Clinical Respiratory Journal最新文献_第2页

The Relationship of Vitamin A and Neonatal Respiratory Diseases: A Meta-Analysis 维生素 A 与新生儿呼吸道疾病的关系：一项 Meta 分析。

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-21 DOI: 10.1111/crj.70030

Yuanyuan Li, Ruoyu Zhang, Zhongliang Li, Qingfeng Zhai

This study systematically analyzes the relationship of vitamin A on the neonatal respiratory diseases. An extensive literature search for relevant studies was conducted on PubMed, Web of Science, and so on. After screening in strict accordance with the inclusion and exclusion criteria, 12 articles on vitamin A deficiency and 12 articles on vitamin A supplementation were included. Stata 17.0 software was used to perform meta-analysis, heterogeneity test, and sensitivity analysis, and the corresponding mathematical model was used to merge the data. The meta-analysis results of the relationship between vitamin A deficiency and neonatal respiratory diseases indicated that compared with the neonates with normal vitamin A, the neonates with vitamin A deficiency had adverse health outcomes of neonatal respiratory diseases (OR = 4.86, 95% CI: 2.68–8.84), of which neonatal respiratory distress syndrome (NRDS) (OR = 4.10, 95% CI: 2.32–7.23) and neonatal pneumonia (OR = 3.22, 95% CI: 2.18–4.77) were analyzed by subgroup analysis. The meta-analysis of the relationship between vitamin A supplementation therapy and neonatal respiratory diseases showed that vitamin A supplementation was an effective therapeutic measure for neonatal respiratory diseases (RR = 1.06, 95% CI: 1.04–1.07): NRDS (RR = 1.03, 95% CI: 1.02–1.05) and NBPD (RR = 1.08, 95% CI: 1.01–1.15). The funnel chart method results show that there was publication bias in studies on vitamin A deficiency induced to and vitamin A supplementation therapy for neonatal respiratory diseases. The sensitivity analysis results showed that excluding some special article had some effect on the final pooled effect. But generally speaking, the result of meta-analysis was stable. There is a statistical correlation of vitamin A on the neonatal respiratory diseases from two aspects of etiological exploration and effect evaluation of treatment.

本研究系统分析了维生素 A 与新生儿呼吸道疾病的关系。我们在 PubMed、Web of Science 等网站上对相关研究进行了广泛的文献检索。严格按照纳入和排除标准进行筛选后，纳入了 12 篇关于维生素 A 缺乏的文章和 12 篇关于维生素 A 补充的文章。使用Stata 17.0软件进行荟萃分析、异质性检验和敏感性分析，并使用相应的数学模型合并数据。维生素 A 缺乏与新生儿呼吸系统疾病关系的荟萃分析结果表明，与维生素 A 正常的新生儿相比，维生素 A 缺乏的新生儿在新生儿呼吸系统疾病方面有不良的健康结局（OR = 4.86，95% CI：2.68-8.84），其中新生儿呼吸窘迫综合征（NRDS）（OR = 4.10，95% CI：2.32-7.23）和新生儿肺炎（OR = 3.22，95% CI：2.18-4.77）是通过亚组分析得出的。维生素 A 补充疗法与新生儿呼吸系统疾病关系的荟萃分析表明，维生素 A 补充疗法是治疗新生儿呼吸系统疾病的有效措施（RR = 1.06，95% CI：1.04-1.07）：NRDS（RR=1.03，95% CI：1.02-1.05）和NBPD（RR=1.08，95% CI：1.01-1.15）。漏斗图法结果显示，有关维生素 A 缺乏诱发新生儿呼吸系统疾病和维生素 A 补充疗法的研究存在发表偏倚。敏感性分析结果显示，排除一些特殊文章对最终的汇总效应有一定影响。但总体而言，荟萃分析的结果是稳定的。从病因探讨和治疗效果评价两个方面来看，维生素 A 对新生儿呼吸系统疾病的影响存在统计学相关性。

