Zhongli Zhan

Expression of TNFR2 by regulatory T cells in peripheral blood is correlated with clinical pathology of lung cancer patients.

CD4+FoxP3+ regulatory T cells (Tregs) represent a major cellular mediator of cancer immune evasion. The expression of tumor necrosis factor receptor type II (TNFR2) on Tregs is reported to identify the maximally suppressive Treg population in both mice and human. We therefore investigated the phenotype and function of TNFR2+ Tregs present in the peripheral blood (PB) of 43 lung cancer patients. Further, the association of TNFR2 expression on Tregs with clinicopathological factors was analyzed. The results showed that in the PB of lung cancer patients, Tregs expressed markedly higher levels of TNFR2 than conventional T cells (Tconvs). Expression of TNFR2 appeared to correlate better than CD25+ and CD127− with FoxP3 expression. PB TNFR2+ Tregs in lung cancer patients were more proliferative and expressed higher levels of the immunosuppressive molecule CTLA-4, and consequently more potently suppressed IFNγ production by cocultured CD8 CTLs. More importantly, higher TNFR2 expression levels on Tregs were associated with lymphatic invasion, distant metastasis and more advanced clinical stage of lung cancer patients. Therefore, our study suggests that TNFR2+ Tregs play a role in promoting tumor progressive metastasis and expression of TNFR2 by PB Tregs may prove to be a useful prognostic marker in lung cancer patients.

Does tumor size improve the accuracy of prognostic prediction in patients with esophageal squamous cell carcinoma after surgical resection

This study aimed to investigate whether the inclusion of tumor size could improve the prognostic accuracy in patients with esophageal squamous cell cancer (ESCC). A total of 387 patients with ESCC who underwent curative resection were enrolled in this analysis. The patients were categorized into small-sized tumors (SSTs) and large-sized tumors (LSTs) using an appropriate cut-off point for tumor size. Kaplan–Meier survival curve and log–rank test were used to evaluate the prognostic value of tumor size. A Cox regression model was adopted for multivariate analysis. Their accuracy was compared based on the presence or absence of tumor size. Using 3.5 cm as the optimal cut-off point, 228 and 159 patients presented with LSTs (≥ 3.5 cm) and SSTs (< 3.5 cm), respectively. The patients with LSTs had significantly worse prognoses than patients with SSTs (23.9% vs. 43.2%, P < 0.001). Multivariate analysis revealed that tumor size, histological type, invasion depth, and lymph node metastasis were independent predictors of overall survival. The addition of tumor size to the AJCC TNM staging improved the predictive accuracy of the 5-year survival rate by 3.9%. Further study showed that tumor size and T stage were independent predictors of the prognosis of node-negative patients, and the combination of tumor size and T stage improved the predictive accuracy by 3.7%. In conclusion, tumor size is indeed a simple and practical prognostic factor in patients with ESCC. It can be used to improve the prognostic accuracy of the current TNM staging, especially for patients with node-negative disease.

Clinical Analysis of Diagnosis and Treatment of Gastrointestinal Stromal Tumors (Report of 96 Cases)

ObjectiveTo investigate the pathological diagnosis, surgical treatment and prognosis of gastrointestinal stromal tumors (GIST).MethodsThe clinicopathological data of 96 post-operative cases with GIST were analyzed retrospectively, and expression of immunohistochemical staining of CD117, CD34, SMA and S -100 was determined.ResultsImmunohistochemical positive staining showed: CD117, 79.1% (76/96); CD34, 58.3% (56/96); SMA, 35.4% (34/96); S-100, 9.3% (9/96). Twenty-three benign cases and 73 malignant cases were reported. The omentums were resected in 39 malignant cases. For the other 34 malignant cases the omentums were left intact. The recurrent and metastatic rates were 5.1% and 26.5%(P<0.05). The incisai section between the normal bowel and the tumor was >5cm in 46 cases, for the other 27 cases, the section was < 5cm. The recurrent and metastatic rates were 6.5% and 29.6%(P<0.05), respectively. The 5-year survival rates of benign and malignant GIST were 91.5% and 57.3%(P<0.05).ConclusionGIST were the most freuquent mesenchymal tumor seen in the gastrointestinal tract. The application of immunohistochemical markers CD117and CD34 are mutually beneficial for a final correct pathological diagnosis. The adaptation of a primary rational treatment, including the complete tumor resection and preventive omentectomy could reduce the recurrence of GIST.

Morphological and ultrastructural observation in the angiogenesis process of human lung adenocarcinoma cell LALU

BACKGROUND To study the morphological and ultrastructural characteristics in the angiogenesis of human lung adenocarcinoma cell LALU. METHODS LALU, human lung adenocarcinoma cell line, was implanted into SCID mice subcutaneously and the angiogenesis process was sequentially observed with light microscope and electron microscope. RESULTS The light microscopy showed that the angiogenesis process of transplanted tumor could be divided into the protophase of tumor angiogenesis and stage of angiogenesis during the 2nd to the 10th day after transplantation. On the 20th day, the metastatic foci were found in the lung. The electron microscopy showed that angioblast cells were found in transplanted tumor tissues on the 2nd day . From the 4th to the 10th day, the vascular endothelial cells began to form blood vessel cavity with complete new-grown basement membrane. The vascular endothelial cells became maturer on the 20th day, however, part of basement membranes of the newly grown blood vessels were incomplete. The cancer cells connected with angioblast cells, vascular endothelial cells and blood vessel walls in the whole process of angiogenesis. CONCLUSIONS The characteristics observed by histopathology and ultrastructure may provide some important indicators in the treatment of lung cancer.