Background and objective It has been proven that heparanase and Ki-67 had relationship with occur-rence and metastasis in lung cancer. The aim of this work was to investigate the expressions of heparanase and Ki-67 and to ex-plore their clinical significance and mutual relations in non-small cell lung cancer (NSCLC). Methods Immunohistochemical method was used to detect the heparanase and Ki-67expression in the routinely paraffin-embedded sections of surgical specimen of 70 cases with NSCLC and 20 ones with normal lung tissues. Results Heparanase and Ki-67 were highly expressed in lung cancer tissues (72.996 and 85.796) while negative in epithelia of normal lung tissues. The expression of heparanase was signifi-cantly correlated with TNM stage (P=0.044) and lymphatic metastasis (P=0.001). The expression of Ki-67 was significantly cor-related with tumor size (P=0.03) and histology type (P=0.001) and differentiation (P=0.01) and lymphatic metastasis (P=0.01) and TNM stage (P=0.043). The expression ofhaparanase and Ki-67 was no significant difference (P=0.323). Conclusion Hepa-ranase and Ki-67 were involved in the occurrence and development of lung cancer and they may predict patients prognosis, while the expression of heparanase and Ki-67 had no association with NSCLC, which may contribute to the different mechanisms involved in tumor occurrence and development.

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

Metastatic pleomorphic liposarcoma in the mediastinum is rare, and the current treatments are most of the times ineffective. We hereby report a case with relapsed pleomorphic liposarcoma adjacent to the psoas major mus-cle and with mediastinal metastasis, to discuss the clinical features and treatment strategies of pleomorphic liposarcoma. The patient's clinical history, imaging findings, pathological diagnosis, and multidisciplinary treatments were retrospectively analyzed. A 41-year old female patient was diagnosed with pleomorphic liposarcoma adjacent to the psoas major muscle and mediastinal metastasis. After multidisciplinary treatments, including surgery, chemotherapy, and targeted therapy, the patient has survived 65 months until now. Surgical resection is considered as the first choice of the treatment for pleomorphic lipo-sarcoma. Multidisciplinary treatments, including chemotherapy and other medical treatments, are effective to slow the disease progression and to reduce the disease recurrence.

The genomic instability may lead to an initiation of cancer in many organisms. Homologous recombination repair (HRR) is vital in maintaining cellular genomic stability. RAD51 associated protein 1 (RAD51AP1), which plays a crucial role in HRR and primarily participates in forming D-loop, was reported as an essential protein for maintaining cellular genomic stability. However, recent studies showed that RAD51AP1 was significantly overexpressed in various cancer types and correlated with poor prognosis. These results suggested that RAD51AP1 may play a significant pro-cancer effect in multiple cancers. The underlying mechanism is still unclear. Cancer stemness-maintaining effects of RAD51AP1 might be considered as the most reliable mechanism. Meanwhile, RAD51AP1 also promoted resistance to radiation therapy and chemotherapy in many cancers. Thus, researches focused on RAD51AP1, and its regulatory molecules may provide new targets for overcoming cancer progression and treatment resistance. Here, we reviewed the latest research on RAD51AP1 in cancers and summarized its differential expression and prognostic implications. In this review, we also outlined the potential mechanisms of its pro-cancer and drug resistance-promoting effects to provide several potential directions for further research.
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Humans ; DNA-Binding Proteins/metabolism* ; RNA-Binding Proteins/metabolism* ; Lung Neoplasms ; DNA Repair ; Genomic Instability ; Rad51 Recombinase/metabolism*

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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Humans ; Lung Neoplasms/complications* ; COVID-19 ; SARS-CoV-2 ; Multiple Pulmonary Nodules ; Pandemics/prevention & control* ; Lung