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引用次数: 0

Identification of a Plasma Exosomal lncRNA- and circRNA-Based ceRNA Regulatory Network in Patients With Lung Adenocarcinoma 鉴定肺腺癌患者血浆外泌体 lncRNA 和 circRNA 的 ceRNA 调控网络

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-20 DOI: 10.1111/crj.70026

Wangyu Zhu, Huafeng Zhang, Liwei Tang, Kexin Fang, Nawa Lin, Yanyan Huang, Yongkui Zhang, Hanbo Le

Background

Exosomes have been established to be enriched with various long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) that exert various biological effects. However, the lncRNA- and circRNA-mediated coexpression competing endogenous RNA (ceRNA) regulatory network in exosomes derived from the plasma of patients with lung adenocarcinoma (LUAD) remains elusive.

Methods and Results

This study enrolled nine patients with lung adenocarcinoma and three healthy individuals, and the differential expression of messenger RNAs (mRNAs), lncRNAs, and circRNAs was detected using microarray analysis, while microRNAs (miRNAs) were detected through RNA sequencing. Additionally, bioinformatics algorithms were applied to evaluate the lncRNA–miRNA–mRNAs/circRNA–miRNA–mRNA network. Differentially expressed cicRNAs were identified via quantitative reverse transcription polymerase chain reaction (RT-qPCR). A total of 1016 lncRNAs, 1396 circRNAs, 45 miRNAs, and 699 mRNAs were differentially expressed in the plasma exosomes of patients with LUAD compared with healthy controls. Among them, 881 lncRNAs were upregulated and 135 were downregulated, 916 circRNAs were upregulated while 480 were downregulated, 45 miRNAs were upregulated while none were downregulated, and 591 mRNAs were upregulated while 108 were downregulated (p ≤ 0.05, and fold change ≥ 2). Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed the biological functions of differentially expressed RNAs. Meanwhile, the RNA networks displayed the regulatory relationship between dysregulated RNAs. Finally, RT-qPCR validated that the expression of circ-0033861, circ-0043273, and circ-0011959 was upregulated in the plasma exosome of patients with LUAD compared to healthy controls (p = 0.0327, p = 0.0002, p = 0.0437, respectively).

Conclusion

This study proposed a newly discovered ncRNA–miRNA–mRNA/circRNA–miRNA–mRNA ceRNA network and identified that the expression of circulating circ-0033861, circ-0043273, and circ-0011959 was up-regulated in the plasma exosomes of patients with LUAD, offering valuable insights for exploring the potential function of exosomal noncoding RNA and identifying potential biomarkers for LUAD.

背景：已证实外泌体富含各种长非编码RNA（lncRNA）和环状RNA（circRNA），可发挥各种生物学效应。然而，从肺腺癌（LUAD）患者血浆中提取的外泌体中，lncRNA和circRNA介导的共表达与内源性RNA（ceRNA）调控网络的竞争仍然难以捉摸：本研究招募了9名肺腺癌患者和3名健康人，利用芯片分析检测了信使RNA（mRNA）、lncRNA和circRNA的差异表达，并通过RNA测序检测了microRNA（miRNA）。此外，还应用生物信息学算法评估了 lncRNA-miRNA-mRNAs/circRNA-miRNA-mRNA 网络。通过定量反转录聚合酶链反应（RT-qPCR）鉴定了差异表达的cicRNA。与健康对照组相比，LUAD 患者血浆外泌体中共有 1016 个 lncRNA、1396 个 circRNA、45 个 miRNA 和 699 个 mRNA 存在差异表达。其中，881个lncRNA上调，135个下调；916个circRNA上调，480个下调；45个miRNA上调，无下调；591个mRNA上调，108个下调（P≤0.05，折合变化≥2）。基因本体（GO）分析和京都基因组百科全书（KEGG）通路分析揭示了差异表达的 RNA 的生物学功能。同时，RNA 网络显示了失调 RNA 之间的调控关系。最后，RT-qPCR验证了与健康对照组相比，circ-0033861、circ-0043273和circ-0011959在LUAD患者血浆外泌体中的表达上调（分别为p = 0.0327、p = 0.0002、p = 0.0437）：该研究提出了一个新发现的ncRNA-miRNA-mRNA/circRNA-miRNA-mRNA ceRNA网络，并确定了循环circ-0033861、circ-0043273和circ-0011959在LUAD患者血浆外泌体中的表达上调，为探索外泌体非编码RNA的潜在功能和确定LUAD的潜在生物标志物提供了有价值的见解。

