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中国肺癌杂志最新文献

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[Research Progress on Immunosenescence in Elderly Patients 
with Advanced Non-small Cell Lung Cancer and Its Immunotherapy]. [老年晚期非小细胞肺癌患者免疫衰老
及其免疫治疗研究进展]。
Q4 Medicine Pub Date : 2025-07-20 DOI: 10.3779/j.issn.1009-3419.2025.102.28
Na Wang, Yaning Luo, Haoyu Lu, Siyuan Cui, Kui Zhao, Fanming Kong

Lung cancer remains the leading cause of cancer-related incidence and mortality worldwide. Among its histological subtypes, non-small cell lung cancer (NSCLC) accounts for the majority of cases, representing the predominant pathological type. Notably, in the elderly population, NSCLC continues to be a major contributor to cancer-related deaths. With the global ageing population, immunosenescence has emerged as a key factor influencing the occurrence, progression, and the efficacy of immunotherapy of NSCLC. Immunosenescence refers to the age-related decline in immune system function, which manifests as alterations in both the quantity and functionality of immune cells. These include thymic involution, T cell exhaustion, epigenetic modifications, weakened immune responses, and a chronic low-grade inflammatory state. This review comprehensively analyzes the role of immunosenescence in elderly patients with advanced NSCLC and proposes potential therapeutic strategies to intervene in the immunosenescence process. By targeting immunosenescence, these strategies aim to inhibit the progression of NSCLC and improve the effectiveness of immunotherapy.
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肺癌仍然是全球癌症相关发病率和死亡率的主要原因。在其组织学亚型中,非小细胞肺癌(NSCLC)占多数,是主要的病理类型。值得注意的是,在老年人群中,非小细胞肺癌仍然是癌症相关死亡的主要原因。随着全球人口老龄化,免疫衰老已成为影响非小细胞肺癌发生、发展和免疫治疗效果的关键因素。免疫衰老是指与年龄相关的免疫系统功能下降,表现为免疫细胞数量和功能的改变。这些包括胸腺退化、T细胞衰竭、表观遗传修饰、免疫反应减弱和慢性低度炎症状态。本文综合分析了免疫衰老在老年晚期NSCLC患者中的作用,并提出了干预免疫衰老过程的潜在治疗策略。通过靶向免疫衰老,这些策略旨在抑制NSCLC的进展,提高免疫治疗的有效性。
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引用次数: 0
[A Case of Endometrial Metastasis in Lung Adenocarcinoma 
after EGFR-TKIs Treatment Failure and Literature Review]. [1例EGFR-TKIs治疗失败后肺腺癌子宫内膜转移
及文献复习]。
Q4 Medicine Pub Date : 2025-07-20 DOI: 10.3779/j.issn.1009-3419.2025.102.27
Fangqian Shen, Zuling Hu, Hua Yang, Puyu Liu, Yuju Bai, Jianguo Zhou, Hu Ma

The incidence and mortality rates of lung cancer remain high, making it the leading cause of cancer-related deaths. In women, the predominant histological subtype is lung adenocarcinoma, commonly associated with epidermal growth factor receptor (EGFR) mutations, and EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can significantly improve patient prognosis. Metastasis of primary lung cancer to the endometrium is extremely rare and is often misdiagnosed as a primary reproductive system tumor, and its occurrence indicates poor prognosis. This article reports a case of an advanced lung adenocarcinoma patient with EGFR mutation, who developed abnormal vaginal bleeding after EGFR-TKIs treatment failure, and biopsy confirmed endometrial metastasis. A review of similar cases is also presented.
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肺癌的发病率和死亡率仍然很高,使其成为癌症相关死亡的主要原因。在女性中,主要的组织学亚型是肺腺癌,通常与表皮生长因子受体(EGFR)突变相关,EGFR-酪氨酸激酶抑制剂(EGFR- tkis)可以显著改善患者预后。原发性肺癌向子宫内膜转移极为罕见,常被误诊为原发性生殖系统肿瘤,其发生预示预后不良。本文报道一例晚期EGFR突变肺腺癌患者,EGFR- tkis治疗失败后出现阴道异常出血,活检证实子宫内膜转移。对类似的案例也进行了回顾。
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引用次数: 0
[Application Value of Neoadjuvant Targeted Therapy in Patients with EGFR-mutant 
Resectable Lung Adenocarcinoma]. [egfr突变
可切除肺腺癌患者新辅助靶向治疗的应用价值]。
Q4 Medicine Pub Date : 2025-07-20 DOI: 10.3779/j.issn.1009-3419.2025.106.18
Shijie Huang, Mengying Fan, Kaiming Peng, Wanpu Yan, Boyang Chen, Wu Wang, Tianbao Yang, Keneng Chen, Mingqiang Kang, Jinbiao Xie

