Abstract. The mutation status of epidermal growth factor receptor (EGFR) is correlated with the response of tumors to EGFR tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC), suggesting its usefulness as a biomarker in NSCLC. The incidence of EGFR mutation in NSCLC is higher in China than in the United States and European countries. There have been some case reports concerning cases of gefitinib-responsive small cell lung cancer (SCLC) with EGFR mutations. However, few large studies concerning the mutation status of SCLC patients have been performed. We detected EGFR mutations in exons 19 and 21 of 40 SCLC patients, three of whom had combined SCLC, from the Zhejiang Cancer Hospital using xTAG technology. Only two patients with combined SCLC had an EGFR mutation in exon 19. To determine the EGFR mutation status and clinical features of combined SCLC, we retrospectively analyzed the clinical features of seven patients with combined SCLC who had undergone surgical treatment in Zhejiang Cancer Hospital between 2007 and 2010. EGFR mutations in exons 19 and 21 were detected using the pyrosequencing assay. Of the seven patients with combined SCLCs, 71.4% were male, 71.4% were heavy smokers, most were over 60 years old and 71.4% of the cases were combined adenocarcinoma. Chemotherapy treatment and tumor stage were correlated with survival time. Of the seven cases, one had a mutation in exon 19 of EGFR in both the conventional SCLC and SCLC combined adenocarcinoma components. Combined SCLC commonly occurs in patients who are heavy smokers, male and over 60 years old, and most of the combined type cases are adenocarcinoma. The treatment of combined SCLC may be applied to cases of conventional SCLC. EGFR mutations may therefore occur in combined SCLCs, especially in SCLC combined adenocarcinoma in China. IntroductionAn epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) may be used as first-line therapy in patients with advanced non-small cell lung cancer (NSCLC) with EGFR mutations (1-5). The results of the INTEREST trial (6) suggest that gefitinib is able to provide similar overall survival to docetaxel in patients across a broad range of clinical subgroups and that EGFR biomarkers, including mutation status, may additionally identify which patients are likely to gain greatest progression-free survival (PFS) and overall response rate (ORR) benefit from treatment with gefitinib. Two hot spots of EGFR mutations are in-frame deletion at codons 747-749 (DEL) in exon 19 and a missense mutation at codon 858 (L858R) in exon 21. A case study concerning a Japanese patient with gefitinib-responsive small cell lung cancer (SCLC) reported that the patient had a deletion in exon 19 of EGFR (7). Another case study has reported that an American SCLC patient who had never smoked and who had an EGFR mutation responded to gefitinib (8). In China, there has also been a case report of a patient with SCLC who responded to gefitinib, but the status of the mutation is unknown (9). Therefore, the EGFR mutation ...

Abstract. Small cell lung cancer (SCLC) is a highly aggressive and lethal type of cancer in humans. SCLC is sensitive to chemotherapy and radiotherapy, but long-term survival is low and the majority of patients eventually develop progressive disease. With the success of imatinib mesylate in the treatment of gastrointestinal stromal tumors expressing c-kit, its use in SCLC serves as a novel molecular therapeutic approach. The activity of imatinib mesylate is correlated with the mutation of c-kit gene exons 9 and 11 in gastrointestinal stromal tumors. The incidence of epidermal growth factor receptor mutation in non-small cell lung cancer is higher in China than in the United States of America and European countries. There may be also differences in the incidence of c-kit mutation between China and European countries. At present, no study examining imatinib mesylate treatment for SCLC in China is available. To investigate the expression and mutation of c-kit and the correlation with prognosis of SCLC in China, immunohistochemistry was used to detect the expression of c-kit, and a pyrosequencing assay was used to detect mutations in c-kit exons 9 and 11 of 36 SCLC patients who received surgical treatment at the Zhejiang Cancer Hospital, Hangzhou, China, between 1998 and 2010. All 36 patients were followed up to analyze the correlation between prognosis and expression and mutation of c-kit. The incidence of c-kit-positive expression was 83.3%, including 25.0% weak staining, 22.2% moderate staining and 36.1% strong staining. The overall survival of patients with c-kit strong staining was shorter compared to patients with c-kit not strong staining. No mutation in c-kit exons 9 and 11 was detected. In conclusion, the findings showed that the expression of c-kit is high, and strong staining is a prognostic factor for worse survival.

Background: The blood-brain barrier (BBB) is the greatest challenge in the treatment of intracranial malignant tumors. Objective: The aim of this study is to determine the role of borneol in opening the BBB and elucidate the underlying mechanisms. Materials and Methods: Twenty Sprague-Dawley (SD) rats were randomized into borneol group intragastrically administered with 10% borneol corn oil (2 mL/kg) and control group. After 30 minutes, 2% Evans blue (4 mL/kg) was injected. Thirty minutes later, brain tissue was analyzed using the Evans blue standard curve. Another 40 SD rats were randomized into high-, medium-, and low-dose borneol groups and a control group. Each rat in the experimental groups was intragastrically administered with 10% borneol corn oil (2 mL/kg, 1.25 mL/kg, and 0.5 mL/kg, respectively). The control group was injected with corn oil of 1.25 mL/kg. After 30 minutes, the rats were killed, and the brain tissues were collected. The expression of occludin, occludens-1, nitric oxide synthase, P-glycoprotein, and intercellular cell adhesion molecule-1 (ICAM-1) was detected by immunohistochemy. Results: The concentration of Evans blue in the borneol group was higher than in the control group (P < .05). The mean density of ICAM-1 expression was higher in the experimental group than in the control group (P < .05). In contrast, significant differences of positive area and total density of ICAM-1 were shown only between the high-dose group and the control group (P < .05). Conclusion: Borneol can open the BBB, which might be related with the increased expression of ICAM-1.

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In vivo sampling of interstitial fluid using microdialysis (MD) fibers has become a standard and accepted procedure. The resulting small volume samples, often with low concentrations of the analyte of interest, present a particular challenge to analytical methods. Rapid developments of analytical techniques with high sensitivity accelerate their combination with MD. On-line MD-based analytical systems are receiving increasing attention because they can provide near real-time data prior to the off-line system. The purpose of this review is to provide information for on-line MD-analytical systems. Special emphasis has been given to the main progression on methodologies of each method during recent years. The advantages, limitations, and adaptivity are also discussed. These methods include on-line MD-liquid chromatography, on-line MD-capillary electrophoresis, on-line MD-mass spectrometry, and on-line MD-biosensor.