Observation on the Effect of Spontaneous Ventilation Single-Port Thoracoscopy and Conventional Thoracoscopy on T Lymphocyte Subsets and Inflammatory Factors in Patients with Non-Small Cell Lung Cancer

Objective:To explore the effects of two types of surgical approaches,spontaneous ventilation single-port thoracoscopy and conventional thoracoscopy,on T lymphocyte subsets and inflammatory factors in patients with non-small cell lung cancer.Methods:Fifty-eight patients with non-small cell lung cancer who underwent surgery in the Affiliated Hospital of Hebei University from January 2020 to December 2021 were selected as the study subjects.All of them underwent standard lobectomy and lymph node dissection.Among them,32 patients who underwent spontaneous ventilation single-port thoracoscopy were included in the study group,while 26 patients who underwent conventional thoracoscopy were included in the control group.The perioperative related indices,lung function,immune factor levels,and inflammatory factor levels were compared between the two groups.Results:In the study group,the perioperative incision length,intraoperative blood loss,operation time,and number of lymph node dissections were 4.28±2.01,77.89±12.02,87.21±16.11,and 20.69±4.45,respectively.In the control group,the perioperative incision length,intraoperative blood loss,operation time,and number of lymph node dissections were 6.32±2.45,84.98±16.98,95.88±14.89,and 21.45±4.36,respectively.There was no statistical difference between the study group and the control group in the number of lymph node dissections and intraoperative blood loss;the lung function in the study group was significantly better than that in the control group;the levels of T cell subsets CD4+,CD8+,CD4+/CD8+,CD16+CD56+of the study group were 46.36±5.87,30.98±4.12,1.19±0.23,and 17.41±6.25,respectively,while those in the control group were 35.78±4.12,34.14±3.87,1.04±0.24,and 12.45±5.56,respectively;the levels of immunoglobulin IgG,IgM,and IgA of the study group were 10.45±2.14,1.21±0.24,and 1.26±0.25,respectively,while those of the control group were 8.78±1.78,1.06±0.12,and 1.06±0.26,respectively,with statistical differences;the levels of CRP,IL-6,IL-8,and TNF-αof the control group were 21.87±4.26,98.01±9.58,111.03±9.96,and 123.05±9.77,respectively,while those of the study group were 19.47±3.89,89.12±8.96,104.32±9.12,and 112.98±9.16,respectively,in which the comparison was statistically significant.Conclusion:In the surgical treatment of non-small cell lung cancer,spontaneous ventilation single-port thoracoscopic surgery has several advantages,which include less trauma and bleeding.It reduces the impact of surgical trauma on the immune function of the body,improves the postoperative lung function and inflammatory stress of the body,as well as accelerates the recovery of patients.It is an alternative to open lung lobectomy for the treatment of lung cancer.

Clinical Application of Circulating Tumor Cells in Evaluating the Effect of Chemotherapy in Advanced Non-Small Cell Lung Cancer

Objective:To explore the value of circulating tumor cells in evaluating the effect of chemotherapy for advanced non-small cell lung cancer.Methods:Sixty-two patients with advanced non-small cell lung cancer who received chemotherapy in the Affiliated Hospital of Hebei University from January 2018 to December 2021 were selected as the research subjects.The positive rate of CTCs after two weeks of chemotherapy and four weeks of chemotherapy as well as the evaluation of imaging efficacy were observed and analyzed.Results:Based on the clinical data of the patients,the positive rate of CTCs in male patients was 77.78%,that in female patients was 80.77%,that in patients≥60 years old was 78.13%,that in patients<60 years old was 76.67%,that in squamous cell carcinoma was 79.31%,that in adenocarcinoma was 78.79%,and that in highly differentiated,moderately differentiated,and poorly differentiated+undifferentiated CTCs was 66.67%,84.21%,and 90.91%,respectively;there was no statistical difference in the general data.The positive rate of CTCs was 88.71%before chemotherapy and 66.13%after two weeks of chemotherapy,in which the difference was statistically significant;the positive rate of CTCs four weeks after chemotherapy was 59.68%,which was statistically significant compared with that before chemotherapy;however,there was no significant difference between two weeks after chemotherapy and four weeks after chemotherapy.After chemotherapy,35 patients had CR+PR,19 patients had SD,and 8 patients had PD.The proportions of CR+PR,SD,and PD in the imaging evaluation results were 56.45%,30.65%,and 12.90%,respectively.After kappa consistency test,it was found that the consistency was good.Conclusion:CTCs can be used as one of the indicators to evaluate the effect of chemotherapy for advanced non-small cell lung cancer.The results are consistent with those of imaging evaluation.The detection of CTCs can be widely used as one of the clinical indicators.

Analysis of Recurrence and Influencing Factors of Spontaneous Pneumothorax After Thoracoscopic Surgery

This study was conducted to explore the factors that are influencing the recurrence of spontaneous pneumothorax after thoracoscopic surgery.Around 110 patients with spontaneous pneumothorax who underwent thoracoscopic bullectomy in Hebei Hospital from May 2017 to May 2021 were included in this study.The patients were divided into the recurrence group(15 cases)and the non-recurrence group(95 cases),and the influences of gender,age,smoking history,height,weight,operation time,the weight of the excised tissue,number of excised pulmonary bullae,postoperative chest tube maintenance time,duration of air leakage,and length of hospital stay on the recurrence of spontaneous pneumothorax after thoracoscopic surgery were investigated.This study found that the height/weight,operation time,duration of air leakage,number of pulmonary bullae removed,weight of the removed tissue,postoperative chest tube maintenance time,and duration of hospital stay in the recurrence group was 3.2±0.4,50.9±1.2,2.1±0.4,1.6±0.2,4.2±1.3,2.4±1.5 and 7.2±1.5,respectively.Meanwhile,the recurrence group was 2.6±0.3,50.8±1.3,1.3±0.2,1.8±0.9,4.4±1.2,4.1±1.7 and 6.9±1.6,respectively.After comparing the relevant factors between the recurrence group and the non-recurrence group,it was found that there was comparability between age,height/weight,duration of air leakage and postoperative chest tube maintenance time,where these factors were shown to affect the recurrence of spontaneous pneumothorax after thoracoscopic surgery,while gender,smoking,operation time,number of resected bullae,weight of resected tissue and length of hospital stay had no effect on recurrence after spontaneous pneumothoracoscopic surgery.In short,thoracoscopic bullectomy is the best clinical treatment for spontaneous pneumothorax,however the occurrence of recurrence of spontaneous pneumothorax after the operation,which is mainly influenced by the patient’s height/weight,postoperative air leakage duration,and chest tube maintenance time.Therefore,it is essential to pay attention to the surgical treatment of the patients,and fully identify the related factors of postoperative recurrence,thereby the follow-up clinical treatment can be carried out effectively.