Background: The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma.

Methods: A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024.

Results: A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%.

Conclusions: The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.

背景:在中国,携带表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)患者比例相对较高。然而,这些患者目前缺乏有效的新辅助治疗方案。本研究旨在通过评价新辅助靶向治疗在egfr突变型可切除肺腺癌患者中的疗效和安全性,探讨其潜在的应用价值。方法:采用多中心回顾性研究,分析2019年7月至2024年10月接受新辅助靶向治疗后手术切除的IIA-IIIB期egfr突变肺腺癌患者的治疗效果。结果:本研究共纳入了来自三个中心的24例egfr突变肺腺癌患者。所有患者均成功手术,R0切除率达100.0%。客观有效率(ORR)为83.3%(20/24)。主要病理缓解率(MPR)为37.5%(9/24),2例(8.3%)患者达到病理完全缓解(pCR)。在新辅助治疗期间,24例患者中有13例(54.2%)出现1-2级不良事件,未发生≥3级不良事件。最常见的治疗相关不良事件是皮疹(n=4, 16.7%)、口腔溃疡(n=2, 8.3%)和腹泻(n=2, 8.3%)。中位随访时间为33.0个月,所有患者无死亡,总生存率(OS)为100.0%。1年无病生存率(DFS)为91.1%,2年无病生存率为86.2%。结论:在egfr突变型可切除肺腺癌患者中应用新辅助靶向治疗是安全可行的,有望成为egfr突变型肺腺癌患者一种极具前景的新辅助治疗方案。
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引用次数: 0
[Applications and Advances of Metabolomics in Lung Cancer Research]. [代谢组学在肺癌研究中的应用与进展]。
Q4 Medicine Pub Date : 2025-07-20 DOI: 10.3779/j.issn.1009-3419.2025.106.20
Daoyun Wang, Zhicheng Huang, Bowen Li, Yadong Wang, Zhina Wang, Nan Zhang, Zewen Wei, Naixin Liang, Shanqing Li

Lung cancer, particularly non-small cell lung cancer (NSCLC), is a leading cause of cancer-related mortality worldwide. In recent years, metabolomics has emerged as a key systems biology approach for analyzing small-molecule metabolites in cells, tissues and organisms. It provides new strategies for early diagnosis and metabolic profiling. Additionally, metabolomics plays a crucial role in studying resistance mechanisms in lung cancer. Tumor cell metabolic reprogramming is a key driving factor in the initiation and progression of lung cancer. Metabolomics studies have revealed how lung cancer cells regulate critical pathways such as energy metabolism, lipid metabolism, and amino acid metabolism to adapt to the demands of rapid proliferation and invasive metastasis. This review summarizes the latest advances in metabolomics research in lung cancer, focusing on the characteristics of metabolic reprogramming, the identification of potential metabolic biomarkers, and the prospects of metabolomics in early diagnosis and the elucidation of resistance mechanisms in lung cancer.
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肺癌,特别是非小细胞肺癌(NSCLC),是全球癌症相关死亡的主要原因。近年来,代谢组学已成为分析细胞、组织和生物体中小分子代谢物的关键系统生物学方法。它为早期诊断和代谢谱分析提供了新的策略。此外,代谢组学在研究肺癌的耐药机制中起着至关重要的作用。肿瘤细胞代谢重编程是肺癌发生和发展的关键驱动因素。代谢组学研究揭示了肺癌细胞如何调节能量代谢、脂质代谢和氨基酸代谢等关键途径,以适应快速增殖和侵袭性转移的需要。本文综述了代谢组学在肺癌研究中的最新进展,重点介绍了代谢重编程的特点、潜在代谢生物标志物的鉴定以及代谢组学在肺癌早期诊断和耐药机制阐明中的应用前景。
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引用次数: 0
[Recent Advances in the Treatment of Non-small Cell Lung Cancer with Brigatinib]. 布加替尼治疗非小细胞肺癌的最新进展。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.106.12
Jia Yu, Shengxiang Ren

