Thoracic Cancer最新文献

Background: Multiport robot-assisted thoracoscopic surgery (mRATS) has been comprehensively evaluated for its clinical efficacy in numerous studies. Nevertheless, the safety and feasibility of uniportal robotic lobectomy and lymphadenectomy require further validation.

Methods: The clinical data of 34 consecutive patients with lung cancer who underwent improved uniportal robotic-assisted thoracoscopic surgery (uRATS) at our hospital between November 2023 and June 2024 were reviewed retrospectively. Camera-centered uRATS was conducted using the da Vinci Surgical Xi system (Intuitive Surgical Inc., 1266 Kifer Road, Sunnyvale, CA 94086, USA). Descriptive statistics are expressed as numbers with percentages for categorical data or medians (ranges) or means with standard deviations for continuous data.

Results: Improved uRATS lobectomy and lymphadenectomy were conducted in 34 patients with postoperative pathology-diagnosed invasive lung cancer. Among the patients, the median number of lymph nodes dissected was 24.5 (range 10-42), and the median number of stations with lymph nodes dissected was 8 (range 6-11). The median durations of the operation and the uRATS procedure were 200 min (range, 142-330 min) and 140 min (range, 80-242 min), and the median intraoperative blood loss volume was 20 mL (range, 10-100 mL), respectively. All postoperative complications, including pneumonia (2/34, 5.8%), air leakage > 5 days (2/34, 5.8%), prolonged wound healing (1/34, 2.9%), and arrhythmia (1/34, 2.9%), were graded as Clavien-Dindo grades I-II. There were no cases of wound infection or postoperative 30-day mortality.

Conclusion: The safety and feasibility of uRATS lobectomy and lymphadenectomy using the da Vinci Surgical Xi system have been preliminarily validated.

Background: Existing studies have shown that transferrin receptor (TfR) is highly expressed on the surface of lung cancer cells, and nanoparticles (NPs) have been widely used as delivery vehicles. The aim of this study was to investigate the effect of the targeted delivery of Fe₃O₄ NPs modified with transferrin (Tf) compared with photothermal treatment for lung cancer.

Methods: The morphology and properties of Fe3O4 NPs modified with Tf were tested by internal morphological characterization experiments including transmission electron microscopy, particle size meter infrared spectrometer and other experiments. The delivery of materials was investigated by cell proliferation and apoptosis experiments, and western blot experiment was used to detect yes-associated protein 1(YAP1) protein expression changes after delivering miR-15a-5p. In addition, animal models were constructed to further explore the targeting properties of the material.

Results: The results demonstrated that the nanomaterial has good stability and targeting properties. Meanwhile, we also discovered that the miR-15a-5p carried by NPs can inhibit cell growth after its entry to the lung cancer cells. The effect became more evident when the nanomaterials were assisted with laser therapy, as verified by in vivo and in vitro experiments. In terms of the related mechanism, miR-15a-5p inhibited YAP1 expression, which affected cell proliferation and apoptosis.

Conclusion: In this study, Fe3O4 NPs modified with Tf delivered miR-15a-5p in combination with photothermal therapy for lung cancer. In future research, the targeted delivery of Tf and the photothermal synergy of nanomaterials will provide a theoretical basis for cancer treatment.

Background: Inflammatory myofibroblastic tumor (IMT) is a rare intermediate-grade neoplasm. It presents a great challenge in diagnosis and treatment. This study aims to identify the clinicopathological characteristics of IMT.

Methods: A retrospective study was conducted, enrolling patients with IMT at Peking Union Medical College Hospital from January 2013 to October 2023. Clinical information, treatments, and efficacy were analyzed.

Results: A total of 72 patients were enrolled, including 38 men and 34 women, with a median age of 46.5 years. The most common primary site included the lung (n = 15, 20.8%), intestinal tract (n = 8, 11.1%), abdominal cavity (n = 7, 9.7%), and nasal sinus (n = 5, 6.9%). Thirty patients harbored anaplastic lymphoma kinase (ALK) fusion genes; Sixty-five (90.3%) patients underwent surgical resection, and 11 of them had postoperative recurrence. Thirty patients received systemic therapy, including nonsteroidal anti-inflammatory drugs (n = 1), steroids (n = 5), chemotherapy (n = 7), targeted therapy (n = 2), and immune checkpoint inhibitor (n = 1).

Conclusions: The most common site of IMT is the lung. Surgery is the main treatment for IMT, and postoperative adjuvant therapy for ALK-positive patients needs to be focused. The molecular testing is essential for all patients diagnosed with IMTs. Systemic treatment needs further research.

