73例肺癌影像学综合性分析

目的:73例肺癌影像学综合性分析。材料与方法:回顾分析73例肺癌检查资料。结果:中心型肺癌43例,周围型肺癌30例各自影像特点及其他部位转移情况进行分析。结论:肺癌影像学特点及肺癌引起其他部位转移非常多而且迅速,选择和得当运用影像学检查方法对于获得诊断及临床制定治疗计划极为重要。

100例肺癌影像学综合性分析

目的:100例肺癌影像学综合性分析。方法:回顾分析100例肺癌检查资料。结果:中心型肺癌54例,周围型肺癌46例各自影像特点及其他部位转移分析。结论:肺癌影像学特点及肺癌引起其他部位转移非常多而且迅速,早期肺部CT检查及薄层扫描极为重要。

ZD1839的肺癌靶向治疗

2002年肺癌学界最令人注目的,莫过于ZD1839肺癌靶向治疗的研究了.审视这段研究,颇有曲径通幽、峰回路转的诗意意境,更有大起大落、荡气回肠的沙场气概.整理和思考这段研究,无疑对临床肿瘤学尤其肺癌的临床研究有莫大的启发.

囊腔类肺癌影像学研究进展

肺癌是全球发病率和死亡率较高的恶性肿瘤之一,2020年全球新发肺癌患者占全部恶性肿瘤的11.4%,仅略低于女性乳腺癌,死亡率高居首位^([1])。囊腔类肺癌是一种以薄壁囊腔为特点的特殊类型肺癌,其发病率较低,文献报道筛查人群发现肺癌病例中3.7%为囊腔类肺癌^([2]),非筛查人群的手术患者中发病率约3.5%^([3])。由于囊腔类肺癌影像学表现不典型,临床容易漏诊或误诊为炎症、感染^([4,5]).

血清CEA、SF和β_2-MG联合检测对肺癌诊断的临床价值

目的探讨血清癌胚抗原、铁蛋白、β2-微球蛋白联合检测在肺癌诊断中的意义。方法收集血清标本:健康人员40例,肺癌患者119例,均采用放射免疫力法检测,所有数据采用x±s,两组间比较用t检验。结果健康人员血清中的癌胚抗原、铁蛋白、β2-微球蛋白的水平均在正常参考范围内;肺癌组:血清中癌胚抗原、铁蛋白、β2-微球蛋白均与对照组相比明显升高,有显著差异(P<0.01)。结论血清癌胚抗原、铁蛋白β2-微球蛋白,联合检测可提高肺癌的诊断率,可作为肺癌的肿瘤标记物。

细胞蜡块联合免疫组化技术在肺癌胸水细胞学病理诊断中的应用价值

分析细胞蜡块联合免疫组化技术在肺癌学胸水细胞病理诊断中的应用价值。方法:选择我院自2020年3月-2022年3月收集的180例肺癌胸水细胞样本为研究对象,将其随机分组为对照组(60例,液基细胞学制片法)、观察组(60例,胸水细胞蜡块联合免疫组化技术制片法)、病理学检测组(60例,病理学细胞检测法),以第三组检测结果为标准,对比前两组诊断灵敏度、特异度、准确率。结果:数据表明,观察组灵敏度、特异度及准确率均明显高于对照组,差异均有统计学意义(P<0.05)。结论:细胞蜡块联合免疫组化技术在肺癌学胸水细胞病理诊断中,能提高诊断的灵敏度、特异度及准确率。

Mechanisms of Lung Cancer Caused By Cooking Fumes Exposure： A Minor Review

Cooking fumes （CFs） are mixtures of many toxic components, such as aldehydes, heterocyclic amines, polycyclic aromatic hydrocarbons, fat aerosols and particulate matters. CFs exposure has been proven to be associated with many diseases. Lung cancer takes the leading place among the diseases being reported caused by CFs exposure. Molecular and biochemical studies have found that CFs exposure may lead to lung cancer by gene damage, formation of reactive oxygen species, blockage of related proteins’ function, and even cell death. However, reviews about the mechanisms of how CFs exposure leads to lung cancer are still lacking. Elucidation of the mechanisms of lung cancer caused by CFs exposure may provide a new insight into the prevention of lung cancer caused by CFs exposure, as well as laying the foundation for the toxicity study of CFs. In this minor review, the mechanisms of how CFs exposure leads to lung cancer were summarized and discussed.

