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Urinary and sexual dysfunctions are among the most common complications in rectal cancer surgery. This study aimed to investigate the protective effect of laparoscopic functional total mesorectum excision (TME) on urinary and sexual functions in male patients.A total of 248 male patients with mid-low rectal cancer were recruited in this study between February 2017 and July 2020. To overcome selection bias, we performed a 1:1 match using six variables, including age, BMI, ASA score, tumor distance, clinical T stage, and tumor size. The urinary function was assessed by the International Prostate Symptom Score (IPSS), sexual function was assessed by a 5-item version of the International Index of Erectile Function (IIEF-5) and ejaculation grading at postoperative 3 and 12 months.79 patients received functional TME surgery (FTME group), and 169 patients received routine TME surgery (RTME group). After the propensity score, 79 pairs were balanced and analyzed. Patients in the FTME group showed a lower IPSS score and higher IIEF-5 score than patients in the RTME group at postoperative 3 and 12 months. The incidence of ejaculation dysfunction for patients in the FTME group was lower than patients in the RTME group at postoperative 3 and 12 months.Laparoscopic functional total mesorectal excision was beneficial to faster recovery of urinary and sexual function for patients with rectal cancer, and it could be used as a superior surgical technique for pelvic autonomic nerve preservation in mid-low rectal cancer.

Purpose: Vaccinia virus has strong potential as a novel therapeutic agent for treatment of pancreatic cancer. We investigated whether arming vaccinia virus with interleukin-10 (IL10) could enhance the antitumor efficacy with the view that IL10 might dampen the host immunity to the virus, increasing viral persistence, thus maximizing the oncolytic effect and antitumor immunity associated with vaccinia virus.Experimental Design: The antitumor efficacy of IL10-armed vaccinia virus (VVLΔTK-IL10) and control VVΔTK was assessed in pancreatic cancer cell lines, mice bearing subcutaneous pancreatic cancer tumors and a pancreatic cancer transgenic mouse model. Viral persistence within the tumors was examined and immune depletion experiments as well as immunophenotyping of splenocytes were carried out to dissect the functional mechanisms associated with the viral efficacy.Results: Compared with unarmed VVLΔTK, VVLΔTK-IL10 had a similar level of cytotoxicity and replication in vitro in murine pancreatic cancer cell lines, but rendered a superior antitumor efficacy in the subcutaneous pancreatic cancer model and a K-ras-p53 mutant-transgenic pancreatic cancer model after systemic delivery, with induction of long-term antitumor immunity. The antitumor efficacy of VVLΔTK-IL10 was dependent on CD4+ and CD8+, but not NK cells. Clearance of VVLΔTK-IL10 was reduced at early time points compared with the control virus. Treatment with VVLΔTK-IL10 resulted in a reduction in virus-specific, but not tumor-specific CD8+ cells compared with VVLΔTK.Conclusions: These results suggest that VVLΔTK-IL10 has strong potential as an antitumor therapeutic for pancreatic cancer. Clin Cancer Res; 21(2); 405–16. ©2014 AACR.

Supplementary Figure 1. Replication, potency and protein expression of IL-10 by VVL∆TK and VVL∆TK-IL-10 in vitro in PT45 cells

Supplementary Figure 5. Analysis of B, Treg, NK and NKT cells in splenocytes of DT6606-OVA tumor-bearing mice after treatment.

Supplementary Table 1. Primers and probes used for qPCR

Supplementary Figure 3. Macrophage infiltration into pancreatic tumors of KPC mice

Supplementary Figure legends. Supplementary Figure legends

Supplementary Figure 2. CD3+ CD8+ T cell infiltration into pancreatic tumors of KPC mice

Supplementary Figure 4. Vaccinia virus coat protein expression in pancreatic tumors of KPC mice

Supplementary Figure 7. Example FACS profiles for virus- or tumor-specific CD8+ cells.

Supplementary Figure 6. Example FACS profiles of CD4+, CD8+, activated and naive T cells.