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引用次数: 0

Unveiling the Enigmatic Role of SLC35F3 in Lung Adenocarcinoma 揭示 SLC35F3 在肺腺癌中的神秘作用

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-16 DOI: 10.1111/crj.70023

Yiwang Ye, Feihu Long, Wei Yue, Zichun Wei, Jianyi Yang, Yuancai Xie

Background

The role of solute carrier family 35 member F3 (SLC35F3) in lung adenocarcinoma (LUAD) remains unclear. To address this gap, we conducted a study employing bioinformatics analysis and experimental validation.

Methods

This study aimed to examine the expression patterns of SLC35F3 in various cancer types, particularly focusing on LUAD, by analyzing data from the Cancer Genome Atlas (TCGA) database to evaluate its clinical relevance. The research also explored potential regulatory mechanisms of SLC35F3, including its interactions with immune infiltration, tumor mutational burden (TMB), and drug sensitivity in LUAD. The investigation included analyzing SLC35F3 expression in single-cell sequencing of LUAD cells, examining genetic variations of SLC35F3 in LUAD, and assessing SLC35F3 expression in cell lines using quantitative real-time PCR (qRT-PCR).

Results

The aberrant expression of SLC35F3 was observed in both pan-cancer and LUAD. In LUAD patients, a statistically significant increase in SLC35F3 expression was correlated with gender (p < 0.001) and was associated with poorer overall survival (OS) (p = 0.020). The expression of SLC35F3 was identified as an independent prognostic determinant in patients with LUAD (p = 0.032). SLC35F3 exhibited associations with various pathways, including cell cycle and more. SLC35F3 expression demonstrated correlations with immune infiltration, TMB, and some drugs in LUAD. Results indicated significant upregulation of SLC35F3 in both LUAD tissues and cell lines.

Conclusions

SLC35F3 may serve as a prognostic biomarker and immunotherapeutic target for patients with LUAD.

Clinical Trial Registration

Not applicable.

背景溶质运载家族 35 成员 F3（SLC35F3）在肺腺癌（LUAD）中的作用仍不清楚。为了填补这一空白，我们采用生物信息学分析和实验验证进行了一项研究。方法本研究旨在通过分析癌症基因组图谱（TCGA）数据库中的数据，研究 SLC35F3 在各种癌症类型中的表达模式，尤其关注 LUAD，以评估其临床相关性。研究还探讨了SLC35F3的潜在调控机制，包括它与免疫浸润、肿瘤突变负荷（TMB）和LUAD中药物敏感性的相互作用。调查包括分析 LUAD 细胞单细胞测序中 SLC35F3 的表达、研究 LUAD 中 SLC35F3 的基因变异以及使用定量实时 PCR (qRT-PCR) 评估细胞系中 SLC35F3 的表达。结果在泛癌症和 LUAD 中均观察到 SLC35F3 的异常表达。在 LUAD 患者中，SLC35F3 表达的显著增加与性别相关（p < 0.001），并与较差的总生存期（OS）相关（p = 0.020）。SLC35F3的表达被确定为LUAD患者的一个独立预后决定因素（p = 0.032）。SLC35F3与细胞周期等多种通路相关。在 LUAD 中，SLC35F3 的表达与免疫浸润、TMB 和某些药物相关。结果表明，SLC35F3 在 LUAD 组织和细胞系中均有明显上调。结论 SLC35F3可作为LUAD患者的预后生物标志物和免疫治疗靶点。临床试验注册不适用。

