Page 81 - GTM-2-4

Global Translational Medicine Prognosis of relapse in squamous cell lung cancer

constitutes the predominant form of lung cancer, accounting It is well-established that the SCC antigen functions
for approximately 85% of cases. The three most prevalent as an inhibitor of certain intracellular serine proteinases,
histological subtypes of NSCLC include adenocarci 70% of thereby conferring resistance to apoptotic factors in
patients with Stage I NSCLC and 35 – 40% with Stage II tumor cells . The CXCR2 receptor serves as a receptor
[8]
(according to TNM classification) noma (AC), squamous for the chemokine CXCL5, and its intense expression by
cell carcinoma (SCC), and large cell carcinoma . In the leukocyte cells plays a role in inflammatory processes
[2]
early stages, only 60– overcome the 5-year survival barrier. associated with tumor growth . In addition, the CD44v6
[9]
The basis of treatment for such patients (Stages I–IIIA) is receptor is implicated in cell adhesion and contributes
tumor resection during surgery. Patients usually undergo to the dissemination of tumor cells . The previous
[10]
surgery in the amount of R0, which involves the complete studies have indicated that the combined assessment of
removal of the tumor tissue and metastases. However, these parameters yields the most prognostic information
during post-operative observation, relapse is diagnosed in compared to their individual evaluation . This article aims
[6]
20% of patients at Stage I and in 51% at Stage II, mainly due to present an evaluation of these markers in a dynamic
to metastases development after resection [3,4] . Performing context, both before and after tumor resection, with the
an R0 operation, the surgeon always assumes that the aim of identifying predictive indicators for assessing the
tumor and existing metastases were completely removed. likelihood of relapse during the first year after treatment in
However, there is no guarantee that tumor cells, even in patients with Stages I–II NSCLC.
a single quantity, or micrometastases could remain in the
surrounding tissue. This lack of guarantee is the reason 2. Materials and methods
for the development of tumor relapses after resection. 2.1. Study population
The monitoring algorithm for patients with NSCLC
includes a physical examination every 3 months for the The characteristics of the patients are presented in Table 1.
first 2 years after surgery, and computed tomography (CT)
scan is performed at 6 and 12 months after treatment . 2.2. Ethical approval and consent
[5]
Essentially, this is the timing of early relapse detection. All patients provided written voluntary consent to
Meanwhile, a relapse can occur up to 6 months or during participate in the study. The study received approval from
the period 6 months to 1 year after surgery . Thus, there the Biomedical Ethics Committee of Belarusian State
[4]
is a need to search for predictors that can serve as an Medical University (Committee meeting No. 2 dated
important addition to ongoing monitoring to identify or 10/04/2021).
predict tumor recurrence in each individual patient after
surgical treatment as early as possible. 2.3. Study design and sample collection
The pre-operative levels of tumor proteins in serum The study involved 57 patients (32 men and 25 women)
and blood cells have proven to be predictive of high or admitted to the clinic of the N.N. Alexandrov National
low relapse-free survival for patients with AC and SCC Cancer Center of Belarus between 2021 and 2022, all
separately . Despite both belonging to the NSCLC group, of whom received an initial diagnosis of Stage I or II
[6]
these histological subtypes exhibit significant differences [1,7] . NSCLC. All patients underwent surgical resection of the
AС typically manifests with peripheral localization of the tumor (surgical volume - R0). Post-treatment monitoring
tumor process, while SCC tends to develop in the central for each patient included a physical examination every
st
[1]
regions of the lung . More than 70% of AC cases are 3 months throughout the 1 year post-surgery. In the
associated with mutations in the epidermal growth factor absence of patient complaints and signs of disease during
receptor (EGFR) gene and anaplastic lymphoma kinase the physical examination, CT scans were performed at 6
(CD246), while no identified gene polymorphisms are and 12 months after treatment, constituting the essential
associated with the development of SCC . In contrast timeframe for early relapse detection. Information
[7]
to AС, SCC predominantly develops in smokers . concerning relapse development in the examined
[1]
Therefore, the separation of NSCLC patients based on their patients after surgery was obtained from CT data in
histological types appears to be more appropriate. Building the Cancer Register of the Republic of Belarus (via the
on our previous investigations, the most reliable prognostic N.N. Alexandrov National Cancer Center of Belarus).
indicators for SCC include SCC antigen, the percentage Candidate biomarkers were measured in all patients
of lymphocytes with the CXCR2 receptor (CXCR2 [% in before treatment and at 3 weeks, 3 months, and 6 months
lymphocytes]) in the total population of these blood cells, post-surgery. Blood obtained on an empty stomach from
and the percentage of monocytes with CD44v6 receptor the cubital vein of patients was collected into a vacutainer
(CD44v6 [% in monocytes]) . with EDTA-K2 as an anticoagulant for this purpose.
[6]

Volume 2 Issue 4 (2023) 2 https://doi.org/10.36922/gtm.2209