Background: Lipid metabolic reprogramming was considered as a new hallmark of malignant tumors. It has been reported to play a crucial biological role in cell proliferation, energy homeostasis and signal-transduction. However, the important value of lipid metabolism-related genes(LMRGs) in prognostic prediction and the tumor immune microenvironment has not been explored by large sample studies in colorectal cancer(CRC). Methods: In this study, the lipid metabolism status of 1086 CRC samples was analyzed using RNA expression profiles and clinical data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, of which the former was determined as training set and the latter as validation set. The risk signature was constructed by the univariate Cox regression and Least Absolute Shrinkage and Selection Operator(LASSO) COX regression. The patients were stratified into high- and low-risk groups according to the median value of the risk score. Immune and mutation landscape between low- and high-risk CRC patients were also explored. Additionally, we established a nomogram integrating the risk signature and clinical factors to improve risk assessment of CRC patients. Results: A four LMRGs signature, including PROCA1, CCKBR, CPT2 and FDFT1, was constructed to predict the prognosis of CRC. The risk signature as an independent prognostic factor for CRC was associated with a variety of parameters. Survival analysis showed that patients with low risk score had a better prognosis. There were different immune landscapes between low and high-risk CRC patients, especially in monocytes, dendritic cells, M0 and M2-like macrophages. Patients in the low-risk group were more likely to have higher tumor mutation burden, stem cell characteristics and level of PD-L1 expression. In addition, it was found that genes that played crucial biological functions in tumorigenesis (including TP53, PI3K and MUC16) had significant differences in mutation frequency between two groups. Conclusion: A lipid metabolism-related risk signature for predicting the prognosis of CRC was identified in this study. Furthermore, this prognostic signature may be a potential biomarker for predicting the efficacy of chemotherapy and anti-PD-L1 therapy in CRC.

Background: A major challenge in immunotherapy is identifying populations that can benefit from treatment. DNA methylation is one of the most extensively studied epigenetic regulation mechanisms and reportedly involved in immune regulation and anticancer immune responses. How the integrated DNA methylation modification pattern affects the tumor microenvironment (TME) and the response to immunotherapy is poorly understood, however. Methods: In this study, samples from 1,691 colorectal cancer (CRC) patients recruited from five independent cohorts were used to comprehensively evaluate DNA methylation regulator patterns and TME characteristics. DNA methylation regulator patterns were determined using unsupervised hierarchical clustering analysis based on 20 DNA methylation regulators. The CIBERSORT and single-sample gene set enrichment analysis algorithms were used to respectively assess tumor-infiltrating immune cell relative abundance and immune-related pathways in each sample. A principal component analysis algorithm–based DNA methylation scoring scheme (DM_Score) was devised to quantify DNA methylation levels in candidates. The predictive value of the DM_Score for immunotherapy was evaluated in two cohorts. The association between the DM_Score and TME was assessed in an external cohort from our center.Results: Three DNA methylation regulator patterns associated with various clinical outcomes and TME characteristics were identified, consistent with classical immune phenotypes (immune-desert, immune-inflamed, and immune-excluded). The DM_Score established based on 270 DNA methylation-related signature genes strongly predicted unfavorable CRC prognoses associated with various mutations and TME landscapes. In addition, the DM_Score was positively correlated with many recognized biomarkers of immunotherapy response, including tumor mutational burden, tumor immune dysfunction and exclusion, immunophenoscore, PD-L1 mRNA, and microsatellite instability. In the two immunotherapy cohorts, a significant survival advantage was observed in patients with a high DM_Score after anti-PD-1/PD-L1 therapy.Conclusions: We present the first comprehensive analysis of cross-talk between DNA methylation modification patterns and TME characteristics in CRC. Quantitative evaluation of DNA methylation levels in individual tumors can aid in guiding more-precise immunotherapy strategies.

