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Targeting of CSF1R abrogates Lewis Lung adenocarcinoma-induced malignant pleural effusion 靶向CSF1R可消除Lewis肺腺癌诱导的恶性胸腔积液
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2861
Sophia F. Magkouta, C. Kosti, Photene C. Vaitsi, Apostolos G. Pappas, Charalampos Moschos, M. Iliopoulou, K. Psarra, I. Kalomenidis
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引用次数: 1
Comparison of pleural fluid pH measurements: blood gas analyzer, pH indicator stick, litmus paper, and point-of-care testing for blood gases 比较胸膜液pH值测量:血气分析仪,pH指示剂棒,石蕊试纸,和点护理测试的血气
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2872
Sang-Ha Kim, Beomsu Shin, S. Lee, M. Lee, W. Lee, S. Yong
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引用次数: 1
Does talc increase risk of non-draining septated pleural effusion after indwelling pleural catheter insertion? 滑石粉是否会增加留置胸膜导管后发生非引流性分隔性胸腔积液的风险?
Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA498
R. Asciak, R. Mercer, R. Hallifax, Maged Hassan, N. Kanellakis, J. Wrightson, I. Psallidas, N. Rahman
Non-draining septated pleural effusions limit effective drainage via indwelling pleural catheters (IPC). Aim: To retrospectively analyse whether previous talc pleurodesis attempt increases chances of a non-draining septated pleural effusion after IPC insertion. Method IPC outcomes and complications for IPC insertions were analysed. ‘MPE group’ were IPC insertions for malignant pleural effusion(MPE), ‘non-MPE group’ were IPC insertions for hepatic hydrothorax(3% overall), benign pleuritis(3%), heart failure(2%), other(2.5%). Mesothelioma cases were analysed separately in view of the possibility of increased pleural tumour-induced fibrin deposition within the pleural space. Results: 202 IPC insertions were analysed: MPE group(n=181), mean age 68 years(SD 13.9), 48% female (n=87); non-MPE group(n=21), mean age 70 years(SD 10.8) (p=0.4), 29%(n=6) female (p=0.09). Overall, 2.7% (n=2) and 4.7% (n=6) of patients with and without prior talc respectively developed non-draining septated pleural effusion (p=0.47). Of these, 2(25%) patients had heterogeneously septated pleural effusion at IPC insertion, and they had not received prior talc, 75%(n=6) developed septation while IPC was in situ. Conclusion: There was no significant difference in rates of non-draining septated effusions between patients who had received prior talc and those who had not, although limited by the retrospective study design and small numbers.
未引流的分隔性胸腔积液限制了通过留置胸膜导管(IPC)的有效引流。目的:回顾性分析先前的滑石粉胸膜穿刺术是否会增加IPC置入后不引流的分隔性胸膜积液的机会。方法分析IPC置入的IPC结局及并发症。“MPE组”为恶性胸腔积液(MPE)的IPC插入,“非MPE组”为肝性胸水(3%)、良性胸膜炎(3%)、心力衰竭(2%)、其他(2.5%)的IPC插入。间皮瘤病例被单独分析,考虑到胸膜腔内增加的胸膜肿瘤诱导的纤维蛋白沉积的可能性。结果:分析202例IPC插入:MPE组(n=181),平均年龄68岁(SD 13.9),女性占48% (n=87);非mpe组(n=21),平均年龄70岁(SD 10.8) (p=0.4),女性占29%(n=6) (p=0.09)。总体而言,2.7% (n=2)和4.7% (n=6)有滑石粉和没有滑石粉的患者分别发生了非引流性分隔性胸腔积液(p=0.47)。其中,2例(25%)患者在IPC置入时出现胸腔积液不均匀分隔,且之前未接受滑石粉治疗,75%(n=6)患者在IPC置入时出现分隔。结论:尽管受到回顾性研究设计和人数较少的限制,但先前接受过滑石粉的患者与未接受过滑石粉的患者之间的非引流性渗液发生率无显著差异。
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引用次数: 0
Assessing breathlessness following pleural fluid drainage using the Visual Analogue Scale for Dyspnoea(VASD) over 1 week(7-DVQ) 使用呼吸困难视觉模拟量表(VASD)评估胸腔液引流后1周内的呼吸困难(7-DVQ)
Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2891
R. Banka, E. Mishra
