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Song Chen,1 Feng Shi,2 Zhiqiang Wu,3 Liguang Wang,4 Hongjie Cai,3 Ping Ma,5 Yuanmin Zhou,5 Qicong Mai,2 Fan Wang,3 Shuangyan Tang,3 Wenquan Zhuang,3 Jiaming Lai,6 Xiaoming Chen,2 Huanwei Chen,4 Wenbo Guo3 1Department of Minimally Invasive Interventional Therapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 2Department of Interventional Radiology, Guangdong Provincial People’s Hospital, Guangzhou, People’s Republic of China; 3Department of Interventional Radiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 4Department of Hepatopancreatic Surgery, the First People’s Hospital of Foshan, Foshan, People’s Republic of China; 5Department of Oncology, the Twelfth People’s Hospital of Guangzhou, Guangzhou, People’s Republic of China; 6Center of Hepato-Pancreato-Biliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of ChinaCorrespondence: Huanwei Chen, Department of Hepatopancreatic Surgery, the First People’s Hospital of Foshan, Foshan, People’s Republic of China, Email chwei_fsyyy@163.com Wenbo Guo, Department of Interventional Radiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China, Email guowenbo@mail.sysu.edu.cnPurpose: The current therapeutic strategies for high-risk, unresectable hepatocellular carcinoma (HCC) patients demonstrate suboptimal outcomes. This study aimed to assess the clinical efficacy of the combined approach of hepatic arterial infusion chemotherapy (HAIC), lenvatinib, and tislelizumab, either with or without transhepatic arterial embolization (TAE), in managing HCC patients with portal vein tumor thrombus (PVTT) and significant tumor load.Patients and Methods: In this multicenter retrospective study, we analyzed patients diagnosed with primary, unresectable HCC presenting with PVTT and substantial tumor load who had undergone treatment with HAIC, lenvatinib, and tislelizumab, with or without TAE (referred to as the THLP or HLP group), between January 2019 and February 2022 across four medical centers in China. The outcomes included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS).Results: The study cohort comprised 100 patients, 50 each in the THLP and HLP groups. The THLP group demonstrated a significantly superior ORR (72% vs 52%, P=0.039). However, both groups exhibited comparable DCR (88% vs 76%, P=0.118), as assessed by the modified response evaluation criteria in solid tumors. The median OS and PFS for the entire cohort were 12.5 months (95% CI, 10.9– 14.8) and 5.0 months (95% CI, 4.2– 5.4), respectively. The THLP group exhibited a significantly extended OS (median, 14.1 vs 11.3 months, P=0.041) and PFS (median, 5.6 vs 4.4 months, P=0.037) in comparison to the HLP group. The most frequently reported treatment-related adverse events included abdominal pain and nausea, both reported by 59% of patients.Conclusion: The combination of HAIC, lenvatinib, tislelizumab, and TAE was feasible in HCC patients with PVTT and high tumor burden, with tolerable safety.Keywords: hepatocellular carcinoma, transhepatic arterial embolization, hepatic arterial infusion chemotherapy, lenvatinib, tislelizumab

Oceanic absorption of heat generated by greenhouse gas emissions has resulted in warming of the dark ocean (>200 m) that contains a large refractory DOM (RDOM) pool. However, changes in microbially mediated production and degradation dynamics for RDOM components in response to warming of dark marginal basins remain unclear. Herein, we integrated data from the dark South China, Mediterranean and Japan Seas (temperature range: 0.09–15.1°C) to demonstrate that in situ production efficiency of two ubiquitous humic-like fluorophores increased at higher dark ocean temperature, whereas chromophores at a wavelength of 325 nm (aCDOM(325)) changed from production to degradation at higher temperature. Increased oxygen consumption and a reduction of labile substrates in future warmer dark ocean environments may initiate the final degradation of some semi-refractory components, thereby increasing the recalcitrance of RDOM, but decreasing the DOM inventory in dark basins and creating a positive feedback to rising atmospheric CO2.

