Clinical Respiratory Journal最新文献_第10页

Quantitative analysis of lung lesions using unenhanced chest computed tomography images 利用未增强胸部计算机断层扫描图像对肺部病变进行定量分析。

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-05-07 DOI: 10.1111/crj.13759

Fariba Zarei, Payam Jannatdoust, Siamak Malekpour, Mahshad Razaghi, Sabyasachi Chatterjee, Vani Varadhan Chatterjee, Amirbahador Abbasi, Rezvan Ravanfar Haghighi

Introduction

Chest radiograph and computed tomography (CT) scans can accidentally reveal pulmonary nodules. Malignant and benign pulmonary nodules can be difficult to distinguish without specific imaging features, such as calcification, necrosis, and contrast enhancement. However, these lesions may exhibit different image texture characteristics which cannot be assessed visually. Thus, a computer-assisted quantitative method like histogram analysis (HA) of Hounsfield unit (HU) values can improve diagnostic accuracy, reducing the need for invasive biopsy.

Methods

In this exploratory control study, nonenhanced chest CT images of 20 patients with benign (10) and cancerous (10) lesion were selected retrospectively. The appearances of benign and malignant lesions were very similar in chest CT images, and only pathology report was used to discriminate them. Free hand region of interest (ROI) was inserted inside the lesion for all slices of each lesion. Mean, minimum, maximum, and standard deviations of HU values were recorded and used to make HA.

Results

HA showed that the most malignant lesions have a mean HU value between 30 and 50, a maximum HU less than 150, and a minimum HU between −30 and 20. Lesions outside these ranges were mostly benign.

Conclusion

Quantitative CT analysis may differentiate malignant from benign lesions without specific malignancy patterns on unenhanced chest CT image.

简介胸片和计算机断层扫描（CT）可能会意外发现肺部结节。如果没有特定的成像特征，如钙化、坏死和对比度增强，很难区分恶性和良性肺结节。然而，这些病变可能表现出不同的图像纹理特征，无法通过肉眼进行评估。因此，Hounsfield 单位（HU）值的直方图分析（HA）等计算机辅助定量方法可以提高诊断准确性，减少侵入性活检的需要：在这项探索性对照研究中，我们回顾性地选择了 20 名良性病变（10 人）和癌症（10 人）患者的非增强胸部 CT 图像。良性病变和恶性病变在胸部 CT 图像中的表现非常相似，因此只能通过病理报告来鉴别。每个病灶的所有切片都在病灶内部插入了自由手感兴趣区（ROI）。记录 HU 值的平均值、最小值、最大值和标准偏差，并利用这些值制作 HA：HA显示，大多数恶性病变的平均HU值介于30和50之间，最大HU值小于150，最小HU值介于-30和20之间。结论：结论：定量 CT 分析可在未增强胸部 CT 图像上区分恶性和良性病变，但没有特定的恶性模式。

{"title":"Quantitative analysis of lung lesions using unenhanced chest computed tomography images","authors":"Fariba Zarei, Payam Jannatdoust, Siamak Malekpour, Mahshad Razaghi, Sabyasachi Chatterjee, Vani Varadhan Chatterjee, Amirbahador Abbasi, Rezvan Ravanfar Haghighi","doi":"10.1111/crj.13759","DOIUrl":"10.1111/crj.13759","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Chest radiograph and computed tomography (CT) scans can accidentally reveal pulmonary nodules. Malignant and benign pulmonary nodules can be difficult to distinguish without specific imaging features, such as calcification, necrosis, and contrast enhancement. However, these lesions may exhibit different image texture characteristics which cannot be assessed visually. Thus, a computer-assisted quantitative method like histogram analysis (HA) of Hounsfield unit (HU) values can improve diagnostic accuracy, reducing the need for invasive biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this exploratory control study, nonenhanced chest CT images of 20 patients with benign (10) and cancerous (10) lesion were selected retrospectively. The appearances of benign and malignant lesions were very similar in chest CT images, and only pathology report was used to discriminate them. Free hand region of interest (ROI) was inserted inside the lesion for all slices of each lesion. Mean, minimum, maximum, and standard deviations of HU values were recorded and used to make HA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HA showed that the most malignant lesions have a mean HU value between 30 and 50, a maximum HU less than 150, and a minimum HU between −30 and 20. Lesions outside these ranges were mostly benign.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Quantitative CT analysis may differentiate malignant from benign lesions without specific malignancy patterns on unenhanced chest CT image.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes associated with neoadjuvant therapy for the treatment of resectable non-small cell lung cancer in real-world practice 现实世界中治疗可切除非小细胞肺癌的新辅助疗法的相关临床结果

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-05-01 DOI: 10.1111/crj.13761

Xiaojie Huang, Guanchao Pang, Zhirong Mao, Baizhou Li, Zhihua Teng, Yan Yang, Zijian Qiu, Xiuxiu Chen, Pingli Wang

Background

In order to improve survival outcomes in resectable non-small cell lung cancer (NSCLC), strategies for neoadjuvant therapy need to be revisited. We evaluated and compared the efficacy of different neoadjuvant therapeutic modalities in a real-world setting.

Methods

A total of 258 patients with clinical stage IIA to IIIB NSCLC was included. All the patients underwent surgical resection after one to four cycles of neoadjuvant treatment consisting of chemotherapy (83), immunotherapy (23), and immunotherapy plus chemotherapy (152).

Results

The radiologic response rate in the combined immunochemotherapy group was 67.8%, higher than that of 48.2% in the chemotherapy group and 4.3% in the immunotherapy group (p < 0.001). An improved major pathological response (MPR) was also achieved in the combined therapy group compared with the chemotherapy group and the immunotherapy group (53.9% vs. 10.8% vs. 8.7%, p < 0.001). Patients in the combined therapy group had a significant trend toward longer disease-free survival than those in the chemotherapy alone group (3-year disease-free survival [DFS] of 68.79% vs. 50.81%; hazard ratio [HR] for progression or death, 0.477; p = 0.003). Multivariate Cox analysis identified radical surgery (HR, 0.328; p = 0.033), ypN0–1 stage (HR, 0.591; p = 0.038) and MPR result (HR, 0.362; p = 0.007) to be independent prognostic factors for DFS.

Conclusions

Neoadjuvant treatment with a combination of immunotherapy plus chemotherapy appears to achieve higher radiological and pathological responses than monotherapy for IIA-IIIB NSCLC. Log-rank analysis showed that a better outcome could be expected in patients with the addition of immunotherapy to neoadjuvant chemotherapy if compared with patients with chemotherapy alone in terms of DFS.