Introduction: VASD is a patient reported outcome assessing dyspnea intensity, consisting of a 100mm horizontal line anchored at 0mm with ‘Not breathless at all’ and at 100mm with ‘Worst possible breathlessness’. Although it is a validated measure of dyspnea change with pleural fluid drainage, the optimal duration of measurement following aspiration is not well established and there appears to be a significant placebo effect after 24 hours. Aim: To assess whether routine measurement of 7-DVQ post pleural aspiration is i.acceptable to patients and has a good(>70%)response rate ii. Assess relationship between volume of pleural fluid drained and mean 7-DVQ. Methods: Between Sept 2017 and Jan 2018, consecutive patients undergoing pleural aspiration in pleural clinic at NNUH were enrolled to fill up 7-DVQ. Baseline VASD was recorded before the aspiration and subsequently the patient was asked to complete it at home for 7 days. Results: Of 23 patients who underwent aspiration,17 questionnaires were returned, of which data for analysis were available from 16 patients. Demographics are summarised in Table 1. Mean VASD at baseline and at end of 7 days was 64 mm(SD 28) and 46 mm(SD 21)respectively. Mean decrease in VASD at end of 7 days was 19 mm(SD 14). Correlation between volume of fluid aspirated and decrease in 7-DVQ was 0.5(p=0.03) Conclusion: This study shows that 7-DVQ as a measure to quantify change in dyspnea post aspiration correlates well with amount of fluid aspirated and baseline dyspnea.A response rate of 73% suggests that 7-DVQ is an acceptable measure for patients.
VASD是一种评估呼吸困难强度的患者报告结果,包括100mm水平线锚定在0mm处,“完全不呼吸”,100mm处锚定“最严重的呼吸困难”。虽然它是胸膜液引流后呼吸困难变化的有效测量方法,但吸入后测量的最佳持续时间尚未确定,24小时后似乎有明显的安慰剂效应。目的:评价胸膜穿刺后常规测量7-DVQ是否可被患者接受并具有良好(>70%)的有效率。评估排胸液量与平均7-DVQ的关系。方法:选取2017年9月至2018年1月在NNUH胸膜门诊连续行胸腔抽吸术的患者,填写7-DVQ。在抽吸前记录基线VASD,随后要求患者在家完成7天。结果:23例患者接受误吸治疗,共回收问卷17份,其中有16例患者的数据可供分析。表1概述了人口统计数据。基线和7天结束时的平均VASD分别为64 mm(SD 28)和46 mm(SD 21)。7 d时VASD平均减少19 mm(SD 14)。吸液量与7-DVQ下降的相关性为0.5(p=0.03)。结论:7-DVQ作为衡量吸液后呼吸困难变化的指标,与吸液量和基线呼吸困难有良好的相关性。73%的应答率表明7-DVQ是患者可接受的测量方法。
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引用次数: 0
In the era of personalised medicine, is pleural fluid cytology sufficient for oncological treatment? 在个体化医疗时代,胸膜液细胞学检查是否足以用于肿瘤治疗?
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2860
R. Mercer, D. McCracken, R. Asciak, R. Hallifax, Maged Hassan, E. Bedawi, N. Rahman
Introduction: Pleural fluid (PF) cytology was previously sufficient to guide oncological treatment. In the current field of personalised medicine, this may not be the case and it is frequently necessary to obtain a tissue sample even when the PF cytology demonstrates malignant cells. This raises the question of the role of PF cytology in the diagnostic pathway of patients with malignant pleural effusion. Aims & Method: All patients who had a procedure performed by the pleural service between 2015 - 2017 were included. Those with PF demonstrating malignant cells were reviewed to determine whether further tissue was required. Those with concurrent pleural histological samples were excluded. Results: 107 patients had positive PF cytology. No further testing was needed in 49 patients; 33 already had a pathological diagnosis and 16 were too unwell for treatment or followed up elsewhere. PF was sufficient to test for receptor or mutation status in 33/58 (57%) patients, 19 (33%) required further pleural biopsies and 6 (10%) underwent alterative procedures to obtain tissue. 52/58 patients had adenocarcinoma cells in the PF. Conclusions: PF cytology was sufficient for definitive oncological treatment in 57% of patients. Further work is needed to determine characteristics which would highlight which patients are likely to need further tests to guide treatments and in which patients PF will be sufficient.