Development of the midgut is characterized by rapid elongation of the gut and its mesentery, resulting in the formation of the primary intestinal loop, which rotates around an axis formed by the superior mesenteric artery. Eventually, a complex twisted intestinal and mesenteric anatomy is formed by displacement, rotation, and fusion. Therefore, we theoretically believed that the colon and its mesentery should be restored to the simple primitive mesenteric state, and then en bloc resection could be better performed. In the present study, we introduced a surgical technique for laparoscopic complete mesocolic excision (CME) based on the concept of developmental anatomy (DA group), which was successfully performed on 65 patients with right-sided colon cancer. As a control, traditional laparoscopic CME surgery (CME group) was also performed on 65 patients with right-sided colon cancer by the same surgical team at the same time period. Compare with the CME group, patients in the DA group presented with the less blood loss (20.3 ± 10.4 ml vs 34.6 ± 22.2 ml, p

Objective. To study the role of long noncoding RNA HOXA10-AS in gastric cancer (GC) and its underlying mechanism which is one of the most common and fetal malignancies. Long noncoding RNA HOXA10-AS is highly expressed and acts in an oncogenic role in cancers. However, its roles in GC are still unknown. Methods. The expression of HOXA10-AS and HOXA10 in GC tissues from the TCGA database was analyzed. Western blot and qRT-PCR assays were applied to examine the expression of HOXA10-AS and HOXA10. Cell proliferation was evaluated with CCK-8 and EdU incorporation assays. Cell apoptosis was analyzed by flow cytometry. Migratory and invasive capacities were evaluated with wound healing and transwell assays. Results. HOXA10-AS and HOXA10 were upregulated in GC, and their expressions were positively correlated. Knockdown of HOXA10-AS inhibited HOXA10 expression in GC cells. Furthermore, knockdown of HOXA10-AS restrained GC cell proliferation, migration, and invasion but promoted apoptosis. In addition, overexpression of HOXA10-AS promoted malignant phenotypes of GC cells, but all these effects could be reversed by knockdown of HOXA10. Conclusion. HOXA10-AS promoted GC cell proliferation, migration and invasion and enhanced apoptosis via upregulating HOXA10. Our study implies a novel regulatory mechanism of malignant phenotypes and provides potential therapeutic targets for GC.

Background: Epithelial-to-mesenchymal transition (EMT) greatly affects the progression and metastasis of colorectal cancer (CRC) which is one of the most malignant tumors. The goal of this study was to evaluate the prognostic value of EMT-related genes and develop a prognostic nomogram for patients’ overall survival (OS) with CRC. Methods: This retrospective study analyzed gene expression profiles and clinical data in 1099 samples of CRC patients from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Risk signature based on public databases was created and examined for its predictive value in CRC patients. The independence and correlation of risk signature with clinicopathological parameters were respectively evaluated through univariate/multivariate analysis and subgroup analysis. A nomogram was established according to risk signature and clinical parameters and validated for its predictive ability. The correlation of risk signature and infiltrating immune cells in CRC was assessed.Results: A four EMT-related genes (ERGs) based signature was constructed and validated for its ability in prognostic prediction in CRC patients. The results showed the ERGs signature as an independent prognostic factor regarding different clinicopathological parameters including age, gender and clinical stage. Besides, the ERGs signature also performed well in subgroup analysis with T3-T4, N-, M0 and early disease stage. A nomogram based on the ERGs signature combining clinical parameters was constructed which showed a promising predictive ability in prognosis of CRC patients’ OS. In addition, we found a positive correlation of the ERGs signature with six different types of immune cells.Conclusion: A novel ERGs signature was identified in this study and ERGs signature can be useful in predicting the prognosis of CRC patients.

