中国肺癌杂志最新文献

Background: Small cell lung cancer (SCLC) is known as recalcitrant cancer with high malignancy and heterogeneity. Immunotherapy has changed the treatment pattern of extensive-disease SCLC (ED-SCLC), but the beneficiary population is limited. Therefore, exploring new therapeutic strategies is an urgent clinical problem to be solved for SCLC. SCLC is characterized by highly active glycolytic metabolism and pyruvate kinase M1 (PKM1) is one of the isozymes of PK, an important rate-limiting enzyme in glycolysis pathway. Previous studies have shown that PKM1 is related to autophagy and drug sensitivity, however, how PKM1 regulates drug sensitivity in SCLC and its mechanism remain unclear. The aim of this study was to investigate the biological functions of PKM1 in SCLC, including its effects on proliferation, migration, autophagy, drug sensitivity, and expression of neuroendocrine (NE)-related markers in SCLC.

Methods: Western blot was used to detect the expression level of PKM1 in SCLC cells. PKM1 gene-overexpressed SCLC cell lines were constructed by stable lentivirus transfection. Proliferation of cells and drug sensitivity were detected by MTT, and migration ability of cells was determined by Transwell. The level of autophagy was detected by flow cytometry. Western blot was used to determine the expression levels of NE-related proteins.

Results: PKM1 was differentially expressed among various SCLC cell lines, and was lower in H1092 cells (P<0.01). Compared with the control group, there was no significant difference in proliferation level of PKM1 overexpressing H1092 cell, but the migration ability was significantly increased (P<0.001), the drug sensitivity was reduced, and the level of autophagy was inhibited (P<0.001). Additionally, overexpression of PKM1 could upregulate the expression of non-neuroendocrine (non-NE)-related proteins (P<0.01) and decrease the expression of NE-related proteins (P<0.01).

Conclusions: PKM1 was differentially expressed in SCLC cell lines, and high expression of PKM1 did not affect the proliferation, but affected the migration of SCLC cells. PKM1 might affect drug sensitivity by inhibiting autophagy and regulating the expression of NE markers. These results provide a theoretical basis for exploring the role of PKM1 in SCLC.

The development and change patterns as well as the disease course management of multiple ground-glass nodules (GGNs) in the lungs are currently hotspots and difficulties in clinical lung cancer research. Understanding the latest advancements in the natural history of multiple GGNs is crucial for grasping the disease variation patterns and formulating management strategies. Meanwhile, utilizing advanced methods such as intelligent follow-up management platforms makes the long-term standardized management of GGNs possible. Therefore, this article provides an overview of the latest research advancements on the natural history of multiple GGNs and new experience in GGNs management.
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Invasive mucinous adenocarcinoma (IMA) is a special type of lung adenocarcinoma that accounts for 2% to 10% of all lung adenocarcinoma. Surgical treatment is preferred for IMA, and traditional chemotherapy drugs and targeted therapy drugs have poor efficacy in this disease. IMA has unique prognostic, imaging and molecular features. The incidence of IMA is very low, so thoracic surgeons may lack of knowledge to the disease and misdiagnose it as benign diseases such as pneumonia and tuberculosis. This article reviews and discusses the imaging, clinicopathological features, treatment methods and prognosis of IMA.
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Background: The incidence rate of lung cancer in Xuanwei has been continuously increasing in recent years, and it also features high incidence across all age groups and high mortality rates among female lung cancer patients. Therefore, the search for more stable biomarkers for the diagnosis of Xuanwei lung cancer holds tremendous clinical application prospects. This study aims to explore the clinical application value of these four microRNAs (miRNAs) individually and in combination with traditional lung cancer tumor markers in the detection and diagnosis of Xuanwei lung cancer.

Methods: By detecting the expression levels of four miRNAs and five traditional lung cancer tumor markers in the serum of 45 Xuanwei lung cancer patients and healthy physical examination participants, the Logistic regression model was employed to comprehensively evaluate the sensitivity, specificity, diagnostic efficacy, and other relevant statistical indicators of the four miRNAs in the diagnosis of Xuanwei lung cancer.

Results: Among the individual miRNAs, miR-4646-5p and miR-3654 showed significant differences in expression levels between the Xuanwei lung cancer group and the control group (P<0.05). miR-3654 demonstrated the best diagnostic performance with a sensitivity of 86.7%, specificity of 82.2%, and an area under the curve of 0.847. Combining miR-3654 with miR-4646-5p and carcinoembryonic antigen (CEA) resulted in the highest diagnostic efficacy for Xuanwei lung cancer, with a sensitivity of 73.3%, specificity of 93.3%, area under the curve of 0.901, and a positive predictive value of 91.7%.

Conclusions: Among the four miRNAs, serum miR-3654 exhibits the best diagnostic efficacy for Xuanwei lung cancer. Combined with miR-4646-5p and CEA, its diagnostic value for Xuanwei lung cancer can be effectively enhanced, making it a promising screening indicator for Xuanwei lung cancer.

Background: The proportion of patients carrying driver gene mutations is notably high among individuals with non-small cell lung cancer (NSCLC) in China. However, the current neoadjuvant treatment strategies for these patients lack evident benefits. This study aims to investigate the efficacy and adverse reactions of neoadjuvant immunochemotherapy in patients with driver gene-positive NSCLC, thereby exploring its potential therapeutic value.