导读:以前胸膜液细胞学检查足以指导肿瘤治疗。在目前的个体化医疗领域,情况可能并非如此,即使PF细胞学显示为恶性细胞,也经常需要获得组织样本。这就提出了PF细胞学在恶性胸腔积液患者诊断途径中的作用的问题。目的与方法:纳入2015 - 2017年间所有胸膜科手术患者。那些有恶性细胞的PF被复查以确定是否需要进一步的组织。排除同时有胸膜组织学标本的患者。结果:107例患者PF细胞学阳性。49例患者无需进一步检测;其中33人已经进行了病理诊断,16人身体不适,无法接受治疗或在其他地方随访。在33/58例(57%)患者中,PF足以检测受体或突变状态,19例(33%)患者需要进一步的胸膜活检,6例(10%)患者接受了其他手术以获得组织。结论:在57%的患者中,PF细胞学检查足以确定肿瘤治疗。需要进一步的工作来确定哪些患者可能需要进一步的检查来指导治疗,哪些患者的PF足够。
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引用次数: 0
Cisplatin/pemetrexed chemotherapy versus palliative care survival in malignant pleural mesothelioma 顺铂/培美曲塞化疗对恶性胸膜间皮瘤姑息治疗生存率的影响
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2894
Ivan Škopljanac, Ivana Šegrt, K. Miše, Emilija Lozo Vukovac, Anita Tolic Biocina
Introduction: Malignant pleural mesothelioma is a rare tumour commonly associated with asbestos exposure however with increasing incidence and poor survival. The standard first-line chemotherapy regimen is the combination of cisplatin and pemetrexed, with median overall survival of 13 months. Other therapeutic options like surgery, radiation and immunotherapy are currently limited therefore patient s performance status and histological subtype are the only prognostic factors (Scherpereel A. et al. EurRespir J 2010;35: 479-95, Scherpereel A. EurRespir J.2017 Mar 15;49(3). Aim and Objectives: The aim of study was to compare the patient9s survival depending on whether they received chemotherapy or not. Methods: We identified retrospectively 24 patients diagnosed with pleural mesothelioma in Department of Pulmonology, Clinical Hospital Center Split, Croatia evaluating their management, whether they were treated by cisplatin/pemetrexed or solely palliative care as a result of poor performance status or refusal of any specific treatment. Kaplan-Meier survival analysis was used (MedCalc Software ver. 18). Results: The overall median survival (OS) time was 14,6 months. A pronounced OS benefit for palliative care versus cisplatin/pemetrexed was observed, 17 vs 8 months, respectively; HR, 0,3665 ; 95% CI, 0,14 to 0,90 ; P = 0,0047, Fig. 1. Conclusions: Chemotherapeutic treatment did not show better outcomes than solely palliative treatment. Future prospective randomized controlled studies are necessary to optimize the treatment of malignant mesothelioma.
