[Clinicopathological characteristics and immune microenvironment of breast squamous cell carcinoma]

Objective: To investigate the clinicopathological characteristics of breast squamous cell carcinoma and to analyze the relationship between its immune microenvironment tumor infiltrating lymphocytes (TILs) and prognosis. Methods: Forty-four cases of primary squamous cell carcinoma of the breast diagnosed and treated in the First Affiliated Hospital of Air Force Medical University, Xi'an, China from January 2006 to July 2022 were selected. Their clinicopathological characteristics were analyzed. The cell composition of TILs was evaluated using immunohistochemistry (Mainly markers of B lymphocytes, T lymphocytes and plasma cells). The relationship between TILs and prognosis was also analyzed. Results: The 44 patients of breast squamous cell carcinoma were all female and all were invasive carcinoma. Eight cases (8/44, 18.2%) were squamous cell carcinoma, while 36 cases (36/44, 81.8%) were mixed squamous cell carcinoma. The mixed components included non-specific carcinoma and spindle cell metaplastic carcinoma (17 cases each). One case contained ductal carcinoma in situ of the breast and 1 case contained tubular carcinoma. The proportion of squamous cell carcinoma was 10% to 90%. The cases with pure squamous cell carcinoma often had a large cystic cavity, which was lined by atypical squamous epithelium, while infiltrating squamous cell carcinoma nests were seen in the breast tissue around the cystic cavity. Immunohistochemical staining showed that p63 and CK5/6 were expressed in the squamous cell carcinoma component, but ER, PR and HER2 were not, except for one case of HER2 1+. The positive rates of TRPS1 and PDL-1 were 76% and less than 1%, respectively. Fifteen cases were in the high TILs group (TILs≥30%) and 29 cases were in the low TILs group (TILs<30%). Twenty-three patients were followed up for 5 to 118 months. Among them, 12 died within 3 years and 9 were alive at the end of the follow up. There was no significant difference in TNM stage, TILs and prognosis between simple squamous cell carcinoma and mixed squamous cell carcinoma. Conclusions: Breast squamous cell carcinoma can be divided into simple squamous cell carcinoma and mixed squamous cell carcinoma. There are differences in gross findings and histology between the simple and mixed squamous cell carcinoma of the breast. Sufficient samples should be taken to avoid missing the diagnosis of a minor squamous component. The prognosis of patients with high TILs is significantly better than that of patients with low TILs. The expression rate of TRPS1 in primary squamous cell carcinoma of breast is high and helpful to the differential diagnosis from metastatic squamous cell carcinoma.

KNOTTED1-like homeobox (KNOX) transcription factors - Hubs in a plethora of networks: A review

KNOX (KNOTTED1-like HOMEOBOX) belongs to a class of important homeobox genes, which encode the homeodomain proteins binding to the specific element of target genes, and widely participate in plant development. Advancements in genetics and molecular biology research generate a large amount of information about KNOX genes in model and non-model plants, and their functions in different developmental backgrounds are gradually becoming clear. In this review, we summarize the known and presumed functions of the KNOX gene in plants, focusing on horticultural plants and crops. The classification and structural characteristics, expression characteristics and regulation, interacting protein factors, functions, and mechanisms of KNOX genes are systematically described. Further, the current research gaps and perspectives were discussed. These comprehensive data can provide a reference for the directional improvement of agronomic traits through KNOX gene regulation.

Application of Anlotinib Combined With Neoadjuvant Chemotherapy in Primary EWS/PNET of Lung: A Case Report

Primary pulmonary EWS/PNET(PPES) is extremely rare and is associated with a poor prognosis. Tumor angiogenesis plays an important role in tumor, so it has become a hot topic in molecular targeted therapy. Anlotinib is a new oral small molecular multi-targeted receptor tyrosine kinase (RTK) inhibitor. This report describes a 20 year-old man with PPES. After 4 neoadjuvant chemotherapy cycles (VACwith alternating IE) combined with anlotinib, the left total pneumonectomy was performed. Then maintenance anlotinib monotherapy was continued, no sign of recurrence to date as an outcome. To our knowledge, this is the first demonstration of anlotinib combined with neoadjuvant chemotherapy efficacy in PPES.

[Epidemiological characteristic and current status of surgical treatment for esophageal cancer by analysis of national registry database]

Objective: To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China. Methods: A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014. Results: Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively. Conclusions: The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

[Up-regulation of DLK1 in non-small cell lung cancer and the relevant molecular mechanism]

OBJECTIVE

To explore the expression of delta-like 1 homolog (DLK1) gene in non-small cell lung cancer (NSCLC) and its regulatory mechanism.

