Efect of body mass index on survival of patients with stage I non-small cell lung cancer

Background:Body mass index(BMI)has a U?shaped association with lung cancer risk.However,the effect of BMI on prognosis is controversial.This retrospective study aimed to investigate the effect of BMI on the survival of patients with stage I non?small cell lung cancer(NSCLC)after surgical resection.Methods:In total,624 consecutive stage I NSCLC patients who underwent radical resection were classified into four groups according to their BMI:underweight(BMI<18.5 kg/m^2),normal weight(BMI obese(BMI>28.0 kg/m^2).The effect of BMI on progress=18.5–22.4 kg/m2),overweight(BMI=22.5–28.0 kg/m^2),andion?free survival(PFS)and over?all survival(OS)was estimated using the Kaplan–Meier method and Cox proportional hazards model.Postoperative complications in each group were analyzed using the Chi square test or Fisher’s exact test.Results:A univariate analysis showed that PFS and OS were longer in the overweight group than in other groups(both P<0.05).A multivariate analysis showed that OS was longer in the overweight group than in other groups(compared with the other three groups in combination:hazard ratio[HR]e underweight group:HR=1.87,95%confidence interval[CI]1.30–2.68,P=0.003;compared with th3,P=2.24,95%CI 1.18–4.25,P=0.013;compared with the normal weight group:HR 1.48–5.59,P=1.58,95%CI 1.07–2.3=0.022;compared with the obese group:HR=2.87,95%CIwe=0.002),but PFS was similar among the groups(HRd an association between being overweight and pro=1.28,95%CI 0.97–1.68,P longed OS in patients at sta=0.080).A subgroup analysis shoge T1a(P 0.001).Overweight=0.024),T1b(P=0.051),and T2a(P=0.02),as well as in patients with a non?smoking history(P=patients had lower rates of postoperative complications,such as respiratory failure(compared with the underweight and obese groups:P=0.014),myocardial infarction(compared with the obese group:P=0.033),and perioperative death(com?pared with the other three groups:P=0.016).Conclusions:Preoperative BMI is an independent prognostic factor for stage I NSCLC patients after resection,with overweight patients having a favorable prognosis.

Identification of serum biomarkers for diagnosing stage Ⅰ lung adenocarcinoma by MALDI-TOF mass spectrometry

Objective To identify specific biomarkers that could improve early diagnosis of lung adenocarcinoma using matrix-assisted laser desorption/ionization (MALDI) technology. Methods Serum samples were isolated from 17 patients with stage Ⅰ lung adenocarcinoma and 17 age-and sex-matched healthy controls,and the serum proteomic profiles were obtained by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry. Results Compared with healthy control group,two highly expressed potential biomarkers were identified with the relative molecular weights of 6 631.64 Da and 4 964.21 Da. The two best novel protein peaks were automatically chosen for the system training and the development of the constructed model. The constructed model was then used to test an independent set of masked serum samples from 15 lung adenocarcinoma patients and 22 healthy individuals. The analysis yielded a sensitivity of 93.3%,and a specificity of 95.5%. Conclusion These results suggest that MALDI-TOF-MS ProteinChip technology is a quick,convenient,and high-output analyzing method that is capable of selecting several relatively potential biomarkers from the serum of lung adenocarcinoma patients and may have a clinical value in the future,and will provide clues to identifying new serologic biomarkers of lung adenocarcinoma.

