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Responsible Institution:National Health Commission of the People’s Republic of China
Sponsor:Chinese Medical Doctor Association
Honorary Editor-in-Chief:Wu Yiling
Editor-in-Chief:Jia Zhenhua
Managing Director:Ma Zhi
Editing:Editorial Board of Chinese Journal of Difficult and Complicated Cases
Publishing:Publishing House of Chinese Journal of Difficult and Complicated Cases
Address:238 Tianshan Street,Shijiazhuang,Hebei Province,China
Post Code:050035
Phone Number:0311-85901735
E-mail:ynbzz@163.com
 
    Current issue
Issue 05 in 2026    Publication date:2026-05-18
 
Li Liangpeng Yang Xiaobing Shi Junfeng Zheng Lin Ma Zhifei

Objective To investigate the expression of fidgetin like factor 1(FIGNL1) and ubiquitin carboxy-terminal hydrolase L3(UCHL3) in non-small cell lung cancer(NSCLC) tissues, and to analyze their correlation with homologous recombination repair genes and prognostic significance. Methods A total of 148 NSCLC patients from the Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital) were collected from June 2018 to June 2021. TCGA database data and q PCR experiments were used to detect the expression of FIGNL1m RNA, UCHL3 m RNA, breast cancer susceptibility gene 1(BRCA1) m RNA, and excision repair cross-complementing gene 1(ERCC1) m RNA. Pearson correlation analysis was used for correlation assessment. FIGNL1 and UCHL3 proteins were detected by immunohistochemistry. Kaplan-Meier curves and multivariate Cox regression analysis were used to investigate the impact of FIGNL1 and UCHL3 protein expression on prognosis. Results TCGA database and q PCR experiments showed that the expression levels of FIGNL1 m RNA, UCHL3 m RNA, BRCA1 m RNA, and ERCC1 m RNA in cancer tissues were significantly higher than those in adjacent normal tissues(t/P = 11.630/<0.001,18.582/<0.001,10.721/<0.001,6.716/<0.001;44.234/<0.001, 36.435/<0.001, 49.040/<0.001, 38.602/<0.001). The expression levels of FIGNL1 m RNA, UCHL3 m RNA, BRCA1m RNA, and ERCC1 m RNA in NSCLC tissues were positively correlated with each other(r = 0.661, 0.589; 0.710, 0.632, all P<0.001). The positive rates of FIGNL1 and UCHL3 in NSCLC cancer tissues were 72.97%(108/148) and 68.92%(102/148),respectively, which were significantly higher than those in adjacent normal tissues(9.46% [15/148] and 8.11% [12/148])(χ2= 120.31, 115.56, both P<0.001). The positive rates of FIGNL1 and UCHL3 in cancer tissues were significantly higher in patients with TNM stage ⅢA and lymph node metastasis than in those with stage Ⅰ–Ⅱ and without lymph node metastasis(χ2/P = 19.592/<0.001, 7.801/0.005, 14.520/<0.001, 6.891/0.009). The mean 3-year survival time of the FIGNL1-positive group was(28.97 ± 0.95) months, which was significantly lower than that of the negative group(34.11 ± 0.75) months(Log-rankχ2= 13.627,P<0.001). The mean 3-year survival time of the UCHL3-positive group was(28.72 ± 0.96) months, which was significantly lower than that of the negative group(34.67 ± 0.51) months(Log-rankχ2= 11.342,P<0.001). FIGNL1 positivity,UCHL3 positivity, TNM stage Ⅲ A, and lymph node metastasis were independent risk factors affecting the prognosis of NSCLC patients [HR(95%CI) = 1.330(1.080-1.637), 1.298(1.082-1.559), 1.189(1.020-1.385), 1.240(1.001-1.535)]. Conclusion The upregulation of FIGNL1 and UCHL3 expression in NSCLC is associated with the expression of homologous recombination repair genes. These proteins may serve as novel tumor markers for prognostic evaluation of NSCLC.