Fan Y, Li Z, Wu L, et al. Drug Des Devel Ther. 2021;15:1509–1519. At the author’s request, we, the Editors and Publisher of Drug Design, Development and Therapy, have retracted the following article. Following publication of the article, concerns were raised about the duplication of images from Figures 2 and 3 with images from other unrelated articles. Specifically, Images for Figure 2D, have been duplicated with images for Figure 6d from Cheng S, Xia B, Li H, et al. RETRACTED ARTICLE: Long non-coding RNA SATB2-AS1 inhibits microRNA-155-3p to suppress breast cancer cell growth by promoting breast cancer metastasis suppressor 1-like. Cancer Cell Int. 2020;20:321. https://doi.org/10.1186/s12935-020-01411-8; Figure 2B from Wei Y, Liao Y, Deng Y, Zu Y, Zhao B, Li F. MicroRNA-503 Inhibits Non-Small Cell Lung Cancer Progression By Targeting PDK1/PI3K/AKT Pathway. Onco Targets Ther. 2019;12:9005–9016. https://doi.org/10.2147/OTT.S213059; Figure 3B from Qiao Z, Tang J, Wu W, et al. Acteoside inhibits inflammatory response via JAK/STAT signaling pathway in osteoarthritic rats. BMC Complement Altern Med. 2019;19:264. https://doi.org/10.1186/s12906-019-2673-7; Figure 6c from Zhong Q, Huang J, Wei J, et al. Circular RNA CDR1as sponges miR-7-5p to enhance E2F3 stability and promote the growth of nasopharyngeal carcinoma. Cancer Cell Int. 2019;19:252. https://doi.org/10.1186/s12935-019-0959-y and Figure 2B from Ma F, Xie Y, Lei Y, et al. The microRNA-130a-5p/RUNX2/STK32A network modulates tumor invasive and metastatic potential in non-small cell lung cancer. BMC Cancer. 2020;20:580. https://doi.org/10.1186/s12885-020-07056-0. Images for Figure 3A and 3B, have been duplicated with images for Figure 2C and Figure 6C from Tantai J, Zhang Y, Zhao H. Heterophyllin B inhibits the adhesion and invasion of ECA‑109 human esophageal carcinoma cells by targeting PI3K/AKT/β‑catenin signaling. Molecular Medicine Reports. 2016;13:1097–1104. https://doi.org/10.3892/mmr.2015.4659 and Figure 5B from Xu G, Lu X, Huang T, Fan J. ARHGAP24 inhibits cell cycle progression, induces apoptosis and suppresses invasion in renal cell carcinoma. Oncotarget. 2016;7:51829–51839. https://www.oncotarget.com/article/10386/text/. The authors were unable to provide an explanation for the duplicated images or provide data for the study. As verifying the validity of published work is core to the integrity of the scholarly record, the authors requested to retract the article and the Editor and Publisher agreed with this decision. We have been informed in our decision-making by our editorial policies and COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.

Zhuo Sang, Xianli Zeng, Xiaohui Yuan, Xiaolin Wang, Liancong Fu, Wenwen Zhuang Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of ChinaCorrespondence: Zhuo Sang, Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China, Tel +86-752-2288288, Email 116920609@qq.comObjective: The current study was to evaluate the association of office blood pressure (OBP) and 24h ambulatory blood pressure (ABP) with left ventricular (LV) structure and function in hypertensive patients. Whether the association was modified by sex was also evaluated.Methods: A total of 694 hypertensive patients without cardiovascular disease were retrospectively included from the inpatient clinic. Regression analysis was performed to evaluate the association of OBP and 24h ABP parameters with LV mass index (LVMi), e’ velocity and left ventricular hypertrophy (LVH) with adjustment for covariates including age, obesity, diabetes mellitus, obstructive sleep apnea, estimated glomerular filtration rate and antihypertensive drugs.Results: There was no difference in OBP by sex. Compared to women, men had a higher 24h (132.6 ± 11.3 vs 129.3 ± 10.0 mm Hg), daytime (136.6 ± 12.9 vs 132.8 ± 9.5 mm Hg) and nighttime (130.3 ± 9.2 vs 125.1 ± 6.6 mm Hg) SBP. The proportion of patients with non-dipping pattern and reverse dipper pattern was also higher in men. In the overall participants, 24h, daytime and nighttime SBP, non-dipping and reverse dipper pattern were associated with LVMi, e’ velocity and LVH, which were not observed in OBP. The magnitude of the association between 24h, daytime and nighttime SBP, non-dipping and reverse dipper pattern with LVMi, e’ velocity and LVH was stronger in men than in women (P-value for interaction < 0.05).Conclusion: Twenty-four-hour ABP appears to be better than OBP in association with LV structural and functional alterations, and this association was modified by sex.Keywords: office blood pressure, ambulatory blood pressure, sex, cardiac structure, cardiac function

