PMC9235397_01
Case 1. (A) Lung nodules (yellow arrows) on chest computed tomography; left - cross section, right - post-treatment by percutaneous microwave ablation. (B) Squamous cells could be seen in the nodules (hematoxylin-eosin staining, 400x). Immunohistochemistry revealed that the tumor was P63-positive, P40-positive, CK5/6-positive, TIF-1-negative, and Napsin-negative. (C) Plasma cells were seen in the bone marrow aspirate and biopsy specimens (Wright staining [WS], 1000x; hematoxylin-eosin staining, 200x). Immunohistochemistry revealed that the plasma cells were CD38-positive, CD138-partly positive, kappa-positive, and lambda-negative.
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Pulmonary nodules were found in the left lung on chest computed tomography (Figure 1A, left). The patient was diagnosed with lung squamous cell carcinoma (LUSC) based on the results of pathological and immunohistochemical tests (Figure 1B). He underwent thoracentesis via percutaneous microwave ablation (Figure 1A, right) at 40W for 9 min. Bone marrow pathology revealed the presence of myeloma cells (Figure 1C), and MM was also diagnosed.
PMC9235397_02
Case 2. (A) Lung mass (yellow arrows) on chest computed mass, cross-section. (B) Adenocarcinoma cells were present in the right lung nodule (hematoxylin-eosin staining, 400x). Immunohistochemistry revealed that the tumor cells were TIF-1-positive, Napsin-positive, CK7-positive, CK5/6-negative, and P40-negative. (C) Plasma cells were present in the bone marrow aspirates and biopsy specimens (Wright staining, 1000x; hematoxylin-eosin staining, 200x). Immunohistochemistry revealed that the plasma cells were CD38-positive, CD138-positive, kappa-positive, and lambda-negative.
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A pulmonary obstruction mass was found in the right lung on chest computed tomography (Figure 2A). A diagnosis of lung adenocarcinoma (LUAD) was made based on pathology results and immunohistochemistry findings (Figure 2B). The diagnosis of MM was further supported by the presence of myeloma cells on bone marrow biopsy. (Figure 2C).
MM and lung cancer bioinformatics analysis (A) Venn diagram indicating the number of differentially expressed genes (B) Correlation of differentially expressed genes with patient over survival (C) Protein-protein interaction network (D-F) Overall survival (OS) analysis based on MECR expression (G-I) Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis (J-L) High expression of MECR positive correlated with oxidative phosphorylation pathway.
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We identified 172 genes differentially expressed among all of the lung tumor datasets and the seven MM datasets (Figure 3A), including 135 DEGs of the 172 identified ones exhibiting similar expression trends. Most of them in the protein-protein interaction network (Figure 3C). Univariate Cox regression analysis showed that one DEG (MECR) was a risk factor (hazard ratio > 1.0) in five datasets (Figure 3B). High MECR expression was associated with a worse prognosis in LUAD, LUSC, and MM (P < 0.05; Figures 3D-F). In LUAD, the "ribosome," "oxidative phosphorylation," and "parkinsons disease" pathways were significantly enriched (all P < 0.05) (Figure 3G). In LUSC, the "ribosome," "oxidative phosphorylation," and "parkinsons disease" pathways were significantly enriched (all P < 0.05) (Figure 3H). In MM, the "DNA replication," "valine leucine and isoleucine degradation" and "oxidative phosphorylation" pathways were significantly enriched (all P < 0.05) (Figure 3I)."oxidative phosphorylation " pathways were significantly enriched in TCGA-LUAD, TCGA-LUSC, TCGA-MM (all P < 0.05) (Figures 3J-L).