 
Zhang Hua Qu Feifei Fan Tielan Hu Zongtao Lou Zhixia

Objective To analyze the relationship between serum heat shock protein H1(HSPH1), tripartite motif containing 11(TRIM11), and calcium-activated chloride channel protein 2(CLCA2) levels and lymph node metastasis and prognosis in patients with non-small cell lung cancer(NSCLC). Methods The NSCLC group comprised 80 patients with NSCLC who received treatment in the Department of Respiratory Medicine at the 902 nd Hospital of the Joint Logistics Support Force of the People' s Liberation Army between February 2022 and February 2024. Based on the presence of lymph node metastasis, patients were categorized into a metastatic subgroup(34 cases) and a non-metastatic subgroup(46 cases). Based on prognosis, they were further divided into a survival subgroup(52 cases) and a mortality subgroup(28 cases). Additionally, 70 patients with benign pulmonary lesions admitted to the hospital during the same period were recruited to form the benign group, while 80 volunteers from the hospital' s health screening program served as the healthy control group. Serum HSPH1 levels were determined using ELISA, while TRIM11 m RNA and CLCA2 m RNA levels were assessed via q RT-PCR. Relative risk analysis was used to evaluate the impact of serum HSPH1, TRIM11 m RNA, and CLCA2 m RNA levels on lymph node metastasis in NSCLC patients. ROC curve analysis was used to evaluate the prognostic predictive value of serum HSPH1,TRIM11 m RNA, and CLCA2 m RNA in patients with non-small cell lung cancer. Results Serum HSPH1 and TRIM11m RNA levels progressively increased across the healthy, benign, and NSCLC groups, while serum CLCA2 m RNA levels progressively decreased(F/P = 568.905/<0.001, 595.132/<0.001, 309.738/<0.001). Compared with the non-metastatic subgroup,the metastatic subgroup exhibited significantly elevated serum HSPH1 and TRIM11 m RNA levels and significantly reduced serum CLCA2 m RNA levels(t/P = 3.067/0.003, 3.866/<0.001, 4.192/<0.001). Compared with the survival subgroup, the mortality subgroup exhibited significantly elevated serum HSPH1 and TRIM11 m RNA levels and significantly reduced serum CLCA2 m RNA levels(t/P = 7.818/<0.001, 7.191/<0.001, 7.992/<0.001). Patients with elevated serum HSPH1 and TRIM11m RNA levels had a 2.171-fold and 2.273-fold increased risk of lymph node metastasis, respectively, compared with those with low levels(χ2/P =7.758/0.005, 8.203/0.004). Patients with low serum CLCA2 m RNA levels had a 3.156-fold increased risk of lymph node metastasis compared with those with high levels(χ2/P =14.238/<0.001). The AUC values for predicting poor prognosis in NSCLC patients using serum HSPH1, TRIM11 m RNA, CLCA2 m RNA individually, and their combination were 0.811,0.782, 0.817, and 0.918, respectively, with the combined predictive value significantly surpassing that of individual markers(Z =2.173, 2.103, 2.165;P = 0.030, 0.035, 0.030). Conclusion NSCLC patients exhibit elevated serum HSPH1 and TRIM11 levels and reduced serum CLCA2 levels, which correlate with lymph node metastasis and survival prognosis. Furthermore, the combined assessment of these three markers demonstrates favorable predictive value for the prognosis of NSCLC patients.

