Wanfeng Guo

Academy of Military Medical Sciences, T’ien-ching-shih, Tianjin Shi, China

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Publications (11)7.08 Total impact

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    ABSTRACT: We investigated the clinical significance of serum bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase isoform 5b (TRACP 5b) and type I collagen carboxyterminal telopeptide (ICTP) as bone metabolic markers for bone metastasis (BM) screening in lung cancer patients. Newly diagnosed advanced lung cancer patients with (N=130) and without (N=135) BM were enrolled in the study. Serum BAP, TRACP 5b and ICTP were measured before the treatment. BAP, TRACP 5b and ICTP values were higher in patients with BM compared with patients without BM (all P<0.0001). Area under ROC curve (AUC) of BAP, TRACP 5b and ICTP was 0.760, 0.753 and 0.835 (all P<0.0001), respectively. The cut-off values for BAP, TRACP 5b and ICTP were 21.8μg/l, 7.8 U/l and 8.8μg/l, respectively. When TRACP 5b and ICTP were combined, AUC was elevated to 0.895 (P<0.0001), and the cut-off values were TRACP 5b 7.6 U/l and ICTP 8.4μg/l. We conclude that serum BAP, TRACP 5b and ICTP may serve as useful tools for BM screening in lung cancer patients.
    Clinica chimica acta; international journal of clinical chemistry 09/2013; · 2.54 Impact Factor
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    ABSTRACT: For advanced non-small cell lung cancer (NSCLC) patients who benefited from prior epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy, the choice of a second TKI therapy has gradually become a new strategy for the treatment. Some investigators recommend that the second therapy should be continued with the original TKI; however, other investigators recommend the administration of another TKI. The aim of this study is to explore which choice is more reasonable. In retrospect, patients with advanced NSCLC or with postoperative relapse of advanced NSCLC achieved complete response (CR), partial response (PR) or stable disease (SD) in prior Gefitinib therapy, progression free survival (PFS) ≥3 months. They received repeated Gefitinib or Erlotinib at an interval of at least one month. The analysis was carried out with respect to efficacy and optimal population of the two groups. A total of 61 patients were enrolled into the study, 30 in Gefitinib group and 31 in Erlotinib group. Baseline characteristics of the two groups were comparable. In the comparison between patients treated with Gefitinib and with Erlotinib, no statistical differences were seen for response rate (10% vs 22.6%, P=0.300,6), disease control rate (60% vs 74.2%, P=0.237,8), median PFS (3.0 vs 3.5 months, P=0.494,5), or median OS (8.3 vs 8.5 months, P=0.140,8). Multivariate analysis showed that in the initial dose of Gefitinib, PFS≥6 months (HR=0.317, 95%CI: 0.102-0.984, P=0.046,9). With an interval ≥3 months (HR=0.224, 95%CI: 0.071-0.713, P=0.011,3) between two doses of TKI, the risk of disease progression was reduced; but if with an interval ≥3 months (HR=0.262, 95%CI: 0.097-0.705, P=0.008,0), the risk of death was reduced. Advanced NSCLC patients who benefited from prior Gefitinib therapy can benefit again either with the original drug Gefitinib or the alternative drug Erlotinib when a second TKI therapy is resumed. Such benefit is related to PFS of initial TKI therapy and time interval between two doses of TKI.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 07/2013; 16(7):345-52.
  • Wanfeng Guo, Hongjun Gao, Xiaoqing Liu
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 06/2013; 16(6):330-2.
