Xianling Liu

Annexin A5 inhibits diffuse large B-cell lymphoma cell invasion and chemoresistance through phosphatidylinositol 3-kinase signaling.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkins lymphoma worldwide. Although patient outcomes have significantly improved to a greater than 40% cure rate by the combinatorial cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy, which is widely used, resistance to the CHOP regimen continues to pose a problem in managing or curing DLBCL. While it promotes the malignancy and chemo-resistance in certain types of cancer, Annexin A5 is negatively correlated with those in other cancers, including DLBCL. In the present study, we explored the effects of Annexin A5 on DLBCL cell invasion and chemoresistance to CHOP. Stable overexpression and knockdown of Annexin A5 were performed in Toledo and Pfeiffer human DLBCL cell lines. Overexpression of Annexin A5 in both cell lines significantly decreased cell invasion, matrix metalloproteinase-9 (MMP-9) expression/activity, phosphatidylinositol 3-kinase (PI3K) activity/Akt phosphorylation, and cell survival against CHOP-induced apoptosis. On the other hand, knockdown of Annexin A5 markedly increased cell invasion, MMP-9 expression/activity, PI3K activity/Akt phosphorylation, and CHOP-induced apoptosis in the DLBCL cell lines, which was abolished by selective PI3K inhibitor BKM120. In conclusion, our study provides the first in vitro evidence that Annexin A5 inhibits DLBCL cell invasion, MMP-9 expression/activity, and chemoresistance to CHOP through a PI3K-dependent mechanism; it provides new insight not only into the biological function of Annexin A5, but also into the molecular mechanisms underlying DLBCL progression and chemoresistance.

MicroRNA-19a promotes nasopharyngeal carcinoma by targeting transforming growth factor β receptor 2

MicroRNA (miR), a class of small non-coding RNA, function as key regulators in gene expression through directly binding to the 3′ untranslated region of their target mRNA, which further leads to translational repression or mRNA degradation. miR-19a, a member of miR-17-92 cluster, has an oncogenic role in a variety of malignant tumors. However, the exact role of miR-19a in nasopharyngeal carcinoma (NPC) has not previously been studied. The present study aimed to investigate the function and mechanism of miR-19a in regulating the viability and invasion of NPC cells. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) data indicated that the expression levels of miR-17-92 cluster members (miR-17, miR-18a, miR-19a and miR-20a) were frequently increased in NPC tissues compared to the normal tissues. It was also demonstrated that miR-19a was significantly upregulated in NPC C666-1 cells compared to NP69 cells (P<0.01). Knockdown of miR-19a led to a significant decrease in the viability and invasion of NPC C666-1 cells (P<0.01), and induced increased protein expression levels of transforming growth factor β receptor 2 (TGFβR2), which was further identified as a direct target gene of miR-19a by using a luciferase reporter assay. Overexpression of TGFβR2 also suppressed the viability and invasion of C666-1 cells, similar to the effects of miR-19a inhibition. Furthermore, knockdown of TGFβR2 reversed the suppressive effects of miR-19a inhibition on C666-1 cell viability and invasion, suggesting that the role of miR-19a in mediating cell viability and invasion is through directly targeting TGFβR2 in NPC cells. In addition, RT-qPCR data demonstrated that the mRNA expression level of TGFβR2 was markedly reduced in NPC tissues and C666-1 cells. In summary, the present study demonstrated an oncogenic role of miR-19a in NPC via mediation of TGFβR2. Therefore, miR-19a may be a potential therapeutic target for NPC.

[Clinical features and prognosis analysis of small-cell lung cancer complicated with hyponatremia].

OBJECTIVEnTo evaluate the clinical features and prognosis of small-cell lung cancer (SCLC) complicated with hyponatremia.nnnMETHODSnThe clinical data of 158 patients with SCLC of the Second Xiangya Hospital from January 2000 to December 2007 were studied retrospectively.nnnRESULTSnThe incidence rate of hyponatremia in SCLC was 42.4%(67/158). The median survival time was 7.6 months in patients with subnormal serum sodium, and 14.1 months in patients with normal values. There was significantly different between 2 groups (P<0.001). The patients who did not fully regain normal values of serum sodium, had poorer survival (6.2 months) compared with the patients with normal serum sodium (10.3 months, P=0.044).nnnCONCLUSIONnThe incidence rate of hyponatremia in SCLC is high. The prognosis of SCLC with hyponatremia is very poor, especially in those who can not regain normal values of serum sodium after the treatment. So diagnosis and treatment at early stage are very important.

