Lung cancer and type 2 diabetes experience in Dolj County (southwest region of Romania) - a clinical, bioclinical and pathological study

BACKGROUND AND AIM

Type 2 diabetes (T2D) and cancer, the most important public health problems nowadays, and the mechanisms between the presence of diabetes and the development of malignancies remain unclear. The leading cause of cancer death in 2020 is attributed to lung cancer. This study aimed to highlight the impact of the association of these two diseases and the predominant histopathological type of lung cancer in the selected group, glycemic imbalance, and information about the course and outlook for these patients.

PATIENTS, MATERIALS AND METHODS

The authors proposed a case-control 10-year period study, between 2007 and 2017, of two groups of patients diagnosed with T2D and lung cancer who underwent hospitalization at the Clinic of Medical Oncology, Emergency County Hospital, Craiova, Romania.

RESULTS

Our study showed a higher incidence of lung adenocarcinoma in patients diagnosed with T2D. The inflammatory syndrome is more pronounced in the diabetic group, which is supported by correlations between lactate dehydrogenase (LDH), albumin, and hemoglobin levels.

CONCLUSIONS

The duration of cancer treatment in lung cancer and the survival rate is strongly influenced by the presence of diabetes as a concomitant disease.

Development of metastasis-associated seven gene signature for predicting lung adenocarcinoma prognosis using single-cell RNA sequencing data

Metastasis is the primary cause of lung adenocarcinoma (LUAD)-related death. This study evaluated the metastasis-associated genes (MAGs) in single-cell RNA sequencing (scRNA-seq) data from LUAD tissues and developed a MAG signature to predict overall survival (OS) of LUAD patients. The LUAD scRNA-seq data was downloaded from the Gene Expression Omnibus (GEO) Database and MAGs were identified from LUAD scRNA-seq data. The LUAD transcriptomic and clinical data were obtained from The Cancer Genome Atlas (TCGA). Cox and LASSO regression analyses were performed to identify differentially expressed MAGs (DEMAGs) with prognostic value that were then used to construct a MAG signature and MAG-nomogram model. Finally, a functional enrichment analysis was performed via Gene Set Enrichment Analysis (GSEA). 414 MAGs and 22 prognostic DEMAGs were revealed in the study. Multivariate Cox proportional hazards regression analysis was utilized to construct a 7-MAG signature for predicting the OS of LUAD patients. Patients with high risk scores had a significantly worse OS than those with low risk scores in the training group (n = 236), and the 7-MAG signature was successfully confirmed in the testing group (n = 232) and the entire TCGA-LUAD cohort (n = 468). Furthermore, univariate and multivariate Cox regression suggested that the 7-MAG signature was an independent prognostic indicator. Additionally, based on the 7-MAG signature, a nomogram was established that could more intuitively help to predict the OS of LUAD patients. The GSEA revealed the underlying molecular mechanisms of the 7-MAG signature in LUAD metastasis. In conclusion, a 7-MAG signature was developed based on LUAD scRNA-seq data that could effectively predict LUAD patient prognosis and provide novel insights for therapeutic targets and the potential molecular mechanism of metastatic LUAD.

High Expression of TLR2 in the serum of patients with tuberculosis and lung cancer, and can promote the progression of lung cancer

Purpose: The present paper investigated the expression of TLR2 in serum of patients with pulmonary tuberculosis and lung cancer, and verifiedthe effect of TLR2 on the biological characteristics of lung cancer cells. Methods: The common differentially expressed genes in tuberculosis and lung cancer samples were analyzed by edgeR. The intersection of genes was taken and the enrichment analysis and string interaction analysis were performed. The expression of TLR2, inflammatory factors IL6, IL17 and IL22 in serum of patients with pulmonary tuberculosis or lung cancer and lung cell were detected by ELISA. The mRNA and protein expression levels of TLR2, caspase-3, Bax and Bcl-2 were detected by qRT-PCR and Western blot. CCK-8, colony formation assay, transwell assay and flow cytometry were performed to detect the proliferation, invasion, migration and cells apoptosis of lung cancer cells. Results: Bioinformatics analysis found that high expression of TLR2 is a core regulator in lung cancer and tuberculosis. TLR2 and inflammatory factors IL6, IL17, IL22 are highly expressed in the serum of patients with tuberculosis and lung cancer by ELISA.TLR2 is also highly expressed in lung cancer cells. Silencing TLR2 inhibited the growth, invasion and migration ability of cells, and the expression of IL6, IL17 and IL22. It also promoted the expression of caspase-3 and Baxwith the decreased expression of Bcl-2. Conclusion: TLR2 and inflammatory factors IL6, IL17 and IL22 were highly expressed in the serum of patients with pulmonary tuberculosis and lung cancer. Silencing TLR2 could inhibit the growth, invasion and migration ability of lung cancer cells, and promote apoptosis.

