Clinical Significance of Serum Haptoglobin and Protein Disulfide-Isomerase A3 in the Screening, Diagnosis, and Staging of Colorectal Cancer

Identification and verification of a combined ferroptosis- and pyroptosis-related signature for a prognostic classifier and immunosuppressive targets in colorectal cancer

BACKGROUND AND STUDY AIMS

Ferroptosis and pyroptosis, two forms of cell death, are increasingly reported for their pivotal roles in cancer biology. However, the understanding of the combined ferroptosis-pyroptosis (FPtosis)-related gene signature in colorectal cancer (CRC) remains limited.

MATERIAL AND METHODS

We conducted a comprehensive investigation of the FPtosis-related signature in CRC. Data integration from both the training and validation cohorts was performed. The FPtosis-related signature was established. We evaluated the prognostic significance of the signature through Kaplan-Meier analysis, as well as univariate and multivariate Cox regression models. Functional analyses were conducted to explore the underlying biological mechanisms. Additionally, we analyzed the correlations between the FPtosis-related signature, immune infiltration, and immune checkpoint blockade (ICB) immunotherapy.

RESULTS

The FPtosis-related signature demonstrated significant prognostic potential and can serve as an independent biomarker for predicting outcomes. The signature showed correlations with advanced tumor stage, invasion depth, lymph node metastasis, and distant metastasis. Subgroup analyses revealed the valuable predictive role of the FPtosis-related signature in predicting survival across different clinical subgroups, including age, gender, tumor stage, invasion depth, lymph node metastasis status, and distant metastasis status. Moreover, the signature exhibited positive associations with inflammation and the infiltration of diverse immune cells, such as neutrophils, M0 and M2 macrophages, and regulatory T cells (Tregs). In microsatellite instable (MSI) CRC, the expression of most ICB genes was higher in the high-FPtosis group compared to the low-FPtosis group.

CONCLUSION

The FPtosis signature can effectively predict the prognosis of CRC and had the potential to improve the development of innovative therapeutic strategies.

Advancing colorectal cancer diagnosis: The role of tumor-derived serum galanin and haptoglobin as novel biomarkers

BACKGROUND

Colorectal cancer (CRC) is a widespread and serious global malignancy. This study aimed to investigate the clinical relevance of galanin (GAL) and haptoglobin (HP) as new diagnostic CRC biomarkers.

METHODS

An enzyme-linked immunosorbent assay was used to determine the GAL and HP levels in the serum of 88 patient with CRC and 88 healthy controls. The carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) contents were quantitatively evaluated via electrochemiluminescence assay. Receiver operating characteristic (ROC) curves were created to identify the diagnostic importance of single and combined CRC detection. The patients' relevant diagnostic and treatment data were collected from their medical records. Statistical analysis methods were employed to examine the relationship between these indicators and the clinical pathological parameters.

RESULTS

Patients with CRC exhibited significantly decreased and increased serum GAL and HP levels, respectively, compared with the healthy controls (P < 0.0001 for both). Furthermore, the HP level was positively correlated with tumor T stage (P = 0.0124). The area under the curve (AUC) of the ROC values for GAL and HP was 0.744 and 0.712, respectively, indicating their diagnostic efficiency. The combination of GAL and HP increased the AUC to 0.753, and when both were integrated with CEA and CA19-9, the AUC further increased to 0.893.

CONCLUSION

This study shows that serum GAL and HP can be used as potential noninvasive diagnostic biomarkers for CRC.

NOX4 Suppresses Ferroptosis Through Regulation of the Pentose Phosphate Pathway in Colorectal Cancer

OBJECTIVE

Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (NOXs) are known as major sources of reactive oxygen species (ROS), yet their role in regulating cellular antioxidative metabolism and ferroptosis is unclear. This study assessed the expression and clinical relevance of NOXs across pan-cancer and investigated the role of NOX4 in colorectal cancer progression METHODS: We analyzed transcriptomic and survival data from The Cancer Genome Atlas (TCGA) for NOXs across 22 types of solid tumors. A CRISPR library targeting NOXs was developed for potential therapeutic target screening in colorectal cancer cells (CRCs). Techniques such as CRISPR-knockout cell lines, 1,2-13C-glucose tracing, PI staining, BrdU assays, and coimmunoprecipitation were employed to elucidate the function of NOX4 in CRCs.

