First People's Hospital of Jinan, Jinan, Shandong Province, China
| |
Collapse
|