Objective: To develop and validate a prediction model for early recurrence of stage I lung adenocarcinoma (LUAD) that combines radiomics features based on preoperative CT with tumour spread through air spaces (STAS). Materials and methods: The most recent preoperative thin-section chest CT scans and postoperative pathological haematoxylin and eosin-stained sections were retrospectively collected from patients with a postoperative pathological diagnosis of stage I LUAD. Regions of interest were manually segmented, and radiomics features were extracted from the tumour and peritumoral regions extended by 3 voxel units, 6 voxel units, and 12 voxel units, and 2D and 3D deep learning image features were extracted by convolutional neural networks. Then, the RAdiomics Integrated with STAS model (RAISm) was constructed. The performance of RAISm was then evaluated in a development cohort and validation cohort. Results: A total of 226 patients from two medical centres from January 2015 to December 2018 were retrospectively included as the development cohort for the model and were randomly split into a training set (72.6%, n = 164) and a test set (27.4%, n = 62). From June 2019 to December 2019, 51 patients were included in the validation cohort. RAISm had excellent discrimination in predicting the early recurrence of stage I LUAD in the training cohort (AUC = 0.847, 95% CI 0.762–0.932) and validation cohort (AUC = 0.817, 95% CI 0.625–1.000). RAISm outperformed single modality signatures and other combinations of signatures in terms of discrimination and clinical net benefits. Conclusion: We pioneered combining preoperative CT-based radiomics with STAS to predict stage I LUAD recurrence postoperatively and confirmed the superior effect of the model in validation cohorts, showing its potential to assist in postoperative treatment strategies.
目的开发并验证一个预测 I 期肺腺癌（LUAD）早期复发的模型，该模型结合了基于术前 CT 的放射组学特征和肿瘤通过气隙扩散（STAS）的特征。材料与方法：从术后病理诊断为 I 期 LUAD 的患者中回顾性收集最近的术前薄层胸部 CT 扫描和术后病理血红素和伊红染色切片。人工分割感兴趣区，提取肿瘤和瘤周区域的放射组学特征，分别以 3 个体素单位、6 个体素单位和 12 个体素单位扩展，并通过卷积神经网络提取二维和三维深度学习图像特征。然后，构建了 RAdiomics Integrated with STAS 模型（RAISm）。然后在开发队列和验证队列中评估了 RAISm 的性能。结果2015年1月至2018年12月，两个医疗中心共226名患者被回顾性纳入模型的开发队列，并随机分为训练集（72.6%，n = 164）和测试集（27.4%，n = 62）。从2019年6月至2019年12月，51名患者被纳入验证队列。在训练队列（AUC = 0.847，95% CI 0.762-0.932）和验证队列（AUC = 0.817，95% CI 0.625-1.000）中，RAISm在预测I期LUAD早期复发方面具有出色的分辨能力。RAISm 在鉴别力和临床净效益方面优于单一模式特征和其他组合特征。结论：我们开创性地将基于术前 CT 的放射组学与 STAS 结合起来预测 I 期 LUAD 术后复发，并在验证队列中证实了该模型的卓越效果，显示了其辅助术后治疗策略的潜力。
{"title":"Adenokarzinome der Lunge: Radiomics könnten prognostische Aussagen verbessern","authors":"S. Lang","doi":"10.1159/000535434","DOIUrl":"https://doi.org/10.1159/000535434","url":null,"abstract":"Objective: To develop and validate a prediction model for early recurrence of stage I lung adenocarcinoma (LUAD) that combines radiomics features based on preoperative CT with tumour spread through air spaces (STAS). Materials and methods: The most recent preoperative thin-section chest CT scans and postoperative pathological haematoxylin and eosin-stained sections were retrospectively collected from patients with a postoperative pathological diagnosis of stage I LUAD. Regions of interest were manually segmented, and radiomics features were extracted from the tumour and peritumoral regions extended by 3 voxel units, 6 voxel units, and 12 voxel units, and 2D and 3D deep learning image features were extracted by convolutional neural networks. Then, the