Various studies have reported resistance mechanisms and treatment methods after epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor treatment; however, treatment policies have not yet been established, and few cases have reported transformation to pleomorphic carcinoma (PC) as the resistance mechanism. Herein, we report the case of a 66-year-old woman who was diagnosed with Stage 4A lung adenocarcinoma (cT2bN0M1b) through bronchoscopic biopsy. Genetic profiling revealed an EGFR L858R mutation; therefore, osimertinib was administered as the first-line therapy and achieved a partial response. After 46 months of osimertinib treatment, the metastases remained under control; however, the primary tumor enlarged and was therefore resected. Pathological examination confirmed the diagnosis of PC. Genetic testing of the surgical pathology specimen showed that the EGFR mutation L858R was retained, and the patient was considered drug-resistant owing to the histologic transformation to PC. The patient continued osimertinib therapy and had no recurrence at 9 months postoperatively. Transformation to PC following osimertinib administration is rare, and we report this unique case. This study was approved by the Jichi Medical University Saitama Medical Center Ethics Committee (S24-073), and written informed consent was obtained from the patient.

Purpose: Our study aimed to comprehensively describe the features of peripheral blood multiple immune cell phenotypes in solid tumor patients during pretreatment and after immunotherapy, providing a more convenient approach for studying the prognosis of immunotherapy in different solid tumor patients.

Methods: We prospectively recruited patients with advanced solid tumors from Peking Union Medical College Hospital (PUMCH) between February 2023 and April 2024. Using multicolor flow cytometry, our study comprehensively observed and described the signatures of peripheral blood lymphocyte subsets including activation, proliferation, function, naïve memory, and T cell exhaustion immune cell subsets in this population of pretreatment and after immunotherapy.

Results: Our study enrolled 59 advanced solid tumor patients with immunotherapy and 59 healthy controls were matched by age and gender. The results demonstrated a marked upregulation in the expression of lymphocyte activation markers CD38 and HLA-DR, as well as exhaustion and proliferation markers PD-1 and Ki67, in solid tumor patients compared to healthy controls. After immune checkpoint blockade (ICB) treatment, mainly the expression of Ki67CD4+T and HLA-DRCD38CD4+T, was significantly upregulated compared to pretreatment levels (p = 0.017, p = 0.019, respectively). We further found that gynecological tumors with better prognoses had higher baseline activation levels of CD4+ T cells compared to other solid tumors with poorer prognoses.

Conclusion: Our study elucidated the characteristics of different lymphocyte subsets in the peripheral blood of solid tumor patients. Further research revealed changes in the phenotypes of different lymphocyte subsets after ICIs treatment, with the activated phenotype of CD4+ T cells playing a crucial role in the antitumor effect. This lays the groundwork for further exploration of prognostic biomarkers and predictive models for cancer patients with immunotherapy.

Background: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related deaths worldwide, with cisplatin (DDP) resistance being a significant challenge in its treatment. Histone deacetylase 1 (HDAC1) has been implicated in the regulation of NSCLC progression; however, its role in the resistance of NSCLC to DDP remains unclear.

Methods: The mRNA levels of HDAC1, ubiquitin specific peptidase 5 (USP5), and Rab interacting lysosomal protein (RILP) were analyzed by quantitative real-time polymerase chain reaction. The protein expression of HDAC1, multidrug resistance protein 1 (MRP1) and RILP was detected by western blotting assay or immunohistochemistry assay. The IC₅₀ value of DDP was determined using a cell counting kit-8 assay, while cell proliferation, apoptosis, and invasion were assessed using 5-Ethynyl-2'-deoxyuridine assay, flow cytometry, and trans well invasion assay, respectively. Cancer stem-like cell properties were analyzed by a sphere formation assay. The interaction between USP5 andHDAC1 was investigated using MG132 assay and co-immunoprecipitation (Co-IP).RILP acetylation was analyzed by a Co-IP assay. A xenograft mouse model assay was employed to study the in vivo effects of HDAC1 silencing on DDP sensitivity.

Results: HDAC1 expression was upregulated in DDP-resistant NSCLC tissues and cells. Silencing HDAC1 enhanced the sensitivity of NSCLC cells to DDP, inhibited cell proliferation, invasion, and the formation of microspheres and induced cell apoptosis. USP5 was found to deubiquitinate and stabilize HDAC1 in DDP-resistant NSCLC cells. Moreover, HDAC1 overexpression reversed the effects induced by USP5 silencing. HDAC1 also sensitized Rab-interacting lysosomal protein (RILP) acetylation in DDP-resistant NSCLC cells, and RILP upregulation counteracted the effects of HDAC1 overexpression in DDP-resistant NSCLC cells. HDAC1 silencing also improved the sensitivity of tumors to DDP in vivo.

