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Table of Content

    08 May 2021, Volume 48 Issue 5 Previous Issue    Next Issue
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    Original Articles
    TGF-β induces high expression of IL-17D in lung cancer-associated fibroblast and promotes recruitment of MDSC
    Shen Jiaxing, Zhang Shan, Chen Xiangjing, Wang Li, Sun Xiaoyan, Lyu Yanmin, Song Guanhua, Yao Chengfang
    2021, 48 (5):  275-281.  doi: 10.3760/cma.j.cn371439-20210115-00053
    Abstract ( 339 )   HTML ( 30 )   PDF (10804KB) ( 112 )   Save

    Objective To investigate the key mechanism of transforming growth factor-β (TGF-β) inducing the expression of interleukin-17D (IL-17D) in lung cancer-associated fibroblast (CAF) and promoting the recruitment of myeloid-derived suppressor cells (MDSCs). Methods C57BL/6 mice were established for B16 lung melanoma metastasis model (tumor model group), and control group was set up, 6 mice in each group. Flow cytometry (FACS) was used to detect the lung CAF and the changes of its ability to secrete IL-17D and the proportion of MDSCs in tumor mice. The changes of TGF-β level in lung tumor were examined by ELISA and quantitative real-time PCR (RT-qPCR). Lung fibroblasts were screened by FACS, and the effects of TGF-β on the secretion of IL-17D, C-C motif chemokine ligand (CCL)2 and CCL7 in fibroblasts were detected by RT-PCR. The migration of MDSCs under the condition of TGF-β stimulating fibroblasts was detected by Transwell. Results The proportion of CAF (CD45-CD326-CD31-) in the tumor model group was higher than that in the control group [(28.02±2.23)% vs. (7.35±2.14)%, t=9.956, P<0.001]. The ability of CAF to secrete IL-17D in the tumor model group was significantly higher than that in the control group [(38.27±2.93)% vs. (19.04±3.16)%, t=5.995, P=0.001]. The proportion of MDSCs in the tumor model group was significantly higher than that in the control group [(12.93±1.27)% vs. (8.21±1.40)%, t=4.804, P=0.009]. Compared with the control group, the protein and transcription levels of TGF-β in lung of the tumor model group were significantly increased [(1 685.07±135.61) ng/L vs. (1 047.98±68.50) ng/L, t=5.051, P=0.002; 2.17±0.03 vs. 1.00±0.05, t=51.237, P<0.001]. In vitro, lung fibroblasts were stimulated with different concentrations of TGF-β (0, 5 and 10 μg/L) for 24 hours, the relative expressions of IL-17D mRNA secreted by stimulated fibroblasts were 0.42±0.01, 0.67±0.01 and 0.84±0.04 respectively, the relative expressions of CCL2 mRNA in each group were 0.89±0.08, 1.08±0.04, 1.19±0.01 and CCL7 were 0.53±0.05, 0.65±0.04, 0.74±0.03 respectively. With the increase of TGF-β concentration, the expression levels of IL-17D, CCL2 and CCL7 in fibroblasts were significantly increased (F=57.384, P<0.001; F=15.802, P=0.004; F=14.544, P=0.005). In addition, compared with the control group (0 μg/L TGF-β), fibroblasts treated with 10 μg/L TGF-β for 24 hours could promote the migration of MDSCs in spleen of tumor mice [(9.59±0.21)% vs. (2.14±0.24)%, t=6.585, P<0.001]. Conclusion TGF-β can induce high expression of IL-17D in lung CAF, which is an important factor in promoting the expressions of CCL2 and CCL7 and the migration of MDSCs in tumor microenvironment.

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    Value of serum miR-196a-5p and miR-105-5p in differential diagnosis of benign and malignant pulmonary nodules
    Cheng Yiming, Li Gang, Wang Zhenming, Lyu Qianwen, Li Shirong
    2021, 48 (5):  282-286.  doi: 10.3760/cma.j.cn371439-20201012-00054
    Abstract ( 409 )   HTML ( 22 )   PDF (3687KB) ( 213 )   Save