Weitao Zhuang,1,2 Chao Zhang,3 Yong Tang,1 Dan Tian,1 Zihua Lan,1,2 Cheng Zeng,1 Guibin Qiao1 1Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China; 2Shantou University Medical College, Shantou, 515041, People’s Republic of China; 3Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of ChinaCorrespondence: Guibin QiaoDepartment of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of ChinaEmail guibinqiao@126.comAbstract: Development of targeted therapies for squamous cell lung cancer (SqCLC) is currently limited by the prevalence of activating mutations and their predicting power of treatment efficacy. In the present study, we describe a case of treatment-naïve stage IIIB SqCLC that harbored a rare epidermal growth factor receptor (EGFR) p.E746_S752delinsV mutation with clinical complete response to neoadjuvant gefitinib. Pathological complete response was confirmed after surgical resection. No disease recurrence was documented after 20-month follow-up. This report suggested that first-generation EGFR tyrosine kinase inhibitor (TKI) could be an option in neoadjuvant context for advanced SqCLC patients harboring EGFR p.E746_S752delinsV mutation and highlighted the clinical benefits of EGFR testing in SqCLC patients who are females and never/former light smokers.Keywords: epidermal growth factor receptor, squamous cell lung cancer, tyrosine kinase inhibitor, next generation sequencing, EGFR p.E746_S752delinsV mutation, EGFR, SqCLC, TKI, NGS

Yingchao Fan,* Zhumeng Li,* Liting Wu, Feng Lin, Jinfeng Shao, Xiaoyan Ma, Yonghua Yao, Wenfang Zhuang, Yuan Wang Medical Laboratory, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, 200438, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenfang Zhuang; Yuan WangMedical Laboratory, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, No. 999 Shiguang Road, Yangpu District, Shanghai, 200438, People’s Republic of ChinaEmail wenfangzhuangmed@163.com; tv0801@163.comBackground: Increasing evidences have revealed that solasodine, isolated from Solanum sisymbriifolium fruits, has multiple functions such as anti-oxidant, anti-tumor and anti-infection. However, its role in pancreatic cancer has not been well studied.Methods: To explore the role of solasodine in pancreatic cancer, human pancreatic cell lines including SW1990 and PANC1 were treated with different concentrations of solasodine for 48 h, and cell viability was evaluated by MTT assay, cell invasion and migration were evaluated by Transwell assay. The effect of solasodine on the apoptosis of SW1990 and PANC1 cells was detected by flow cytometry. To further explore the antitumor effect of solasodine in vivo, an SW1990 tumor-bearing mouse model was constructed. The effects of solasodine on cytokines in the serum of SW1990 tumor-bearing mice were also evaluated by ELISA assay.Results: Specifically, in vitro, solasodine could significantly inhibit the proliferation of pancreatic cancer cell lines SW1990 and PANC1 cells. Flow cytometric analysis indicated that solasodine could induce apoptosis of SW1990 and PANC1 cells. Western blot assay indicated that solasodine could significantly inhibit the activation of Cox-2/Akt/GSK3β signal pathway. Meanwhile, the release of Cytochrome c from mitochondria to cytoplasm which can raise the caspases cascade (C-caspase 3 and C-caspase 9) was significantly enhanced by solasodine. In vivo, the results showed that solasodine had potent anti-tumor activities with a lower cytotoxicity. In addition, the serum TNF-α, IL-2 and IFN-γ levels in SW1990 tumor-bearing mice after the treatment of solasodine was significantly increased.Conclusion: Taken together, our results suggested that the solasodine could prevent the progression of pancreatic cancer by inhibiting proliferation and promoting apoptosis, as well as stimulating immunity, suggesting that solasodine might be a potential therapeutic strategy for pancreatic cancer.Keywords: pancreatic cancer, solasodine, Cox-2/Akt/GSK3β signal pathway, apoptosis, apoptosis

Hu C, Zhuang W, Qiao Y, et al. Onco Targets Ther. 2019;12:933–944. The Editor and Publisher of OncoTargets and Therapy wish to retract the published article. Concerns were raised regarding the alleged duplication of western blot images in Figure 2. Specifically, Figure 2, A1, GAPDH bands, appear to have been duplicated with the same bands from Figure 2, C1, Cyclin D1. The authors responded to our queries but were unable to provide a satisfactory explanation for the alleged duplication, nor were they able to provide original data that could adequately verify the findings. The Editor requested to retract the article and the authors do not agree with this decision. We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.