The discovery of anaplastic lymphoma kinase (ALK) tyrosine kinase gene rearrangement mutations in non-small cell lung cancer (NSCLC) has driven continuous advancements in ALK-targeted therapies. The next generation of ALK tyrosine kinase inhibitor, Brigatinib, has demonstrated significant efficacy in patients with ALK-positive NSCLC, offering clinical benefits in deep response of tumor, treatment of brain metastases patients, quality of life, and long-term survival. This review will provide current advancements and exploratory directions for Brigatinib.
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非小细胞肺癌(NSCLC)中间变性淋巴瘤激酶(ALK)酪氨酸激酶基因重排突变的发现推动了ALK靶向治疗的不断进步。新一代ALK酪氨酸激酶抑制剂Brigatinib已经在ALK阳性NSCLC患者中显示出显著的疗效,在肿瘤的深度反应、脑转移患者的治疗、生活质量和长期生存方面提供了临床益处。本综述将提供Brigatinib的最新进展和探索方向。
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引用次数: 0
[A Case Report of Coexistence of EGFR and ROS-1 Gene Mutations 
in Non-small Cell Lung Cancer]. [非小细胞肺癌中EGFR和ROS-1基因突变
共存1例报道]。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.102.26
Juan Zhao, Jiaofeng Yu, Ye Fu, Yan Zhao, Mingli Zhao

Lung cancer represents one of the most prevalent malignant tumors globally, and its treatment has entered the era of targeted therapy. The epidermal growth factor receptor (EGFR) mutation is a common type of genetic mutation in non-small cell lung cancer (NSCLC), while c-ros oncogene 1 receptor tyrosine kinase (ROS-1) fusion mutation is a rare mutation site. Currently, there are few case reports on the coexistence of EGFR and ROS-1 gene mutations. This study reports a case of NSCLC with coexisting EGFR and ROS-1 gene mutations, aiming to provide relevant treatment strategies for clinical practice.
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肺癌是全球最常见的恶性肿瘤之一,其治疗已进入靶向治疗时代。表皮生长因子受体(EGFR)突变是非小细胞肺癌(NSCLC)中一种常见的基因突变类型,而c-ros癌基因1受体酪氨酸激酶(ROS-1)融合突变是一种罕见的突变位点。目前,EGFR与ROS-1基因突变共存的病例报道较少。本研究报告1例EGFR和ROS-1基因突变共存的NSCLC,旨在为临床提供相关的治疗策略。
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引用次数: 0
[Research Progress and Challenges of Oligometastasis in Non-small Cell Lung Cancer]. [非小细胞肺癌少转移的研究进展与挑战]。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.102.22
Songzhen Li, Tianhang Shao, Shuyang Yao