RESULTS

NOX4 emerged as a key therapeutic target for colorectal cancer from TCGA data. CRISPR screening highlighted its essential role in CRC survival, with functional experiments confirming that NOX4 upregulation promotes cell survival and proliferation. The interaction of NOX4 with glucose‑6‑phosphate dehydrogenase (G6PD) was found to enhance the pentose phosphate pathway (PPP), facilitating ROS clearance and protecting CRCs against ferroptosis.

CONCLUSIONS

This study identified NOX4 as a novel ferroptosis suppressor and a therapeutic target for the treatment of colorectal cancer. The findings suggest that a coupling between NADPH oxidase enzyme NOX4 and the PPP regulates ferroptosis and reveal an accompanying metabolic vulnerability for therapeutic targeting in colorectal cancer.

ADAM17 promotes colorectal cancer migration and invasion by regulating the TGF-β/Smad signaling pathway

OBJECTIVE

Investigate ADAM17 expression in colorectal cancer (CRC) at molecular and cellular levels and its potential mechanism in promoting tumorigenesis by regulating CRC cell migration and invasion.

MATERIALS AND METHODS

The study measured ADAM17 mRNA and protein levels in colorectal cancer cells and tissues using qPCR and immunohistochemical staining, and assessed the cells' proliferation, migration, and invasion abilities.

RESULTS

ADAM17 expression was significantly higher in CRC tissues than in non-cancerous tissues and was linked to metastasis and poor prognosis in CRC patients. Silencing ADAM17 reduced cell migration and invasion. Mechanistically, knocking down ADAM17 decreased the expression of TGF-β/Smad pathway-related proteins, which inhibited proteins associated with migration and invasion, thus impairing these cellular processes.

CONCLUSION

ADAM17 likely promotes the migration and invasion of CRC cells by regulating the TGF-β/Smad signaling pathway. This study aids in understanding the molecular mechanisms of CRC metastasis and development, and supports the development of new therapeutic targets.

LncRNA FAM30A Suppresses Proliferation and Metastasis of Colorectal Carcinoma by Blocking the JAK-STAT Signalling

Colorectal carcinoma (CRC) poses a serious risk to global human health. Long non-coding RNAs (LncRNAs) play an important role in the pathogenesis of CRC. There is a scarcity of data about a newly identified lncRNA, FAM30A. Our major objective is to investigate the role of FAM30A in the process of CRC. Gene expression data and correlated clinical information were retrieved and downloaded from public databases to identify differentially expressed genes linked to CRC. The expression of FAM30A was identified in clinical samples and CRC cell lines using via Quantitative Real-time Polymerase Chain Reaction (qPCR) assay also. The survival significance of FAM30A was determined via R package "survival." Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was performed to identify FAM30A-related signalling pathway. The levels of proteins expression were determined by western blot assay. The effect of FAM30A on CRC cell biological behaviours was evaluated by cell function experiments. FAM30A was identified down-regulated in CRC based on the data from public database. FAM30A had lower expression in CRC clinical samples and cell lines. Low FAM30A expression was positively related to a poor prognosis in CRC patients. After FAM30A was overexpressed, the proliferation, invasion, and migration abilities of CRC cells were decreased, and the rate of CRC cell apoptosis increased. Furthermore, overexpression of FAM30A could block JAK-STAT signalling. FAM30A suppresses proliferative, invasive, and migratory abilities of CRC through blocking JAK-STAT signalling. Thus, it can be a novel biomarker of CRC prognosis.

Exploring the correlation between Tom1L1 and the efficacy of neoadjuvant chemotherapy for locally progressive mid-low rectal cancer

OBJECTIVE

To investigate the specificity of Target of Myb1-Like1 (Tom1L1) expression in colorectal adenocarcinoma tissues and analyze the predictive value of Tom1L1 in the efficacy of neoadjuvant chemotherapy for patients with rectal adenocarcinoma.