Prognostic Impact of Histopathologic Response after Neoadjuvant Chemotherapy in Stage Ⅲ_A Non-small Cell Lung Cancer

Objective： To investigate prognostic impact of histopathologic response induced by neoadjuvant chemotherapy in patients with stage ⅢA non-small cell lung cancer （NSCLC）. Methods： Forty patients with stage ⅢA NSCLC underwent two cycles of neoadjuvant chemotherapy with mitomycin, vindosine, and cisplatin followed by surgery. Histopathologic response in resection of the tumor was examined after surgery. Tumor regression was classified as grade Ⅳ, grade Ⅲ, grade Ⅱ, and grade Ⅰ according to the extent of tumor necrosis and the extent of the vital tumor tissues. The tumor regression grading was correlated with the survival time of the patients. Results： After two cycles of chemotherapy, 19 （47.5%） of 40 patients had objective response （2 complete and 17 partial response）. In 40 resected tumor specimens, 2 （5%） were classified as regression grade Ⅳ, 16 （40%） as regression grade Ⅲ, 18 （45%） as regression gradeⅡ, and 4 （10%） as regression grade Ⅰ. The rate of complete surgical resection was significantly higher in patients with tumor regression grade Ⅲ-Ⅳ （〈10% vital tumor tissue）（P〈0.05）. The median survival time in patients classified as having tumor regression grade Ⅲ-Ⅳ was significantly longer than that in patients who had regression grade Ⅰ-Ⅱ （P〈0.05）. The 3-year survival rate in patients with regression grade Ⅲ-Ⅳ was markedly higher than that in patients who had regression grade Ⅰ-Ⅱ （P〈0.05）. Conclusion： The extent of tumor regression induced by neoadjuvant chemotherapy is a critical issue for successful therapeutic approach in patients with stage ⅢA NSCLC. In resected specimens of tumors after chemotherapy, the presence of marked tumor regression （regression grade Ⅲ-Ⅳ） is predictive for superior survival time.

The Expression and Clinical Significance of Fas and FasL in Lung Cancer

Objective: To investigate the expression and clinical significance of Fas andFasL in lung cancer. Methods: SP immunohistochemical technique was used to detect the expression ofFas and FasL in 46 cases of lung cancer and 30 cases of adjacent non-neoplastic tissue. Results:Down-regulation, of Fas and up-regulation of FasL were found in lung carcinoma. The levels of Fasexpression in squamous cell carcinoma, adenocarcinoma and SCLC were significantly lower than that ofadjacent normal tissues (P<0. 01) , while the expression levels of FasL were the opposite (P< 0.05). Fas expression was associated with high histological grade and no metastasis (P<0. 05). FasLexpression was related to histological grade, late clinical stage and metastasis (P<0. 05). BothFas and FasL expression was not related to the histological type of lung cancer (P>0. 05). Thelevel of Fas expression was negatively related to that of FasL (P<0. 05). Conclusion:Down-regulation of Fas and up-regulation of FasL may work in coordination with the occurrence,development and metastasis of lung cancer. Fas or FasL can be used as one of markers in earlydiagnosis of lung cancer. Therefore, the combined assay may be helpful in predicting the grade ofmalignancy and the prognosis of patients with lung cancer.

学习2024年全球慢性阻塞性肺疾病防治创义的几点思考

2024年修订的全球慢性阻塞性肺疾病(简称慢阻肺)防治创义(以下简称GOLD2024)于2023年11月13日提前发布[1],通读了GOLD2024,新版GOLD在十多个方面做了较大改动:进一步扩充有关保留比值肺功能受损(Preserved Ratio Impaired Spirometry,PRISm)的相关信息;增加肺过度充气部分;在肺功能章节中增加了使用支气管舒张剂之前的肺功能检查说明;新增了目标人群中筛查慢阻肺部分,增加了利用肺癌影像学进行慢阻肺筛查,包括目标人群的肺功能检查和利用其他肺部异常影像进行慢阻肺筛查.

Expression of Collagen Ⅳ, Fibronectin, Laminin in Non-small Cell Lung Cancer and Its Correlation with Chemosensitivities and Apoptosis~*