恶性胸膜间皮瘤是一种罕见的肿瘤,通常与石棉暴露有关,但发病率上升,生存率低。标准的一线化疗方案是顺铂联合培美曲塞,中位总生存期为13个月。其他治疗选择,如手术、放疗和免疫治疗目前有限,因此患者的运动状态和组织学亚型是唯一的预后因素(Scherpereel A. et al.)。张建军,张建军。中国生物医学工程学报,2010;35:479-95。目的和目的:研究的目的是比较患者是否接受化疗的生存率。方法:我们回顾性分析了24例在克罗地亚斯普利特临床医院中心肺病科诊断为胸膜间皮瘤的患者,评估了他们的治疗情况,无论他们是由于表现不佳或拒绝任何特定治疗而接受顺铂/培美曲塞治疗还是单纯姑息治疗。采用Kaplan-Meier生存分析(MedCalc Software ver.)。18)。结果:总中位生存期(OS)为14.6个月。与顺铂/培美曲塞相比,姑息治疗的OS获益明显,分别为17个月和8个月;Hr, 0,3665;95% CI为0.14 ~ 0.90;P = 0.0047,图1。结论:化疗并不比单纯姑息治疗有更好的预后。未来有必要进行前瞻性随机对照研究,以优化恶性间皮瘤的治疗。
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引用次数: 0
Effects of cisplatin and pemetrexed on 3D phenotypes of benign mesothelial and malignant pleural mesothelioma cells 顺铂和培美曲塞对良性胸膜间皮瘤和恶性胸膜间皮瘤细胞三维表型的影响
Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2895
Eleftherios D. Papazoglou, R. Jagirdar, E. Pitaraki, O. Kotsiou, C. Hatzoglou, K. Gourgoulianis, S. Zarogiannis
{"title":"Effects of cisplatin and pemetrexed on 3D phenotypes of benign mesothelial and malignant pleural mesothelioma cells","authors":"Eleftherios D. Papazoglou, R. Jagirdar, E. Pitaraki, O. Kotsiou, C. Hatzoglou, K. Gourgoulianis, S. Zarogiannis","doi":"10.1183/13993003.CONGRESS-2018.PA2895","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2895","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89296299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EBUS-TBNA for the diagnosis of intrathoracic lymphadenopathy in patients with previously diagnosed breast carcinoma EBUS-TBNA对既往乳腺癌患者胸内淋巴结病变的诊断价值
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2892
N. Živković, A. Ljilja, Nina-Petra Novak, N. Tudorić
The diagnostic method of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for the confirmation of extrathoracic malignant disease dissemination into mediastinal lymph nodes has been proven as highly efficient (sensitivity 93%, specificity 100%). The aim of this research was to carry out a retrospective study of the medical records of patients with newly developed mediastinal/hilar lymphadenopathy (ML) and previously diagnosed extrathoracic malignant disease, select the patients with previously diagnosed breast carcinoma, and analyze the results of EBUS-TBNA. The retrospective, single-center clinical observational study was conducted in the period from January 2015 to August 2017, in which the EBUS-TBNA results were analyzed for 77 patients who had met the inclusion criteria. A malignant etiology of the ML was confirmed in 39/77 patients (50.64%). Patients with previously diagnosed breast carcinoma showed a divergence within this group. A malignant etiology of the ML was confirmed in 10/14 patients (71.42%), and a benign one in 3/14 patients (21.42%). In one patient with reactive lymphadenopathy and pulmonary parenchymal infiltration, primary lung carcinoma was confirmed by thoracotomy. Two patients showed signs of reactive/granulomatous ML during chemotherapy with paclitaxel, and in one patient sarcoidosi was confirmed. To conclude, in spite of the high percentage of a malignant etiology of newly developed ML in patients with previously diagnosed breast carcinoma, their cytological verification is necessary due to the possibility of a reactive/granulomatous lymph node reaction, especially in patients undergoing chemotherapy with paclitaxel.