Lysophosphatidylcholine Biomarkers of Lung Cancer Detected by Ultra-performance Liquid Chromatography Coupled with Quadrupole Time-of-flight Mass Spectrometry

Centrifugal ultrafiltration after methanol extraction of whole plasma was used as an optimal condition for the preparation of blood plasma before metabonomic studies. The plasma samples from 102 lung cancer patients and 34 healthy volunteers were prepared with this approach. With ultra-performance liquid chromatography（UPLC） coupled with quadrupole time-of-flight mass spectrometry（Q-TOF MS） analysis, the samples were investigated in order to find potential disease biomarkers. After data acquisition, orthogonal signal correction partial least squares models were built to differentiate the healthy volunteers from lung cancer patients and to identify metabolites that showed significantly different expression between the two groups. Several metabolite ions were identified as potential biomarkers according to the variable importance in the project（VIP） value in both ion modes. Five lysophosphatidylcholines were further identified as specifically lysoPC 16：0, isomer of lysoPC 16：0, lysoPC 18：0, lysoPC 18：1 and lysoPC 18：2. These results suggest that UPLC coupled with Q-TOF MS is an effective technique for the analysis of plasma metabolites in metabonomic studies.

Oval-Shaped Radiographic Opacity Mimicking a Lung Mass

Phantom tumor of the lung is an infrequent presentation of volume overload in congestive heart failure. This finding is often mistaken for a lung mass that leads to extensive workup and unnecessary treatments. A 75-year-old male was evaluated for a right lower lobe rounded opacity. A transthoracic echocardiogram showed normal left ventricular function. Biopsy of the mass was unremarkable. Patient was managed with diuretics, and subsequent lung imaging revealed resolution of the opacity.

Prognostic value of computed tomography derived skeletal muscle mass index in lung cancer:A meta-analysis

BACKGROUND The prognostic role of the skeletal muscle mass index(SMI)derived from computed tomography(CT)imaging been well verified in several types of cancers.However,whether the SMI could serve as a reliable and valuable predictor of long-term survival in lung cancer patients remains unclear.AIM To identify the prognostic value of the CT-derived SMI in lung cancer patients.METHODS The PubMed,Web of Science,and Embase electronic databases were searched up to November 5,2021 for relevant studies.The Reference Citation Analysis databases were used during the literature searching and selection.Hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association of the SMI with the overall survival(OS)of lung cancer patients.All statistical analyses were performed with STATA 12.0 software.RESULTS A total of 12 studies involving 3002 patients were included.The pooled results demonstrated that a lower SMI was significantly related to poorer OS(HR=1.23,95%CI:1.11-1.37,P<0.001).In addition,the subgroup analyses stratified by treatment(nonsurgery vs surgery),tumor stage(advanced stage vs early stage),and tumor type(non-small cell lung cancer vs lung cancer)showed similar results.CONCLUSION The CT-derived SMI is a novel and valuable prognostic indicator in lung cancer and might contribute to the clinical management and treatment of lung cancer patients.

肺癌合并非结核分枝杆菌感染的临床病理学特征

目的 分析肺癌合并非结核分枝杆菌(NTM)感染的临床病理学特征、诊断及鉴别诊断,以提高对肿瘤合并感染的认识及诊断水平。方法 回顾性分析2010年1月至2023年12月该院16例肺癌合并NTM感染患者的临床病理特征、免疫表型及分子生物学特征,并结合文献进行探讨。结果 16例肺癌合并NTM感染的患者临床主要表现为发热、咳嗽咳痰、咯血及胸闷等呼吸系统症状,仅1例无临床症状。有2例患者有吸烟史,3例患者患有潜在的肺部疾病,如双肺多发囊状支气管扩张和肺囊肿。肺癌的组织学类型为常见的鳞状细胞癌5例,腺癌10例(其中5例为原位腺癌或微小浸润性腺癌)及小细胞癌1例;分枝杆菌感染结果显示,感染胞内分枝杆菌5例,龟/脓肿分枝杆菌4例,鸟分枝杆菌3例,蟾蜍分枝杆菌3例及堪萨斯分枝杆菌1例;肿瘤分期为Ⅰ~Ⅱ期12例,Ⅲ期3例。经随访,1例患者因放弃肿瘤治疗出现呼吸衰竭而死亡。结论 肺癌合并NTM感染是罕见的肺部疾病,在肺癌的诊治过程中,局限性肿块的穿刺后要反复检测来诊断是否NTM感染与肺癌合并发生,尤其是对于已经确诊肺癌的高危患者,如出现间质性肺病、支气管扩张及新辅助免疫的相关治疗等因素,需要进一步明确是否存在NTM感染。

Systemic air embolism after transthoracic lung biopsy: A case report and review of literature

Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a very rare (0.07%) but potentially lifethreatening complication. We report a fatal case of air embolism to the cerebral and coronary arteries confirmed by head and chest CT, followed by a review of the literature.

