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PURPOSE There are conflicting results in the literature about the relationship between PD-1/PD-L1 expression and prognosis in non-small cell lung cancer (NSCLC). The purpose of this study was to identify the relationship between NSCLC patients' clinicopathologic characteristics and PD-1/PD-L1 expression. METHODS Pathology specimens of eligible stage II-III NSCLC patients were immunohistochemically stained with PD-1 and PD-L1 antibodies. Patient files and digital records were retrospectively reviewed for demographic and clinical features such as age, gender, smoking status, Eastern Cooperative Oncology Group (ECOG) performance status (PS), histological tumor subtype, applied chemotherapeutic types and their dates and survival data. Statistical analyses were performed to evaluate prognostic effects of staining status of PD-L1 and PD-1 in tumor cells and PD-L1 in tumor infiltrating inflammatory cells. RESULTS In a total 74 patients, 45.9% of them were positive for PD-L1 in tumor cells, 67.9% positive for PD-L1 in tumor infiltrating inflammatory cells and 83.8% positive for PD-1 in tumor cells (p>0.05). There was a statistically significant relationship between the positive staining of PD-L1 tumor cells and increased overall survival (OS) in univariate analysis (3-year OS; PD-L1(+) 76.6% vs PD-L1(-) 41%, p=0.031). In multivariate analysis only stage and ECOG PS were statistically significant. CONCLUSIONS PD-L1 positivity in tumor cells was a positive prognostic factor for OS in patients with stage II and III NSCLC.PURPOSE Drug resistance in lung cancer is a growing and challenging problem affecting the overall treatment and quality of the patient's life. The main purpose of the current study was to investigate the anticancer effects of flavokawain-B in gemcitabine-resistant non-small lung cancer cells (NSCLC) along with evaluating its mode of action by studying its effects on programmed cell death, ROS production, cell migration and invasion and PI3K/AKT signalling pathway. METHODS Cell proliferation rate was studied using MTS cell viability assay while apoptosis induction by flavokawain-B was studied by fluorescence microscopy using DAPI staining as well as flow cytometry using Annexin V-FITC/propidium iodide (PI). Effects on mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) were studied by flow cytometry using Rh-123 and DCH-DA dyes respectively. Effects on cell migration and cell invasion were examined by in vitro wound healing assay and transwell assay respectively. Changes in PI3K/AKT proteiated via apoptosis induction, ROS production, loss of MMP, suppression of cell migration and invasion and blocking PI3K/AKT signalling pathway.PURPOSE This study aimed to compare between the clinical efficacy of laparotomy and laparoscopic radical resection of gastric cancer and their effects on C-reactive protein (CRP), carcinoembryonic antigen (CEA) and insulin resistance. METHODS 210 patients with gastric cancer admitted to Dongying People's Hospital from September 2013 to July 2015 were included in this study. The patients were divided according to surgery type into the laparotomy group (n = 104) and the laparoscopy group (n = 106). The operative time, intraoperative bleeding, lymph node dissection, postoperative exhaust time and postoperative complications were recorded. Peripheral blood CRP and CEA levels were measured by enzyme-linked immunosorbent assay (ELISA). Fasting blood glucose (FBG), AND fasting insulin (FINS) levels were measured before operation and 1, 3 and 7 days after operation. All patients were followed up by telephone and letters for 5 years. The patients in the two groups were investigated by a quality of life questionnaire. RESULTS The intraoperative bleeding and postoperative exhaust time in THE laparoscopy group were significantly lower than those in the traditional laparotomy group, while the operative time and the number of lymph node dissections were higher. The CRP and CEA in the laparoscopy group were significantly lower than in the laparotomy group on the 1ST, 2ND and 3RD day after operation (p less then 0.05). The FBG, FINS and HOMA-IR in the laparoscopy group were significantly lower than those in the laparotomy group on the 1ST and 3RD day after operation (p less then 0.05). The scores of quality of life in the laparoscopy group were lower than those in the laparotomy group (p less then 0.05). CONCLUSION In conclusion, laparoscopic radical resection of gastric cancer can reduce the levels of CRP, CEA and insulin resistance, while the degree of inflammation and insulin resistance after laparoscopy is lower than that after laparotomy, which is beneficial to postoperative recovery.PURPOSE Lung cancer is one of the deadly diseases with limited treatment options available. The main aim of the current study was to investigate the antitumor effects of levopimaric acid - a naturally occurring diterpene, against cisplatin-resistant non-small cell lung carcinoma cells A-549 and normal MRC5 cells. Effects of levopimaric acid on autophagy, reactive oxygen species (ROS), apoptosis and ERK/MAPK signalling pathways were also investigated in the current study. METHODS Proliferation rate was monitored by MTS assay. Apoptosis was detected by DAPI staining as well as western