 
Lu Yuan Wang Wei Zhang Xiang Ren Mengmeng Song Yingjian Chen Lingzhen

Objective To explore the evaluation value of18F-FDG PET/CT combined with serum annexin A2(ANXA2) and C-X-C motif chemokine ligand 16(CXCL16) for the efficacy of neoadjuvant chemotherapy(NAC) in patients with non-small cell lung cancer(NSCLC). Methods From April 2023 to June 2025, 180 NSCLC patients treated in the Department of Nuclear Medicine at Xuzhou First People' s Hospital(Xuzhou Medical University Affiliated Xuzhou Municipal Hospital) were studied(all received NAC treatment). Based on NAC efficacy, they were divided into an effective group(119 cases) and an ineffective group(61 cases). Logistic regression was used to analyze the influencing factors of NAC efficacy in NSCLC patients, and relative risk was used to analyze the risk of treatment failure at different levels of ANXA2 and CXCL16.ROC curve analysis was used to evaluate the value of predicting NAC efficacy in NSCLC patients. Results The expression levels of MTV, TLG, serum ANXA2, and CXCL16 in the ineffective group were all significantly higher than those in the effective group(t/P = 7.685/<0.001, 6.494/<0.001, 7.789/<0.001, 7.906/<0.001). Poorly differentiated tumor cells, high MTV,high TLG, high serum ANXA2, and high CXCL16 were independent risk factors for poor NAC response [OR(95%CI) =3.056(1.334-7.002), 2.703(1.383-5.284), 2.238(1.270-3.943), 2.815(1.342-5.905), 2.976(1.380-6.417)]. The risk of NAC treatment failure in patients with high expression of ANXA2 and CXCL16 was 1.576 times and 1.620 times that of those with low expression, respectively [95%CI =(1.209-2.053),(1.256-2.088)]. The AUCs for evaluating NAC efficacy in NSCLC patients using MTV, TLG, serum ANXA2, CXCL16, and their combination were 0.738, 0.727, 0.760, 0.770, and0.912, respectively. The combined assessment of the four indicators was superior to each individual assessment(Z = 2.512,2.537, 2.493, 2.486; all P<0.001). Conclusion MTV, TLG, and serum levels of ANXA2 and CXCL16 are elevated in NSCLC patients who do not respond to NAC treatment. Combined detection of these markers demonstrates high value in evaluating the efficacy of NAC treatment in NSCLC patients.

 
Liu Jing Zhang Yanyan Guo Xiaojun Cheng Zhengxiang

Objective To study the expression of Deltex E3 ubiquitin ligase 2(DTX2) and PHD finger protein 12(PHF12) in lung adenocarcinoma and their relationship with clinicopathological features and prognosis. Methods Clinical data of 98 patients with lung adenocarcinoma admitted to the Department of Oncology of Tongchuan People' s Hospital from February 2020 to February 2022 were selected. R language was used to analyze the expression of DTX2 m RNA and PHF12m RNA in the TCGA database. The expression of DTX2 m RNA/protein and PHF12 m RNA/protein was verified by quantitative real-time PCR and immunohistochemistry. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the impact of DTX2 and PHF12 expression on the prognosis of lung adenocarcinoma. Results TCGA database analysis showed that the expression levels of DTX2 m RNA and PHF12 m RNA in lung adenocarcinoma tissues were significantly higher than those in normal lung tissues(t = 16.909, 14.600, both P<0.001). The expression of DTX2 m RNA was positively correlated with that of PHF12 m RNA in lung adenocarcinoma tissues(r = 0.566,P<0.001). q PCR results showed that the expression levels of DTX2 m RNA and PHF12 m RNA in lung adenocarcinoma tissues were(2.62±0.48) and(3.12±0.51), respectively, which were significantly higher than those in adjacent normal tissues(0.94 ± 0.25,1.04 ± 0.27)(t = 30.730, 35.682,both P<0.001). Immunohistochemistry results showed that the positive rates of DTX2 and PHF12 in lung adenocarcinoma tissues were 63.27%(62/98) and 61.22%(60/98), respectively, which were significantly higher than those in adjacent normal tissues(6.12% [6/98] and 5.10% [5/98])(χ2= 70.618, 69.630, both P<0.001). The positive rates of DTX2 and PHF12 protein were significantly higher in patients with TNM stage ⅢA and lymph node metastasis than in those with TNM stage Ⅰ–Ⅱand without lymph node metastasis(χ2/P = 15.941/<0.001, 19.542/<0.001; 14.930/<0.001, 18.382/<0.001). The 3-year progression-free survival rates of patients in the DTX2-positive and PHF12-positive groups were 33.87%(21/62) and 33.33%(20/60), respectively, which were significantly lower than those in the negative groups(72.22% [26/36] and 71.05% [27/38])(Log-rankχ2= 15.440, 21.390, both P<0.001). TNM stage ⅢA, lymph node metastasis, DTX2 positivity, and PHF12 positivity were independent risk factors affecting the prognosis of lung adenocarcinoma [HR(95%CI) = 1.330(1.091-1.621), 1.297(1.070-1.572), 1.354(1.041-1.761), 1.288(1.040-1.595)]. Conclusion The expression of DTX2 and PHF12 is upregulated in lung adenocarcinoma and is associated with TNM stage and lymph node metastasis. These proteins may serve as novel markers for prognostic evaluation in non-small cell lung cancer.