A Preliminary Analysis of Non-small Cell Lung Cancer Biomarkers in Serum

To identify potential serum biomarkers that could be used to discriminate lung cancers from normal. Methods Proteomic spectra of twenty-eight serum samples from patients with non-small cell lung cancer and twelve from normal individuals were generated by SELDI (Surfaced Enhanced Laser Desorption/Ionization) Mass Spectrometry. Anion-exchange columns were used to fractionate the sera into 6 designated pH groups. Two different types of protein chip arrays, IMAC-Cu and WCX2, were employed. Samples were examined in PBSII Protein Chip Reader (Ciphergen Biosystem Inc) and the discriminatory profiling between cancer and normal samples was analyzed with Biomarker Pattern software. Results Five distinct potential lung cancer biomarkers with higher sensitivity and specificity were found, with four common biomarkers in both IMAC-Cu and WCX2 chip; the remaining biomarker occurred only in WCX2 chip. Two biomarkers were up-regulated while three biomarkers were down-regulated in the serum samples from patients with non-small cell lung cancer. The sensitivities provided by the individual biomarkers were 75%-96.43% and specificities were 75%-100%. Conclusions The preliminary results suggest that serum is a capable resource for detecting specific non-small cell lung cancer biomarkers. SELDI mass spectrometry is a useful tool for the detection and identification of new potential biomarker of non-small cell lung cancer in serum.

Effects of Formaldehyde Inhalation on Lung of Rats

Objective To analyze protein changes in the lung of Wistar rats exposed to gaseous formaldehyde (FA) at 32-37 mg/m3 for 4 h/day for 15 days using proteomics technique. Methods Lung samples were solubilized and separated by two-dimensional electrophoresis (2-DE), and gel patterns were scanned and analyzed for detection of differently expressed protein spots. These protein spots were identified by MALDI-TOF-MS and NCBInr protein database searching. Results Four proteins were altered significantly in 32-37 mg/m3 FA group, with 3 proteins up-regulated, 1 protein down-regulated. The 4 proteins were identified as aldose reductase, LIM protein, glyceraldehyde-3-phosphate dehydrogenase, and chloride intracellular channel 3. Conclusion The four proteins are related to cell proliferation induced by FA and defense reaction of anti-oxidation. Proteomics is a powerful tool in research of environmental health, and has prospects in search for protein markers for disease diagnosis and monitoring.

Simultaneous Paragonimus infection involving the breast and lung:A case report

BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.

Nonintubated thoracoscopic lobectomy plus lymph node dissection following segmentectomy for central type pulmonary masses

Lung cancer is the most common cancer worldwide. In the United States, it causes more cancer-related deaths than the next four causes （breast cancer, prostate cancer, colon cancer, and pancreatic cancer） of cancer-related mortality combined （1）. About 30% of people have already progressed to stage III lung cancer and 40% to stage IV at the time they are diagnosed （2）. Although chest X-ray and sputum cytology, when applied in health check-ups, can identify some relatively small tumors, they are not able to lower the overall mortality （3）. More recently,

Comparative Proteomics Analysis of Exhaled Breath Condensate in Lung Cancer Patients