blot assay. Electron microscopy was used to investigate the autophagic effects of levopimaric acid. Effects on ROS and mitochondrial membrane potential (MMP) were evaluated by flow cytometry. Protein expression was examined by western blotting. RESULTS It was found that levopimaric acid exerts potent antiproliferative effects against the cisplatin-resistant lung cancer cells and exhibited an IC50 of 15 μM. However, the toxic effects of levopimaric acid were seen to be insignificant against the normal cells. The anticancer effects of levopimaric acid were due to induction of apoptosis which was also associated with modulation of apoptosis-related proteins (Bax and Bcl-2). Levopimaric acid also induced autophagy which was also associated with alterations of autophagy-related protein expressions (LC3I, II, and p62). Levopimaric acid caused ROS-mediated alterations in the MMP. It was also found that the molecule could induce drug-resistant lung cancer cell death by activating p38 MAPK and JNK signalling pathways while inhibiting ERK pathway. CONCLUSION The current results strongly indicate that levopimaric acid may prove to be a potential anticancer drug candidate provided further in depth studies are carried out.PURPOSE This study aimed to compare the efficacy of laparoscopic and conventional left hemicolectomy for treating colon cancer and their effects on stress response and quality of life of patients. METHODS 92 patients with colon cancer were selected. Forty three patients in the study group were treated with laparoscopic left hemicolectomy, and 49 patients in the control group were treated with conventional left hemicolectomy. The surgery, postoperative recovery, intraoperative and postoperative complications were compared between the two groups. The enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of IL1β and IL-6. see more The quality of life of patients after surgery was analyzed by the Functional Assessment of Cancer Therapy-Lung (FACT-L). RESULTS The operation time and intraoperative blood loss of the study group were statistically lower than those of the control group (p less then 0.05). The postoperative exhaust time and hospitalization time of the study group were statistically shorter than those of the control group (p less then 0.05). Serum IL-1β and IL-6 levels in the study group were significantly lower than those in the control group (p less then 0.05). In the two groups, the overall scores of quality of life after surgery were significantly lower than those before surgery (p less then 0.05). After surgery, the overall score of quality of life in the study group was significantly higher than that in the control group (p less then 0.05). CONCLUSION The laparoscopic left hemicolectomy with surgical approaches on the surgical plane has high safety and marked efficacy.PURPOSE Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients. METHODS This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity 67.1%, specificity 54.5%) and ≤16% for PDW (sensitivity 66.7%, specificity 60.0%). RESULTS The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV≤8.5 fL and PDW>16 fL (p16% had significantly longer RFS than that in those with PDW ≤16 fL among stage III patients (p less then 0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS. CONCLUSION Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.PURPOSE To compare the clinical efficacy and safety between laparoscopic complete mesocolic excision (CME) and traditional radical operation for colon cancer in the treatment of stage III colon cancer. METHODS A total of 196 patients with stage III colon cancer treated in out hospital from January 2014 to February 2016 were selected and divided into two groups using a random number table. One group (CME group, n=98) received laparoscopic CME, while another group (Traditional group, n=98) underwent traditional radical operation for colon cancer. The surgery-related indexes and perioperative complications were compared between the two groups, the pathological diagnosis of the patient's surgical specimens was recorded, and the survival of all patients was followed up. RESULTS The general clinical characteristics of the patients were comparable between the two groups, and no perioperative death occurred. The operation time had no statistically significant difference between the two groups (p=0.190). There was overtly less intraoperative blood loss and shorter postoperative hospital stay in the CME group than those in the Traditional group (129.35±34.54 mL vs. 162.43±38.16 mL, p0.05). The number of lymph nodes dissected and the number of positive lymph nodes detected were clearly greater in the CME group than in the Traditional group (p less then 0.001). At the end of the follow-up, the overall survival rate and tumor-free survival rate were notably higher in the CME group than in the Traditional group (p=0.046, p=0.038). CONCLUSION In comparison with traditional radical operation for colon cancer, laparoscopic CME has higher yield of lymph nodes dissected, smaller intraoperative blood loss, no increase in perioperative complications, and higher overall survival and tumor-free survival of patients, demonstrating it as safe and applicable in the treatment of stage III colon cancer.
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