Objective:To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage.Methods:The study time range is between March 2019 and M...Objective:To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage.Methods:The study time range is between March 2019 and March 2021.A sample of 30 patients with early multiple primary lung cancer admitted to this hospital were included,and they were divided into a study group,a control group,and samples within the group using a random number table scheme n=15,patients in the control group underwent staged bilateral thoracoscopic pneumonectomy,and patients in the study group underwent bilateral thoracoscopic pneumonectomy at the same time.The indicators of the two groups were compared and analyzed.Results:There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).There were significant differences in the VAS score,total length of hospital stay,and total surgical costs on the first day after surgery(P<0.05);there was no significant difference in the two groups'postoperative recovery indicators and the incidence of complications(P>0.05).Conclusion:It is safe and feasible to treat patients with multiple primary lung cancer in both lungs at the same time with simultaneous bilateral thoracoscopic surgery,and is suitable for promotion.展开更多
Multiple primary lung cancer(MPLC)is an increasingly prevalent subtype of lung cancer.According to recent genomic studies,the different lesions of a single MPLC patient exhibit functional similarities that may reflect...Multiple primary lung cancer(MPLC)is an increasingly prevalent subtype of lung cancer.According to recent genomic studies,the different lesions of a single MPLC patient exhibit functional similarities that may reflect evolutionary convergence.We perform whole-exome sequencing for a unique cohort of MPLC patients with multiple samples from each lesion found.Using our own and other relevant public data,evolutionary tree reconstruction reveals that cancer driver gene mutations occurred at the early trunk,indicating evolutionary contingency rather than adaptive convergence.Additionally,tumors from the same MPLC patient are as genetically diverse as those from different patients,while within-tumor genetic heterogeneity is significantly lower.Furthermore,the aberrant molecular functions enriched in mutated genes for a sample show a strong overlap with other samples from the same tumor,but not with samples from other tumors or other patients.Overall,there is no evidence of adaptive convergence during the evolution of MPLC.Most importantly,the similar between-tumor diversity and between-patient diversity suggest that personalized therapies may not adequately account for the genetic diversity among different tumors in an MPLC patient.To fully exploit the strategic value of precision medicine,targeted therapies should be designed and delivered on a per-lesion basis.展开更多
Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of ca...Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of cancer death.Therefore,we aimed to investigate the risk of second primary lung cancer(SPLC)in patients with thyroid cancer.Methods:We searched the PubMed,Web of Science,Embase,and Scopus databases up to November 24,2021,for relevant research and merged the standardized incidence ratios(SIRs)and 95%confidence intervals(95%CIs)to evaluate the risk of developing SPLC in patients with thyroid cancer.Results:Fourteen studies involving 1,480,816 cases were included in our meta-analysis.The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population(SIR=1.21,95%CI:1.07-1.36,P<0.01,I^(2)=81%,P<0.01).Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients(SIR=1.65,95%CI:1.40-1.94,P<0.01,I^(2)=75%,P<0.01).Conclusions:Thyroid cancer patients are more likely to develop SPLC than the general population,especially women.However,other risk factors must be investigated,and more prospective studies are needed to confirm our results.Registration:International Prospective Register of Systematic Reviews:No.CRD42021285399.展开更多
Background:Distinguishing multiple primary lung cancer(MPLC)from intrapulmonary metastasis(IPM)is critical for their disparate treatment strategy and prognosis.This study aimed to establish a non-invasive model to mak...Background:Distinguishing multiple primary lung cancer(MPLC)from intrapulmonary metastasis(IPM)is critical for their disparate treatment strategy and prognosis.This study aimed to establish a non-invasive model to make the differentiation pre-operatively.Methods:We retrospectively studied 168 patients with multiple lung cancers(307 pairs of lesions)including 118 cases for modeling and internal validation,and 50 cases for independent external validation.Radiomic features on computed tomography(CT)were extracted to calculate the absolute deviation of paired lesions.Features were then selected by correlation coefficients and random forest classifier 5-fold cross-validation,based on which the lesion pair relation estimation(PRE)model was developed.A major voting strategy was used to decide diagnosis for cases with multiple pairs of lesions.Cases from another institute were included as the external validation set for the PRE model to compete with two experienced clinicians.Results:Seven radiomic features were selected for the PRE model construction.With major voting strategy,the mean area under receiver operating characteristic curve(AUC),accuracy,sensitivity,and specificity of the training versus internal validation versus external validation cohort to distinguish MPLC were 0.983 versus 0.844 versus 0.793,0.942 versus 0.846 versus 0.760,0.905 versus 0.728 versus 0.727,and 0.962 versus 0.910 versus 0.769,respectively.AUCs of the two clinicians were 0.619 and 0.580.Conclusions:The CT radiomic feature-based lesion PRE model is potentially an accurate diagnostic tool for the differentiation of MPLC and IPM,which could help with clinical decision making.展开更多
Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low wate...Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler(LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-α, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.展开更多
Endotracheal/endobronchial metastasis (EEM) generally originates from nonpulmonary malignancies such as cancers of the breast, colon, and kidney. Although the incidence of EEM has been reported to be between 2.0% an...Endotracheal/endobronchial metastasis (EEM) generally originates from nonpulmonary malignancies such as cancers of the breast, colon, and kidney. Although the incidence of EEM has been reported to be between 2.0% and 50.0%, cases diagnosed after radical resection of primary lung cancer are extremely rare. We hereby presented a patient of squamous cell lung carcinoma who was confirmed to have EEM 3 years alter his radical resection of primary tumor.展开更多
The expression of tumor suppresser gene Pproducts Pprotein in patients with primary lung cancer has been studied by ABC immunohistochemical method using McAb 1801 as probe.