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    ABSTRACT: The improved survival of patients with lung cancer depends on early diagnosis of lung cancer. However, the traditional diagnostic techniques have several limitations. Mass spectrometry (MS) has been applied as a core technology for cancer diagnosis in preliminary proteomic studies. The aim of this study is to explore the differences in the serum peptide levels of patients with non-small cell lung cancer (NSCLC) and healthy individuals using matrix-assisted laser desorption/ionization (MALDI)-time-of-flight (TOF)-MS. A NSCLC serum classification model was then established. One hundred and thirty three cases of patients with NSCLC serum specimens and 132 cases of healthy human serum specimens were randomly divided into two groups in accordance with the ratio of three to one without age and gender differences. The training group was used to establish the classification model, this group included serum samples from 100 NSCLC cases and 100 healthy individuals. The test group for validating the proposed model was composed of the remaining serum samples from 33 NSCLC cases and 32 healthy individuals. Peptides were extracted from the samples using magnetic beads- immobilized metal affinity capture - copper, and their mass spectra were obtained using an automated MALDI-TOF-MS system. The MS data from the training group was analyzed using the ClinproToolTM software to identify the individual peptide fragments and establish the classification model. The sensitivity and specificity of the model were verified by blind testing with the test group. Among the 131 different peptide peaks, ranging from m/z 1,000 Da to 10,000 Da, 14 peaks were significantly different in the NSCLC samples of the training group, as compared with the controls (P<0.000,001; AUC≥0.9); these included 2 higher peaks and 12 lower peaks. The classification model was established, and the test group was verified for only 3 peptide peaks (7,478.59, 2,271.44 and 4,468.38 Da), which were selected by the statistical software. Blind testing revealed that the proposed method had 100% sensitivity, 96.9% specificity and 98.5% accuracy. Our results showed that the serum peptide levels were significantly different between NSCLC patients and healthy individuals. A serum peptide-based classification of NSCLC patients was established using an automated MALDI-TOF-MS system. This method demonstrated high sensitivity and specificity in a small-scale test. Future studies should test the proposed model through mass validation. The model could be compared or combined with traditional diagnostic methods to establish novel techniques for the early diagnosis of patients with NSCLC.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 05/2013; 16(5):233-9.
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    ABSTRACT: The incidence of young non-small cell lung cancer (NSCLC) annually increases. The aim of this study is to analyze the clinical pathological characteristics of young (less than 40 years old) NSCLC patients. The data of 102 young NSCLC were retrospectively analyzed. Among the 102 patients, 43.1% were women and 29.4% were smokers. The male-to-female ratio was 1.32:1. The most frequent histologic type was adenocarcinoma (77.5%). Tumor differentiation was mostly poor (64.1%), and 87.8% had stages IIIb and IV diseases. The median recurrence time of 6 patients who had tumor resection was 13.5 months. The objective response rate (ORR) of 87 patients who received first-line chemotherapy was 46.0%, the disease control rate (DCR) was 79.3%, and the median time to progression (TTP) was 5.0 months. The ORR of 38 patients who received epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) therapy was 40.0%, with a DCR of 65.7% and a median TTP of 5.5 months. The DCR of 12 patients who received EGFR-TKI twice or more times was 66.7%, with a median TTP of 3.0 months. The time from the first presenting symptom until diagnosis was usually long. The female proportion presented an upward trend and the correlation became attenuated between young NSCLC patients and smoking. Most of the young NSCLC patients had adenocarcinoma and poor tumor differentiation. Multidisciplinary and systematic therapies were needed to improve the poor prognosis of the young NSCLC patients.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 02/2013; 16(2):73-7.
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    ABSTRACT: It has been proven that epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) significantly benefits advanced non-small cell lung cancer (NSCLC) patients harboring EGFR mutations in progression-free survival time with better tolerance. This study is undertaken to analyze efficacy and tolerance of advanced NSCLC patients harboring EGFR mutations taking EGFR-TKI as a first-line therapy. Tumor samples from 54 patients with advanced NSCLC were examined for EGFR activating mutations (deletion mutation in exon 19 and the L858R point mutation in exon 21) by direct sequencing. The patients were first-line treated with oral administration of EGFR-TKI until disease progression. The efficacy and adverse events were observed, and survival was followed up. Among the patients, 61% (33 of 54) had EGFR exon 19 deletion, and 39% (21 of 54) had EGFR L858R point mutation. All patients received first-line TKI therapy. The total response rate was 96%, median progression free survival (PFS) was 8.3 months and median survival was 19.5 months. The patients with EGFR exon 19 deletion had significantly longer median PFS (9 versus 7 months, P=0.002) and longer median overall survival (OS)(25 versus 16 months, P=0.001) than patients with EGFR L858R point mutation. There is no significance in efficacy between gefitinib and erlotinib, and gefitinib is safer than erlotinib. The most common adverse events were rash and diarrhea. Two (4%) grade 4 skin toxity effects, two (4%) grade 3 aminotransferase level elevations, and one (1) grade 3 stomatitis were observed. The first-line EGFR-TKI treatment in advanced NSCLC patients harboring EGFR mutations is efficient and safe, which is more efficient in patients with EGFR exon 19 deletion than those with EGFR L858R mutation.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 05/2012; 15(5):299-304.