Methods: A total of 50 patients from two centers were retrospectively collected to compare the efficacy and adverse reactions among driver gene-positive NSCLC patients after different treatments and further explore the response to neoadjuvant immunochemotherapy among different EGFR-sensitive subtypes.

Results: A total of 50 patients from two centers were included in this study. Among the 40 patients from Peking University People's Hospital (PKUPH), 21 received neoadjuvant immunotherapy, with 57.1% showing partial response on imaging. The major pathological response (MPR) rate after neoadjuvant immunochemotherapy was 38.1%, and pathological complete response (pCR) was only observed in this group. No significant differences were noted in adverse events or their impact on surgical difficulty among different treatments. Additionally, 10 patients from Hunan Cancer Hospital (HNCA) were included to analyze the differences in efficiency among EGFR-sensitive subtypes under various neoadjuvant strategies. No significant radiological response differences were observed between neoadjuvant immunotherapy and targeted therapy. However, patients with the L858R mutation exhibited MPR and pCR only after receiving immunotherapy, surpassing targeted therapy outcomes, while no significant differences were found among 19del patients.

Conclusions: Under the premise of not exacerbating adverse effects, neoadjuvant immunochemotherapy achieved superior rates of MPR and pCR, with long-term survival comparable to targeted therapy.

Small cell lung cancer (SCLC) is a type of lung cancer with high malignant degree, rapid transformation, rapid invasion and metastasis, which is prone to early metastasis and poor prognosis. Bone metastases of SCLC occur in three stages: cancer cells proliferate at the primary site, break through local tissues, enter the blood circulation to form circulating tumor cells (CTCs), reach bone tissue through blood circulation, and take root and germinate to form new tumor sites with the support of the bone microenvironment. However, traditional imaging and pathology examinations have disadvantages such as low sensitivity, high cost and difficulty in implementation. Exploratory studies based on blood marker detection as screening and efficacy evaluation of SCLC bone metastases have been reported in recent years. By reviewing the molecular biological mechanism of SCLC bone metastasis formation, this paper found that conventional diagnostic methods such as imaging and pathological biopsy were inadequate in SCLC bone metastasis. The changes in hyaluronic acid, protein biomarkers, non-coding RNA, and biomarkers in liquid biopsy were earlier than the changes in imaging, which had the advantages of simple operation and good repeatability. It provides a new idea and method for the early diagnosis of SCLC bone metastasis, which is worthy of clinical application.
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Airway management in complex tracheobronchial surgery (TBS) remains a challenge in thoracic surgery. The use of extracorporeal membrane pulmonary oxygenation (ECMO) in thoracic surgery is rather rare, except for lung transplantation. To report the safety and efficacy of ECMO in complex TBS, a total of 5 patients with tracheobronchial and bronchial reconstructive surgery supported by ECMO in the Department of Thoracic Surgery of Tangdu Hospital, Air Force Medical University from May 2019 to June 2024 were collected. Among them, 4 cases of tracheal tumor (including long-segment trachea resection and reconstruction, or carinal resection and reconstruction) and 1 case of acute airway obstruction caused by tracheal rupture were included, all of which were performed in veno-venous ECMO (V-V ECMO) mode. Systemic heparinization was used in 2 patients, and anticoagulation was not performed in 3 patients, which were maintained only by ECMO heparin-coated lines. 4 patients recovered well after surgery, and 1 patient died 1 month after surgery due to immune-related pneumonia. For complex TBS, or in emergency situations (tracheal stenosis with risk of asphyxiation), ECMO can provide adequate support and safeguard.
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Pulmonary mixed squamous cell and glandular papilloma (MSCGP) is a subtype of pulmonary papilloma, which can be classified as central type and peripheral type based on its site of development. The central type is the most common. The clinical manifestations of pulmonary MSCGP are mainly related to the location of the tumor. Surgery is the main treatment for this disease. Bronchoscopic interventional treatment for the MSCGP in the central trachea could receive satisfactory effect. We reported a patient suffered from diffuse tracheal MSCGP who was treated by bronchoscopic interventional treatment in Respiratory Disease Center, Dongzhimen Hospital of Beijing University of Chinese Medicine, aiming to enhance the recognition of the clinical features and provide clinical references for the diagnosis and treatment of such disease.
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Immunotherapy has become the cornerstone of current malignant tumor treatment. However, the response of different patients to immunotherapy is highly heterogeneous, and not all patients can benefit from it. There is an urgent need to find biomarkers that can effectively predict the efficacy of immunotherapy. C-C chemokine ligand 4 (CCL4) is a cytokine, belonging to the inflammatory CCL subfamily. It is mainly secreted by immune cells and tumor cells and shows low or no expression in normal tissues but abnormally high expression in various malignant tumor tissues. After binding to CCL4 and its receptor C-C chemokine receptor type 5 (CCR5), it can recruit and mediate immune cell migration, destroy the stability of the tumor microenvironment (TME), participate in carcinogenesis and promote the development of tumors. In the tumor immune microenvironment, CCL4 can mediate and recruit the directed migration of key immune cells such as monocytes, macrophages, natural killer (NK) cells, and T cells, which makes it a potentially important element affecting the efficacy of immunotherapy and has specific value. This paper reviews the research progresses of CCL4's effects on immune escape in TME, in order to provide clues and references for basic research and clinical diagnosis and treatment.
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