背景为了提高可切除非小细胞肺癌（NSCLC）的生存率，需要重新审视新辅助治疗策略。我们评估并比较了现实世界中不同新辅助治疗模式的疗效。方法共纳入 258 例临床 IIA 期至 IIIB 期 NSCLC 患者。所有患者在接受一至四个周期的新辅助治疗（包括化疗（83例）、免疫治疗（23例）和免疫治疗加化疗（152例））后均接受了手术切除。结果免疫化疗联合组的放射学反应率为67.8%，高于化疗组的48.2%和免疫治疗组的4.3%（P< 0.001）。与化疗组和免疫治疗组相比，联合治疗组的主要病理反应（MPR）也有所改善（53.9% vs. 10.8% vs. 8.7%，p <0.001）。与单纯化疗组相比，联合治疗组患者的无病生存期有明显延长趋势（3年无病生存期[DFS]为68.79% vs. 50.81%；病情进展或死亡的危险比[HR]为0.477；P = 0.003）。多变量考克斯分析发现根治性手术（HR，0.328；P = 0.033）、ypN0-1分期（HR，0.591；P = 0.038）和MPR结果（HR，0.362；P = 0.007）是DFS的独立预后因素。结论对 IIA-IIIB NSCLC 采用免疫疗法加化疗联合疗法进行新辅助治疗似乎比单一疗法获得更高的放射学和病理学反应。对数秩分析显示，在新辅助化疗基础上加用免疫疗法的患者与单纯化疗的患者相比，在DFS方面会有更好的预后。

{"title":"Clinical outcomes associated with neoadjuvant therapy for the treatment of resectable non-small cell lung cancer in real-world practice","authors":"Xiaojie Huang, Guanchao Pang, Zhirong Mao, Baizhou Li, Zhihua Teng, Yan Yang, Zijian Qiu, Xiuxiu Chen, Pingli Wang","doi":"10.1111/crj.13761","DOIUrl":"https://doi.org/10.1111/crj.13761","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In order to improve survival outcomes in resectable non-small cell lung cancer (NSCLC), strategies for neoadjuvant therapy need to be revisited. We evaluated and compared the efficacy of different neoadjuvant therapeutic modalities in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 258 patients with clinical stage IIA to IIIB NSCLC was included. All the patients underwent surgical resection after one to four cycles of neoadjuvant treatment consisting of chemotherapy (83), immunotherapy (23), and immunotherapy plus chemotherapy (152).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The radiologic response rate in the combined immunochemotherapy group was 67.8%, higher than that of 48.2% in the chemotherapy group and 4.3% in the immunotherapy group (<i>p</i> < 0.001). An improved major pathological response (MPR) was also achieved in the combined therapy group compared with the chemotherapy group and the immunotherapy group (53.9% vs. 10.8% vs. 8.7%, <i>p</i> < 0.001). Patients in the combined therapy group had a significant trend toward longer disease-free survival than those in the chemotherapy alone group (3-year disease-free survival [DFS] of 68.79% vs. 50.81%; hazard ratio [HR] for progression or death, 0.477; <i>p</i> = 0.003). Multivariate Cox analysis identified radical surgery (HR, 0.328; <i>p</i> = 0.033), ypN0–1 stage (HR, 0.591; <i>p</i> = 0.038) and MPR result (HR, 0.362; <i>p</i> = 0.007) to be independent prognostic factors for DFS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neoadjuvant treatment with a combination of immunotherapy plus chemotherapy appears to achieve higher radiological and pathological responses than monotherapy for IIA-IIIB NSCLC. Log-rank analysis showed that a better outcome could be expected in patients with the addition of immunotherapy to neoadjuvant chemotherapy if compared with patients with chemotherapy alone in terms of DFS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140818919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of the epidemiological situation of influenza in Guangzhou under the prevention and control of COVID-19 in June 2022 2022年6月广州市防控COVID-19流感疫情形势分析

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-05-01 DOI: 10.1111/crj.13754

Yuezhi Deng, Yongping Lin, Weihong Lin

Objective

Under the prevention and control measures of COVID-19, the epidemiological situation of respiratory pathogens is not well known. Understanding the patterns of respiratory pathogens epidemiology under the prevention and control measures of COVID-19 is important to guide resource allocation for existing and future treatment and prevention strategies.

Methods

In total, 659 fever outpatients nasopharyngeal swabs were collected at fever illness onset during June in 2022 at the First Hospital of Guangzhou Medical University. Swabs were tested by real-time fluorescent single-tube multiplex polymerase chain reaction (PCR) for 12 respiratory pathogens. Moreover, 108 of the 659 swabs were tested for influenza virus antigen.

Results

At least one pathogen was detected in 477 (72.38%) of 659 fever outpatients with multiple pathogens identified in 25 (3.79%). The highest multiple infectious pattern is parainfluenza virus in combination with influenza (five cases). Influenza A virus (IFA), human rhinovirus (HRV), and parainfluenza virus are the three leading virus pathogens with proportions of 64.64%, 5.01%, and 2.88%. School-age children and adult groups have the highest pathogens positivity rate of 81.28% and 83.87%.

Conclusion

A high proportion of adolescents and adults has respiratory pathogens detected during fever illnesses during June in 2022 under the prevention and control of COVID-19. These data indicate that diagnosis, prevention, and control of respiratory tract infection should be paid attention under the prevention and control of COVID-19.