RAdiomics Integrated with STAS model (RAISm) was constructed. The performance of RAISm was then evaluated in a development cohort and validation cohort. Results: A total of 226 patients from two medical centres from January 2015 to December 2018 were retrospectively included as the development cohort for the model and were randomly split into a training set (72.6%, n = 164) and a test set (27.4%, n = 62). From June 2019 to December 2019, 51 patients were included in the validation cohort. RAISm had excellent discrimination in predicting the early recurrence of stage I LUAD in the training cohort (AUC = 0.847, 95% CI 0.762–0.932) and validation cohort (AUC = 0.817, 95% CI 0.625–1.000). RAISm outperformed single modality signatures and other combinations of signatures in terms of discrimination and clinical net benefits. Conclusion: We pioneered combining preoperative CT-based radiomics with STAS to predict stage I LUAD recurrence postoperatively and confirmed the superior effect of the model in validation cohorts, showing its potential to assist in postoperative treatment strategies.","PeriodicalId":402207,"journal":{"name":"Kompass Pneumologie","volume":"45 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138972556","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}
A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour promoting role for PM2.5 air pollutants and provide impetus for public health policy initiatives to address air pollution to reduce disease burden.
{"title":"Adenokarzinome der Lunge: Feinstaubbelastung fördert Tumorentwicklung","authors":"K. Hekmat","doi":"10.1159/000535378","DOIUrl":"https://doi.org/10.1159/000535378","url":null,"abstract":"A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour promoting role for PM2.5 air pollutants and provide impetus for public health policy initiatives to address air pollution to reduce disease burden.","PeriodicalId":402207,"journal":{"name":"Kompass Pneumologie","volume":"4 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007718","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}
Objectives: Asthma has significant occupational consequences. The objective of our study was to investigate the links between asthma and the career path, taking into account gender and age at asthma onset. Methods: Using cross-sectional data collected at inclusion in the French CONSTANCES cohort in 2013-2014, we studied the links between each career path indicator (number of job periods, total duration of employment, numbers of part-time jobs and work interruptions due to unemployment or health issues, employment status at inclusion) on the one hand, and current asthma and asthma symptom score in the last 12 months on the other hand, as reported by the participants. Multivariate analyses were performed separately for men and women using logistic and negative binomial regression models adjusted for age, smoking status, body mass index and educational level. Results: When the asthma symptom score was used, significant associations were observed with all of the career path indicators studied: a high symptom score was associated with a shorter total duration of employment as well as a greater number of job periods, part-time jobs and work interruptions due to unemployment or health issues. These associations were of similar magnitude in men and women. When current asthma was used, the associations were more pronounced in women for some career path indicators.
