The clinical value of exhaled nitric oxide in patients with lung cancer

Abstract

Introduction and Objectives: To investigate the clinical value of fractional exhaled nitric oxide (FeNO) in lung cancer patients. Methods: A total of 172 healthy control subjects and 164 patients with histopathologically confirmed lung cancer were enrolled in this study. The FeNO measurements and pulmonary function tests were conducted in the Chinese PLA General Hospital. The recorded data included FeNO, the forced expiratory volume in one second (FEV 1 ), the forced vital capacity (FVC), FEV 1 /FVC, the FEV 1 (% predicted), the demographic characteristics, the presence of complications and the smoking status. Results: The patients with lung cancer had a significantly higher level of eNO than the healthy control subjects (33.85 6 15.63 ppb, n 5 163; 16.83 6 4.17 ppb, n 5 172; P < 0.01). The areas under receiver operating characteristic curves for eNO predicting airway inflammation in lung cancer subjects and healthy control subjects was 0.932 (95% confidence interval: 0.904-0.961). In the lung cancer group, the eNO levels in the squamous cell carcinoma, adenocarcinoma, small-cell lung cancer and lung carcinoid tumor groups were significantly different (P < 0.01). Lung cancer patients with a predicted FEV 1 % value <80% had a higher level of eNO than the patients with a predicted FEV 1 % value 80%. Conclusions: The eNO levels in patients with lung cancer were higher than the normal level, especially in the patients with squamous cell carcinoma and small-cell lung cancer. The differences in eNO among the lung cancer subtypes were statistically significant. Measuring eNO will be helpful in diagnosing airway inflammation in lung cancer and in the classification of lung cancer.Please cite this paper as:

Nitric oxide promotes cancer cell dedifferentiation by disrupting an Oct4:caveolin-1 complex: A new regulatory mechanism for cancer stem cell formation

“…The intrinsic factors include tumor suppressor proteins, oncoproteins, and epigenetic regulators, whereas the extrinsic factors include microenvironmental mediators, cytokines, and paracrines in the circulating system. NO is a microenvironmental mediator that is elevated in several types of cancer, including lung cancer, colon cancer, and breast cancer (19,59,60). An aberrantly high expression of NO was also shown to be correlated with poor prognosis of several cancers.…”

“…As Oct4 (72)(73)(74) and Cav-1 (75)(76)(77)(78) were found in various types of normal and cancerous cells, and the function of Oct4 in the regulation of stem cell properties was widely demonstrated in both CSC and noncancerous stem cells (72)(73)(74), it is interesting to investigate for the Cav-1:Oct4 suppressor complex in normal stem cells. Also, the abundance of Oct4 in cancer cells may be enhanced by the fact that the cancer cells frequently reside in a high NO concentration environment (19) or gain of Akt function (79).…”

“…In recent years, the role of the microenvironment in cancer progression has increasingly been recognized (18). Nitric oxide (NO) is a key mediator frequently up-regulated in lung cancer microenvironment (19). It is also known to play a pivotal role in controlling several cellular processes in both normal and pathological conditions (20).…”

“…It is also known to play a pivotal role in controlling several cellular processes in both normal and pathological conditions (20). In lung cancer, NO and its producing enzymes, nitric-oxide synthases (NOSs), are highly up-regulated (19,21). NO has also been shown to promote anoikis or cell survival after detachment (22), motility (23), CSC-like phenotypes (24), and chemotherapeutic resistance (25,26).…”

Ultrafast Screening of COVID-19 by Machine Learning Analysis of Exhaled NO

“…After at least 28 years of exploration, it was determined that the detection of FeNO could accurately predict lung cancer, asthma, scleroderma, sarcoidosis and other lung diseases [5][6][7][9][10][11][12][13][14][15][16][17] . After the severe acute respiratory syndrome coronavirus (SARS-CoV) outbreak in 2002-2003, relevant studies showed that the NO concentration in the organism changes with the degree of infection by a coronavirus 18,19 . For example, in the early stage of infection with SARS-CoV, activation of epithelial cells, such as those in alveoli, to produce cytokines results in the upregulation of inducible NO synthase, further increasing the NO concentration and thus playing an antiviral role in controlling SARS-CoV infection 20 .…”