BACKGROUND Primary lung cancer is the leading cause of cancer-related death worldwide.Common metastatic sites include the brain,liver,bones,and adrenal glands.However,gastric metastases from lung cancer are rare.This ...BACKGROUND Primary lung cancer is the leading cause of cancer-related death worldwide.Common metastatic sites include the brain,liver,bones,and adrenal glands.However,gastric metastases from lung cancer are rare.This case may be the first report of a combined gastroscopic and laparoscopic resection for gastric metasta-tic adenosquamous carcinoma(ASC).CASE SUMMARY We report a case of gastric metastasis from lung cancer.The patient was a 61-year-old Han Chinese female who first attended our hospital complaining of a per-sistent cough,leading to the diagnosis of advanced-stage lung adenocarcinoma.After more than four years of chemotherapy,the patient began to experience epi-gastric pain.Endoscopy was performed,and pathological examination of biopsy specimens confirmed that the gastric lesion was a metastasis from lung cancer.The lesion was successfully resected by combined gastroscopy and laparoscopy.Histopathological examination of the resected gastric specimen revealed ASC.CONCLUSION Gastric metastases from lung cancer are rare.Endoscopy,histological and immunohistochemical staining are useful for diagnosing metastatic lesions.Surgical management may provide extended survival in appropriately selected patients.展开更多
文摘Objective:To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage.Methods:The study time range is between March 2019 and March 2021.A sample of 30 patients with early multiple primary lung cancer admitted to this hospital were included,and they were divided into a study group,a control group,and samples within the group using a random number table scheme n=15,patients in the control group underwent staged bilateral thoracoscopic pneumonectomy,and patients in the study group underwent bilateral thoracoscopic pneumonectomy at the same time.The indicators of the two groups were compared and analyzed.Results:There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).There were significant differences in the VAS score,total length of hospital stay,and total surgical costs on the first day after surgery(P<0.05);there was no significant difference in the two groups'postoperative recovery indicators and the incidence of complications(P>0.05).Conclusion:It is safe and feasible to treat patients with multiple primary lung cancer in both lungs at the same time with simultaneous bilateral thoracoscopic surgery,and is suitable for promotion.
基金supported by the National Key Research and Development Program of China to J.-R. Y.(2021YFF1200904 and2021YFA1302500)the National Natural Science Foundation of China to J.-R. Y.(31871320 and 81830103)+1 种基金by Science and Technology Planning Project of ZhuHai,China to H. C.by Science and Technology Planning Project of Guangdong Province,China to X. Z.(2014A030304053)
文摘Multiple primary lung cancer(MPLC)is an increasingly prevalent subtype of lung cancer.According to recent genomic studies,the different lesions of a single MPLC patient exhibit functional similarities that may reflect evolutionary convergence.We perform whole-exome sequencing for a unique cohort of MPLC patients with multiple samples from each lesion found.Using our own and other relevant public data,evolutionary tree reconstruction reveals that cancer driver gene mutations occurred at the early trunk,indicating evolutionary contingency rather than adaptive convergence.Additionally,tumors from the same MPLC patient are as genetically diverse as those from different patients,while within-tumor genetic heterogeneity is significantly lower.Furthermore,the aberrant molecular functions enriched in mutated genes for a sample show a strong overlap with other samples from the same tumor,but not with samples from other tumors or other patients.Overall,there is no evidence of adaptive convergence during the evolution of MPLC.Most importantly,the similar between-tumor diversity and between-patient diversity suggest that personalized therapies may not adequately account for the genetic diversity among different tumors in an MPLC patient.To fully exploit the strategic value of precision medicine,targeted therapies should be designed and delivered on a per-lesion basis.