Oligometastasis represents a transitional state between early localized disease and widespread metastasis, characterized by limited tumor burden and distinct tumor biological behavior. Due to the relatively restricted number of metastatic lesions and involved organs, aggressive systemic therapy combined with local consolidative therapy offers potential for cure. With rapid advancements in molecular targeted therapies and immunotherapy, comprehensive management of oligometastatic non-small cell lung cancer (NSCLC) has gained increasing attention. This review summarizes the definition of NSCLC oligometastasis, recent therapeutic progress, and existing challenges, aiming to provide insights for clinical diagnosis and treatment strategies.
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少转移是一种从早期局部转移到广泛转移的过渡状态,其特点是肿瘤负荷有限,肿瘤生物学行为独特。由于转移病灶和受累器官的数量相对有限,积极的全身治疗结合局部巩固治疗提供了治愈的可能性。随着分子靶向治疗和免疫治疗的快速发展,寡转移性非小细胞肺癌(NSCLC)的综合治疗越来越受到人们的关注。本文综述了NSCLC寡转移的定义、最近的治疗进展和存在的挑战,旨在为临床诊断和治疗策略提供见解。
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{"title":"[Research Progress and Challenges of Oligometastasis in Non-small Cell Lung Cancer].","authors":"Songzhen Li, Tianhang Shao, Shuyang Yao","doi":"10.3779/j.issn.1009-3419.2025.102.22","DOIUrl":"10.3779/j.issn.1009-3419.2025.102.22","url":null,"abstract":"<p><p>Oligometastasis represents a transitional state between early localized disease and widespread metastasis, characterized by limited tumor burden and distinct tumor biological behavior. Due to the relatively restricted number of metastatic lesions and involved organs, aggressive systemic therapy combined with local consolidative therapy offers potential for cure. With rapid advancements in molecular targeted therapies and immunotherapy, comprehensive management of oligometastatic non-small cell lung cancer (NSCLC) has gained increasing attention. This review summarizes the definition of NSCLC oligometastasis, recent therapeutic progress, and existing challenges, aiming to provide insights for clinical diagnosis and treatment strategies.\u2029.</p>","PeriodicalId":39317,"journal":{"name":"中国肺癌杂志","volume":"28 6","pages":"467-471"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Advances in the Treatment of Multiple Primary Lung Cancer]. 【多发性原发性肺癌的治疗进展】。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.102.17
Ying Xiao, Xiaobo Chen, Xinghe Tong, Xudong Yang, Yanlong Yang, Yunping Zhao

In recent years, the incidence of multiple primary lung cancer (MPLC) has been increasing, and it cannot be ignored in clinical practice. The treatment of MPLC is still controversial, but surgical treatment is recognized as the most important treatment. However, current studies have shown that the treatment of MPLC needs to develop multimodal treatment according to different patients. This review summarizes multiple treatment method for MPLC, including surgery, ablation, chemotherapy, radiotherapy, targeted therapy, and immunotherapy in order to enhance understanding of MPLC treatment.
.

近年来,多发性原发肺癌(multiple primary lung cancer, MPLC)的发病率不断上升,在临床实践中不容忽视。MPLC的治疗仍有争议,但手术治疗被认为是最重要的治疗方法。然而,目前的研究表明,MPLC的治疗需要根据不同的患者发展多模式治疗。本文综述了MPLC的多种治疗方法,包括手术、消融、化疗、放疗、靶向治疗和免疫治疗,以提高对MPLC治疗的认识。
。
{"title":"[Advances in the Treatment of Multiple Primary Lung Cancer].","authors":"Ying Xiao, Xiaobo Chen, Xinghe Tong, Xudong Yang, Yanlong Yang, Yunping Zhao","doi":"10.3779/j.issn.1009-3419.2025.102.17","DOIUrl":"10.3779/j.issn.1009-3419.2025.102.17","url":null,"abstract":"<p><p>In recent years, the incidence of multiple primary lung cancer (MPLC) has been increasing, and it cannot be ignored in clinical practice. The treatment of MPLC is still controversial, but surgical treatment is recognized as the most important treatment. However, current studies have shown that the treatment of MPLC needs to develop multimodal treatment according to different patients. This review summarizes multiple treatment method for MPLC, including surgery, ablation, chemotherapy, radiotherapy, targeted therapy, and immunotherapy in order to enhance understanding of MPLC treatment.\u2029.</p>","PeriodicalId":39317,"journal":{"name":"中国肺癌杂志","volume":"28 6","pages":"460-466"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Trend of Death and Years of Life Lost Caused by Lung Cancer in Handan, 2017-2023]. 2017-2023年邯郸市肺癌死亡及生命损失趋势[j]。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.106.15
Nianzhen Fang, Yang Zhao, Yang Yang

Background: Lung cancer ranks as the foremost cause of cancer-related deaths in China, significantly undermining population health and longevity. By analyzing the trends of death and years of life lost caused by lung cancer in Handan from 2017 to 2023, data support is provided for the formulation of prevention and treatment strategies.