METHODS

The expression levels of DLK1 protein in 204 NSCLC tissues were examined by immunohistochemical (IHC) staining, and the correlation between DLK1expression and clinicopathological features was analyzed. Bisulfate sequencing PCR (BSP) of DNA samples from the tumor tissues of 18 NSCLC patients was performed to evaluate the DNA methylation status of CpG island in the DLK1 promoter region, and also compared with the corresponding IHC staining of DLK1 protein in the same samples.

RESULTS

Among the 102 squamous cell carcinoma (SCC) tissue specimens and their adjacent normal bronchial epithelia, DLK1 was up-regulated in 72 and 37 samples, respectively (P=0.001), and among 102 adenocarcinomas (ADC) tissues and their adjacent alveolar tissues, DLK1 was up-regulated in 77 and 7 samples, respectively (P<0.001). In addition, overexpression of DLK1 was significantly associated with histological type, clinical stage and tumor size of NSCLC (P<0.05 for all). The expression of DLK1protein was inversely correlated with its promoter methylation (P<0.05).

CONCLUSION

DLK1 expression is up-regulated in NSCLCs, which may be due, at least in part, to the DNA hypomethylation in the promoter region of theDLK1 gene.

[Clinicopathologic features of adenoid cystic carcinoma of breast]

Objective: To investigate the clinicopathologic features and grading of adenoid cystic carcinoma (ACC) of the breast. Methods: Sixteen cases of ACC of the breast were analyzed and graded according to the previous report. Immunohistochemical (IHC) staining was used to detect the immunophenotype, Ki-67 proliferative index and expression of EZH2, and the association with tumor grade and outcome was analyzed. Results: Of the 16 cases, 11 were grade Ⅰ, with the epithelial and myoepithelial cells being arranged into tubular and cribriform structure with no solid component; three were grade Ⅱ, which were composed of mixed tubular, cribriform and solid component (<30%); and two were grade Ⅲ, which showed mainly solid component (>90%) and the tumor cells showed basaloid features with scanty cytoplasm and hyperchromatic nuclei, and mitotic count was>5/10 HPF. Immunophenotypically, the epithelial cells expressed CK7, CK8/18 and CD117; the myoepithelial cells expressed p63 and CK5/6; while the basaloid cells were positive for CK5/6 and CD117.Tubular and cibriform ACC showed low Ki-67 and EZH2 expression, while the two cases of solid variant with basaloid features showed high level of Ki-67 and EZH2 expression. Follow-up data were available in 13 cases with a median follow-up period of 42 months. Lung metastasis occurred after 12 months in one grade Ⅱ case and the patient died of disease after 34 months. Vertebral metastasis occurred after 12 months in one grade Ⅲ case and axillary lymph node metastasis occurred in another grade Ⅲ case. All other patients were free of disease at the end of the follow-up periods. Conclusions: ACC shows morphologic spectrum varying from low to high grade, the latter can may give rise to local and distant metastasis. ACC should not be regarded simply as low malignant potential, and should be graded for optimal treatment.

Expression of nuclear factor-kappa B in hepatocellular carcinoma and its relation with the X protein of hepatitis B virus

AIM

In this study we investigated the relationship of the X protein of HBV and nuclear factor-kappa B (NF-kappa B) and the expression of NF-kappa B in human hepatocellular carcinoma tissues.

METHODS

Immunohistochemistry SP method was used to detect the expression of NF-kappa B and the X protein of HBV in human hepatocellular carcinoma tissues of 52 cases. Gene transfection mediated by lipofectamine was used to transfect the eukaryotic expression vector pCDNA3.1-HBX of HBV x gene into human hepatocellular carcinoma cell line HCC-9204 and NF-kappa B was detected.

RESULTS

NF kappa B was widely expressed in human hepatocellular carcinoma tissues in a total of 52 cases and its expression was related to the X protein of HBV. NF-kappa B was localized both in the cytoplasm and the nuclei of hepatocellular carcinoma cells in 11 cases which were positive for the X protein of HBV while in 41 cases negative for the X protein of HBV, NF-kappa B was only localized in the cytoplasm of hepatocellular carcinoma cells but translocated to the nuclei of hepatocellular carcinoma cells after the eukaryotic expression vector pCDNA3.1-HBX was transfected into HCC-9204 cells.

CONCLUSION

This study strongly suggests that the nuclear factor NF-kappa B is widely expressed in hepatocellular carcinoma tissues in different styles according to the expression of the X protein of HBV. NF-kappa B is abnormally activated in hepatocellular carcinoma, which is probably related to the X protein of HBV. The X protein of HBV can activate NF-kappa B to translocate into nuclei of hepatocellular carcinoma cells.

[Study on effect of shenmai injection in protecting myocardium against ischemia-reperfusion injury in thrombolytic therapy with urokinase for acute myocardial infarction patients evaluated by 99mTc-MIBI myocardial imaging]

OBJECTIVE

To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT).