目标在 COVID-19 的预防和控制措施下，呼吸道病原体的流行病学情况尚不十分清楚。了解 COVID-19 防控措施下呼吸道病原体的流行模式对于指导现有和未来治疗和预防策略的资源分配非常重要。方法 2022年6月，广州医科大学附属第一医院共采集了659名发热门诊患者的鼻咽拭子。咽拭子通过实时荧光单管多重聚合酶链反应（PCR）检测 12 种呼吸道病原体。此外，还对 659 份咽拭子中的 108 份进行了流感病毒抗原检测。结果在 659 名发热门诊患者中，477 人（72.38%）至少检测出一种病原体，25 人（3.79%）检测出多种病原体。最多的多重感染模式是副流感病毒合并流感（5 例）。甲型流感病毒（IFA）、人类鼻病毒（HRV）和副流感病毒是三种主要病毒病原体，所占比例分别为 64.64%、5.01% 和 2.88%。学龄儿童和成人组的病原体阳性率最高，分别为 81.28% 和 83.87%。结论在 COVID-19 的预防和控制下，2022 年 6 月期间，青少年和成人在发热疾病中检出呼吸道病原体的比例较高。这些数据表明，在预防和控制 COVID-19 的过程中，应重视呼吸道感染的诊断、预防和控制。

{"title":"Analysis of the epidemiological situation of influenza in Guangzhou under the prevention and control of COVID-19 in June 2022","authors":"Yuezhi Deng, Yongping Lin, Weihong Lin","doi":"10.1111/crj.13754","DOIUrl":"https://doi.org/10.1111/crj.13754","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Under the prevention and control measures of COVID-19, the epidemiological situation of respiratory pathogens is not well known. Understanding the patterns of respiratory pathogens epidemiology under the prevention and control measures of COVID-19 is important to guide resource allocation for existing and future treatment and prevention strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 659 fever outpatients nasopharyngeal swabs were collected at fever illness onset during June in 2022 at the First Hospital of Guangzhou Medical University. Swabs were tested by real-time fluorescent single-tube multiplex polymerase chain reaction (PCR) for 12 respiratory pathogens. Moreover, 108 of the 659 swabs were tested for influenza virus antigen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At least one pathogen was detected in 477 (72.38%) of 659 fever outpatients with multiple pathogens identified in 25 (3.79%). The highest multiple infectious pattern is parainfluenza virus in combination with influenza (five cases). Influenza A virus (IFA), human rhinovirus (HRV), and parainfluenza virus are the three leading virus pathogens with proportions of 64.64%, 5.01%, and 2.88%. School-age children and adult groups have the highest pathogens positivity rate of 81.28% and 83.87%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high proportion of adolescents and adults has respiratory pathogens detected during fever illnesses during June in 2022 under the prevention and control of COVID-19. These data indicate that diagnosis, prevention, and control of respiratory tract infection should be paid attention under the prevention and control of COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140819004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic outcomes of radial endobronchial ultrasound bronchoscopy guided by manual navigation in the evaluation of peripheral pulmonary lesions: An observational study 人工导航引导下的径向支气管内超声支气管镜在评估肺部外周病变时的诊断结果：观察性研究

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-29 DOI: 10.1111/crj.13768

Mingli Yuan, Yi Hu, Liangchao Wang, Wen Yin, Yang Xiao

Background and Aims

Manual navigation (MN), drawing a bronchoscopic road map simply by looking at the consecutive computed tomography (CT), is feasible and economical. However, scant data about the use of MN in radial endobronchial ultrasound (r-EBUS) bronchoscopy have been documented till now. We aimed to evaluate the diagnostic performance of r-EBUS bronchoscopy guided by MN for diagnosing peripheral pulmonary lesions (PPLs) and to determine clinical factors affecting the diagnostic yield.

Methods

We performed a retrospective, cohort study of consecutive patients with PPLs who underwent r-EBUS bronchoscopic biopsy via guidance of MN from May 2020 to June 2021 in our Respiratory Endoscopic Division. The overall diagnostic yield of MN-guided r-EBUS, the factors affecting the yield, and the diagnostic performance for malignancy were evaluated.

Results

A total of 102 patients (103 lesions) were evaluated. The overall diagnostic yield of MN-guided r-EBUS was 82.0%, and it ranged from 79.6% to 82.5%, assuming the undermined cases were all positive cases (79.6%) or negatives (82.5%). The sensitivity of MN-guided r-EBUS for malignancy was 71.4%, ranging from 68.2% to 71.4%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 67.3%, ranging from 63.8% to 69.0%. The multivariate logistic regression showed that “bronchus sign on CT” was the only predictor of the overall diagnostic yield (odds ratio = 11.5, 95% confidence interval: 1.9–70.9, P = 0.009).

Conclusions

MN-guided r-EBUS is feasible in diagnosing PPLs, especially for lesions with bronchus sign on CT.

背景和目的手动导航（MN），即通过观察连续的计算机断层扫描（CT）绘制支气管镜路线图，既可行又经济。然而，到目前为止，有关在径向支气管内超声（r-EBUS）支气管镜检查中使用手动导航的数据还很少。我们的目的是评估 MN 引导下的 r-EBUS 支气管镜诊断周围肺部病变（PPL）的性能，并确定影响诊断率的临床因素。方法我们对 2020 年 5 月至 2021 年 6 月期间在本院呼吸内镜科接受 MN 引导的 r-EBUS 支气管镜活检的连续 PPLs 患者进行了一项回顾性队列研究。评估了 MN 引导 r-EBUS 的总体诊断率、影响诊断率的因素以及对恶性肿瘤的诊断效果。结果共评估了 102 名患者（103 个病灶）。MN-guided r-EBUS的总体诊断率为82.0%，假定被破坏的病例均为阳性病例（79.6%）或阴性病例（82.5%），诊断率在79.6%至82.5%之间。MN引导下的r-EBUS对恶性肿瘤的敏感性为71.4%，介于68.2%和71.4%之间，特异性为100%，阳性预测值为100%，阴性预测值为67.3%，介于63.8%和69.0%之间。多变量逻辑回归显示，"CT 显示支气管征象 "是唯一能预测总体诊断率的因素（几率比 = 11.5，95% 置信区间：1.9-70.9，P = 0.009）。结论 MN引导下的r-EBUS可用于诊断PPL，尤其是CT上有支气管征的病变。