Muhammad Ishfaq Ahmad,1,2 Muhammad Akram Naseem,2 Ramiz Ur Rehman,2 Weiqing Zhuang,1 Rizwan Ali,2 Muhammad Suhaib Manzoor2 1School of Internet Economics and Business, Fujian University of Technology, Fuzhou, Fujian, People’s Republic of China; 2Lahore Business School, The University of Lahore, Lahore, Punjab, PakistanCorrespondence: Weiqing ZhuangSchool of Internet Economics and Business, Fujian University of Technology, No. 33 Xueyuan Road, University Town, Minhou, Fuzhou, Fujian, People’s Republic of ChinaTel +86-13805012485Email zmakio@aliyun.comPurpose: This study aimed to investigate the willingness of international medical students enrolled in Chinese universities to return to their home countries based on their risk perception of the recent outbreak of the novel coronavirus disease (COVID-19).Materials and Methods: A well-structured questionnaire was incorporated into the WeChat survey, a special feature within this mobile application, similar to Google Docs. The questionnaire was sent to 1190 international medical students across China between January 1, 2020 and May 15, 2020. A total of 897 completed questionnaires were returned, indicating a 75% response rate.Results: The survey findings show that the risk perception of international medical students about COVID-19 was low because of the strong preventive measures taken by the Chinese government against COVID-19. Moreover, they were willing to stay in China until the completion of their degrees. In contrast, students who have completed their degrees were willing to return home immediately if possible.Conclusion: These findings are of serious concern for developing countries where they come from because their return to their home countries may cause an epidemic outbreak in those regions.Keywords: strong preventive, serious concern, developing countries, epidemic outbreak

Muhammad Ishfaq Ahmad,1 Weiqing Zhuang,1 Anika Sattar2 1School of Internet Economics and Business, Fujian University of Technology, Fuzhou, Fujian, People’s Republic of China; 2Department of Public Administration and Law, Liaoning Technical University, Fuxin, Liaoning, People’s Republic of ChinaCorrespondence: Weiqing ZhuangSchool of Internet Economics and Business, Fujian University of Technology, No.33 Xue Yuan Road, University Town, Minhou, Fuzhou, Fujian, People’s Republic of ChinaTel +86-13805012485Email zmakio@aliyun.comPurpose: Orphaned children carry many psychological and emotional issues with them throughout their lives, which influence every decision they make, including investment decisions. A lack of self-determination and low confidence may make orphans make more risky decisions than their nonorphan counterparts. In this study, we aimed to see how this risky behavior was reflected in investment choices during the COVID-19 pandemic.Methods: A well-structured questionnaire was distributed to 230 adult investors (130 orphans and 100 nonorphans) between January 22 and March 13, 2020.Results: Orphans were found to be risk-takers during the COVID-19 pandemic, as hypothesized from their childhood history. Moreover, female investors showed more sensible (less risky) behavior than male investors when investing in fixed-income securities. Income and age showed significant inverse relationships with risk tolerance, while education showed a positive but insignificant effect.Conclusion: This study indicates that orphan investors enjoy taking risks and their behavior toward risk remains consistent, even in abnormal conditions, such as a global pandemic. It also suggests that their risk-taking behavior remains stable from orphanhood through to adulthood, contradicting many reports that orphans make reasonable decisions in adulthood.Keywords: global pandemic, risk-taking behavior, adulthood, investment choices

Jiabi Chen, Qingliu He, Weihui Liu, Yining Li, Wei Zhuang Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, People’s Republic of ChinaCorrespondence: Wei ZhuangThe Second Affiliated Hospital of Fujian Medical University, Zhongshan North Road, Licheng District, Quanzhou, Fujian 362000, People’s Republic of ChinaFax +86 59 587365269Email lx2998121314@163.comObjective: To explore the survival value of cytoreductive partial nephrectomy (cPN) in elderly with metastatic renal cell carcinoma (EmRCC) and evaluate the characteristics of patients who benefit from cPN.Materials and Methods: This was a study including 6105 patients aged ≥ 65 years with metastatic renal cell carcinoma (RCC) queried from Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2015, among which 1264 patients underwent cytoreductive nephrectomy (CN), 78 patients underwent cPN and 1186 patients underwent cytoreductive radical nephrectomy (cRN). Kaplan–Meier (K-M) method and Cox proportional-hazards model (COX) were used to evaluate the survival prognosis. Overall survival (OS) was compared between groups using propensity score matching (PSM) to balance the effects of confounding factors such as general features and pathological features. At last, we constructed a nomogram visualization modelled by R language to predict survival.Results: For patients with EmRCC, especially for male patients with tumors size ≤ 7 cm, N0 stage, or isolated metastases, cPN brought a better survival than cRN. Tumor size and N stage were independent risk factors affecting the survival of cPN patients. cPN for patients with tumor size > 7 cm or N1 stage may present a higher risk of death.Conclusion: The implementation of cPN for patients with EmRCC who meet specific clinical characteristics such as tumors size ≤ 7 cm, N0 stage, or isolated metastases seems to help improve the survival prognosis.Keywords: elderly, metastatic renal cell carcinoma, partial nephrectomy, radical nephrectomy, survival