Accumulating studies have shown that the dysregulation of microRNAs is related to the carcinogenesis and development of gastric cancer (GC), and the role of miR-635 in GC remains largely unknown. miR-635 and Kinesin Family Member C1 (KIFC1) mRNA expression in GC tissues and paracancerous tissues and cells were detected by quantitative real-time PCR. KIFC1 protein expression in GC tissues and paracancerous normal tissues and cells was detected by immunohistochemistry and western blot. Cell proliferation was monitored by Cell Counting Kit-8 assay and 5-bromo-2′-deoxyuridine assay. Transwell assay was employed to detect the migration and invasion of GC cells. The dual-luciferase reporter gene assay was adopted to detect the targeting relationship between miR-635 and KIFC1. Compared with paracancerous tissues, miR-635 expression was remarkably decreased in GC tissues; conversely, KIFC1 expression was significantly increased. Compared with human normal gastric epithelial cell GSE-1, miR-635 expression was markedly decreased in GC cell lines. Meanwhile, KIFC1 expression was significantly increased, and the Kaplan-Meier Plotter database showed that its high expression was remarkably associated with poor prognosis. Additionally, miR-635 can negatively regulate KIFC1. miR-635 can target KIFC1 to inhibit proliferation, migration and invasion of GC cells. Collectively, miR-635 is lowly expressed in GC, and it inhibits proliferation, migration and invasion of GC cells via regulating KIFC1.

Dibromoacetic acid (DBA) is a by-product of disinfection in drinking water, which could cause many adverse effects in test animals. However, little research on its neurotoxicity has been conducted, and its mechanism has not been elucidated. In the present study, ninety Sprague−Dawley rats were administered DBA at doses of 0, 30, and 90 mg/kg body weight for 28 days via oral gavage. We found that DBA could induce obvious neurotoxicity in the pineal gland as indicated by histological changes and impaired rhythm of melatonin in pineal and serum. In the mechanism study, transcriptome data showed that DBA exposure could induce 732 differential expression genes. Besides, GO and KEGG analysis results indicated that these genes were enriched in circadian rhythms, among which CREB1 had the most significant fold change. And immunofluorescence staining (IF) and immunohistochemical staining (IHC) results showed that the number of amber-colored masculine neurons for the p-CREB1 in the 90 mg/kg group was markedly lower, and staining for the p-CREB1 was weaker. Moreover, the results of PCR and western blot showed that DBA exposure could down-regulate the expressions of CREB1 and p-CREB1, leading to the decreased expressions of gene and protein of arylalkylamine N-acetyltransferase (AANAT), and then resulting in the impaired melatonin synthesis in the pineal and serum. In conclusion, DBA exposure is associated with abnormal melatonin rhythm via inhibition of the p-CREB1-AANAT signalling pathway.

Purpose: Vaccinia virus has strong potential as a novel therapeutic agent for treatment of pancreatic cancer. We investigated whether arming vaccinia virus with interleukin-10 (IL10) could enhance the antitumor efficacy with the view that IL10 might dampen the host immunity to the virus, increasing viral persistence, thus maximizing the oncolytic effect and antitumor immunity associated with vaccinia virus. Experimental Design: The antitumor efficacy of IL10-armed vaccinia virus (VVLΔTK-IL10) and control VVΔTK was assessed in pancreatic cancer cell lines, mice bearing subcutaneous pancreatic cancer tumors and a pancreatic cancer transgenic mouse model. Viral persistence within the tumors was examined and immune depletion experiments as well as immunophenotyping of splenocytes were carried out to dissect the functional mechanisms associated with the viral efficacy. Results: Compared with unarmed VVLΔTK, VVLΔTK-IL10 had a similar level of cytotoxicity and replication in vitro in murine pancreatic cancer cell lines, but rendered a superior antitumor efficacy in the subcutaneous pancreatic cancer model and a K-ras-p53 mutant-transgenic pancreatic cancer model after systemic delivery, with induction of long-term antitumor immunity. The antitumor efficacy of VVLΔTK-IL10 was dependent on CD4+ and CD8+, but not NK cells. Clearance of VVLΔTK-IL10 was reduced at early time points compared with the control virus. Treatment with VVLΔTK-IL10 resulted in a reduction in virus-specific, but not tumor-specific CD8+ cells compared with VVLΔTK. Conclusions: These results suggest that VVLΔTK-IL10 has strong potential as an antitumor therapeutic for pancreatic cancer. Clin Cancer Res; 21(2); 405–16. ©2014 AACR.