{"title":"Diagnostic outcomes of radial endobronchial ultrasound bronchoscopy guided by manual navigation in the evaluation of peripheral pulmonary lesions: An observational study","authors":"Mingli Yuan, Yi Hu, Liangchao Wang, Wen Yin, Yang Xiao","doi":"10.1111/crj.13768","DOIUrl":"https://doi.org/10.1111/crj.13768","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Manual navigation (MN), drawing a bronchoscopic road map simply by looking at the consecutive computed tomography (CT), is feasible and economical. However, scant data about the use of MN in radial endobronchial ultrasound (r-EBUS) bronchoscopy have been documented till now. We aimed to evaluate the diagnostic performance of r-EBUS bronchoscopy guided by MN for diagnosing peripheral pulmonary lesions (PPLs) and to determine clinical factors affecting the diagnostic yield.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective, cohort study of consecutive patients with PPLs who underwent r-EBUS bronchoscopic biopsy via guidance of MN from May 2020 to June 2021 in our Respiratory Endoscopic Division. The overall diagnostic yield of MN-guided r-EBUS, the factors affecting the yield, and the diagnostic performance for malignancy were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 102 patients (103 lesions) were evaluated. The overall diagnostic yield of MN-guided r-EBUS was 82.0%, and it ranged from 79.6% to 82.5%, assuming the undermined cases were all positive cases (79.6%) or negatives (82.5%). The sensitivity of MN-guided r-EBUS for malignancy was 71.4%, ranging from 68.2% to 71.4%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 67.3%, ranging from 63.8% to 69.0%. The multivariate logistic regression showed that “bronchus sign on CT” was the only predictor of the overall diagnostic yield (odds ratio = 11.5, 95% confidence interval: 1.9–70.9, <i>P</i> = 0.009).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MN-guided r-EBUS is feasible in diagnosing PPLs, especially for lesions with bronchus sign on CT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140814160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of intestinal microecology and immune function alterations for immunotherapy outcomes in advanced unresectable lung adenocarcinoma 肠道微生态和免疫功能改变对晚期不可切除肺腺癌免疫疗法疗效的影响

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-29 DOI: 10.1111/crj.13762

Shuang He, Jin Tian, Jianhua Zang, Lin Long, Peng Liu, Yexi Zhang, Jun Xiao

Objective

This investigation aims to explore alterations in intestinal microecology and immune function among patients with advanced, unresectable lung adenocarcinoma undergoing different outcomes from immunotherapy.

Methods

A cohort of 30 patients diagnosed with advanced unresectable lung adenocarcinoma received sintilimab immunotherapy as a monotherapy. Post four treatment cycles, efficacy was assessed, leading to the segregation of patients into two distinct cohorts: those responsive to treatment and those nonresponsive. Analysis involved observing variations in the abundance, distribution, and composition of fecal intestinal microorganisms pretreatment and posttreatment via 16S rRNA gene sequencing.

Results

In this study involving 30 advanced lung adenocarcinoma patients, significant observations were made regarding the impact of immunotherapy on immune function and the gut microbiome composition. Patients were divided into treatment and control groups, revealing that immunotherapy led to a significant increase in CD4+ T cells and a decrease in CD8+ T cells among the treatment-responsive individuals, indicating an enhanced immune response. Furthermore, an in-depth analysis of the gut microbiome showed an increase in diversity and abundance of beneficial bacteria such as Faecalibacterium and Subdoligranulum in the treatment group. These findings highlight the dual effect of immunotherapy on modulating immune function and altering gut microbiome diversity, suggesting its potential therapeutic benefits in improving the health status of patients with advanced lung adenocarcinoma.

Conclusion

The structuring of gut flora plays a pivotal role in augmenting the efficacy of anti-tumor immunotherapy, underscoring the interplay between intestinal microecology and immune response in cancer treatment outcomes.

目的本研究旨在探讨晚期不可切除肺腺癌患者在接受免疫疗法后肠道微生态和免疫功能的变化。方法 30 例晚期不可切除肺腺癌患者接受了辛替利马单抗免疫疗法。四个治疗周期后，对疗效进行了评估，从而将患者分为两个不同的组群：对治疗有反应的组群和无反应的组群。分析包括通过 16S rRNA 基因测序观察治疗前和治疗后粪便肠道微生物的丰度、分布和组成变化。结果在这项涉及 30 名晚期肺腺癌患者的研究中，观察到了免疫疗法对免疫功能和肠道微生物组组成的重要影响。研究将患者分为治疗组和对照组，结果显示，免疫疗法使治疗反应组的 CD4+ T 细胞显著增加，CD8+ T 细胞减少，表明免疫反应增强。此外，对肠道微生物组的深入分析显示，治疗组中有益细菌（如粪便杆菌和亚多利格兰菌）的多样性和丰度均有所增加。这些发现凸显了免疫疗法在调节免疫功能和改变肠道微生物组多样性方面的双重作用，表明免疫疗法在改善晚期肺腺癌患者的健康状况方面具有潜在的治疗效果。结论肠道菌群的结构在增强抗肿瘤免疫疗法的疗效方面发挥着关键作用，突出了肠道微生态与免疫反应在癌症治疗结果中的相互作用。

{"title":"Implications of intestinal microecology and immune function alterations for immunotherapy outcomes in advanced unresectable lung adenocarcinoma","authors":"Shuang He, Jin Tian, Jianhua Zang, Lin Long, Peng Liu, Yexi Zhang, Jun Xiao","doi":"10.1111/crj.13762","DOIUrl":"https://doi.org/10.1111/crj.13762","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This investigation aims to explore alterations in intestinal microecology and immune function among patients with advanced, unresectable lung adenocarcinoma undergoing different outcomes from immunotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 30 patients diagnosed with advanced unresectable lung adenocarcinoma received sintilimab immunotherapy as a monotherapy. Post four treatment cycles, efficacy was assessed, leading to the segregation of patients into two distinct cohorts: those responsive to treatment and those nonresponsive. Analysis involved observing variations in the abundance, distribution, and composition of fecal intestinal microorganisms pretreatment and posttreatment via 16S rRNA gene sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study involving 30 advanced lung adenocarcinoma patients, significant observations were made regarding the impact of immunotherapy on immune function and the gut microbiome composition. Patients were divided into treatment and control groups, revealing that immunotherapy led to a significant increase in CD4+ T cells and a decrease in CD8+ T cells among the treatment-responsive individuals, indicating an enhanced immune response. Furthermore, an in-depth analysis of the gut microbiome showed an increase in diversity and abundance of beneficial bacteria such as Faecalibacterium and Subdoligranulum in the treatment group. These findings highlight the dual effect of immunotherapy on modulating immune function and altering gut microbiome diversity, suggesting its potential therapeutic benefits in improving the health status of patients with advanced lung adenocarcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The structuring of gut flora plays a pivotal role in augmenting the efficacy of anti-tumor immunotherapy, underscoring the interplay between intestinal microecology and immune response in cancer treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140814161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic utility of blood inflammation biomarkers before and after treatment on the survival of patients with locally advanced non-small cell lung cancer undergoing stereotactic body radiotherapy 接受立体定向体外放射治疗的局部晚期非小细胞肺癌患者治疗前后血液炎症生物标志物对生存期的预后作用

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-29 DOI: 10.1111/crj.13749

Fang Fang, Zhen Jia, Hongliang Xie, Yangsen Cao, Xiaofei Zhu, Xiao Yu Yang, Xueling Guo, Huojun Zhang

Background and Objective

The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) were significant and succinct indicators of systemic inflammation. We assessed the influence of stereotactic body radiotherapy (SBRT) on NLR and PLR in patients with locally advanced non-small cell lung cancer (LA-NSCLC).