    Objective To investigate the differences in the expression levels of miR-196a-5p and miR-105-5p in serum of patients with benign and malignant pulmonary nodules and their diagnostic value of malignant pulmonary nodules. Methods The expression levels of miRNAs in cancer tissues of lung adenocarcinoma and lung squamous cell carcinoma and paracancerous tissues in The Cancer Genome Atlas (TCGA) database were analyzed, and the miRNAs with significantly different expression levels in cancer tissues and paracancerous tissues were selected as target miRNAs. A total of 72 patients with pulmonary nodules admitted to Weifang People's Hospital of Shandong Province from June 2019 to July 2020 were selected. The expression levels of target miRNAs in serum of patients with pulmonary nodules were detected by qRT-PCR. Receiver operating characteristic (ROC) curve was used to compare the diagnostic value of target miRNAs with tumor markers Cyfra21-1, NSE and CEA in malignant pulmonary nodules. Results After screening, the target miRNAs were identified as miR-196a-5p and miR-105-5p. Twenty-six patients in the benign pulmonary nodules group and 46 patients in the malignant pulmonary nodules group were included. The levels of serum miR-196a-5p [M (P25, P75)] in the benign and malignant nodules group were 0.63 (0.09, 2.15) and 1.93(0.93, 4.97) respectively, and the levels of miR-105-5p in the two groups were 2.03 (0.54, 7.95) and 10.65 (5.94, 18.39) respectively. Compared with the benign pulmonary nodules group, the levels of serum miR-196a-5p and miR-105-5p in the malignant pulmonary nodules group were increased, and there were statistically significant differences (Z=-3.083, P=0.002; Z=-4.092, P<0.001). The levels of serum Cyfra21-1 in the benign and malignant pulmonary nodules group were 2.48 (1.84, 3.78) and 2.20 (1.47, 3.32) μg/L respectively, the levels of serum NSE in the two groups were 15.58 (12.45, 18.95) and 14.43 (12.07, 17.87) μg/L respectively, and the levels of serum CEA in the two groups were 1.16 (0.55, 2.11) and 1.17 (0.61, 1.68) μg/L respectively. There were no significant differences in serum Cyfra21-1, NSE and CEA between the benign and malignant pulmonary nodules group (Z=-1.161, P=0.246; Z=-0.305, P=0.761; Z=-0.271, P=0.786). The area under the curve (AUC) of the combination of miR-196a-5p and miR-105-5p for the diagnosis of malignant pulmonary nodules was 0.762 (sensitivity 89.1%, specificity 61.5%), which was higher than the value of the combination of Cyfra21-1, NSE and CEA for the diagnosis of malignant pulmonary nodules (AUC=0.591, sensitivity 58.7%, specificity 64.5%). Conclusion The combination of serum miR-196a-5p and miR-105-5p can assist in the diagnosis of malignant pulmonary nodules and has higher diagnostic value.

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    Reviews
    Application of optical coherency tomography in tumor diagnosis and treatment
    Yang Jiankai, Huo Haoran, Sun Guozhu, Fan Zhenzeng, Jiao Baohua
    2021, 48 (5):  287-291.  doi: 10.3760/cma.j.cn371439-20200819-00055
    Abstract ( 307 )   HTML ( 11 )   PDF (3758KB) ( 262 )   Save

    Optical coherency tomography (OCT) is one of the powerful optical imaging tools that allows cross-sectional tomography of the microstructure in living subjects with high resolution. With the rapid development of OCT and a wide range of preclinical and clinical tumor imaging, it provides profound insights into the complex physiological, cellular and molecular behaviors of tumors. Preclinical OCT has elucidated many inscrutable aspects of tumor biology, while clinical applications of OCT are revolutionizing diagnosis and therapies. As a new noninvasive optical imaging technique, OCT can realize the intraoperative imaging of tumor and provide meaningful image data, which will provide great help for the diagnosis, classification and boundary determination of tumor diseases in the future.

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    Relationship between bacteria and breast cancer
    Luo Lan, Chen Chuang, Li Xinqian, Sun Shengrong
    2021, 48 (5):  292-295.  doi: 10.3760/cma.j.cn371439-20200629-00056
    Abstract ( 385 )   HTML ( 35 )   PDF (3007KB) ( 366 )   Save

    With the application of high throughput sequencing and other technologies, in recent years people have found that bacteria are not only the causative factors of common breast diseases such as mastitis, but also may be involved in the occurrence and development of breast cancer. There are unique bacterial communities in the internal tissues of the breast, and their existence may be related to the incidence of breast cancer. Recent studies have found that intestinal flora may also affect the incidence of breast cancer by regulating estrogen and other pathways. Further exploration of the influence of bacteria on breast cancer will provide new ideas for diagnosis and treatment of breast cancer.

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    Risk factors and predictive biomarkers of immune checkpoint inhibitor-associated pneumonia in non-small cell lung cancer
    Wang Hui, Xia Rong, Wei Qingwen, Wan Yixin
    2021, 48 (5):  296-301.  doi: 10.3760/cma.j.cn371439-20210115-00057
    Abstract ( 423 )   HTML ( 48 )   PDF (4638KB) ( 271 )   Save

    The use of immune checkpoint inhibitors (ICIs) has changed the clinical outcome of non-small cell lung cancer (NSCLC), with the widespread application of ICIs, immune-related adverse events (irAEs) have also appeared. Immune checkpoint inhibitor pneumonitis (CIP) is a serious adverse event of ICIs treatment that needs attention. Therefore, early identification of high-risk groups of CIPs and early intervention can reduce the occurrence of permanent drug withdrawal and severe CIPs, thereby improving patients' prognosis.

