Xuejun Chen

SAA1 Induces TGF ‐β1 Secretion by Ovarian Cancer Cells, Leading to M2 Macrophage Polarization and Inhibition of NK Cell Activity

ABSTRACT Natural killer (NK) cells play an important role in immune surveillance of tumors. The molecular mechanism of NK cells killing ovarian cancer cells remains elusive. This study attempts to show a potential mechanism of NK cell killing by polarization of M2 macrophages. Serum amyloid A1 protein (SAA1) expression in ovarian cancer tissue and its correlation with macrophage markers and TGF‐β1 expression were analyzed using bioinformatics. TGF‐β1 levels were determined by western blot and ELISA. Immunohistochemistry, flow cytometry, and immunofluorescence were employed to analyze the expression of M1 and M2 macrophage markers and NK cell markers. NK cytotoxicity was assessed using the lactate dehydrogenase assay and ELISA. TUNEL staining was used to detect tumor cell apoptosis. The xenograft tumor mouse model was utilized to reveal the in vivo function of the SAA1/TGF‐β1 axis. SAA1 was upregulated in ovarian cancer and positively correlated with M2 macrophage marker expression. Overexpression of SAA1 upregulated M2 macrophage markers in mouse tumor tissue. In vitro experiments showed that SAA1 induced polarization of M2 macrophages, and this effect was reversed by anti‐TGF‐β1 treatment. SAA1 inhibited the expression of NK cell activity markers and cytotoxicity by mediating M2 macrophage polarization. Finally, we demonstrated in vivo that partial reversal of the effects of SAA1 overexpression on NK cell activity and M2 macrophage polarization was achieved through anti‐TGF‐β1 therapy. SAA1 repressed NK cell killing in ovarian cancer by facilitating M2 macrophage polarization through TGF‐β1. The findings suggested that SAA1 may be a target for ovarian cancer therapy.

Prognosis and Efficacy of Laparoscopic Surgery on Patients with Endometrial Carcinoma: Systematic Evaluation and Meta-Analysis

Objective. The prognosis and efficacy of laparoscopic surgery (LPS) and open surgery or robotic surgery (RS) on endometrial carcinoma (EC) patients were compared. Methods. Data as of May 2021 were retrieved from databases like PubMed, Embase, Cochrane Library, and Web of Science. The study involved randomized controlled trials (RCTs), cohort studies, or case-control studies for comparing the effects of LPS and open surgery or robotic surgery (RS) on EC treatment. The primary outcomes included duration of operation, blood loss, length of stay (LOS), postoperative complications, and recurrence rate. Secondary outcomes included 3-year progression-free survival (PFS) rate/disease-free survival (DFS) rate and 3-year overall survival (OS) rate. Results. A total of 24 studies were involved, and all of them were cohort studies except 1 RCT and 1 case-control study. There was no significant difference in duration of operation between LPS and open surgery ( MD = − 0.06 , 95% CI: -0.37 to 0.25) or RS ( MD = − 0.15 , 95% CI: -1.27 to 0.96). In comparison with the open surgery, LPS remarkably reduced blood loss ( MD = − 0.43 , 95% CI: -0.58 to -0.29), LOS ( MD = − 0.71 , 95% CI: -0.92 to -0.50), and the complication occurrence rate ( RR = 0.83 , 95% CI: 0.73 to 0.95). However, LPS and RS saw no difference in blood loss ( MD = 0.01 , 95% CI: -0.77 to 0.79). Besides, in comparison with RS, LPS prominently shortened the LOS ( MD = 0.26 , 95% CI: 0.12 to 0.40) but increased the complication occurrence rate ( RR = 1.74 , 95% CI: 1.57 to 1.92). In contrast to open surgery or RS, LPS saw no difference in occurrence rate ( RR = 0.75 , 95% CI: 0.56 to 1.01; RR = 0.97 , 95% CI: 0.62 to 1.53), 3-year PFS/DFS ( RR = 0.99 , 95% CI: 0.90 to 1.09; RR = 1.30 , 95% CI: 0.87 to 1.96), and 3-year OS ( RR = 0.97 , 95% CI: 0.91 to 1.04; RR = 1.21 , 95% CI: 0.91 to 1.60). Conclusion. In sum, LPS was better than open surgery, which manifested in the aspects of less blood loss, shorter LOS, and fewer complications. LPS, therefore, was the most suitable option for EC patients. Nevertheless, LPS had no advantage over RS, and sufficient prospective RCTs are needed to further confirm its strengths.