Methods

We reviewed the medical data of patients with LA-NSCLC who underwent SBRT between 1 January 2013 and 31 December 2018. NLR and PLR values recorded at pre- and post-SBRT were examined. We assessed the correlation between pre/post-SBRT NLR and PLR and survival outcomes. The decision tree evaluation was conducted using Chi-square automatic detection.

Results

In total, 213 patients were included in the study with a median follow-up duration of 40.00 (ranging from 5.28 to 100.70) months. Upon dichotomization by a median, we identified that post-SBRT NLR > 5.5 and post-SBRT PLR > 382.0 were negatively associated with shorter overall survival (OS). In the multivariate assessment, post-SBRT PLR > 382.0 was the only factor. Based on post-SBRT PLR, tumor locations, and tumor stage, we categorized patients into low, medium, or high-risk groups.

Conclusions

Post-SBRT PLR > 382.0 correlated with survival in patients undergoing SBRT. The decision tree model might play a role in future risk stratification to guide the clinical practice of individualized SBRT for LA-NSCLC.

背景和目的中性粒细胞-淋巴细胞比值（NLR）和血小板-淋巴细胞比值（PLR）是全身炎症的重要而简洁的指标。我们评估了立体定向体放射治疗（SBRT）对局部晚期非小细胞肺癌（LA-NSCLC）患者 NLR 和 PLR 的影响。方法我们回顾了2013年1月1日至2018年12月31日期间接受SBRT的LA-NSCLC患者的医疗数据。检查了SBRT前后记录的NLR和PLR值。我们评估了SBRT前后NLR和PLR与生存结果之间的相关性。决策树评估采用Chi-square自动检测法进行。结果总共有 213 名患者被纳入研究，中位随访时间为 40.00 个月（从 5.28 个月到 100.70 个月不等）。按中位数进行二分后，我们发现，SBRT 后 NLR > 5.5 和 PLR > 382.0 与较短的总生存期（OS）呈负相关。在多变量评估中，SBRT 后 PLR > 382.0 是唯一的因素。根据SBRT后PLR、肿瘤位置和肿瘤分期，我们将患者分为低、中、高风险组。结论 SBRT 后 PLR > 382.0 与接受 SBRT 患者的生存率相关。决策树模型可能会在未来的风险分层中发挥作用，为LA-NSCLC的个体化SBRT临床实践提供指导。

{"title":"Prognostic utility of blood inflammation biomarkers before and after treatment on the survival of patients with locally advanced non-small cell lung cancer undergoing stereotactic body radiotherapy","authors":"Fang Fang, Zhen Jia, Hongliang Xie, Yangsen Cao, Xiaofei Zhu, Xiao Yu Yang, Xueling Guo, Huojun Zhang","doi":"10.1111/crj.13749","DOIUrl":"https://doi.org/10.1111/crj.13749","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) were significant and succinct indicators of systemic inflammation. We assessed the influence of stereotactic body radiotherapy (SBRT) on NLR and PLR in patients with locally advanced non-small cell lung cancer (LA-NSCLC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the medical data of patients with LA-NSCLC who underwent SBRT between 1 January 2013 and 31 December 2018. NLR and PLR values recorded at pre- and post-SBRT were examined. We assessed the correlation between pre/post-SBRT NLR and PLR and survival outcomes. The decision tree evaluation was conducted using Chi-square automatic detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 213 patients were included in the study with a median follow-up duration of 40.00 (ranging from 5.28 to 100.70) months. Upon dichotomization by a median, we identified that post-SBRT NLR > 5.5 and post-SBRT PLR > 382.0 were negatively associated with shorter overall survival (OS). In the multivariate assessment, post-SBRT PLR > 382.0 was the only factor. Based on post-SBRT PLR, tumor locations, and tumor stage, we categorized patients into low, medium, or high-risk groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Post-SBRT PLR > 382.0 correlated with survival in patients undergoing SBRT. The decision tree model might play a role in future risk stratification to guide the clinical practice of individualized SBRT for LA-NSCLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140814159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical characteristics of persistent or recurrent pneumonia combined with airway malacia in children 儿童持续性或复发性肺炎合并气道不良的临床特征

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-29 DOI: 10.1111/crj.13767

Zhuxia Li, Xinxing Zhang, Huiquan Sun, Chuangli Hao, Xuejun Shao, Jun Xu, Xin Zhang, Yuqing Wang

Objective

The aim of this study is to investigate the clinical characteristics and pathogens involved in persistent or recurrent pneumonia combined with airway malacia in children.

Methods

We retrospectively reviewed the information of children hospitalised with persistent or recurrent pneumonia, including clinical presentations, laboratory examination results and pathogens.

Results

A total of 554 patients were admitted, 285 (51.44%) of whom were found to have airway malacia. There were 78 (27.37%), 166 (58.25%) and 41 (14.39%) patients with mild, moderate and severe malacia, respectively. Patients with airway malacia were younger than those without malacia (6.0 vs. 12.0 months, p < 0.01) and were more likely to present with wheezing (75.07%), fever (34.39%), dyspnoea (28.77%), cyanosis (13.68%) and wheezing in the lungs (78.95%). The incidence of preterm delivery, oxygen therapy, paediatric intensive care unit (PICU) admission and mechanical ventilation was higher, and the hospital stay (11.0 vs. 10.0 days, p = 0.04) was longer in these patients than in those without malacia. Patients with severe airway malacia were more likely to undergo oxygen therapy, PICU admission, mechanical ventilation and have multiple malacia than were those with mild or moderate malacia. Mycoplasma pneumoniae (30.18%) was the most common pathogen.

Conclusion

Severe airway malacia likely aggravates conditions combined with pneumonia. The proportion of multisite malacia was greater in severe airway malacia patients.

