Ribonucleotide reductase subunit M2 may play a role as a potential prognostic biomarker in several cancers. In this study, we evaluated whether RRM2 gene expression is associated with the prognosis of patients with lung adenocarcinoma (LUAD) using publicly available data from The Cancer Genome Atlas (TCGA). Wilcoxon signed-rank test and logistic regression were performed to evaluate the association between RRM2 expression and clinical features in patients with LUAD. Kaplan-Meier and Cox regression methods were used to examine the effect of RRM2 expression level in the overall survival, and a nomogram was performed to illustrate the correlation between the RRM2 gene expression and the risk of LUAD. TCGA data set was used for gene set enrichment analysis (GSEA). We also performed a further experiment in vitro to assess the effect of RRM2 expression on the proliferation and invasive abilities of LUAD cells and its key signaling pathway proteins. Our results revealed that the expression level of RRM2 in patients with LUAD was much higher than that in normal tissues ( p = 3.99e-32). High expression of RRM2 was significantly associated with tumor stage (IV vs. I: OR = 3.02, p = 0.012) and TNM classification (T2 vs . T1: OR = 1.88, p = 0.001; N2 vs . N0: OR = 2.69, p < 0.001). Kaplan-Meier survival analysis showed that high expression of RRM2 was associated with a worse prognosis of LUAD compared low expression of RRM2 ( p = 7.86e-04). Multivariate analysis showed that high RRM2 expression was an independent factor affecting overall survival (HR = 1.29, p < 0.001). The association between RRM2 gene expression and the risk of LUAD was presented in a nomogram. GSEA revealed that the cell cycle, p53 signaling pathway, DNA replication, small cell lung cancer, apoptosis, and pathways in cancer were differentially enriched in patients with high expression of RRM2 . RRM2 over-expression promoted the proliferation and invasive abilities of LUAD cells. RRM2 over-expression increased the activation of Bcl-2 and E-cadherin signaling pathways, and reduced the activation of p53 signaling pathway. In summary, high RRM2 expression is an independent predictive factor of poor prognosis in patients with lung adenocarcinoma.
The objective of this study is to investigate relationship between the expressions of heparanase and vascular endothelial growth factor-C (VEGF-C) mRNA and tumorigenesis, progression in human lung cancer. The expressions of heparanase and VEGF-C mRNA in 65 cases of lung cancer (31 cases of squamous cell carcinoma, 25 adenocarcinoma, 3 large cell carcinoma, and 6 small cell carcinoma), adjacent tissues of cancer, and normal tissues were tested by reverse transcription-polymerase chain reaction (RT-PCR) and analyzed by clinico-pathological characteristics and prognosis of lung cancer. The rate of expressions of heparanase and VEGF-C mRNA in tumor tissues (55.4, 61.5 %) was significantly higher than that in adjacent tissues of cancer (12.3, 15.4 %) and normal tissues (3.1, 4.6 %) (P<0.05). It was shown that heparanase and VEGF-C mRNA expressions did not correlate with the pathological type and grade of the tumor (P>0.05), but they correlated with the clinical stage and survival time of the patients (P < 0.05). Overexpression of heparanase and VEGF-C mRNA in lung cancer tissues perhaps participates in regulation of tumorigenesis and progression. The expressions of heparanase and VEGF-C mRNA should be used as a useful marker of the biological behavior of lung cancer and as an independent prognosis factor for the patient's survival.
The aim of this study is to evaluate the safety and efficacy of lung volume reduction surgery (LVRS) by videoassisted thoracoscopic surgery (VATS) in the treatment of chronic obstructive pulmonary disease (COPD). A total of 90 patients with COPD from 2002 to 2012 were enrolled into our study, comprising 22 who underwent conventional thoracotomies and 68 VATS. Pulmonary function testings, arterial blood gases analysis, and quality of life between these two groups were compared. VATS was found to be superior to the conventional thoracotomy in terms of length of hospital stay, intraoperative blood loss, intubation time, volume of chest tube drainage, and postoperative pain assessment (P<0.05). However, significant differences in pulmonary function testings, arterial blood gases analysis, 6-min walking distance (6-MWD), and postoperative quality of life between the two groups were not found (P>0.05). LVRS by VATS is a safe and reliable surgical approach for the treatment of COPD, with less invasiveness and shorter hospital recovery time.
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