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    Systemic therapy of advanced biliary tract cancer
    Long Xin, Wu Han, Peng Jin, Zhou Fuxiang
    2021, 48 (5):  302-307.  doi: 10.3760/cma.j.cn371439-20200819-00058
    Abstract ( 327 )   HTML ( 10 )   PDF (4586KB) ( 295 )   Save

    The incidence rate of biliary tract cancer is increasing year by year. Systemic therapy is the most important treatment for patients with advanced or unresectable biliary tract cancer. Gemcitabine combined with cisplatin is still the standard first-line chemotherapy, while gemcitabine combined with TS-1 and gemcitabine combined with nab-paclitaxel are also the first-line treatment options. Studies have confirmed that immunotherapy as a back-line treatment has a significant advantage in survival, and the disease control rate of nivolumab is 61% and the median overall survival is more than 1 year. In addition, targeted drugs targeting FGFR2, IDH1/2, HER-2 and other major driving genes of biliary tract cancer also show good antitumor activity, and become research hotspots in the treatment of advanced biliary tract cancer. Summarizing the research progress of systematic chemotherapy, immunotherapy and molecular targeted therapy for advanced biliary tract cancer can provide help for clinical practice.

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    Role of heterogeneity of cancer-associated fibroblasts in targeted therapy of pancreatic cancer
    Yan Zhiying, Mao Yifeng, Zhu Yingwei, Xu Kequn
    2021, 48 (5):  308-312.  doi: 10.3760/cma.j.cn371439-20200528-00059
    Abstract ( 398 )   HTML ( 10 )   PDF (3911KB) ( 187 )   Save

    The incidence of pancreatic cancer is increasing year by year, but the clinical diagnosis and treatment progress is limited and the prognosis is poor. Tumor microenvironment (TME) is closely related to the invasion, metastasis and chemotherapy resistance of pancreatic cancer. Cancer-associated fibroblasts (CAFs) are fibroblasts in a state of continuous activation, which are the most prominent components in TME. CAFs can promote the malignant biological behavior of pancreatic cancer through a variety of molecule-mediated mechanisms. Moreover, several attempts targeting CAFs for the treatment of pancreatic cancer have been largely unsuccessful. It may be related to the heterogeneity of CAFs in pancreatic cancer. Therefore, in-depth study of its heterogeneity and accurate targeting of some specific phenotypes and functional CAFs subtypes in the matrix on this basis may be more promising in the clinical treatment of pancreatic cancer.

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    Stereotactic body radiotherapy for localized prostate cancer
    Du Xiao, Zhou Juying
    2021, 48 (5):  313-316.  doi: 10.3760/cma.j.cn371439-20200802-00060
    Abstract ( 426 )   HTML ( 22 )   PDF (3025KB) ( 171 )   Save

    External-beam radiotherapy is one of the principle treatment options for localized prostate cancer. Conventionally fractionated radiotherapy is widely used in clinical practice. Studies have shown that prostate cancer is highly sensitive to hypofractionated radiotherapy, also known as stereotactic body radiotherapy (SBRT), and increasing radiotherapy dose can significantly improve the local control rate of tumor. A number of recently completed researches have shown that SBRT is as effective as conventionally fractionated radiotherapy. In terms of radiation toxicity, the short-term toxicity of SBRT is more obvious than that of conventionally fractionated radiotherapy, but there is no significant difference in long-term toxicity. SBRT can provide more convenience for patients, and the medical cost is lower, so it has a great clinical application prospect.

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    Stratified therapeutic choices in elderly patients with diffuse large B-cell lymphoma
    Li Qiao'er, Zou Liqun
    2021, 48 (5):  317-320.  doi: 10.3760/cma.j.cn371439-20200814-00061
    Abstract ( 429 )   HTML ( 21 )   PDF (3014KB) ( 266 )   Save

    The prognosis of elderly (>60 years) patients with diffuse large B-cell lymphoma (DLBCL) is significantly worse compared with young patients, and there is currently no standard treatment. Elderly patients with DLBCL are highly heterogeneous, a stratification before treatment can help achieve precise medicine and improve outcome of them. R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) is still the recommended treatment for fit elderly DLBCL patients; and for unfit or very old patients, chemotherapy of reduced dose or palliative treatments should be considered. Choices for relapsed or refractory patients are limited, and novel compounds or therapies that are well tolerated may have a good application prospect.

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