目的本研究旨在探讨儿童持续性或复发性肺炎合并气道不良的临床特征和病原体。方法我们回顾性研究了因持续性或复发性肺炎住院的儿童的资料，包括临床表现、实验室检查结果和病原体。结果共收治 554 名患者，其中 285 人（51.44%）被发现气道畸形。轻度、中度和重度气道畸形患者分别为 78 人（27.37%）、166 人（58.25%）和 41 人（14.39%）。气道畸形患者比无气道畸形患者更年轻（6.0 个月对 12.0 个月，P <0.01），更有可能出现喘鸣（75.07%）、发热（34.39%）、呼吸困难（28.77%）、发绀（13.68%）和肺部喘鸣（78.95%）。与无气道畸形的患者相比，这些患者早产、接受氧疗、入住儿科重症监护室（PICU）和机械通气的发生率更高，住院时间更长（11.0 对 10.0 天，P = 0.04）。与轻度或中度气道畸形患者相比，重度气道畸形患者更有可能接受氧疗、入住重症监护病房（PICU）、接受机械通气和出现多个气道畸形。肺炎支原体（30.18%）是最常见的病原体。结论严重气道畸形可能会加重合并肺炎的病情。严重气道畸形患者中多部位畸形的比例更高。

{"title":"Clinical characteristics of persistent or recurrent pneumonia combined with airway malacia in children","authors":"Zhuxia Li, Xinxing Zhang, Huiquan Sun, Chuangli Hao, Xuejun Shao, Jun Xu, Xin Zhang, Yuqing Wang","doi":"10.1111/crj.13767","DOIUrl":"https://doi.org/10.1111/crj.13767","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study is to investigate the clinical characteristics and pathogens involved in persistent or recurrent pneumonia combined with airway malacia in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed the information of children hospitalised with persistent or recurrent pneumonia, including clinical presentations, laboratory examination results and pathogens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 554 patients were admitted, 285 (51.44%) of whom were found to have airway malacia. There were 78 (27.37%), 166 (58.25%) and 41 (14.39%) patients with mild, moderate and severe malacia, respectively. Patients with airway malacia were younger than those without malacia (6.0 vs. 12.0 months, <i>p</i> < 0.01) and were more likely to present with wheezing (75.07%), fever (34.39%), dyspnoea (28.77%), cyanosis (13.68%) and wheezing in the lungs (78.95%). The incidence of preterm delivery, oxygen therapy, paediatric intensive care unit (PICU) admission and mechanical ventilation was higher, and the hospital stay (11.0 vs. 10.0 days, <i>p</i> = 0.04) was longer in these patients than in those without malacia. Patients with severe airway malacia were more likely to undergo oxygen therapy, PICU admission, mechanical ventilation and have multiple malacia than were those with mild or moderate malacia. <i>Mycoplasma pneumoniae</i> (30.18%) was the most common pathogen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Severe airway malacia likely aggravates conditions combined with pneumonia. The proportion of multisite malacia was greater in severe airway malacia patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140814156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Causal influence of gut microbiota on small cell lung cancer: a Mendelian randomization study 肠道微生物群对小细胞肺癌的因果影响：孟德尔随机研究

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-29 DOI: 10.1111/crj.13764

Wenjing Yang, Xinxia Fan, Wangshu Li, Yan Chen

Background

Previous studies have hinted at a significant link between lung cancer and the gut microbiome, yet their causal relationship remains to be elucidated.

Methods

GWAS data for small cell lung cancer (SCLC) was extracted from the FinnGen consortium, comprising 179 cases and 218 613 controls. Genetic variation data for 211 gut microbiota were obtained as instrumental variables from MiBioGen. Mendelian randomization (MR) was employed to determine the causal relationship between the two, with inverse variance weighting (IVW) being the primary method for causal analysis. The MR results were validated through several sensitivity analyses.

Results

The study identified a protective effect against SCLC for the genus Eubacterium ruminantium group (OR = 0.413, 95% CI: 0.223–0.767, p = 0.00513), genus Barnesiella (OR = 0.208, 95% CI: 0.0640–0.678, p = 0.00919), family Lachnospiraceae (OR = 0.319, 95% CI: 0.107–0.948, p = 0.03979), and genus Butyricimonas (OR = 0.376, 95% CI: 0.144–0.984, p = 0.04634). Conversely, genus Intestinibacter (OR = 3.214, 95% CI: 1.303–7.926, p = 0.01125), genus Eubacterium oxidoreducens group (OR = 3.391, 95% CI: 1.215–9.467, p = 0.01973), genus Bilophila (OR = 3.547, 95% CI: 1.106–11.371, p = 0.03315), and order Bacillales (OR = 1.860, 95% CI: 1.034–3.347, p = 0.03842) were found to potentially promote the onset of SCLC.

Conclusion

We identified potential causal relationships between certain gut microbiota and SCLC, offering new insights into microbiome-mediated mechanisms of SCLC pathogenesis, resistance, mutations, and more.

背景以前的研究暗示肺癌与肠道微生物组之间存在重要联系，但它们之间的因果关系仍有待阐明。方法从芬兰基因联盟（FinnGen consortium）中提取了小细胞肺癌（SCLC）的 GWAS 数据，其中包括 179 例病例和 218 613 例对照。211 个肠道微生物群的遗传变异数据作为工具变量从 MiBioGen 获得。孟德尔随机化（MR）被用来确定两者之间的因果关系，反方差加权（IVW）是因果分析的主要方法。通过多项敏感性分析验证了孟德尔随机分析的结果。结果研究发现，反刍优杆菌属组（OR = 0.413，95% CI：0.223-0.767，p = 0.00513）、巴氏杆菌属（OR = 0.208，95% CI：0.0640-0.678，P = 0.00919）、Lachnospiraceae 科（OR = 0.319，95% CI：0.107-0.948，P = 0.03979）和 Butyricimonas 属（OR = 0.376，95% CI：0.144-0.984，P = 0.04634）。相反，肠杆菌属（OR = 3.214，95% CI：1.303-7.926，p = 0.01125）、Eubacterium oxidoreducens 组属（OR = 3.391，95% CI：1.215-9.467，p = 0.01973）、Bilophila 属（OR = 3.547，95% CI：1.106-11.371，p = 0.03315）和 Bacillales 目（OR = 1.860，95% CI：1.034-3.347，p = 0.03842）被发现可能会促进 SCLC 的发病。结论我们确定了某些肠道微生物群与 SCLC 之间的潜在因果关系，为了解微生物介导的 SCLC 发病机制、抵抗力、突变等提供了新的视角。