{"title":"Asthma bronchiale – ein Karrierekiller?","authors":"M. Velasco Garrido, Alexandra M. Preisser","doi":"10.1159/000533536","DOIUrl":"https://doi.org/10.1159/000533536","url":null,"abstract":"Objectives: Asthma has significant occupational consequences. The objective of our study was to investigate the links between asthma and the career path, taking into account gender and age at asthma onset. Methods: Using cross-sectional data collected at inclusion in the French CONSTANCES cohort in 2013-2014, we studied the links between each career path indicator (number of job periods, total duration of employment, numbers of part-time jobs and work interruptions due to unemployment or health issues, employment status at inclusion) on the one hand, and current asthma and asthma symptom score in the last 12 months on the other hand, as reported by the participants. Multivariate analyses were performed separately for men and women using logistic and negative binomial regression models adjusted for age, smoking status, body mass index and educational level. Results: When the asthma symptom score was used, significant associations were observed with all of the career path indicators studied: a high symptom score was associated with a shorter total duration of employment as well as a greater number of job periods, part-time jobs and work interruptions due to unemployment or health issues. These associations were of similar magnitude in men and women. When current asthma was used, the associations were more pronounced in women for some career path indicators.","PeriodicalId":402207,"journal":{"name":"Kompass Pneumologie","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134630211","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}
Xiaoxuan Han, Danni Li, Felisa Reyes-Ortega, Elena K. Schneider-Futschik
Die Gabe von Medikamenten über die Lunge wird seit langem zur lokalen und systemischen Anwendung verschiedener Medikamente bei akuten und chronischen Atemwegserkrankungen eingesetzt. Bestimmte Lungenkrankheiten, wie z.B. Mukoviszidose, sind in hohem Maße von chronischen Behandlungen abhängig, einschließlich der gezielten Verabreichung von Medikamenten in die Lunge. Die Medikamentengabe über die Lunge hat im Vergleich zu anderen Verabreichungsformen verschiedene physiologische Vorteile und ist für den Patienten bequemer. Die Formulierung von Trockenpulver für die pulmonale Verabreichung erweist sich jedoch aufgrund der aerodynamischen Einschränkungen und der geringeren Toleranz der Lungen als schwierig. Ziel dieser Übersichtsarbeit ist es, einen Überblick über die Struktur des Atmungstrakts bei Patienten mit Mukoviszidose zu geben, auch während akuter und chronischer Lungeninfektionen und Exazerbationen. Darüber hinaus werden die Vorteile einer gezielten Verabreichung über die Lunge diskutiert, einschließlich der physikalisch-chemischen Eigenschaften von Trockenpulver und der Faktoren, die die klinische Wirksamkeit beeinflussen. Aktuelle und in der Entwicklung befindliche inhalierbare Medikamente werden ebenfalls diskutiert.
{"title":"Trockenpulverinhalation über die Lunge bei Mukoviszidose","authors":"Xiaoxuan Han, Danni Li, Felisa Reyes-Ortega, Elena K. Schneider-Futschik","doi":"10.1159/000531803","DOIUrl":"https://doi.org/10.1159/000531803","url":null,"abstract":"Die Gabe von Medikamenten über die Lunge wird seit langem zur lokalen und systemischen Anwendung verschiedener Medikamente bei akuten und chronischen Atemwegserkrankungen eingesetzt. Bestimmte Lungenkrankheiten, wie z.B. Mukoviszidose, sind in hohem Maße von chronischen Behandlungen abhängig, einschließlich der gezielten Verabreichung von Medikamenten in die Lunge. Die Medikamentengabe über die Lunge hat im Vergleich zu anderen Verabreichungsformen verschiedene physiologische Vorteile und ist für den Patienten bequemer. Die Formulierung von Trockenpulver für die pulmonale Verabreichung erweist sich jedoch aufgrund der aerodynamischen Einschränkungen und der geringeren Toleranz der Lungen als schwierig. Ziel dieser Übersichtsarbeit ist es, einen Überblick über die Struktur des Atmungstrakts bei Patienten mit Mukoviszidose zu geben, auch während akuter und chronischer Lungeninfektionen und Exazerbationen. Darüber hinaus werden die Vorteile einer gezielten Verabreichung über die Lunge diskutiert, einschließlich der physikalisch-chemischen Eigenschaften von Trockenpulver und der Faktoren, die die klinische Wirksamkeit beeinflussen. Aktuelle und in der Entwicklung befindliche inhalierbare Medikamente werden ebenfalls diskutiert.","PeriodicalId":402207,"journal":{"name":"Kompass Pneumologie","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124568985","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}
{"title":"7 Fragen an die Trägerin des «International Klosterfrau Group Awards» 2023","authors":"F. Decrue","doi":"10.1159/000531216","DOIUrl":"https://doi.org/10.1159/000531216","url":null,"abstract":"","PeriodicalId":402207,"journal":{"name":"Kompass Pneumologie","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129072777","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}
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