Lower Disease-specific Survival Rates Research Articles

LncRNA LINC01833 is a Prognostic Biomarker and Correlates with Immune Infiltrates in Patients with Lung Adenocarcinoma by Integrated Bioinformatics Analysis.

Due to the absence of accurate tools for early detection and successful treatment, lung adenocarcinoma (LUAD) is one of the most aggressive tumors with high morbidity and mortality globally. It is absolutely necessary to investigate the process behind its development and search for new biomarkers that could aid in the early detection of LUAD. There is a correlation between the immune microenvironment of the tumor and the prognosis of lung cancer as well as the efficacy of immunotherapy. Long noncoding RNAs (lncRNAs) have been identified as potential prognostic biomarkers linked to immunological activities. In this study, we identified 1 downregulated lncRNA and 76 upregulated lncRNAs in LUAD samples from TCGA datasets. Among the 77 dysregulated lncRNAs, our attention focused on lncRNA LINC01833 (LINC01833). When compared with nontumor specimens, the level of expression of LINC01833 was shown to be significantly elevated in LUAD samples. In addition, the data of the ROC study revealed that LUAD patients with high LINC01833 expression had an AUC value of 0.840 (95% confidence interval: 0.804 to 0.876). There was a correlation between high LINC01833 expression and an advanced clinical stage. Patients who had a high expression of LINC01833 were shown to have a lower overall survival rate (p < 0.001) and a lower disease-specific survival rate (p = 0.004) in comparison to patients who were in the low LINC01833 group, according to the data on survival. In addition, the results of the multivariate analysis revealed that high LINC01833 expression was an independent predictor of poor survival in LUAD. Moreover, the immune analysis revealed that we found that the expression of LINC01833 was positively associated with Th2 cells, aDC, and Tgd, while negatively associated with Mast cells, Tcm, Eosinophils, iDC, DC, Tem, Th17 cells, and pDC. Overall, our data point to the possibility that the unique lncRNA LINC01833 might be employed as a diagnostic and prognostic marker, and as a result, it has a significant impact on clinical practice.

Abstract 5972: HLJ1 deficiency enhanced diethylnitrosamine-induced hepatocarcinogenesis in a gene targeting mouse model