METHODS

The cancerous tissues and paracancerous normal tissues of 102 patients diagnosed with colorectal adenocarcinoma without treatment were selected; quantitative polymerase chain reaction (qPCR), Western blot and immunohistochemistry (IHC) were adopted to validate the expression level of Tom1L1 in the two groups. Furthermore, 34 patients with locally progressive mid-low rectal adenocarcinoma, who were treated with neoadjuvant Xelox chemotherapy prior to the operation, IHC was adopted to detect the expression of Tom1L1 protein in patients before and after neoadjuvant chemotherapy and to analyze the relationship between the expression level of Tom1L1 and the sensitivity of neoadjuvant therapy.

RESULTS

The results of qPCR, Western blot and IHC showed that the expression of Tom1L1 in colorectal adenocarcinoma tissues was significantly higher than that in paracancerous normal tissues, with a statistically significant difference (P < 0.01); Neoadjuvant chemotherapy was significantly more effective in patients with low expression of Tom1L1 protein than in those with high expression of Tom1L1 protein, with a statistically significant difference (P < 0.05).

CONCLUSIONS

Tom1L1 is highly expressed in colorectal adenocarcinoma tissues; neoadjuvant Xelox chemotherapy can have an impact on Tom1L1 expression in progressive rectal cancer; patients with locally progressive mid-low rectal adenocarcinoma who have low Tom1L1 expression are more sensitive to neoadjuvant chemotherapy.

Ferroptosis and immunosenescence in colorectal cancer

Colorectal cancer (CRC), ranked as the globe's third leading malignancy. Despite advancements in therapeutic approaches, the mortality rate remains distressingly high for those afflicted with advanced stages of the disease. Ferroptosis is a programmed form of cell death. The ways of ferroptosis mainly include promoting the accumulation of cellular ROS and increasing the level of cellular Labile iron pool (LIP). Immunosenescence is characterized by a gradual deterioration of the immune system's ability to respond to pathogens and maintain surveillance against cancer cells. In CRC, this decline is exacerbated by the tumor microenvironment, which can suppress the immune response and promote tumor progression. This paper reviews the relationship between iron prolapse and immune senescence in colorectal cancer, focusing on the following aspects: firstly, the different pathways that induce iron prolapse in colorectal cancer; secondly, immune-immune senescence in colorectal cancer; and lastly, the interactions between immune senescence and iron prolapse in colorectal cancer, e.g., immune-immune senescent cells often exhibit increased oxidative stress, leading to the accumulation of ROS, and consequently to lipid peroxidation and induction of iron-induced cell death. At the same time, ferroptosis induces immune cell senescence as well as alterations in the immune microenvironment by promoting the death of damaged or diseased cells and leading to the inflammation usually associated with it. In conclusion, by exploring the potential targets of ferroptosis and immune senescence in colorectal cancer therapy, we hope to provide a reference for future research.

PDIA3 orchestrates effector T cell program by serving as a chaperone to facilitate the non-canonical nuclear import of STAT1 and PKM2

Dysregulated T cell activation underpins the immunopathology of rheumatoid arthritis (RA), yet the machineries that orchestrate T cell effector program remain incompletely understood. Herein, we leveraged bulk and single-cell RNA sequencing data from RA patients and validated protein disulfide isomerase family A member 3 (PDIA3) as a potential therapeutic target. PDIA3 is remarkably upregulated in pathogenic CD4 T cells derived from RA patients and positively correlates with C-reactive protein level and disease activity score 28. Pharmacological inhibition or genetic ablation of PDIA3 alleviates RA-associated articular pathology and autoimmune responses. Mechanistically, T cell receptor signaling triggers intracellular calcium flux to activate NFAT1, a process that is further potentiated by Wnt5a under RA settings. Activated NFAT1 then directly binds to the Pdia3 promoter to enhance the expression of PDIA3, which complexes with STAT1 or PKM2 to facilitate their nuclear import for transcribing T helper 1 (Th1) and Th17 lineage-related genes, respectively. This non-canonical regulatory mechanism likely occurs under pathological conditions, as PDIA3 could only be highly induced following aberrant external stimuli. Together, our data support that targeting PDIA3 is a vital strategy to mitigate autoimmune diseases, such as RA, in clinical settings.