Oncolytic viruses based on adenovirus type 5 (Ad5) have been developed as a new class of therapeutic agents for cancers that are resistant to conventional therapies. Clinical experience shows that these agents are safe, but virotherapy alone has not achieved long-term cure in cancer patients. The vast majority of oncolytic adenoviruses used in clinical trials to date have deletion of the E3B genes. It has been demonstrated that the antitumor potency of the E3B-deleted mutant (dl309) is inferior to adenovirus with E3B genes intact. Tumors treated with dl309 show markedly greater macrophage infiltration than E3B-intact adenovirus. However, the functional mechanisms for this were not previously known. Here, we demonstrate that deletion of E3B genes increases production of chemokines by monocytes after adenovirus infection and increases monocyte migration. The E3B 14,700-Da protein (E3B-14.7K) inhibits STAT1 function by preventing its phosphorylation and nuclear translocation. The STAT1 inhibitor, fludarabine, rescues the effect of E3B-14.7K deletion by downregulating target chemokine expression in human and murine monocytes and results in an enhanced antitumor efficacy with dl309 in vivo. These findings have important implications for clinical use of E3B-deleted oncolytic adenovirus and other E3B-deleted adenovirus vector-based therapy.

Metastasis accounts for the poor outcome of patients with pancreatic cancer. We recently discovered PRSS3 to be over-expressed in metastatic human pancreatic cancer cells. This study aimed to elucidate the role of PRSS3 in the growth and metastasis of human pancreatic cancer.PRSS3 expression in human pancreatic cancer cell lines was detected by qPCR and immunoblotting. The effect of PRSS3 on cancer cell proliferation, migration and invasion in vitro, tumour growth and metastasis in vivo were investigated by manipulation of PRSS3 expression in human pancreatic cancer cell lines. VEGF expression was detected by ELISA, and the pathway through which PRSS3 regulates VEGF expression was investigated. The therapeutic effect of targeting this pathway on metastasis was assessed in vivo. Immunohistochemistry was employed to detect PRSS3 expression in human pancreatic cancer tissues.PRSS3 was over-expressed in the metastatic PaTu8988s cell line, but not in the non-metastatic PaTu8988t cell line. Over-expression of PRSS3 promoted pancreatic cancer cell proliferation as well as invasion in vitro, and tumour progression and metastasis in vivo. Stepwise investigations demonstrated that PRSS3 upregulates VEGF expression via the PAR1-mediated ERK pathway. ERK inhibitor significantly delayed the progression of metastases of pancreatic cancer and prolonged the survival of animals bearing metastatic pancreatic cancer (p0.05). 40.54% of human pancreatic cancers (n=74) were positive for PRSS3 protein. A significant correlation was observed between PRSS3 expression and metastasis (p0.01). Multivariate Cox regression analysis indicated that patients with PRSS3 expression in their tumours had a shorter survival time compared to those without PRSS3 expression (p0.05).PRSS3 plays an important role in the progression, metastasis and prognosis of human pancreatic cancer. Targeting the PRSS3 signalling pathway may be an effective and feasible approach for treatment of this lethal cancer.

The aim of our study was to investigate the biological effects of Bcl-XL antisense oligodeoxynucleotide (ASODN) transfected into cultured esophageal carcinoma cells and human esophageal carcinoma xenograft in nude mice. Cationic liposome-mediated ASODN was used to transfect esophageal carcinoma cells. RT-PCR, Western blot, MTT assay, flow cytometry, and in situ apoptosis cells detection (TUNEL detection) were used to systematically study the biological effects of transfected cells both in vitro and in vivo. In this study, the results showed that the proliferation of esophageal carcinoma cells in ASODN group decreased significantly when compared with the control group (P < 0.05), at 57.3% Bcl-XL mRNA inhibitory rate, and a significant decreasing of Bcl-XL protein expression, at the apoptosis rates of (31.1 ± 5.8)% and 35.0% by flow cytometry and TUNEL assay respectively (P < 0.01, when compared with control groups). It also showed that the growth of human esophageal carcinoma in nude mice of ASODN group was significantly inhibited (P < 0.05), together with a significant decreased expression level of Bcl-XL mRNA and protein, and an induced tumor cell apoptosis in nude mice. Our result indicates Bcl-XL ASODN can effectively inhibit the proliferation of esophageal carcinoma cells in vitro and tumor growth in vivo. The suppression of Bcl-XL expression by ASODN may offer both a therapeutic approach and an important theoretic foundation for gene therapy against esophageal carcinoma.

