Cancer cells usually show different metabolic patterns compared with healthy cells due to the reprogramming of metabolic processes. The process of lipid metabolism undergoes notable changes, leading to the accumulation of lipid droplets in cells. Additionally, this phenotype is considered an important marker of cancer cells. Lipid droplets are a highly dynamic type of organelle in the cell, which is composed of a neutral lipid core, a monolayer phospholipid membrane and lipid droplet-related proteins. Lipid droplets are involved in several biological processes, including cell proliferation, apoptosis, lipid metabolism, stress, immunity, signal transduction and protein trafficking. Epidermal growth factor receptor (EGFR)-activating mutations are currently the most effective therapeutic targets for non-small cell lung cancer. Several EGFR tyrosine kinase inhibitors (EGFR-TKIs) that target these mutations, including gefitinib, erlotinib, afatinib and osimertinib, have been widely used clinically. However, the development of acquired resistance has a major impact on the efficacy of these drugs. A number of previous studies have reported that the expression of lipid droplets in the tumor tissues of patients with lung cancer are elevated, whereas the association between elevated numbers of lipid droplets and drug resistance has received little attention. The present review describes the potential association between lipid droplets and drug resistance. Furthermore, the mechanisms and implications of lipid droplet accumulation in cancer cells are analyzed, as wells as the mechanism by which lipid droplets suppress endoplasmic reticulum stress and apoptosis, which are essential for the development and treatment of lung cancer. Contents

Purpose: To investigate the therapeutic effect of ulinastatin on postoperative complications and cognitive function in elderly patients with esophageal cancer after thoracic laparoscopic surgery. Methods: A total of 100 elderly in-patients with esophageal cancer who had undergone thoracic laparoscopic surgery from April 2019 to December 2020 were selected and randomly assigned to control and study groups. Patients in control group received conventional treatment, while those in the study group were administered ulinastatin. The two groups were compared with respect to response, incidence of postoperative complications, Mini-Mental State Examination (MMSE) cognitive function score, Barthel Index (BI) scores; preoperative, intraoperative, 12-h and 24-h post-surgery levels of IL-1β and IL-6; levels of CD3+, CD4+ and CD8+, as well as duration of surgery and waking time. Results: Response, MMSE score, BI index, and levels of CD3+, CD4+ and CD8+ in the study group were significantly higher than those in the control group (p < 0.05). Incidence of postoperative complications, and expression levels of IL-1β and IL-6 12 h and 24 h after surgery in the study group were lower than the corresponding control levels (p < 0.05). There were no significant differences in duration of operation and waking time between the two groups (p > 0.05). Conclusion: Ulinastatin significantly reduces postoperative complications, and also improves cognitive function in elderly patients with esophageal cancer after thoracic laparoscopic surgery. This finding is of great significance in the treatment of these patients.