Abstract Liver cancer is the sixth most common cancer and the fourth leading cause of cancer-related death worldwide. The conventional treatments such as surgical resection and liver transplantation are applicable to only a small proportion of patients and prolongation of survival is restricted. Therefore, it is urgent to develop cancer biomarkers for defining cancer risk, diagnosis, prognosis and even find new therapeutic targets. Human Liver DnaJ-Like Protein (HLJ1), which belongs to DnaJ heat shock protein family (HSP40) member B4 (DNAJB4), has been reported to act as a tumor suppressor in NSCLC, colorectal cancer, melanoma metastasis. However, the precise role of HLJ1 in liver cancer tumorigenesis and the progress of HCC carcinogenesis has not been elucidated yet. Thus, we investigate whether HLJ1 has tumor-suppressive or oncogenic role on DEN-induced liver cancer development in a mouse model. Wild-type (WT) and HLJ1 knockout (HLJ1−/−) mice are injected with 20 mg/kgbw DEN at postnatal day 15. Thereafter, 50 mg/kgbw DEN is administrated weekly to mice between age 4 to 12 weeks. Mice were sacrificed at age 30 and 36 weeks to assess the tumor count and size. In another group, mice are injected with DEN and age day 15 and then 500 ppm PB is administrated in drinking water until mice were sacrifice at age 52 weeks. The liver tissues are frozen and fixed for western blotting and IHC analysis. For cDNA microarray analysis, gene expression microarray samples were from 6-8 weeks wild-type and HLJ1−/− mice livers. When sacrificed at age 30 and 36 weeks, HLJ1−/− mice exhibited higher tumor multiplicity, serum ALT, AST levels, and larger macroscopic tumor nodules than WT mice. In DEN+PB treatment group, higher incidence rate can be observed in HLJ1−/− mice than in WT mice. This indicated HLJ1 protects liver from DEN-induced HCC carcinogenesis and knockout of HLJ1 confers to more severe HCC induction. Furthermore, p-STAT3 expression was higher in normal part of HLJ1−/− mice liver compared to that of WT mice liver, which suggest the role of HLJ1 in regulating p-STAT3 signaling in the early stage of tumor formation. Using IHC staining and western blotting to analyze HLJ1 expression level, we found half of the tumors express higher HLJ1 than adjacent normal part did, which suggested a tumor-promoting role of HLJ1 after tumor initiation and formation. In cDNA microarray analysis, network analysis of genes enriched in HCC map folder revealed involved objects JunB, c-Myc, p21 and Cyclin D1, which was further confirmed by quantitative PCR. p21 and Cyclin D1 were highly expressed in the liver of HLJ1−/− comparing to that of WT mice, which suggested HLJ1-related genes p21 and Cyclin D1 may have roles in HCC formation. Clinical information of 362 liver cancer patients from TCGA database exhibited that higher expression of HLJ1 in tumor part is correlated to lower disease-specific survival rate. It indicated that HLJ1 may be a tumor marker for HCC prognosis and clinical outcome prediction. It also suggested that HLJ1 may play an oncogenic role after tumor formation. In summary, HLJ1 has protective role against DEN-induced hepatocarcinogenesis through down-regulated p-STAT3 and cyclin D1 whereas it could also be an enhancer to promote tumor progression after tumor formation. Hence, HLJ1 could be a target for liver cancer therapy and a prognostic biomarker in the future. Citation Format: Wei-Jia Luo, Min-Hui Chien, Jeremy J. W. Chen, Sung-Liang Yu, Pan-Chyr Yang, Kang-Yi Su. HLJ1 deficiency enhanced diethylnitrosamine-induced hepatocarcinogenesis in a gene targeting mouse model [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5972.

Combined Hepatic and Pulmonary Metastasectomies From Colorectal Carcinoma. Data From the Prospective Spanish Registry 2008–2010

IntroductionResection of both liver and lung metastases from colorectal carcinoma (CRC) is a standard of care in selected patients with oligometastatic disease. We present here the analysis of the subgroup of patients undergoing combined surgery from the Spanish Group of Surgery of Pulmonary Metastases (PM) from Colorectal Carcinoma (GECMP-CCR-SEPAR). MethodsWe analyze characteristics, survival and prognostic factors of patients undergoing combined resection from March-2008 to February-2010 and followed-up during at least 3 years, from the prospective multicenter Spanish Registry. ResultsA total of 138 patients from a whole series of 543 cases from 32 thoracic surgery units underwent both procedures. Seventy-seven (43.8%) resected liver metastases were synchronic with colorectal tumor. Median disease specific survival (DSS) from first pulmonary metastasectomy was 48.9 months, being three and 5-year DSS 65.1% and 41.7%, respectively. From CRC-surgery median DSS was 97.2 months, with 3 and 5-year DSS rates of 96.7% and 77%, respectively. Five-year DSS from pulmonary metastasectomy was 41.7% for patients with combined resection and 52.4% for those without hepatic involvement (P=.04). Differences disappeared when considering DSS from colorectal surgery. Carcinoembrionary antigen (CEA) before lung surgery over 10mg/dl and bilateral PM were independent prognostic factors for survival (hazard ratio 2.4 and 2.5, respectively). ConclusionsPatients with resection of PM of CRC with history of resected hepatic metastases presented significantly lower disease specific survival rates than those undergoing pulmonary metastasectomy alone. CEA before lung surgery and bilateral PM associated worse prognosis.