Summary Survival following pancreatic cancer remains poor despite incremental advances in surgical and adjuvant therapy, and new strategies for treatment are needed. Oncolytic virotherapy is an attractive approach for cancer treatment. In this study, we have evaluated the effectiveness of the Lister vaccine strain of vaccinia virus armed with the endostatin-angiostatin fusion gene (VVhEA) as a novel therapeutic approach for pancreatic cancer. The Lister vaccine strain of vaccinia virus was effective against all human pancreatic carcinoma cells tested in vitro, especially those insensitive to oncolytic adenovirus. The virus displayed inherently high selectivity for cancer cells, sparing normal cells both in vitro and in vivo, with effective infection of tumors after both intravenous (IV) and intratumoral (IT) administration. The expression of endostatin-angiostatin fusion protein was confirmed in a pancreatic cancer model both in vitro and in vivo, with evidence of inhibition of angiogenesis. This novel vaccinia virus demonstrated significant antitumor potency in vivo against the Suit-2 model by IT administration. The present study suggests that the novel Lister strain of vaccinia virus armed with the endostatin-angiostatin fusion gene is a potential therapeutic agent for pancreatic cancer.

The changes in cancer cell surface molecules and intracellular signaling pathways during tumorigenesis make delivery of adenovirus-based cancer therapies inefficient. Here we have identified carcinoembryonic antigen- related cell adhesion molecule 6 (CEACAM6) as a cellular protein that restricts the ability of adenoviral vectors to infect cancer cells. We have demonstrated that CEACAM6 can antagonize the Src signaling pathway, downregulate cancer cell cytoskeleton proteins, and block adenovirus trafficking to the nucleus of human pancreatic cancer cells. Similar to CEACAM6 overexpression, treatment with a Src-selective inhibitor significantly reduced adenovirus replication in these cancer cells and normal human epithelial cells. In a mouse xenograft tumor model, siRNA-mediated knockdown of CEACAM6 also significantly enhanced the antitumor effect of an oncolytic adenovirus. We propose that CEACAM6-associated signaling pathways could be potential targets for the development of biomarkers to predict the response of patients to adenovirus-based therapies, as well as for the development of more potent adenovirus-based therapeutics.

Oncolytic viruses based on adenovirus type 5 (Ad5) have been developed as a new class of therapeutic agents for cancers that are resistant to conventional therapies. Clinical experience shows that these agents are safe, but virotherapy alone has not achieved long-term cure in cancer patients. The vast majority of oncolytic adenoviruses used in clinical trials to date have deletion of the E3B genes. It has been demonstrated that the antitumor potency of the E3B-deleted mutant ( dl 309) is inferior to adenovirus with E3B genes intact. Tumors treated with dl 309 show markedly greater macrophage infiltration than E3B-intact adenovirus. However, the functional mechanisms for this were not previously known. Here, we demonstrate that deletion of E3B genes increases production of chemokines by monocytes after adenovirus infection and increases monocyte migration. The E3B 14,700-Da protein (E3B-14.7K) inhibits STAT1 function by preventing its phosphorylation and nuclear translocation. The STAT1 inhibitor, fludarabine, rescues the effect of E3B-14.7K deletion by downregulating target chemokine expression in human and murine monocytes and results in an enhanced antitumor efficacy with dl 309 in vivo . These findings have important implications for clinical use of E3B-deleted oncolytic adenovirus and other E3B-deleted adenovirus vector-based therapy.