METHODS

Five hundred and thirty-seven patients were randomly divided into two groups. The SMI group (n = 292) was treated with thrombolytic treatment plus SMI and the control group (n = 245) with thrombolytic treatment only. Single photon emission computerized tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared.

RESULTS

The reperfusion rate of infarction related area (IRA) in the two groups was not different significantly (72.26% vs 72.65%, P > 0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P < 0.01 and P < 0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P < 0.01).

CONCLUSION

Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.

Continuous-Wave and Passively Mode-Locked Operation of a Cunyite (Cr(4+):Ca(2)GeO(4)) Laser

Continuous-wave and mode-locked Cr(4+):Ca(2)GeO(4) lasers that use a fiber laser pump source were demonstrated. The continuous-wave Cr(4+):Ca(2)GeO(4) laser yielded a maximum output power of 415 mW at 1420 nm and a tuning range of 1335-1492 nm. With a saturable-absorber mirror, 60-ps pulses and 110-mW maximum output power were generated from a passively mode-locked Cr(4+):Ca(2)GeO(4) laser.

[Inhibitory effects of N-(4-hydroxylphenol) retinamide on transformed human bronchial epithelial cells in vitro and reconstructed human bronchial epithelium in vivo]

Precancerous lesion is one of most important steps in tumorigenesis. It has been shown that retinoids have reliable effects on controlling many kinds of animal tumor and malignant tumor cell lines in vitro, but there is no laboratory report on the biological effect of retinoids on the precancerous lesion of human lung cancer. In this study the methods including of cell serum-free culture, precancerous model of human bronchial epithelium reconstructed in rat trachea/xenotransplanted in nude mice, flowcytometry, immunohistochemistry, TUNEL and pathological observation have been used to study the biological effects of N-(4-hydroxylphenol) retinamide (4-HPR), one new kind of retinoids, on transformed human bronchial epithelial cells in vitro and premalignant human bronchial epithelium in vivo. The results showed that in the study in vitro, the proliferation of transformed human bronchial epithelial cells, the ratio of cells in S phase, and the percentage of cells that positively react to antibody Ki-67 and mpm-2 were inhibited, but apoptotic cells were induced significantly by 4-HPR exposure. At the experiment in vivo, both growth rates and precancerous grades of the reconstructed human bronchial epithelium were reduced, and apoptotic cells were also observed in epithelium after 4-HPR treatment. The results suggested that 4-HPR is one of hopeful chemopreventive medicines to lung cancer.

An airbone mold-derived product, beta-1,3-D-glucan, potentiates airway allergic responses

Repeated inhalation of allergen leads to the down-regulation of allergen-specific IgE responses in non-atopic individuals as well as in mice. This phenomenon is named inhalation-induced IgE tolerance. In contrast, inhaled allergen causes significant IgE and allergic responses in atopic persons. The mechanisms involved in this differential regulation of airway allergen-specific immune responses remain unclear. Besides the allergen exposure of genetically susceptible individuals, environmental contamination is considered to play a role as an initiating factor for airway allergic responses. Using a murine model, we demonstrate here that airborne beta-1, 3-D-glucan, which exists frequently in our environment, particularly in highly humid areas, can abrogate inhalation-induced IgE isotype-specific down-regulation and promote airway eosinophil infiltration to inhaled antigen.

Molecular cytogenetic alterations in the early stage at human bronchial epithelial cell carcinogenesis

Lung carcinogenesis is a multi-step process involving activation of oncogenes and inactivation of tumor suppress genes. Many molecular and cytogenetic alterations occur in the early stages of carcinogenesis. We have developed an effective culture system for human bronchial epithelial cells and lung cancer cells. Four immortalized human bronchial epithelial cell lines were established by transfecting the epithelial cells with plasmid DNA containing the early region of SV40. Some molecular and cytogenetic alterations, such as 3p-, 2q-, 9p-, c-myc translocation t(8;14) (q23; q32), were found in one immortalized bronchial epithelial cell line M when approaching malignant transformation. An increase in cell proliferation and decrease of apoptosis were noted in the late passages of the immortalized cell line M. Some molecular cytogenetic alterations were also observed in human primary non-small cell lung cancers. Molecular cytogenetic alterations during the early stage of carcinogenesis of human bronchial epithelial cells may be useful as biomarkers for both diagnosis and intermediate endpoint of chemoprevention of lung cancer.