Yuqiao Chen,1 Huan Chen,2 Beibei Mao,2 Yuan Zhou,1 Xinying Shi,2 Lu Tang,1 Hong Jiang,3 Guo Wang,4 Wei Zhuang1 1Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People’s Republic of China; 2Beijing Genecast Biotechnology Co., Beijing 100000, People’s Republic of China; 3Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People’s Republic of China; 4Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People’s Republic of ChinaCorrespondence: Wei ZhuangXiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People’s Republic of ChinaTel +86-152-0089-9869Fax +86-731-8432-7623Email zhuangwei@csu.edu.cnObjective: We investigated the relationship of the transcriptional tumor immune microenvironment with prognosis of patients with locally advanced lung adenocarcinoma (LUAD).Materials and methods: A targeted RNA-Seq approach was used to measure the abundance of 395 immune-related transcripts of 24 formalin-fixed paraffin embedded (FFPE) tumor specimens from our institution and transcription data of 85 matched LUAD samples from The Cancer Genome Atlas (TCGA). Gene set variation analysis (GSVA) was used to identify gene sets related to prognosis, and the microenvironment cell-population (MCP)-counter method was used to quantify infiltrated immune cells. Survival analysis with the log rank test was used to determine the relationships of different immune-related transcripts with prognosis. Cox proportional hazards models were also used to identify risk factors associated with poor prognosis.Results: Among our patients, GSVA and the log rank test demonstrated that enrichment of the antigen processing pathway (P = 0.01) correlated with a favorable prognosis. MCP-counter and survival analysis demonstrated that greater CD8 T cell infiltration correlated with a favorable prognosis (P = 0.05), but greater infiltration of neutrophils (P = 0.014) and NK cells (P = 0.015) correlated with poor prognoses. Cox hazard analysis showed that greater infiltration of neutrophils was an independent risk factor for poor prognosis. These results were consistent with LUAD data from TCGA.Conclusion: When integrated with computational bioinformatics methods, targeted RNA-Seq from FFPE specimens provides profiles of the tumor immune microenvironment that have prognostic value for patients with locally advanced LUAD.Keywords: NSCLC, lung adenocarcinoma, RNA-Seq, tumor immune microenvironment, transcriptomic markers

Chenxi Hu,1,* Wei Zhuang,2,* Yun Qiao,2,* Bin Liu,2 Liang Liu,2 Kaiyuan Hui,1 Xiaodong Jiang1,2 1Tumor Laboratory, Department of Oncology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City 222002, China; 2Department of Oncology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City 222002, China *These authors contributed equally to this work Purpose: The goals of this study were to determine the effects of combined inhibition of STAT3 and vascular endothelial growth factor receptor 2 (VEGFR2) pathways on the radiosensitivity of non-small-cell lung cancer (NSCLC) cells, and to assess the underlying mechanisms.Methods: The expressions of VEGFR2, STAT3, related signaling molecules, hypoxia-inducible factor 1-alpha (HIF-1α), and cyclin D1 were determined by Western blotting. Radiosensitivity was assessed using the colony-forming assay, and cell cycle and cell death were analyzed by flow cytometry. A nude mouse xenograft tumor model of Calu-1 cells was established. The hepatorenal toxicity of the above-mentioned treatment on tumor-bearing mice was observed by H&E staining. The expression of STAT3, VEGFR2, HIF-1α, and cyclin D1 of the transplanted tumor tissues was detected by immunohistochemistry. Apoptosis of tumor tissues was evaluated by TUNEL staining.Results: In vitro, we selected two cell lines with high expression levels of STAT3, including Calu-1 cells that exhibit high VEGFR2 expression and A549 cells that exhibit low VEGFR2 expression. When apatinib treatment was combined with S3I-201, the expression of VEGFR2, STAT3, and their downstream signaling molecules was significantly decreased (P