基金National Natural Science Foundation of China(Nos.92159302,81871890,91859203)
文摘Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of cancer death.Therefore,we aimed to investigate the risk of second primary lung cancer(SPLC)in patients with thyroid cancer.Methods:We searched the PubMed,Web of Science,Embase,and Scopus databases up to November 24,2021,for relevant research and merged the standardized incidence ratios(SIRs)and 95%confidence intervals(95%CIs)to evaluate the risk of developing SPLC in patients with thyroid cancer.Results:Fourteen studies involving 1,480,816 cases were included in our meta-analysis.The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population(SIR=1.21,95%CI:1.07-1.36,P<0.01,I^(2)=81%,P<0.01).Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients(SIR=1.65,95%CI:1.40-1.94,P<0.01,I^(2)=75%,P<0.01).Conclusions:Thyroid cancer patients are more likely to develop SPLC than the general population,especially women.However,other risk factors must be investigated,and more prospective studies are needed to confirm our results.Registration:International Prospective Register of Systematic Reviews:No.CRD42021285399.
基金supported by Grants from the National Natural Science Foundation of China(No.82102109)by Grants from Development Center for Medical Science&Technology National Health Commission of China(No.WA2020RW10)by Grants from Shanghai Municipal Commission of Health and Family Planning Program(No.20184Y0037).
文摘Background:Distinguishing multiple primary lung cancer(MPLC)from intrapulmonary metastasis(IPM)is critical for their disparate treatment strategy and prognosis.This study aimed to establish a non-invasive model to make the differentiation pre-operatively.Methods:We retrospectively studied 168 patients with multiple lung cancers(307 pairs of lesions)including 118 cases for modeling and internal validation,and 50 cases for independent external validation.Radiomic features on computed tomography(CT)were extracted to calculate the absolute deviation of paired lesions.Features were then selected by correlation coefficients and random forest classifier 5-fold cross-validation,based on which the lesion pair relation estimation(PRE)model was developed.A major voting strategy was used to decide diagnosis for cases with multiple pairs of lesions.Cases from another institute were included as the external validation set for the PRE model to compete with two experienced clinicians.Results:Seven radiomic features were selected for the PRE model construction.With major voting strategy,the mean area under receiver operating characteristic curve(AUC),accuracy,sensitivity,and specificity of the training versus internal validation versus external validation cohort to distinguish MPLC were 0.983 versus 0.844 versus 0.793,0.942 versus 0.846 versus 0.760,0.905 versus 0.728 versus 0.727,and 0.962 versus 0.910 versus 0.769,respectively.AUCs of the two clinicians were 0.619 and 0.580.Conclusions:The CT radiomic feature-based lesion PRE model is potentially an accurate diagnostic tool for the differentiation of MPLC and IPM,which could help with clinical decision making.
文摘Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler(LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-α, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.
文摘Endotracheal/endobronchial metastasis (EEM) generally originates from nonpulmonary malignancies such as cancers of the breast, colon, and kidney. Although the incidence of EEM has been reported to be between 2.0% and 50.0%, cases diagnosed after radical resection of primary lung cancer are extremely rare. We hereby presented a patient of squamous cell lung carcinoma who was confirmed to have EEM 3 years alter his radical resection of primary tumor.
文摘The expression of tumor suppresser gene Pproducts Pprotein in patients with primary lung cancer has been studied by ABC immunohistochemical method using McAb 1801 as probe.
文摘BACKGROUND Primary lung cancer is the leading cause of cancer-related death worldwide.Common metastatic sites include the brain,liver,bones,and adrenal glands.However,gastric metastases from lung cancer are rare.This case may be the first report of a combined gastroscopic and laparoscopic resection for gastric metasta-tic adenosquamous carcinoma(ASC).CASE SUMMARY We report a case of gastric metastasis from lung cancer.The patient was a 61-year-old Han Chinese female who first attended our hospital complaining of a per-sistent cough,leading to the diagnosis of advanced-stage lung adenocarcinoma.After more than four years of chemotherapy,the patient began to experience epi-gastric pain.Endoscopy was performed,and pathological examination of biopsy specimens confirmed that the gastric lesion was a metastasis from lung cancer.The lesion was successfully resected by combined gastroscopy and laparoscopy.Histopathological examination of the resected gastric specimen revealed ASC.CONCLUSION Gastric metastases from lung cancer are rare.Endoscopy,histological and immunohistochemical staining are useful for diagnosing metastatic lesions.Surgical management may provide extended survival in appropriately selected patients.