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    ABSTRACT: Pemetrexed in combination with platinum or a single-agent has been approved for the first- and second-line treatment of non-small cell lung cancer (NSCLC). However, the role of pemetrexed therapy in the third-line and beyond treatment of NSCLC has yet to be generally accepted. The present retrospective study reports the efficacy and safety of pemetrexed in the third-line and beyond treatment of advanced non-squamous NSCLC. A total of 46 patients with advanced non-squamous NSCLC received a combination of pemetrexed plus platinum or a single-agent after multi-line treatment failed to yield positive results. Of the 46 patients who participated in the study, 7 achieved partial responses, 20 reached a stage of stable disease, and 19 reached a stage of progressive disease. The over-all object response rate was 15.2% and the disease control rate (DCR) was 58.7%. The median progression-free survival time was 3.0 months. Pemetrexed in combination with platinum yielded a higher DCR than the pemetrexed plus single-agent treatment (P=0.043). Common adverse events included nausea, vomiting and myelosuppression. Administration of pemetrexed after failure of multi-line treatment is clinically beneficial to patients with advanced non-squamous NSCLC. The toxic effects of the treatment appear to be tolerable.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 02/2012; 15(2):117-21.
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    ABSTRACT: Lung cancer is the leading cause of cancer mortality worldwide. Nonsmall cell lung cancer (NSCLC) accounts for most of these cases. Interleukin 4 (IL-4) is a typical pleiotropic T helper 2 cytokine and plays crucial roles in tumor immunology. IL-4 gene -590T/C polymorphism has been shown to be associated with different autoimmune diseases and cancers. The present study evaluated the correlation between this polymorphism and the susceptibility to NSCLC in the Chinese population. The IL-4 variant -590T/C was detected by polymerase chain reaction-restriction fragment length polymorphism in 1072 NSCLC cases and 1126 age-matched healthy controls. Data were analyzed using the Chi-square test. Results showed that frequencies of IL-4 -590 TC, CC genotype, and -590 C allele were significantly lower in patients with NSCLC than in healthy controls (odds ratio [OR]=0.77, 95% confidence interval [CI] 0.64-0.93, p=0.006; OR=0.54, 95% CI 0.38-0.76, p=0.0004; and OR=0.72, 95% CI 0.62-0.83, p=1.1 × 10(-5), respectively). Our data suggest that the -590T/C polymorphism of the IL-4 gene is associated with a decreased susceptibility to NSCLC.
    DNA and cell biology 12/2011; 31(5):797-800. · 2.28 Impact Factor
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    Wanfeng Guo, Xiaoqing Liu, Hongjun Gao
    Acta oncologica (Stockholm, Sweden) 08/2011; 50(7):1133-5. · 2.27 Impact Factor
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    ABSTRACT: It has been shown that carbonic anhydrase IX (CAIX) was closely related to tumor hypoxia. Proliferating cell nuclear antigen (Ki67) is considered to be an objective indicator which could reliable and comprehensive response to cell population proliferation; vascular endothelial growth factor (VEGF) was positively correlated with tumor angiogenesis. The aim of this study is to investigate the significance of the expression of CAIX in non-small cell lung cancer (NSCLC) tissues by analyzing the correlation between CAIX and clinical characteristics of patients with lung cancer and VEGF, Ki67 expressions. CAIX, VEGF and Ki67 protein were detected in 76 cases of NSCLC and 10 cases of lung inflammatory pseudotumor by immunohistochemistry. CAIX was expressed in 45 of 64 cases of NSCLC and not expressed in benign lesion pulmonary tissues. VEGF was expressed in 55 of 76 cases and Ki67 was expressed in 30 of 76 cases. The expression of CAIX in squamous cell carcinoma (SC) was higher than that in adenocarcinoma (AC) (69.7% vs 27.9%, P=0.001). In 34 cases who received radiotherapy, the objective response rates of CAIX positive and negative groups were 27.8% and 62.5% respectively; the expression of CAIX was positively correlated with VEGF (r=0.231, P=0.043) and was not correlated with Ki67 (r=0.064, P=0.583). Compared with benign lesion pulmonary tissue, the expression of CAIX in NSCLC tissues is significantly increased and is positively correlated with VEGF. The expression of CAIX was also correlated with the objective response rate of radiotherapy, which provided new evidence about that hypoxia can increase NSCLC radiotherapy resistance.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 09/2010; 13(9):861-6.
  • Source
    Wanfeng Guo, Xiaoqing Liu
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 12/2009; 12(12):1374-6.