Objective： To study the expression of extracellular matrix （ECM） proteins including Collagen Ⅳ （Co Ⅳ）, Fibronectin, Laminin in human non-small cell lung cancer （NSCLC） specimens and the relationship between ECM and cell adhesion, proliferation, apoptosis and drug sensitivity in NSCLC cell line. And to investigate the role of phosphatidylinositol 3-kinase （PI3-K） in signal transduction of Co Ⅳ in NSCLC. Methods： The expression of ECM proteins was detected by using immunohistochemical staining （Envision＇s）. Adherent cells were stained with 1% methylene blue. Cell proliferation and cytotoxic effects were monitored by MTT assay. Cell apoptosis was analyzed by FITC-Annexin V/PI double staining variables flow cytometry （FCM）. Results： The expression rate of Co Ⅳ （93%） was the highest compared to others in NSCLC stroma. After treated with Co Ⅳ, the adhesion of H1299 cells was increased and the cytotoxicity of cis-platinum （DDP） against H1299 cells was decreased compared to the control （P〈0.05）. After treated with Co Ⅳ both survival and proliferation rates were higher and apoptosis rate was lower than without Co Ⅳ （P〈0.05）. PI3-K inhibitor LY294002 decreased both survival and proliferation rates （82.7%±2.0% and 75.2%±6.8%, respectively）, even on Co Ⅳ-coated surface （92.2%±2.8% and 84.6%±9.2%, respectively）. And it also helped DDP increase apoptosis. Conclusion： ECM remodeling existed in NSCLC. Co Ⅳ protected NSCLC cells from DDP-induced apoptosis and weakened the cytotoxicity of DDP. PI3-K pathway might be the crucial mechanism of apoptosis impairment and drug resistance.

Fulminant hepatic failure resulting from small-cell lung cancer and dramatic response of chemotherapy

Prompt treatment in tumor-associated encephalopathy may prolong survival. We describe a 69-year-old male patient who was presented with fulminant hepatic failure, secondary to small-cell lung carcinoma with rapidly progressing encephalopathy. Both symptoms remitted following chemotherapy, suggesting swift diagnosis and administration of chemotherapy to be effective in treatment of fulminant hepatic failure and encephalopathy.

Helicobacter pyloriseroprevalence in patients with lung cancer

AIM:To assess Helicobacter pylori(Hpylon)seroprevalence in a cohort of Greek patients with lung cancer. METHODS:Seventy-two lung cancer patients(55 males and 17 females,aged 58.2±11.7 years)and 68,age and gender-matched,control subjects were enrolled.All subjects underwent an enzyme-linked immunosorbent assay IgG serologic test for Hpylori diagnosis. RESULTS:A correlation between age and HpyloriIgG level was detected for both lung cancer patients(r=0.42, P=0.004)and controls(r=0.44,P=0.004).Seropositivity for Hpyloridid not differ significantly between patients with lung cancer and controls(61.1% vs 55.9%,P>0.05). Concerning the mean serum concentration of IgG antibodies against Hpylori,no significant difference between the two groups was detected(32.6±19.1 vs 27.4±18.3 U/mL, P>0.05). CONCLUSION:No significant association between Hpylori infection and lung cancer was found.

Lung Cancer Epidemiology in China's Mainland

Lung cancer incidence has increased rapidly in China over the last 20 years, especially in females. Among the 183 registered worldwide populations, lung cancer incidence in males was ranked as the 73rd, 74th, 127th and 23rd respectively for Shanghai, Tianjin, Qidong and Hong Kong, and in females the 52nd, 13th, 102nd and 23rd. The sex ratio （M/F） ranged from 1.5 to 3.5 for most areas. The ratio of squamous/ adenocarcinoma was 2.01 in males and 0.67 in females in Tianjin, 0.97 and 0.28 in Hong Kong, 1.00 and 0.61 in the US white population and 1.18 and 0.49 in US blacks. Much research on risk factors have been conducted and documented including the following： genetic predisposition/polymorphism, smoking/coal soot and DNA adduct, cytochrome p450-1A1 （CYP1A1）, glutathione S-transferase-M （GST-M）, viral infection/HPV infection, high background radiation, family history, tobacco consumption, mental health, prior lung diseases, coal soot indoor air pollution, cooking fume indoor air pollution, hormones, diet, occupational exposure, outdoor air pollution, socioeconomic level/education, alcohol consumption and their interactions（addition/synergy）. Based on current information we should carefully devise a plan to control lung cancer that can be put into practice.

REDUCED TUMORIGENICITY OF METASTATIC HUMAN LUNG CANCER CELL SUBLINE（PGCL3） TRANSFECTED WITH hRARβ GENE

The recombinant PSG5-RARβ plasmid and the G418-resistant PSV2neo Plasmid ( 10 : 1) were cotransfected into PGCL3 cells by copreciprtation with calcium phosphate. The transfectants CR3 and CR4, which expressed the RARβ gene. were identified by Northern blot hybridization. The results showed that the in vitro growth and invasion of CR3 and CR4 were dramatically reduced compared to the control-transfected cell (CSV1). Furthermore, the colony-forming abilities in soft agar and the tumorigenicrty in nude mice of CR3 and CR4 were abrogated. Our results suggests that RARβ functions not only as a receptor mediating the RA action, but also as a suppressor in lung tumorigenesis.