支气管内超声-经支气管穿刺(EBUS-TBNA)诊断胸外恶性疾病播散至纵隔淋巴结的诊断方法已被证明是高效的(灵敏度93%,特异性100%)。本研究的目的是回顾性研究新发纵隔/肺门淋巴结病(ML)和既往诊断的胸外恶性疾病患者的病历,选择既往诊断为乳腺癌的患者,并分析EBUS-TBNA结果。本研究于2015年1月至2017年8月进行回顾性、单中心临床观察性研究,对符合纳入标准的77例患者的EBUS-TBNA结果进行分析。77例患者中有39例(50.64%)确诊为恶性病因。先前诊断为乳腺癌的患者在该组中表现出差异。10/14例(71.42%)确诊为恶性,3/14例(21.42%)确诊为良性。一例反应性淋巴结病变伴肺实质浸润,经开胸证实为原发性肺癌。两名患者在紫杉醇化疗期间出现反应性/肉芽肿性ML的迹象,其中一名患者被证实为结节病。总之,尽管先前诊断为乳腺癌的患者中新发展的ML的恶性病因率很高,但由于可能存在反应性/肉芽肿性淋巴结反应,特别是在接受紫杉醇化疗的患者中,他们的细胞学验证是必要的。
{"title":"EBUS-TBNA for the diagnosis of intrathoracic lymphadenopathy in patients with previously diagnosed breast carcinoma","authors":"N. Živković, A. Ljilja, Nina-Petra Novak, N. Tudorić","doi":"10.1183/13993003.congress-2018.pa2892","DOIUrl":"https://doi.org/10.1183/13993003.congress-2018.pa2892","url":null,"abstract":"The diagnostic method of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for the confirmation of extrathoracic malignant disease dissemination into mediastinal lymph nodes has been proven as highly efficient (sensitivity 93%, specificity 100%). The aim of this research was to carry out a retrospective study of the medical records of patients with newly developed mediastinal/hilar lymphadenopathy (ML) and previously diagnosed extrathoracic malignant disease, select the patients with previously diagnosed breast carcinoma, and analyze the results of EBUS-TBNA. The retrospective, single-center clinical observational study was conducted in the period from January 2015 to August 2017, in which the EBUS-TBNA results were analyzed for 77 patients who had met the inclusion criteria. A malignant etiology of the ML was confirmed in 39/77 patients (50.64%). Patients with previously diagnosed breast carcinoma showed a divergence within this group. A malignant etiology of the ML was confirmed in 10/14 patients (71.42%), and a benign one in 3/14 patients (21.42%). In one patient with reactive lymphadenopathy and pulmonary parenchymal infiltration, primary lung carcinoma was confirmed by thoracotomy. Two patients showed signs of reactive/granulomatous ML during chemotherapy with paclitaxel, and in one patient sarcoidosi was confirmed. To conclude, in spite of the high percentage of a malignant etiology of newly developed ML in patients with previously diagnosed breast carcinoma, their cytological verification is necessary due to the possibility of a reactive/granulomatous lymph node reaction, especially in patients undergoing chemotherapy with paclitaxel.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73555500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Red cell distribution width value as a novel biomarker for exudative pleural fluid. 红细胞分布宽度值作为一种新的胸腔渗出液生物标志物。
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2870
A. Sharifi, D. Amir
{"title":"Red cell distribution width value as a novel biomarker for exudative pleural fluid.","authors":"A. Sharifi, D. Amir","doi":"10.1183/13993003.congress-2018.pa2870","DOIUrl":"https://doi.org/10.1183/13993003.congress-2018.pa2870","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72936288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rotation Aiding (RA’s) technique for EBUS-TBNA biopsy of intrathoracic lymph node: a comparison of conventional Jab method 旋转辅助(RA’s)技术用于胸内淋巴结EBUS-TBNA活检:与传统针刺法的比较
Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2875
S. Ra, W. Kwon, Yongjik Lee, C. Park, H. Cha, B. Kang, Taehoon Lee, Y. Jegal, J. Ahn, Y. Chee, K. Seo
{"title":"Rotation Aiding (RA’s) technique for EBUS-TBNA biopsy of intrathoracic lymph node: a comparison of conventional Jab method","authors":"S. Ra, W. Kwon, Yongjik Lee, C. Park, H. Cha, B. Kang, Taehoon Lee, Y. Jegal, J. Ahn, Y. Chee, K. Seo","doi":"10.1183/13993003.congress-2018.pa2875","DOIUrl":"https://doi.org/10.1183/13993003.congress-2018.pa2875","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80773406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Pleural and Mediastinal Malignancies
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