Objective:To explore the effects of serum cystatin C (Cys C) and uric acid (UA) concentrations before treatment on the prognosis of small cell lung cancer (SCLC) patients.Methods:A total of 196 patients diagnosed with SCLC in Affiliated Hospital of Qingdao University from April 2015 to December 2018 were selected, and hematological indicators such as serum Cys C and UA before treatment were collected. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of Cys C and UA. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for univariate and multivariate analysis.Results:The optimal cut-off values of serum Cys C and UA before treatment were 0.775 mg/L and 296.45 μmol/L, respectively. Survival analysis showed that with the optimal cut-off value, the median progression-free survival (PFS) of patients with high concentrations of serum Cys C and UA (5.49 months vs. 8.57 months, χ2=35.943, P<0.001; 6.67 months vs. 8.20 months, χ2=8.047, P=0.005) and overall survival (OS) (13.37 months vs. 23.95 months, χ2=21.355, P<0.001; 14.13 months vs. 20.97 months, χ2=11.333, P=0.001) were shorter than those of patients with low concentrations. Univariate analysis showed that factors related to PFS were smoking history ( HR=0.707, 95% CI: 0.518-0.965, P=0.029), staging ( HR=1.776, 95% CI: 1.329-2.373, P<0.001), first-line medication ( HR=1.596, 95% CI: 1.072-2.376, P=0.021), chest radiotherapy ( HR=2.407, 95% CI: 1.803-3.214, P<0.001), Cys C ( HR=3.602, 95% CI: 1.716-7.561, P=0.001), UA ( HR=1.002, 95% CI: 1.000-1.003, P=0.036), and alkaline phosphatase ( HR=1.010, 95% CI: 1.004-1.016, P=0.001); factors related to OS included smoking history ( HR=0.577, 95% CI: 0.382-0.870, P=0.009), staging ( HR=1.846, 95% CI: 1.295-2.630, P=0.001), chest radiotherapy ( HR=2.041, 95% CI: 1.426-2.921, P<0.001), Cys C ( HR=9.506, 95% CI: 3.278-27.564, P<0.001) and UA ( HR=1.003, 95% CI: 1.001-1.005, P=0.006). Multivariate analysis showed that chest radiotherapy ( HR=2.553, 95% CI: 1.774-3.672, P<0.001), Cys C ( HR=4.538, 95% CI: 1.875-10.982, P=0.001) and alkaline phosphatase ( HR=1.011, 95% CI: 1.005-1.018, P=0.001) were independent prognostic factors for PFS; Cys C ( HR=9.028, 95% CI: 2.680-30.413, P<0.001) was an independent prognostic factor for OS. Conclusion:Both serum Cys C and UA concentrations before treatment in SCLC patients have a certain relationship with the prognosis of the patients. Those with elevated concentrations have shorter PFS and OS and poor prognosis. The high concentration of serum Cys C before treatment may indicate a rapid progression of the disease and a short survival time. It is necessary to pay attention to disease progression and recurrence.

This article reviews the related literature on the reversal of multi-drug resistance in tumors by cepharanthine, and summarizes the reversal effects and mechanisms of multi-drug resistance in different tumors such as leukemia, liver cancer, ovarian cancer, breast cancer, esophageal cancer and colon cancer. Its reversal effect on multi-drug resistance of tumors is the result of a multi-channel, multi-link combination. The main mechanism is to inhibit membrane transporter function, affect enzyme transfer system, inhibit anti-apoptotic pathway activation and anti-apoptotic protein expression.

In recent years, lung cancer has become the leading cause of cancer-related deaths. There is increasing evidence that many lipids and lipid analogs are key regulators of tumorigenesis, and factors that affect blood lipid levels such as smoking, diet, and obesity may be associated with cancer risk. With the deepening of research on the relationship between lipids and tumorigenesis, exploring the correlation between blood lipids and lung cancer risk and prognosis has become a research hotspot. This article reviews the research progress of the relationship between blood lipid levels and the risk of lung cancer, blood lipid levels and the prognosis of lung cancer patients, and the adjustment of blood lipid drugs and the prevention and treatment of lung cancer.
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BACKGROUND: Lung cancer is the leading cause of cancer-related death, and small cell lung cancer (SCLC) has a poor prognosis in all types of lung cancer. This study evaluated the relationship between pretreatment serum apolipoprotein levels and prognosis in patients with SCLC, seeks a new index can guide diagnosis and treatment of SCLC. METHODS: This study retrospectively analyzed the clinical data of 122 patients with SCLC. The clinical results of patients with serum apolipoprotein levels within 2 weeks before treatment were collected, including apolipoprotein AI (ApoA-I), apolipoprotein B (ApoB), and the ratio of apolipoprotein B to apolipoprotein AI (ApoB/ApoA-I). Patients' progression-free survival (PFS) and overall survival (OS) are the main outcome indicators. The best critical to determine the index's value by X-tile tool. For survival analysis, Kaplan-Meier method was used for analysis, and Cox regression analysis method was used for single factor analysis and multifactor analysis. RESULTS: Compared with patients with low ApoA-I levels, patients with high ApoA-I levels (ApoA-I>1.12 g/L) had better OS (21.5 mon vs 12.3 mon, P=0.007) and PFS (7.3 mon vs 5.5 mon, P=0.017). In contrast, patients with higher ApoB/ApoA-I levels had worse median OS than patients with lower ApoB/ApoA-I levels (13.4 mon vs 20.7 mon, P=0.012). Multivariate Cox regression analysis showed that ApoA-I was an independent prognostic factor affecting PFS in SCLC patients (HR=0.67, 95%CI: 0.45-0.99, P=0.043). ApoB/ApoA-I is an independent risk factor for OS in patients with SCLC (HR=1.98, 95%CI: 1.21-3.23, P=0.007). CONCLUSIONS Serum ApoA-I level and ApoB/ApoA-I level before treatment can be important prognostic factors for SCLC, which is helpful to judge the prognosis of patients.

BACKGROUND: Studies have shown that elevated serum lactate dehydrogenase (LDH) concentration can lead to poor prognosis in patients with small cell lung cancer and lung adenocarcinoma, but its relationship with the prognosis of patients with lung large-cell neuroendocrine carcinoma (L-LCNEC) is not clear. This study aims to explore the influence of L-LCNEC preoperative serum LDH concentration and postoperative LDH concentration change trend on the disease-free survival (DFS) of patients after surgery, so as to judge the clinical prognosis of L-LCNEC provides new ideas. METHODS: Collected the clinical data. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value, while the Kaplan-Meier and Cox proportional hazard model were used to analyze data. RESULTS: DFS was shortened in patients with high serum LDH concentration before operation and increased LDH concentration after operation (P<0.001, P<0.001). The preoperative LDH concentration and postoperative LDH concentration change trend were independent prognostic factors for patients (P<0.001, P=0.037). CONCLUSIONS Preoperative LDH concentration and its postoperative concentration change trend in patients with L-LCNEC are independent prognostic factors for DFS of patients.