{"title":"Causal influence of gut microbiota on small cell lung cancer: a Mendelian randomization study","authors":"Wenjing Yang, Xinxia Fan, Wangshu Li, Yan Chen","doi":"10.1111/crj.13764","DOIUrl":"https://doi.org/10.1111/crj.13764","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have hinted at a significant link between lung cancer and the gut microbiome, yet their causal relationship remains to be elucidated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>GWAS data for small cell lung cancer (SCLC) was extracted from the FinnGen consortium, comprising 179 cases and 218 613 controls. Genetic variation data for 211 gut microbiota were obtained as instrumental variables from MiBioGen. Mendelian randomization (MR) was employed to determine the causal relationship between the two, with inverse variance weighting (IVW) being the primary method for causal analysis. The MR results were validated through several sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study identified a protective effect against SCLC for the genus <i>Eubacterium ruminantium</i> group (OR = 0.413, 95% CI: 0.223–0.767, <i>p</i> = 0.00513), genus <i>Barnesiella</i> (OR = 0.208, 95% CI: 0.0640–0.678, <i>p</i> = 0.00919), family Lachnospiraceae (OR = 0.319, 95% CI: 0.107–0.948, <i>p</i> = 0.03979), and genus <i>Butyricimonas</i> (OR = 0.376, 95% CI: 0.144–0.984, <i>p</i> = 0.04634). Conversely, genus <i>Intestinibacter</i> (OR = 3.214, 95% CI: 1.303–7.926, <i>p</i> = 0.01125), genus <i>Eubacterium oxidoreducens</i> group (OR = 3.391, 95% CI: 1.215–9.467, <i>p</i> = 0.01973), genus <i>Bilophila</i> (OR = 3.547, 95% CI: 1.106–11.371, <i>p</i> = 0.03315), and order Bacillales (OR = 1.860, 95% CI: 1.034–3.347, <i>p</i> = 0.03842) were found to potentially promote the onset of SCLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We identified potential causal relationships between certain gut microbiota and SCLC, offering new insights into microbiome-mediated mechanisms of SCLC pathogenesis, resistance, mutations, and more.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140814155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Studying of anti-inflammatory and antioxidant effects of tectorigenin in ovalbumin-induced asthma mice models 在卵清蛋白诱导的哮喘小鼠模型中研究橘霉素的抗炎和抗氧化作用

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-25 DOI: 10.1111/crj.13742

Jingning Guo, Yanping Shi, Yujun Wang, Seyyed Shamsadin Athari, Tao Chen

Background

Allergic asthma is an important respiratory system problem characterized by airway inflammation, breathlessness, and bronchoconstriction. Allergic asthma and its outcomes are triggered by type 2 allergic immune responses. Tectorigenin is a methoxy-isoflavone with anti-inflammatory effects. In this study, we investigated the effects of tectorigenin on the pathophysiology of allergic asthma in an animal model.

Methods

Asthmatic mice were treated with tectorigenin. Then airway hyperresponsiveness (AHR), eosinophil percentage, levels of interleukin (IL)-33, IL-25, IL-13, IL-5, IL-4, total and ovalbumin (OVA)-specific immunoglobulin (Ig)E, and lung histopathology were evaluated.

Result

Tectorigenin significantly (P 〈 0.05) reduced eosinophil infiltration (41 ± 7%) in the broncho-alveolar lavage fluid (BALF), serum IL-5 level (41 ± 5, pg/mL), and bronchial and vascular inflammation (scores of 1.3 ± 0.2 and 1.1 ± 0.3, respectively) but had no significant effects on AHR, serum levels of IL-33, −25, −13, and −4 (403 ± 24, 56 ± 7, 154 ± 11, and 89 ± 6 pg/mL, respectively), total and OVA-specific IgE (2684 ± 265 and 264 ± 19 ng/mL, respectively), goblet cell hyperplasia, and mucus production.

Conclusion

Tectorigenin could control inflammation and the secretion of inflammatory mediators of asthma, so it can be regarded as a potential antiasthma treatment with the ability to control eosinophilia-related problems.

背景过敏性哮喘是一种重要的呼吸系统疾病，以气道炎症、呼吸困难和支气管收缩为特征。过敏性哮喘及其后果是由 2 型过敏性免疫反应引发的。Tectorigenin 是一种具有抗炎作用的甲氧基异黄酮。本研究在动物模型中探讨了蓟黄素对过敏性哮喘病理生理学的影响。方法用蓟黄素治疗哮喘小鼠。然后评估气道高反应性（AHR）、嗜酸性粒细胞百分比、白细胞介素（IL）-33、IL-25、IL-13、IL-5、IL-4、总免疫球蛋白（Ig）E和卵清蛋白（OVA）特异性免疫球蛋白（Ig）E的水平以及肺组织病理学。结果 Tectorigenin 能明显（P 〈 0.05）减少支气管肺泡灌洗液（BALF）中的嗜酸性粒细胞浸润（41 ± 7%）、血清 IL-5 水平（41 ± 5，pg/mL）、支气管和血管炎症（评分分别为 1.3 ± 0.2 和 1.1 ± 0.3），但对AHR、血清IL-33、-25、-13和-4水平（分别为403 ± 24、56 ± 7、154 ± 11和89 ± 6 pg/mL）、总IgE和OVA特异性IgE（分别为2684 ± 265和264 ± 19 ng/mL）、小管细胞增生和粘液分泌无显著影响。结论 Tectorigenin 能控制炎症和哮喘炎症介质的分泌，因此可被视为一种潜在的抗哮喘治疗方法，具有控制嗜酸性粒细胞相关问题的能力。