The effect of cigarette smoking on lung cancer evolution

The aim of this paper is to elucidate the risk of lung carcinogenesis from cigarette smoking among current and former smokers. To achieve this goal, we have set up a stochastic three-stage model to fit the data of Surveillance, Epidemiology, and End Results (SEER) program besides the data set of smoking derived from the Nurses' Health Study cohort of females (NHS) and the Health Professionals Follow up Study cohort of men (HPFS). The calculations are performed by considering both mutation and clonal expansion rates as parameters in each compartment. For current smokers, our findings show that cigarette smoking has more significant impact on the mutation rates of cells than the clonal expansion rates of premalignant cells among men and women. In particular, for male patients, cigarette smoking affects the mutation in normal cells and the transformation from premalignant cells to malignant ones in the optimal model. In addition, cigarette smoking induces only the initial mutation rates in normal cells among American women. For current and former smokers, cigarette smoking stimulates only the clonal expansion rate of the first premalignant cells in both sexes. However, we find that the impact of cigarette smoking is minimal in former smokers who have stopped smoking for over ten years among men and women in US.

Expression of autophagy-related factor p62 for lung cancer diagnosis and prognosis: A systematic review and meta-analysis

p62/SQSTM1 is the scaffold protein implicated in selective autophagy, which is induced by cellular stress. Research has shown that p62 is highly expressed in cancer. Moreover, p62 can easily promote tumor metastasis. However, studies have not reached a consensus on the relationship of p62 expression with the diagnosis and prognosis of lung cancer. We conducted a systematic review and meta-analysis of studies on p62 expression in the prognosis and clinical-pathological parameters of lung cancer patients. Literature search was performed with PubMed, Web of Science, EMBASE, Cochrane Library, and SpringerLink databases. Fixed-effects and random-effects models were used to study the relationship of p62 expression with patients' overall survival (OS) and clinical-pathological parameters. I2 was used to test for heterogeneity. Egger's test was used to assess publication bias. The meta-analysis collected and considered 13 articles, which included 1393 lung cancer patients. The studies show that the high expression of p62 is associated with poor OS in lung cancer patients. The clinical-pathological parameters of patients show that p62 is more highly expressed in high TNM stage (II + III + IV VS. I), Lymph node metastasis (N1 VS. N0), and distant metastases (D1 VS. D0). However, there is no correlation between the p62 expression and the Beclin 1 and LC3B in lung cancer patients. In conclusion, the over-expression of p62 is associated with poor OS in lung cancer patients and can be used as a biomarker for lung cancer diagnosis and prognosis.

Theoretical substantiation of the ways of increasing the efficiency of specialized medical aid in patients with lung cancer

OBJECTIVE

Introduction: Organizational changes in the context of the transformation of the health system in Ukraine are based on deep and consistent structural and functional transformations and directed to the providing of specialized care of appropriate quality and efficiency, which are the main target function and a prominent criterion for the functioning of the national health system. The aim: Theoretical substantiation of the ways of increasing the efficiency of specialized medical aid in patients with lung cancer.

PATIENTS AND METHODS

Materials and methods: Accounting medical records were the main source for the investigation, along with that the results of sociological researches in oncological patients with lung cancer and the results of expert estimation of the ways of increasing the efficiency of specialized aid for such kind of patients. Some methods were also used, such as system approach and analysis, sociological method, methods of conceptual modeling and expert values.

RESULTS

Results: An increase of integral efficiency of a specialized medical aid for cancer patients in Ukraine could be reached by expected medical one (introduction of preventive, diagnostic and therapeutic technologies); social one (healthy way of life; satisfaction by the quality and availability as primary as specialized medical aid) and economic efficiency (reduction of economic losses because of disability; shortening of inpatient medical aid financing because of less number of patients with neglected stages of the disease). All of that is grounded on the development and introduction of organizational medical technologies, directed on the early detection of lung cancer and provides justification and development of an optimized model for the early detection of this disease.

CONCLUSION

Conclusions: The disadvantages and lack of efficiency of the existing system of specialized cancer care in Ukraine have identified the necessity of a systematic and integrated solution of the problem of early detection of lung cancer based on the optimization of its model, based on the principles of systemicity and complexity, the use of modern science and practice achievements in the management and organization of specialized medical care, application between sector interaction and improvement of its information and communication and organizational-economic components.

[Association rules analysis of Fufang Kushen injection in combination with modern medications in treating lung cancer: real-world study based on hospital information]

The present study was aimed to analyze the association rules of Fufang Kushen injection in combination with other modern medications in treating lung cancer based on the electrical medical records in real world clinical situations extracted from hospital information system in Institute of Basic Medical Sciences, China Academy of Chinese Medical Sciences, and provide reference for improving rationality of clinical drug use and exploring the prescription rules as well as subsequent in-depth analysis. The electrical medical records of the hospitalized patients using Fufang Kushen injection for lung cancer were extracted to analyze the frequency distribution characteristics in combined application with western medicine, and Apriori algorithm was used to analyze the specific association rules in combined drug use. A total of 49 597 patients were included in the study. The commonly combined modern medications included 5-HT receptor blockers, antibiotics, chemotherapy drugs, antitumor immune regulating drugs, glucocorticoid drugs and analgesics, which was usually applied in combination with traditional Chinese medications such as those for removing blood stasis, spleen and stomach nourishing drugs, Qi-regulating agent, heat-clearing and detoxifying prescriptions, laxative and Qi invigorating agent in clinical treatment. The results revealed that the distribution characteristics in combined application and association combinations of Fufang Kushen injection had specific rules, consistent with the clinical orientation of this drug in treatment of lung cancer. Such results may provide reference for reasonable application of Fufang Kushen injection in clinical treatment.