Unraveling molecular similarities between colorectal polyps and colorectal cancer: a systems biology approach

BACKGROUND/AIMS

Colorectal cancer (CRC) and colorectal polyps are intimately linked, with polyps acting as precursors to CRC. Understanding the molecular mechanisms governing their development is crucial for advancing diagnosis and treatment. Employing a systems biology approach, we investigated the molecular similarities between polyp and CRC.

METHODS

We analyzed gene expression profiles, protein-protein interactions, transcription factors, and gene ontology to identify common differentially expressed genes (DEGs) and unravel shared molecular pathways.

RESULTS

Our analysis revealed 520 commonly dysregulated genes in polyps and CRC, serving as potential biomarkers and pivotal contributors to disease progression. Gene ontology analysis elucidated distinct biological processes associated with upregulated and downregulated DEGs in both conditions, highlighting common pathways, including signal transduction, cell adhesion, and positive regulation of cell proliferation. Moreover, protein-protein interaction networks shed light on subnetworks involved in rRNA processing, positive regulation of cell proliferation, mRNA splicing, and cell division. Transcription factor analysis identified major regulators and differentially expressed transcription factors in polyp and CRC. Notably, we identified common differentially expressed transcription factors, including ZNF217, NR3C1, KLF5, GATA6, and STAT3, with STAT3 and NR3C1 exhibiting increased expression.

CONCLUSIONS

This comprehensive analysis enriches our understanding of the molecular mechanisms underlying polyp formation and CRC development, providing potential targets for further investigation and therapeutic intervention. Our findings contribute substantively to crafting personalized strategies for refining the diagnosis and treatment of polyps and CRC.

Comparison of complications and long-term survival after minimally invasive esophagectomy versus open esophagectomy in patients with esophageal cancer and chronic obstructive pulmonary disease

OBJECTIVE

To compare the complications and long-term survival of esophageal cancer patients with chronic obstructive pulmonary disease (COPD) after minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) using propensity score matching (PSM).

METHODS

Esophageal cancer patients who underwent esophagectomy at the Thoracic Surgery Department of the First Affiliated Hospital of Hebei North University from January 2010 to December 2018 were retrospectively enrolled. The incidence of postoperative complications and prognosis of the MIE (n = 132) and OE (n = 138) groups were compared. To reduce bias, 1:1 PSM was adopted for the analysis.

RESULTS

The median disease-free survival (DFS) of the MIE and OE groups were 24 months and 26 months, respectively, and neither group reached median survival. There was no significant difference between the two groups in terms of 3-year DFS and overall survival (OS). The stratification of the patients on the basis of the percentage of estimated forced expiratory volume in the first second (%FEV1) did not result in significant differences in the survival rates. A total of 42 patients (50%) in the MIE group and 55 patients (65.48%) in the OE group experienced complications, and the difference was statistically significant (OR=0.527, 95% CI: 0.283-0.981, P=0.042). The incidence of acute COPD exacerbation (OR=0.213, 95% OR, CI: 0.068-0.666, P=0.004) and pulmonary atelectasis requiring bronchoscopic aspiration (OR=0.232, 95% OR, CI: 0.082-0.659, P=0.004) were significantly higher in the OE versus the MIE group. In addition, the distribution of the various grades of complications also differed significantly between the two groups (P=0.016). While the incidence of minor complications (≤Grade II) was similar in both groups (P=0.503), that of severe complications (≥Grade III) was markedly higher in the OE group (P=0.002) and the Grade-IIIa complications were predominant (P=0.001). The severity of complications was correlated with the postoperative duration of hospital stay in both groups (r=0.187, P=0.015). No significant difference was observed in the incidence of minor complications (≤Grade II) between the two groups following stratification on the basis of %FEV1, whereas severe complications were more frequent in the OE group among patients with %FEV1 between 60% and 70% (P=0.001<0.05).

CONCLUSION

There was no significant difference in the postoperative DFS and OS of esophageal cancer patients with COPD after undergoing MIE or OE. However, MIE significantly reduced the incidence of severe postoperative complications among patients with %FEV1 between 60% and 70%.