Pharmacokinetics of gemcitabine in Chinese patients with non-small-cell lung cancer

To determine the pharmacokinetics of gemcitabine (2′,2′-difluorodeoxycytidine) in Chinese non-small-cell lung cancer (NSCLC) patients. Six study subjects were administered gemcitabine at a fixed dose rate of 10 mg/m2 per min (1200 mg/m2, two hours infusion) and carboplatin, and plasma gemcitabine concentrations were measured by ion-pair reversed-phase high-performance liquid chromatography (HPLC). 3P97 Pharmaceutical Kinetics Software was used for the calculation of pharmacokinetic parameters. The obtained mean parameters, elimnation half life (t1/2) (10.67±3.38 min), area under the curve (AUC) (7.55±1.53 (μg·h)/ml), and clearance (CL) (3940.05±672.08 ml/min), were consistent with those reported in literature. The hematologic toxicology result showed that the regimen was effective on and tolerated by the patients.

CYFRA 21-1 as an early predictor of first line chemotherapy response in advanced non small cell lung cancer

Objective： In an era of ever evolving, promising new therapies for advanced non small cell lung cancer （NSCLC）, early predictors of response to therapy, are needed. We evaluated early variations in CYFRA 21-1 serum levels of patients with advanced NSCLC receiving first line chemotherapy and correlated the results with objective tumor response. Methods： 29 consecutive, previously untreated, patients of advanced non small cell lung cancer, with measurable disease on CT scan were evaluated. All patients were treated with conventional systemic chemotherapy, although the choice of chemotherapy was left to the discretion of the treating physicians. Serum samples were obtained immediately before the start of 1st and 2nd cycles of chemotherapy. CYFRA 21-1 was measured with an electrochemiluminescense immunoassay on an automatic analyzer （Elecsys 2000; Roche Diagnostics）. Response was evaluated using Response evaluation criteria in solid tumors （RECIST） criteria. Results： 10 patients had partial response, 9 patients had stable disease and 9 had progressive disease. None of the patients had complete response. 21/29 （72%） patients had an elevated baseline value of CYFRA 21-1.62% patients （18/29） had a decrease in CYFRA 21-1 after 1 cycle of chemotherapy. The average reduction in the 2nd reading was irrespective of whether baseline value was normal or not. The average reduction was statistically significant （P = 0.002; 95% CI, from 0.8369 to 3.49464; t test）. 8 out of 10 （80%） patients with partial response had a reduction in their 2nd reading of. CYFRA （P = 0.019; 95% CI, from 0.81965 to 7.20035; t test） which was significant. We also observed that 6/9 （66%） patients whose disease remains stable also had a decrease in their subsequent reading （P = 0.0106; 95% CI, from -0.44942 to 3.82720; t test）, though it was not significant statistically. Although 5 out of 9 （55%） patients, who had an increase in their CYFRA 21-1 level, had progressive disease, but it was not statistically significant （P = 0.537; 95% CI, from -1.20021 to 2.13354; ttest）. 14 out of 19 （73%） who either had partial response or had stable disease, had a reduction in their 2nd value of CYFRA 21-1 and was significant statistically （P = 0.004; 95% CI, from 0.74792 to 3.50208; t test）. We also observed that except for 1 patient, all patients who had a decrease of 42% or more in their subsequent CYFRA 21-1 level, were those who had either responded to chemotherapy or had stable disease （P = 0.001）, which was statistically significant. Conclusion： We can conclude that monitoring of serum marker CYFRA 21-1, early dudng first-line chemotherapy may be a useful prognostic tool for evaluation of early tumor response in patients with advanced NSCLC.

Current Research on Consolidation Therapy and Follow-up Health Care in Advanced Non-small Cell Lung Cancer Patients

Following concurrent radio-chemotherapy or first-line chemotherapy for advanced non-small cell lung cancer （NSCLC）, continuous maintenance therapy given to patients with stable disease （SD） and follow-up treatment is called consolidation therapy. Concerning NSCLC patients with a non-operable dry Stage-IIIB （N3） disease, i.e. contra-lateral mediastinal and hilar lymph node, or homolateral/contra-lateral scalene and Troisier sign, a 2 or 3-course of standard-dosage Taxotere consolidation therapy can be performed after concurrent radio-chemotherapy. In pursuance of evidence-based medicine （EBM）, low-dose Taxotere maintenance therapy, and biological targeted therapy of patients with appropriate symptoms are suitable for second-line therapy for moist of the Stage-ⅢB （malignant pleural effusion） and Ⅳ patients.