Expression Level And Clinical Significance Of Exchange Protein Directly Activated By CAMP (EPAC) In Advanced Non-small Cell Lung Cancer (NSCLC)

Objective: With the rapid development of modern medicine,the clinical treatment of advanced non-small cell lung cancer(NSCLC)has become more and more mature,and the combination of multiple anti-cancer regimens have been used to control the abnormal growth of tumors.Therefore,it is critical to identify effective biomarkers for targeted treatment of lung cancer.The current study aimed to examine the expression level and clinical significance of exchange protein directly activated by c AMP,EPAC1 and EPAC2,in advanced NSCLC,and explore the feasibility that EPACs may be used as a therapeutic target for advanced NSCLC.Methods: We collected lung tissues with NSCLC from 40 patients with advanced NSCLC diagnosed by surgery and 24 adjacent healthy tissues of patients undergoing tumor surgery in the First Affiliated Hospital of Wannan Medical College between April 2021 and October 2022.The lung tissue samples were placed in an enzyme-free EP tube containing RNAlater solution and stored overnight in a 4°C refrigerator before being transferred to a new enzyme-free EP tube and stored at-80°C the next day until use.The expression levels of EPAC1 and EPAC2 in both lung cancer tissues and adjacent healthy tissues were determined by quantitative RT-PCR.We then determined whether there are significant differences in the expression levels of EPAC1 and EPAC2 between NSCLC tissues and adjacent healthy tissues and further analyzed whether the expression levels of the two signaling molecules had significant differences in the clinical characteristics of patients.We also conducted correlation analysis on the expression levels of EPAC1 and EPAC2 in tumor tissues.Results: 1.The expression level of EPAC1 in NSCLC tissues was significantly lower than that in adjacent healthy tissues(P<0.0001);2.The expression level of EPAC2 in NSCLC tissues was significantly higher than that in adjacent healthy tissue(P=0.035);3.The expression levels of EPAC1 and EPAC2 were not significantly correlated with the clinical characteristics of patients(gender,age,histopathological type,TNM stage,neutrophil-lymphocyte ratio,primary tumor size,smoking history,ECOG score,distant metastasis);4.There was no correlation between the expression levels of these two EPAC proteins in tumor tissues of NSCLC patients(R2=0.2409,P>0.05);5.In the ROC curve analysis,the area under the curve(AUC)of EPAC1 is 0.9073(P<0.0001)and the AUC of EPAC2 is 0.6583(P<0.05).Conclusion: 1.The expression level of EPAC1 in tumor tissues of patients with advanced NSCLC was significantly lower than that in adjacent healthy tissues;2.The expression level of EPAC2 in tumor tissues of patients with advanced NSCLC is significantly higher than that in adjacent health tissues;3.The expression levels of EPAC1 and EPAC2 may be useful in the diagnosis of advanced NSCLC.