Combined Hepatic and Pulmonary Metastasectomies From Colorectal Carcinoma. Data From the Prospective Spanish Registry 2008–2010

IntroductionResection of both liver and lung metastases from colorectal carcinoma (CRC) is a standard of care in selected patients with oligometastatic disease. We present here the analysis of the subgroup of patients undergoing combined surgery from the Spanish Group of Surgery of Pulmonary Metastases (PM) from Colorectal Carcinoma (GECMP-CCR-SEPAR). MethodsWe analyze characteristics, survival and prognostic factors of patients undergoing combined resection from March-2008 to February-2010 and followed-up during at least 3 years, from the prospective multicenter Spanish Registry. ResultsA total of 138 patients from a whole series of 543 cases from 32 thoracic surgery units underwent both procedures. Seventy-seven (43.8%) resected liver metastases were synchronic with colorectal tumor. Median disease specific survival (DSS) from first pulmonary metastasectomy was 48.9 months, being three and 5-year DSS 65.1% and 41.7%, respectively. From CRC-surgery median DSS was 97.2 months, with 3 and 5-year DSS rates of 96.7% and 77%, respectively. Five-year DSS from pulmonary metastasectomy was 41.7% for patients with combined resection and 52.4% for those without hepatic involvement (P=.04). Differences disappeared when considering DSS from colorectal surgery. Carcinoembrionary antigen (CEA) before lung surgery over 10mg/dl and bilateral PM were independent prognostic factors for survival (hazard ratio 2.4 and 2.5, respectively). ConclusionsPatients with resection of PM of CRC with history of resected hepatic metastases presented significantly lower disease specific survival rates than those undergoing pulmonary metastasectomy alone. CEA before lung surgery and bilateral PM associated worse prognosis.

Additive effect of the AZGP1, PIP, S100A8 and UBE2C molecular biomarkers improves outcome prediction in breast carcinoma

The deregulation of key cellular pathways is fundamental for the survival and expansion of neoplastic cells, which in turn can have a detrimental effect on patient outcome. To develop effective individualized cancer therapies, we need to have a better understanding of which cellular pathways are perturbed in a genetically defined subgroup of patients. Here, we validate the prognostic value of a 13-marker signature in independent gene expression microarray datasets (n = 1,141) and immunohistochemistry with full-faced FFPE samples (n = 71). The predictive performance of individual markers and panels containing multiple markers was assessed using Cox regression analysis. In the external gene expression dataset, six of the 13 genes (AZGP1, NME5, S100A8, SCUBE2, STC2 and UBE2C) retained their prognostic potential and were significantly associated with disease-free survival (p < 0.001). Protein analyses refined the signature to a four-marker panel [AZGP1, Prolactin-inducible protein (PIP), S100A8 and UBE2C] significantly correlated with cycling, high grade tumors and lower disease-specific survival rates. AZGP1 and PIP were found in significantly lower levels in invasive breast tissue as compared with adjacent normal tissue, whereas elevated levels of S100A8 and UBE2C were observed. A predictive model containing the four-marker panel in conjunction with established clinical variables outperformed a model containing the clinical variables alone. Our findings suggest that deregulated AZGP1, PIP, S100A8 and UBE2C are critical for the aggressive breast cancer phenotype, which may be useful as novel therapeutic targets for drug development to complement established clinical variables.

Role of Adjuvant Radiotherapy for Stage II Thymoma After Complete Tumor Resection

To determine whether patients with Masaoka stage II thymoma benefit from adjuvant radiation therapy after complete tumor resection. A total of 107 patients with stage II thymoma who underwent complete resection of their tumors between September 1964 and October 2006 were retrospectively analyzed. Sixty-six patients were treated with adjuvant radiotherapy, and 41 patients received surgery alone. Eight patients (7.5%) had a relapse of their disease, including two patients (4.5%) who had surgery alone, and 6 patients (9.5%) who had adjuvant radiation therapy. Disease-free survival rates at 5 and 10 years were 92.3% and 82.6%, respectively, for the surgery-plus-radiation group, and 97.6% and 93.1%, respectively, for the group that underwent surgery alone (p = 0.265). Disease-specific survival rates at 5 and 10 years were 96.4% and 89.3%, respectively, for the surgery-plus-radiation group and 97.5% and 97.5% for the surgery group (p = 0.973). On univariate analysis, patients with type B3 thymomas had the lowest disease-free survival rates among all subtypes (p = 0.001), and patients with large thymomas (>7 cm) had lower disease-specific survival rates than those with small tumors (<7 cm) (p = 0.017). On multivariate analysis, histological type (type B3) thymoma was a significant independent prognostic factor. Adjuvant radiotherapy after complete tumor resection for patients with stage II thymoma did not significantly reduce recurrence rates or improve survival rates. Histological type (type B3) thymoma was a significant independent prognostic factor. Further investigation should be carried out using a multicenter randomized or controlled study.