The prognosis for patients with non-small cell lung cancer (NSCLC) remains poor in spite of better treatments. This relates mainly to the fact that the majority of patients present with advanced disease. There is a need to identify tools which can improve screening for lung cancer in the at risk patient population. The aim of this study was to compare the breath proteomic profile of NSCLC patients with healthy control subjects to explore the potential of new biomarkers of lung cancer. Comparative proteomic analysis of exhaled breath condensate (EBC) between 14 patients with NSCLC and 13 healthy control subjects were carried out using LTQ FT Ultra mass spectrometry and database searching to determine any unique proteins. In total, 29 unique proteins were identified using multiple protein identification algorithms. A comparison of lung cancer, smoker, and ex-smoker proteomes showed that 18 proteins were shared among the three groups. While one unique protein was found in smokers and lung cancer patients, four proteins were unique to ex-smokers. This data set provides a foundation for evaluation of these proteins from EBC as potential biomarkers for non-invasive lung cancer diagnosis.

Cost-effectiveness of lung cancer screening by low-dose CT in China:a micro-simulation study

Background:The effectiveness of lung cancer screening with low-dose computed tomography(LDCT)has been established.The current study evaluates the cost-effectiveness of lung cancer screening with LDCT in a general population in China.Methods:A previously validated micro-simulation model was used to simulate a cohort of men and women on a lifetime horizon in the presence and absence of LDCT screening.The modeling data were collected from numerous national and international sources.Simulated screening scenarios included different combinations of screening intervals and start and stop ages.Additional costs(valued in Chinese Yuan,CNY;1 USD=6.8976 CNY,1 EUR=7.8755 CNY in 2020),life-years gained(LYG)and mortality reduction due to screening were also determined.The costs and life-years were discounted by 3%.All results were scaled to 1,000 individuals.The average cost-effectiveness ratio(ACER)was calculated.A willingness-to-pay threshold of CNY 217.3k/LYG was considered.A healthcare system perspective was adopted.Results:Compared to no screening,lung cancer screening by LDCT in a general Chinese population yielded 21.0-36.7 LYG in men and 9.2-16.6 LYG in women across the scenarios.For men,biennial LDCT screening yielded an ACER of CNY 171.4k-306.3k/LYG relative to no screening.Biennial screening performed between 55 and 75 years of age was optimal at the defined threshold;it resulted in CNY 174.6k/LYG and a lung cancer mortality reduction of 9.1%,and this scenario had a 75%probability of being cost-effective.For women,the ACER ranged from CNY 364.2k to 1193.3k/LYG.Conclusions:In China,lung cancer screening with LDCT in the general population including never smokers could be cost-effective for men with 75%probability,but not for women.The optimal strategy for men would be performing biennial screening between 55 and 75 years of age.

Influence of Smoking Status and Body Mass Index on Serum Carcinoembryonic Antigen Concentration in Patients with Thoracic Diseases

BACKGROUND: Although the serum carcinoembryonic antigen (CEA) concentration is the well-known prognostic marker of non-small cell lung cancer (NSCLC), serum CEA concentration has been reported to be affected by smoking status and body mass index (BMI). There are no previous investigations that examined the relationship between BMI and serum CEA concentration in thoracic disease, including NSCLC. METHODS: Consecutive 384 NSCLC patients and 87 patients with benign thoracic disease were enrolled. The relationship between serum CEA concentration and smoking status and BMI in patients with benign thoracic benign disease and NSCLC was examined. RESULTS: In patients with benign thoracic disease, serum CEA concentration significantly increased with smoking status and Brinkman index. However, serum CEA concentration was not related with BMI. Serum CEA concentration of patients with NSCLC was significantly higher than those with benign disease. In NSCLC patients, the relationship between serum CEA concentration and smoking status was also found. A significant relationship between serum CEA concentration and smoking status was also found in patients with adenocarcinoma which is known to have weaker associations with smoking in carcinogenesis. On the other hand, we failed to find the relationship between serum CEA concentration and BMI in NSCLC patients. CONCLUSION: Serum CEA concentration may be affected by smoking status but not BMI in our Japanese patients with thoracic disease.