Conclusion: USP5-dependentstabilization of HDAC1 contributed to cisplatin resistance and the malignancy of NSCLC by diminishing the levels of RILP acetylation, which suggested that targeting the HDAC1-USP5axis might represent a novel therapeutic strategy for overcoming DDP resistance in NSCLC patients.

Introduction: To evaluate the impact of antibiotic (ATB) exposure on the outcome of chemoimmunotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC).

Methods: In this multicenter retrospective study, 132 patients with ES-SCLC who received chemoimmunotherapy were included from three hospitals in China. Patients receiving ATB within 30 days prior to initiating ICI therapy (p-ATB) and those receiving concurrent ICI therapy until cessation (c-ATB)were compared to those who did not (n-ATB). Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and immune-related adverse events (irAEs) were assessed. To avoid immortal time bias, c-ATB was analyzed as a time-dependent covariate in the Cox proportional hazards model.

Results: Among the 132 patients, 25 were included in the p-ATB group and 26 in the c-ATB group, while 81 patients were categorized in the n-ATB group. Multivariate analysis revealed no significant differences in PFS (aHR = 1.028, 95% CI: 0.666-1.589, p = 0.900) and OS (aHR = 0.957, 95% CI: 0.549-1.668, p = 0.877) between the p-ATB and n-ATB groups. Similarly, p-ATB had no significant impact on ORR (p = 0.510) or irAEs (p = 0.516). The use of c-ATB had no significant effect on either PFS (aHR: 1.165, 95% CI: 0.907-1.497; p = 0.232) or OS (aHR: 1.221, 95% CI: 0.918-1.624; p = 0.171) by multivariate analysis.

Conclusions: p-ATB has no significant impact on PFS, OS, ORR, or the incidence of irAEs in ES-SCLC patients receiving chemoimmunotherapy. Similarly, c-ATB does not seem to affect PFS or OS.

Background: Cancer is a severe threat to human health, and surgery is a major method of cancer treatment. This study aimed to develop an optical sensor for fast cancer tissue.

Methods: The tissue autofluorescence spectrum and diffuse reflectance spectrum were obtained by using a laboratory-developed optical sensor system. A total of 151 lung tissue samples were used in this ex vivo study.

Results: Experimental results demonstrate that tissue autofluorescence spectroscopy with a 365-nm excitation has better performance than diffuse reflectance spectroscopy, and 63 of 64 test samples (98.4% accuracy) were correctly classified with tissue autofluorescence spectroscopy and our developed data analysis method.

Conclusions: Our promising ex vivo study results show that the developed optical sensor system has great promise for future clinical translation for intraoperative lung cancer detection and other applications.

Background: Metastasis to the thyroid gland from lung adenocarcinoma is rare and challenging to diagnose due to similar histopathological features. This study aimed to analyze the clinicopathological characteristics of and treatment strategies for lung adenocarcinoma metastasis to the thyroid based on 11 years of institutional experience.

Methods: A retrospective study included patients with lung adenocarcinoma metastasis to the thyroid at our center from 2010 to 2023. Clinicopathological features and clinical outcomes were analyzed.

Results: Among 9714 lung adenocarcinoma patients, nine patients (five females, 55.6%) were diagnosed with thyroid metastasis, presenting primarily with cough symptoms. Most patients (88.9%) had synchronous tumors, whereas a minority (11.1%) had metachronous tumors. The median time from primary tumor diagnosis to metastasis was 4.8 months. Most patients developed bilateral thyroid metastases (88.9%). Diagnosis of thyroid metastasis was primarily through fine-needle aspiration (FNA), with one case misdiagnosed as papillary thyroid carcinoma. Immunohistochemical staining revealed thyroid transcription factor-1 (TTF-1) and novel aspartic proteinase of pepsin family A (Napsin-A) positivity and paired box 8 (PAX8) negativity. Genetic testing found epidermal growth factor receptor mutations in 71.4% of patients. The individualized comprehensive therapy included surgery, chemotherapy, immunotherapy, and targeted and supportive therapy. The median overall survival was 56.0 months, with a progression-free survival of 12.7 months. Kaplan-Meier (K-M) analysis suggested improved survival with no advanced symptoms (p = 0.03) and targeted therapies (p = 0.05).

Conclusions: Lung adenocarcinoma metastasis to the thyroid is a rare disease, with an incidence of 0.1% among lung adenocarcinoma patients. Early treatment after symptom onset and personalized targeted therapies may improve prognosis. Despite rapid disease progression, favorable outcomes can be achieved with comprehensive treatment.