{"title":"Studying of anti-inflammatory and antioxidant effects of tectorigenin in ovalbumin-induced asthma mice models","authors":"Jingning Guo, Yanping Shi, Yujun Wang, Seyyed Shamsadin Athari, Tao Chen","doi":"10.1111/crj.13742","DOIUrl":"https://doi.org/10.1111/crj.13742","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic asthma is an important respiratory system problem characterized by airway inflammation, breathlessness, and bronchoconstriction. Allergic asthma and its outcomes are triggered by type 2 allergic immune responses. Tectorigenin is a methoxy-isoflavone with anti-inflammatory effects. In this study, we investigated the effects of tectorigenin on the pathophysiology of allergic asthma in an animal model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Asthmatic mice were treated with tectorigenin. Then airway hyperresponsiveness (AHR), eosinophil percentage, levels of interleukin (IL)-33, IL-25, IL-13, IL-5, IL-4, total and ovalbumin (OVA)-specific immunoglobulin (Ig)E, and lung histopathology were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Tectorigenin significantly (P 〈 0.05) reduced eosinophil infiltration (41 ± 7%) in the broncho-alveolar lavage fluid (BALF), serum IL-5 level (41 ± 5, pg/mL), and bronchial and vascular inflammation (scores of 1.3 ± 0.2 and 1.1 ± 0.3, respectively) but had no significant effects on AHR, serum levels of IL-33, −25, −13, and −4 (403 ± 24, 56 ± 7, 154 ± 11, and 89 ± 6 pg/mL, respectively), total and OVA-specific IgE (2684 ± 265 and 264 ± 19 ng/mL, respectively), goblet cell hyperplasia, and mucus production.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tectorigenin could control inflammation and the secretion of inflammatory mediators of asthma, so it can be regarded as a potential antiasthma treatment with the ability to control eosinophilia-related problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative study of imaging and pathology of primary mucinous adenocarcinoma with different imaging manifestations 具有不同影像学表现的原发性粘液腺癌影像学和病理学比较研究

IF 1.7 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-04-14 DOI: 10.1111/crj.13750

Jun Han, Jie Gao, Demei Chen, Mou Du, Yuxin Wu, Xidong Ma, Mei Xie, Hua Han, Chongchong Wu, Xinying Xue

Background

Pulmonary mucinous adenocarcinoma is a special type of lung cancer. Its imaging manifestations are diverse, which brings challenges to clinical diagnosis. However, its formation mechanism is unclear.

Objective

The objective of this study is to analyse the relevant mechanisms of the formation of pulmonary mucinous adenocarcinoma by observing its different imaging and pathological manifestations.

Data and methods

Retrospective analysis was conducted on imaging manifestations and pathological data of 103 patients with pulmonary mucinous adenocarcinoma confirmed intraoperatively or pathologically.

Results

Forty-three patients had pulmonary mucinous adenocarcinoma with a solitary nodule/mass, 41 patients with localized pneumonia and 19 patients with diffuse pneumonia. Their CT manifestations included ‘falling snowflake sign’, ground-glass opacity close to the heart, vacuous signs/honeycombing and withered tree branches. Under the microscope, all the three types of pulmonary mucinous adenocarcinoma had visibly formed mucus lakes but were made of tumour cells with totally different shapes, which included the goblet-like shape (tall column-like shape) and quasi-circular shape. Tall column-shaped tumour cells were negative or weakly positive for thyroid transcription factor-1 (TTF-1) and strongly positive for ALK mutation, whereas quasi-circular tumour cells were positive for TTF-1 and less positive for ALK mutation.

Conclusion

The different imaging manifestations of mucinous adenocarcinoma are possibly due to the different amounts or viscosity of mucus produced, and the mechanisms of its formation may include (1) tumour cells in different shapes have different abilities to produce mucus; (2) tumours in different stages produce different amounts or viscosity of mucus; and (3) the TTF-1 and ALK genes affect the production of mucus.

背景肺粘液腺癌是一种特殊类型的肺癌。其影像学表现多种多样，给临床诊断带来了挑战。然而，其形成机制尚不清楚。目的通过观察肺粘液腺癌的不同影像学和病理学表现，分析其形成的相关机制。数据和方法对 103 例经术中或病理证实的肺粘液腺癌患者的影像学表现和病理学资料进行回顾性分析。结果 43 例患者的肺粘液腺癌为单发结节/肿块，41 例患者为局部肺炎，19 例患者为弥漫性肺炎。他们的 CT 表现包括 "雪花飘落征"、靠近心脏的磨玻璃不透明、空洞征/蜂窝状和枯树枝。在显微镜下，三种类型的肺粘液腺癌都有明显的粘液湖，但由形状完全不同的肿瘤细胞组成，包括高柱状（高柱状）和准圆形。高柱状肿瘤细胞的甲状腺转录因子-1（TTF-1）呈阴性或弱阳性，ALK突变呈强阳性；而准圆形肿瘤细胞的TTF-1呈阳性，ALK突变呈弱阳性。结论粘液腺癌的不同影像学表现可能是由于产生的粘液量或粘度不同，其形成机制可能包括：（1）不同形状的肿瘤细胞产生粘液的能力不同；（2）不同阶段的肿瘤产生的粘液量或粘度不同；（3）TTF-1 和 ALK 基因影响粘液的产生。

{"title":"Comparative study of imaging and pathology of primary mucinous adenocarcinoma with different imaging manifestations","authors":"Jun Han, Jie Gao, Demei Chen, Mou Du, Yuxin Wu, Xidong Ma, Mei Xie, Hua Han, Chongchong Wu, Xinying Xue","doi":"10.1111/crj.13750","DOIUrl":"https://doi.org/10.1111/crj.13750","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulmonary mucinous adenocarcinoma is a special type of lung cancer. Its imaging manifestations are diverse, which brings challenges to clinical diagnosis. However, its formation mechanism is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to analyse the relevant mechanisms of the formation of pulmonary mucinous adenocarcinoma by observing its different imaging and pathological manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data and methods</h3>\u0000 \u0000 <p>Retrospective analysis was conducted on imaging manifestations and pathological data of 103 patients with pulmonary mucinous adenocarcinoma confirmed intraoperatively or pathologically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-three patients had pulmonary mucinous adenocarcinoma with a solitary nodule/mass, 41 patients with localized pneumonia and 19 patients with diffuse pneumonia. Their CT manifestations included ‘falling snowflake sign’, ground-glass opacity close to the heart, vacuous signs/honeycombing and withered tree branches. Under the microscope, all the three types of pulmonary mucinous adenocarcinoma had visibly formed mucus lakes but were made of tumour cells with totally different shapes, which included the goblet-like shape (tall column-like shape) and quasi-circular shape. Tall column-shaped tumour cells were negative or weakly positive for thyroid transcription factor-1 (TTF-1) and strongly positive for ALK mutation, whereas quasi-circular tumour cells were positive for TTF-1 and less positive for ALK mutation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The different imaging manifestations of mucinous adenocarcinoma are possibly due to the different amounts or viscosity of mucus produced, and the mechanisms of its formation may include (1) tumour cells in different shapes have different abilities to produce mucus; (2) tumours in different stages produce different amounts or viscosity of mucus; and (3) the TTF-1 and ALK genes affect the production of mucus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140552949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0