Changes in intracellular and extracellular proteins after ERGIC3 knockdown in lung cancer:Proteins interacting with ERGIC3,HORN,and FLNA

Objective:Endoplasmic reticulum-Golgi intermediate compartment 3(ERGIC3)promotes cell proliferation and metastasis in lung cancer,but its molecular mechanism is unclear.Methods:The GLC-82 cells were randomly divided into the ERGIC3i group and the negative control group.The cells were transfected with ERGIC3 siRNA or control siRNA in the groups,respectively.The ERGIC3-interacting proteins expressed in cells or extracellularly were isolated by the immunoprecipitation method and detected by isobaric tags for relative and absolute quantitation and liquid chromatography-tandem mass spectrometry.The differentially expressed proteins were determined by bioinformatic methods.Results:After ERGIC3 knockdown,88 extracellular differentially expressed proteins,41 upregulated and 47 down-regulated,were detected in the supernatant of cultured cells.Among 52 intracellular differentially expressed proteins,33 were up-regulated and 19 down-regulated.Cluster analysis showed that the extracellular differential proteins are mainly involved in Ca2+binding and transport and I-kappa B kinase/NF-kappa B signal transduction.The upregulated proteins are mainly involved in the biological process of H3-K27 and H3-K4 methylation in cells.Co-immunoprecipitation assay showed that proteins interacting with ERGIC3 were rich in cytoskeleton construction and RHO GTPases activated p21-activated kinases.The intersection of these two research methods shows that ERGIC3 interacts with HORN and filamin A(FLNA).Conclusion:Proteomic analyses reveal that ERGIC3 acts as a vesicle transmembrane protein on the distribution of various extracellular and intracellular proteins and regulates the extracellular and intracellular biological processes by specifically binding hornin(HORN)and FLNA proteins.These findings maybe provide new methods and ideas for ERGIC3 as a therapeutic target for lung cancer.

Rosai-Dorfman disease with lung involvement in a 10-year-old patient:A case report

BACKGROUND Rosai-Dorfman disease(RDD)is a rare benign proliferative disease whose etiology is not clear and may be related to infection or unexplained immune dysfunction.The authors present a case of RDD with lung involvement in a 10-year-old patient.CASE SUMMARY A 10-year-old girl found that her left cervical lymph nodes were enlarged for more than 7 mo,and the largest range was about 6.5 cm×5.9 cm×8.1 cm.Cervical magnetic resonance imaging showed multiple masses in the left neck,with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images.A malignant tumor,with a high possibility of lymph node metastasis,was initially considered.At the same time,lung computed tomography showed multiple nodules of different sizes scattered on both sides of the lung,with uniform internal density.Thus,a possible metastatic tumor was considered.Finally,RDD was diagnosed by pathology and immunohistochemistry.According to the antibiogram,clindamycin was administered for 2 wk,and prednisone acetate was administered for 7 wk.Nine months later,the ulcer in the left neck was better than before,but the imaging showed that the lesion was not controlled.CONCLUSION The diagnosis of RDD cannot be made by a single tool and its treatment is a longterm exploratory process.Follow-up is necessary.

Identification of differentially expressed proteins in human stage Ⅰ lung adenocarcinoma and tumor-adjacent tissues with two-dimension gel electrophoresis profiling