Xi Shi,1,* Shiwei Qiu,1,* Wei Zhuang,1,* Caiji Wang,1 Shili Zhang,1 Na Yuan,1 Fukang Yuan,2 Yuehua Qiao1 1The Institute of Audiology and Speech Science of Xuzhou Medical College, Xuzhou 221002, People’s Republic of China; 2Department of Vascular Surgery of Xuzhou Central Hospital, Xuzhou Institute of Cardiovascular Disease, Xuzhou 221009, People’s Republic of China *These authors contributed equally to this work Background: Follicle-stimulating hormone (FSH) has multiple biological functions. It is currently considered that FSH can inhibit cervical cancer, and our aim was to explore the underlying molecular mechanisms. Materials and methods: An in vivo experiment using nude mice injected with HeLa cells was performed. Flow cytometry, western blotting, and real-time quantitative PCR analyses were done. Results: Twenty one days after injection of HeLa cells, the subcutaneous tumor mass was significantly lower (P

Chengping Hu,1 Juan Jiang,1 Yuanyuan Li,1 Chunfang Zhang,2 Weixing Zhang,2 Haihe Jiang,2 Yang Gao,2 Wei Zhuang,2 Kaibo Lei,2 Yong Tang,2 Rongjun Wan1 1Department of Respiratory and Critical Care Medicine, National Key Clinical Specialty, Xiangya Hospital, Central South University, Changsha, China; 2Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, China Background: Tumor cell dissemination after needle biopsy has been reported in a variety of malignancies, including non-small-cell lung cancer (NSCLC). However, there is little clinical evidence in regard to whether preoperative biopsy increases the risk of recurrence in completely resected NSCLC.Patients and methods: A total of 322 patients diagnosed as pathological stage I NSCLC using intraoperative biopsy (IOB) (control group), preoperative percutaneous needle biopsy (PNB) or bronchoscopic biopsy were included in this study. Baseline characteristics were collected and compared. The disease-free survival (DFS) of patients was analyzed using Kaplan–Meier method. Subgroup analysis and Cox regression were performed to evaluate the effect of preoperative biopsy on recurrence risk with adjustment for potential confounders.Results: Among these patients, 202 (63%) underwent IOB, 66 (20%) underwent PNB, and 54 (17%) underwent bronchoscopic biopsy. DFS of patients who had preoperative PNB or bronchoscopic biopsy was similar to those who had IOB (P=0.514 and 0.869). Neither preoperative PNB nor transbronchial biopsy significantly affected recurrence incidence across all the relevant subgroups. Furthermore, multivariate analysis showed that preoperative biopsy was not associated with increased recurrence risk in NSCLC patients with adjustment for confounders, while squamous cell carcinoma and adjuvant chemotherapy were associated with prolonged DFS.Conclusion: Neither preoperative PNB nor bronchoscopic biopsy increased the recurrence risk in patients with resected stage I NSCLC, indicating that these procedures could be safely used for diagnosis of early-stage NSCLC. Keywords: non-small-cell lung cancer, biopsy, recurrence, percutaneous needle biopsy, bronchoscopy, surgery

You-cai Zhu,1 Xing-hui Liao,2 Wen-xian Wang,3 Chun-wei Xu,4 Wu Zhuang,5 Li-hua Zhong,4 Kai-qi Du,1 Yan-ping Chen,4 Gang Chen,4 Mei-yu Fang6 1Department of Chest Disease Diagnosis and Treatment Center, 2Department of Tumor Molecular Laboratory, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, 3Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 4Department of Pathology, Fujian Provincial Cancer Hospital, 5Department of Medical Thoracic Oncology, Fujian Provincial Cancer Hospital, Fujian Medical University Cancer Hospital, Fujian, Fuzhou, 6Department of Comprehensive Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People’s Republic of China Abstract: Anaplastic lymphoma kinase (ALK) rearrangement responds to ALK tyrosine kinase inhibitors (TKIs) in lung cancer. Many cases ultimately acquire resistance to crizotinib. Resistance, including ALK-dominant or ALK non-dominant, mechanisms have been described. Transformation to small-cell lung cancer is rare. Herein, we report a 49-year-old man diagnosed with adenocarcinoma, who was negative for EGFR and ALK genes as detected by reverse transcription polymerase chain reaction, and was treated with crizotinib. A new biopsy showed a small-cell lung cancer after disease progression. Then, next-generation sequencing (NGS) was carried out and detected a TP53 gene mutation, an ALK rearrangement, and no loss of the retinoblastoma gene (RB). Although a regimen for small-cell lung cancer may be one treatment option, a heterogeneous tumor may exist at the time of diagnosis and manifest during the course of disease. Keywords: lung cancer, ALK, crizotinib, small-cell lung cancer