Establishment and characterization of a SV40T-transformed human bronchial epithelial cell line

The majority of human lung cancers originate from the carcinogenesis of bronchial epithelial cells. To study the malignant progression of human bronchial epithelial cells, we established a SV40T-transformed human bronchial epithelial cell line, and observed some biological and genetic changes of the cell line at different passages. In a 2-year culture, this cell line was approaching malignancy without obvious senescence. Cells in a later passage proliferated faster and required less growth factors than those of an early passage. After continued passaging, these cells were resistant to the terminal squamous differentiation effects of serum, and many of the cells grew anchorage independently. However, no tumor formed after cells were injected into nude mice. Some genetic alterations were found accompanying those morphological changes, such as 3p- and activation of c-myc, c-erbB-2 and bcl2, suggesting that those genetic alterations may contribute to the carcinogenesis of human bronchial epithelial cells at an early stage. This cell line should be particularly useful for studying the progression of human lung cancers.

[Evaluation on the quality of life among 130 esophageal carcinoma cases--ten years after surgical treatment]

A follow-up study questionaires on the quality of life of 130 cases with carcinoma of the esophagus who survived over 10 years postoperatively in our hospital, was conducted from January 1993 to December 1994. Results showed that 82.3% of the patients were able to eat ordinary food, 85.4% of them could carry on regular work and do physical labor, 86.2% of them had high spirits with a sense of well-being. A total number of 88.5% of the patients were very satisfied with their quality of life and 76.9% of them felt excellant. The authors reckoned that both the occurrance of complications in digestive tract and the postoperative mental status play important roles in affecting the quality of life.

Integration of SV40 at 12q23 in SV40-immortalized human bronchial epithelial cells

In four SV40-immortalized human bronchial epithelia] cell lines established in our laboratory, we identified the SV40 integration sites by fluorescence in situ hybridization. We found that in the late passage of all the four cell lines, SV40 integrated at 12q23. It is possible that only SV40 integration at 12q23 is necessary for the immortalization of human bronchial epithelial cells. Some DNA sequences or genes in the region, such as IGF-1, may be involved with a proliferative advantage of the cells with 12q23 SV40 integration.

2q-, a non-random chromosomal abnormality in human non-small-cell lung cancer

Many cytogenetic studies have been carried out on human lung cancer. However the chromosomal alterations in human lung cancers are often complex, making it difficult to identify some abnormal chromosomes by routine cytogenetic studies. Using FISH (fluorescence in situ hybridization), we studied the alterations of chromosome 2, 3, and 17 in four human bronchial epithelial cell lines, two human non-small-cell lung cancer (NSCLC) cell lines, and 12 primary NSCLC specimens. 2q- was found in three out of four human bronchial epithelial cell lines, two NSCLC cell lines, and three out of seven primary NSCLC specimens tested. 3p- was noted in five cases of twelve primary NSCLC patients examined. 3p- was the first cytogenetic discovery and the most prominent abnormality in lung cancer. 2q- has rarely been reported in human lung cancer but loss of heterozygosity by RFLP analysis for 2q had been reported in human NSCLC. Our results indicate that 2q- was also a non-random chromosomal abnormality in the early stage of the development of human NSCLC. There would be one or more putative tumor suppressor gene(s) on the long arm of chromosome 2. Loss of the gene(s) presumably contributes to the carcinogenesis of human non-small-cell lung cancer.

[Symptoms complex of traditional Chinese medicine in patients with congestive heart failure]

This paper have carried out clinical study on 65 cases of congestive heart failure (CHF). (1) The insufficiency of Heart-Qi was the main cause of invasion of CHF. Along with aggravation of CHF, the Heart Yin deficiency developed into the Heart Yang deficiency and accompanying symptoms multiplied gradually. (2) Except plasma aldosterone (pALD) (P greater than 0.05), the levels of plasma atrial natriuretic polypeptide (pANP) and plasma angiotensin II (pAII) in the Heart Yin deficiency group was increased obviously compared with healthy persons (P less than 0.05-0.001). In the Heart Yang deficiency group, the levels of pANP and pALD was increased markedly (P less than 0.05-0.005), the level of pAII was decreased obviously (P less than 0.05), as compared with the Heart Yin deficiency group. (3) There were positive correlations between pANP and pALD (P less than 0.005), negative correlations between pAII and pANP, pALD (P less than 0.001).

[Induction of papilloma and carcinoma in the forestomach of mice by in vivo formation of N-3-methylbutyl-N-1-methylacetonylnitrosamine (MAMBNA)]

Forestomach papilloma and carcinoma, as well as liver lesion, were induced in mice by gavaging precursors of the new nitrosamine, MAMBNA (N-3-methylbutyl-N-1-methylacetonylnitrosamine) and NaNO2. The results were-similar to those in mice and rats fed on preformed MAMBNA compound. However, the induction of such tumors by in vivo formation of MAMBNA required longer time and much larger doses. Moreover, the lesions of epithelial hyperplasia in the urinary bladder, lymphoid tumor, intestinal carcinoma and interstitial-cell tumor of the testis also developed in some of the experimental animals. This may indicate that the intragastric synthesis of MAMBNA is less effective in the production of forestomach tumors in mice.