Squamous cell carcinoma of the spleen: A case report

Tumor incidence in the spleen is relatively low compared with that in other organs. The majority of primary splenic tumors are benign, and the majority of malignant tumors are lymphoma or fibrosarcoma. While the occurrence of single squamous cell carcinoma in the spleen is rare, the present study reports a case of single splenic squamous cell carcinoma in which the patient received surgery, chemotherapy and Chinese herbal treatment, and died 14 months after diagnosis. As to the best of our knowledge this case type has not been previously reported; the present study provides insight into the response for standard treatment and the prognosis of the splenic squamous cell carcinoma for a single case.

Using Artificial Intelligence (Watson for Oncology) for Treatment Recommendations Amongst Chinese Patients with Lung Cancer: Feasibility Study

Background Artificial intelligence (AI) is developing quickly in the medical field and can benefit both medical staff and patients. The clinical decision support system Watson for Oncology (WFO) is an outstanding representative AI in the medical field, and it can provide to cancer patients prompt treatment recommendations comparable with ones made by expert oncologists. WFO is increasingly being used in China, but limited reports on whether WFO is suitable for Chinese patients, especially patients with lung cancer, exist. Here, we report a retrospective study based on the consistency between the lung cancer treatment recommendations made for the same patient by WFO and by the multidisciplinary team at our center. Objective The aim of this study was to explore the feasibility of using WFO for lung cancer cases in China and to ascertain ways to make WFO more suitable for Chinese patients with lung cancer. Methods We selected all lung cancer patients who were hospitalized and received antitumor treatment for the first time at the Second Xiangya Hospital Cancer Center from September to December 2017 (N=182). WFO made treatment recommendations for all supported cases (n=149). If the actual therapeutic regimen (administered by our multidisciplinary team) was recommended or for consideration according to WFO, we defined the recommendations as consistent; if the actual therapeutic regimen was not recommended by WFO or if WFO did not provide the same treatment option, we defined the recommendations as inconsistent. Blinded second round reviews were performed by our multidisciplinary team to reassess the incongruent cases. Results WFO did not support 18.1% (33/182) of recommendations among all cases. Of the 149 supported cases, 65.8% (98/149) received recommendations that were consistent with the recommendations of our team. Logistic regression analysis showed that pathological type and staging had significant effects on consistency (P=.004, odds ratio [OR] 0.09, 95% CI 0.02-0.45 and P<.001, OR 9.5, 95% CI 3.4-26.1, respectively). Age, gender, and presence of epidermal growth factor receptor gene mutations had no effect on consistency. In 82% (42/51) of the inconsistent cases, our team administered two China-specific treatments, which were different from the recommendations made by WFO but led to excellent outcomes. Conclusions In China, most of the treatment recommendations of WFO are consistent with the recommendations of the expert group, although a relatively high proportion of cases are still not supported by WFO. Therefore, WFO cannot currently replace oncologists. WFO can improve the efficiency of clinical work by providing assistance to doctors, but it needs to learn the regional characteristics of patients to improve its assistive ability.

Synchronous colorectal cancer and multiple myeloma with chest wall involvement: Is this a coincidence?

Multiple primary malignant neoplasms (MPMNs) are rare malignant neoplasms that simultaneously or successively occur in the same patient as 2 or more primary malignancies. Currently, an increasing number of cases are being reported. In general, MPMNs more commonly occur as 2 solid tumors or 2 hematological malignancies. Cases of MPMN that involve a solid tumor and a hematological malignancy are rare. Here, we report a case of synchronous colorectal cancer (CRC) and multiple myeloma (MM) with chest wall involvement. After reviewing the literature, we believe that there may be a distinct syndrome involving CRC and MM. The patient in our case study suffered refractory anemia following surgery and 2 cycles of chemotherapy. Initially, the anemia was considered to be a common manifestation of CRC in this patient. Interestingly, although he received a blood transfusion, his hemoglobin levels remained low. He later developed hematuria, proteinuria, multiple osteoporosis in the costal bones, and thrombocytopenia. These new symptoms drew our attention, and we considered a diagnosis of synchronous primary CRC and MM, with the anemia as a symptom of MM. Based on the results of a bone marrow aspirate, MM was confirmed. Therefore, when CRC is associated with refractory anemia, we should not only assume that anemia is a classical symptom of CRC, a result of chronic blood loss, nutritional deficiencies, or myelosuppression due to chemotherapy, but we should also consider that it may reflect the possibility of a coexisting hematologic malignancy. As the treatment of these 2 malignancies is different, early diagnosis and treatment based on definitive diagnosis as early as possible will be beneficial to overall prognosis.