P53 alteration independently predicts poor outcomes in patients with endometrial cancer: A clinicopathologic study of 131 cases and literature review

Objective The aim of this study was to evaluate the prognostic impact of p53 alteration in human uterine endometrial adenocarcinoma. Methods One hundred and thirty-one patients with primary endometrial adenocarcinoma were included in the study. The p53 mutation and/or protein expression were evaluated by polymerase chain reaction-single-strand conformational polymorphism and by immunohistochemical analysis, respectively. Clinical and pathological parameters were obtained from medical records. Survival data were estimated using Kaplan–Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method. Results Thirty nine cases (29.8%) containing p53 alterations had a lower disease specific-survival rate and disease-free survival rate than those without p53 alterations. Statistically significant correlations were seen between p53 alteration and non-endometrioid histology type, high grade tumors, and the absence of progesterone receptor. Multivariate analyses showed that both p53 alteration and FIGO stage at diagnosis were adverse prognostic factors. The group of women with p53 alteration had an 11.0-fold increased risk of disease specific death (95% confidence interval: 1.008–120.765) compared to women whose tumors lacked p53 alteration. Conclusion p53 alteration defines a subset of endometrial adenocarcinoma with highly aggressive behavior and predicts lower survival in patients with endometrial adenocarcinoma.

Mucinous gastric carcinomas

Mucinous gastric carcinoma (MGC) is characterized by substantial mucous lakes within tumors and comprises 3% of gastric carcinomas at the authors' institute. The authors analyzed the clinicopathologic characteristics, mucin gene expression profiles, microsatellite instability (MSI), and status of the human epidermal growth factor receptor 2 (HER-2) and epidermal growth factor receptor (EGFR) genes in 133 MGCs and compared them with the same variables in nonmucinous gastric carcinomas (NMGCs). In addition, the prognostic implications of clinicopathologic parameters were evaluated. Patients who had MGC had deeper invasion (P=.003), more frequent lymph node metastasis (P<.001), more advanced pathologic stage (P<.001), more frequent lymphatic invasion (P<.001), and lower disease-specific survival rates (P<.0001) than patients who had NMGC. However, a mucinous histology per se was not identified as an independent prognostic factor. Negative mucin 1, cell surface associated (MUC1) status (P<.001); positive mucin 2, oligomeric mucus/gel-forming (MUC2) status (P<.001); negative mucin 5AC, oligomeric mucus/gel-forming (MUC5AC) status (P=.036); and negative mucin 6, oligomeric mucus/gel-forming (MUC6) status (P<.001) were more frequent in MGCs. The frequency of MSI in MGC was not significantly different from that in NMGC. MGCs had a significantly lower incidence of HER-2 protein overexpression (P=.046), HER-2 gene amplification (P=.009), and EGFR protein overexpression (P=.017) than NMGCs; and multivariate analysis identified EGFR overexpression as a factor associated with a poor prognosis (P=.047). Patients with MGC who had a predominance of signet ring cells in mucin pools had poorer disease-specific survival than patients who had MGC with predominant tubular differentiation (P=.017). The clinicopathologic and molecular characteristics of MGCs differed from those of NMGCs. Furthermore, the results indicated that EGFR overexpression and histologic subtyping by predominant tumor cell type in mucin pools may be helpful for predicting clinical outcome in patients with MGC.