Methods: Lung cancer death data in Handan during 2017-2023 were collected. Excel 2010, SPSS 26.0 and Joinpoint 4.9.0.0 were used to analyze the mortality rate of lung cancer, average annual percentage change (AAPC), cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs), Fulfillment index, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and standardized potential years of life lost rate (SPYLLR).

Results: The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend (AAPC=-7.10%, P<0.01). The CELE of lung cancer increased by 2.49 years (AAPC=0.48%, P<0.05). The life loss rate decreased by 21.43% (AAPC=-4.61%, P<0.05). The Fulfillment index by lung cancer increased with the growth of age from 2017 to 2023. The PYLL, PYLLR, standardized potential years of life lost (SPYLL) and SPYLLR of lung cancer during 2017 to 2023 were 134,219.75 person years, 2.03‰, 98,735.63 person years, and 1.49‰, respectively. The annual PYLLR and SPYLLR showed a decreasing trend (AAPC=-6.34%, -9.34%, respectively, P<0.01).

Conclusions: The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend, and the impact of lung cancer on life expectancy decreased. The mortality rates of lung cancer showed significant differences among different ages and genders. It is necessary to take good measures to prevent and control lung cancer in males and higher age groups.

背景:肺癌是中国癌症相关死亡的首要原因,严重影响着人群的健康和寿命。通过分析2017 - 2023年邯郸市肺癌死亡人数和预期寿命变化趋势,为制定防治策略提供数据支持。方法:收集2017-2023年邯郸市肺癌死亡数据。采用Excel 2010、SPSS 26.0和Joinpoint 4.9.0.0分析肺癌死亡率、平均年变化百分比(AAPC)、消除原因预期寿命(CELE)、预期寿命潜在增益(PGLEs)、实现指数、潜在寿命损失年数(PYLL)、潜在寿命损失率(PYLLR)和标准化潜在寿命损失率(SPYLLR)。结果:2017 - 2023年邯郸市肺癌标准化死亡率呈下降趋势(AAPC=-7.10%)。结论:2017 - 2023年邯郸市肺癌标准化死亡率呈下降趋势,肺癌对预期寿命的影响减小。肺癌死亡率在不同年龄和性别之间存在显著差异。在男性及以上年龄人群中,有必要采取措施预防和控制肺癌。
{"title":"[Trend of Death and Years of Life Lost Caused by Lung Cancer in Handan, 2017-2023].","authors":"Nianzhen Fang, Yang Zhao, Yang Yang","doi":"10.3779/j.issn.1009-3419.2025.106.15","DOIUrl":"10.3779/j.issn.1009-3419.2025.106.15","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer ranks as the foremost cause of cancer-related deaths in China, significantly undermining population health and longevity. By analyzing the trends of death and years of life lost caused by lung cancer in Handan from 2017 to 2023, data support is provided for the formulation of prevention and treatment strategies.</p><p><strong>Methods: </strong>Lung cancer death data in Handan during 2017-2023 were collected. Excel 2010, SPSS 26.0 and Joinpoint 4.9.0.0 were used to analyze the mortality rate of lung cancer, average annual percentage change (AAPC), cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs), Fulfillment index, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and standardized potential years of life lost rate (SPYLLR).</p><p><strong>Results: </strong>The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend (AAPC=-7.10%, P<0.01). The CELE of lung cancer increased by 2.49 years (AAPC=0.48%, P<0.05). The life loss rate decreased by 21.43% (AAPC=-4.61%, P<0.05). The Fulfillment index by lung cancer increased with the growth of age from 2017 to 2023. The PYLL, PYLLR, standardized potential years of life lost (SPYLL) and SPYLLR of lung cancer during 2017 to 2023 were 134,219.75 person years, 2.03‰, 98,735.63 person years, and 1.49‰, respectively. The annual PYLLR and SPYLLR showed a decreasing trend (AAPC=-6.34%, -9.34%, respectively, P<0.01).</p><p><strong>Conclusions: </strong>The standardized mortality rate of lung cancer in Handan from 2017 to 2023 showed a decreasing trend, and the impact of lung cancer on life expectancy decreased. The mortality rates of lung cancer showed significant differences among different ages and genders. It is necessary to take good measures to prevent and control lung cancer in males and higher age groups.</p>","PeriodicalId":39317,"journal":{"name":"中国肺癌杂志","volume":"28 6","pages":"427-433"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy]. [颅神经冷冻治疗预防VATS肺叶切除术中长时间漏气]。
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.3779/j.issn.1009-3419.2025.102.23
Qingyu Meng, Yongkun Wu, Yufei Wang, Zhanlin Guo