Objective： The aim of this study was to establish reproducible two-dimensional electrophoretic assay used for profiling and identification of differentially expressed proteins in human stage I lung adenocarcinoma and paired normal tumor-adjacent tissue. Methods： The proteins from 12 human stage I lung adenocarcinoma tissues and normal tumor-adjacent tissues were separated using isoelectric focusing electrophoresis （the first dimension） and the subsequent homogeneous SDS-polyacrylamide gel electrophoresis （SDS-PAGE） （the second dimension）. The differentially expressed proteins were determined with PDQuest image analysis software, and identified using matrix-assisted laser desorption/ionization time of flight mass spectrometry （MALDI-TOF-MS） and database searching. Results： The well-reproducible 2-DE gel patterns of human stage I lung adenocarcinoma and normal tumor-adjacent tissues were profiled and 26 differentially expressed proteins uncovered. Nine of these 26 protein spots were cut out from the preparation gels and determined with MALDI-TOF-MS. Searching against the protein database, four candidate proteins were identified. They were 60S acidic ribosomal protein P2, Cathepsin B1, Apolipoprotein A-I precursor, and La 4.1 protein. Conclusion： In this study, high reproducible 2-DE gel protein images of human stage I lung adenocarcinoma and paired normal tumor-adjacent tissues were achieved successfully, and 4 differentially expressed proteins were revealed. These data will be helpful for screen of early biomarker and study of molecular mechanisms of human lung adenocarcinoma.

体重指数对Ⅲ/Ⅳ期非小细胞肺癌患者冷冻消融术后生存期的影响

目的探讨体重指数(BMI)与接受冷冻消融治疗的Ⅲ/Ⅳ期非小细胞肺癌(NSCLC)患者的生存期关系。方法回顾性分析49例接受CT引导下冷冻消融治疗的Ⅲ/Ⅳ期NSCLC患者的临床资料。对BMI与消融术后生存期(COS)进行了相关性分析。结果49例患者中,体重不足者3例,正常体重者33例,超重者13例,肥胖者0例。体重不足组、正常体重组、超重组平均COS分别为11.00月、10.79月,17.08月。LSD法两两比较,正常体重组与超重组COS差异有统计学意义,P=0.013<0.05。Spearman相关分析示,分期(r=-0.355,P=0.015<0.05)、BMI(r=0.399,P=0.006<0.05)与患者消融后生存期有相关关系;控制分期后行偏相关分析,BMI仍与COS存在相关(r=0.327,P=0.028<0.05)。结论BMI与冷冻消融治疗Ⅲ/Ⅳ期NSCLC患者的生存期独立相关,高BMI的患者COS更长。

基于气相色谱质谱研究肺癌呼气特征性挥发有机化合物

对肺癌患者呼出气体中挥发性有机化合物(VOCs)进行定性定量检测,研究肺癌患者呼气VOCs浓度变化,筛查肺癌特异性呼气VOCs。应用气相色谱质谱联用仪(GC-MS)检测360例受试者的呼气VOCs样品,包括134名健康志愿者、176名肺癌患者和50名乳腺癌患者。每个受试者采集3个平行样以及1个室内环境样。对检测到的挥发性有机物(VOCs)进行定量分析,联合使用Mann-Whitney U检验和正交偏最小二乘判别分析(OPLS-DA)模型筛选出8种肺癌患者呼气特征性VOCs,包括顺式-2-丁烯、苯、1,2-二氯丙烷、三氯乙烯、4-甲基-2-戊酮、3-甲基戊烷、正辛烷和萘。模型诊断的准确度、精准度、灵敏度和特异性分别为95.41%、95.15%、93.99%和96.67%,F1分数为94.51%,诊断性能好。综上,以上8种VOCs可作为肺癌患者的呼气特征性VOCs,为肺癌的早期呼气诊断提供新的数据支撑和方法。

范伏元教授从“络脉不和”论治肺结节经验

范伏元教授基于络脉沟通内外、渗灌气血、联系脏腑的生理特点,从肺痹、肺积认识肺结节,以络脉不和为肺结节根本病机,从伏邪凝痰痹络、胃络不和痰瘀结为窠囊进行阐发,以“通络开痹,和荣散结”“和胃逐瘀,安神化浊”为核心治法,分别以疏风宣肺汤、加味温胆汤处方辨治,将宏观脏腑辨证调和诸脏与微观络脉辨证调和络脉营卫气血津液沟通渗灌相结合,临床疗效确切。