Background: Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its incidence remains high. Phrenic nerve cryotherapy (PNC) temporarily inhibits phrenic nerve function, causing diaphragm elevation, which reduces thoracic cavity volume, enhances pleural apposition, and mitigates air leakage. This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy.

Methods: A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, from June 2023 to January 2025, were enrolled and randomly assigned to the control group (n=54) and the experimental group (n=54). The patients in both the two groups received VATS lobectomy and systematic lymph node dissection, with the experimental group also undergoing PNC during the operation. The baseline characteristics, intraoperative, postoperative indicators and dynamic changes in air leakage between the two groups were compared.

Results: The baseline clinical characteristics were comparable between the two groups (P>0.05). The incidence of pulmonary air leakage at 24 h after surgery (31.5% vs 29.6%) and the incidence of postoperative PAL (20.4% vs 14.8%) showed no significant differences between the two groups (P>0.05). The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases (32.0%) in the control group, compared to 14 cases (46.7%) in the experimental group. Moreover, during the progression from air leakage at 24 hours post-surgery to postoperative PAL, air leakage ceased in 6 cases (35.3%) in the control group and 8 cases (50.0%) in the experimental group, with a statistically significant difference (P<0.001). Compared to the control group, the patients in the experimental group exhibited more pronounced postoperative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery.

Conclusions: The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage, reducing the occurrence of postoperative PAL.

背景:视频胸腔镜肺叶切除术是肺癌的主要手术治疗方法。影响术后恢复的一个重要因素是长时间的漏气(PAL)。尽管有许多临床策略可以预防和处理术后PAL,但其发病率仍然很高。膈神经冷冻疗法(PNC)暂时抑制膈神经功能,引起膈膜抬高,从而减少胸腔容积,增强胸膜并减轻漏气。本研究探讨PNC在VATS肺叶切除术中预防术后PAL的疗效。方法:选取2023年6月~ 2025年1月内蒙古医科大学附属医院胸外科手术的符合条件的肺癌患者108例,随机分为对照组(n=54)和实验组(n=54)。两组患者均行VATS肺叶切除术及系统淋巴结清扫术,实验组在术中同时行PNC。比较两组患者的基线特征、术中、术后指标及漏气动态变化。结果:两组患者的基线临床特征具有可比性(P < 0.05)。两组术后24 h肺漏气发生率(31.5% vs 29.6%)和术后PAL发生率(20.4% vs 14.8%)差异无统计学意义(P < 0.05)。术中漏气试验至术后24小时,对照组漏气8例(32.0%),实验组14例(46.7%)。此外,从术后24小时漏气到术后PAL进展过程中,对照组6例(35.3%)停止漏气,实验组8例(50.0%)停止漏气,差异有统计学意义(p)。结论:PNC联合肺主动修复可作为术中漏气高危患者的重要干预措施,减少术后PAL的发生。
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引用次数: 0
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中国肺癌杂志
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