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引用次数: 0

Clinical Management in NSCLC Patients With EGFR Mutation After Osimertinib Progression With Unknown Resistance Mechanisms 奥希替尼进展后表皮生长因子受体（EGFR）突变且耐药机制不明的 NSCLC 患者的临床治疗

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-15 DOI: 10.1111/crj.70025

Xin Liao, Tingting He, Xiong Wan, Pian Liu, Jing Li, Yong He, Yubo Wang

<div> <section> <h3> Background</h3> <p>Osimertinib is approved as a standard treatment for non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation by FDA. However, the mechanisms of resistance for nearly half of patients after osimertinib progression are still unknown, and the optimal therapies for these patients are still controversial. In this retrospective study, we compared efficacy and safety between immunotherapy + chemotherapy, chemotherapy alone, and osimertinib + bevacizumab in NSCLC patients after osimertinib progression with unknown resistance mechanisms.</p> </section> <section> <h3> Methods</h3> <p>Advanced NSCLC patients with unknown resistance mechanisms after osimertinib progression were retrospectively reviewed and divided into immunotherapy + chemotherapy, chemotherapy alone, and osimertinib + bevacizumab treatment groups according to the treatment they received after osimertinib progression. Clinicopathological features, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared between groups.</p> </section> <section> <h3> Results</h3> <p>A total of 121 patients were enrolled in this study, 22 in the immunotherapy + chemotherapy group, 72 in the chemotherapy group, and 27 in the osimertinib + bevacizumab group. The ORR was much higher in the immunotherapy + chemotherapy group compared with chemotherapy or osimertinib + bevacizumab group (55.56% vs. 14.81% vs. 0% in patients after progression on 1st line osimertinib treatment; 30.77% vs. 6.67% vs. 13.33% in patients after progression on 2nd/3rd line osimertinib treatment). Median PFS was also significantly longer in the immunotherapy + chemotherapy group compared with other groups (8.2 months vs. 4.0 months vs. 6.0 months in all patients, <i>p</i> = 0.0066). The median OS did not reach remarkable difference among groups, although osimertinib + bevacizumab group had a numerically longer median OS (37.0 months vs. 37.0 months vs. 47.6 months in all patients, <i>p</i> = 0.6357). Compared with immunotherapy + chemotherapy and chemotherapy, treatment-related adverse events (AEs) of osimertinib + bevacizumab were milder, especially in AEs related to gastrointestinal and bone marrow suppression.</p> </section> <section> <h3> Conclusion</h3> <p>Our study provides clinical evidence that NSCLC patients after osimertinib progression with unknown resistance mechanisms may benefit from immunotherapy + chemotherapy, with higher ORR and longer PFS compared with osimertinib + bevacizumab or chemotherapy group

背景奥希替尼被美国食品药品管理局批准为表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）患者的标准治疗药物。然而，近一半患者在奥希替尼治疗进展后出现耐药的机制仍不清楚，这些患者的最佳治疗方法仍存在争议。在这项回顾性研究中，我们比较了免疫疗法+化疗、单纯化疗和奥希替尼+贝伐单抗治疗耐药机制不明的奥希替尼进展后 NSCLC 患者的疗效和安全性。方法回顾性分析奥希替尼进展后耐药机制不明的晚期NSCLC患者，根据他们在奥希替尼进展后接受的治疗分为免疫治疗+化疗组、单纯化疗组和奥希替尼+贝伐单抗治疗组。比较各组的临床病理特征、客观反应率（ORR）、无进展生存期（PFS）和总生存期（OS）。结果本研究共纳入121例患者，其中免疫疗法+化疗组22例，化疗组72例，奥希替尼+贝伐单抗组27例。与化疗或奥希替尼+贝伐单抗组相比，免疫疗法+化疗组的ORR更高（奥希替尼一线治疗进展后患者的ORR为55.56% vs. 14.81% vs. 0%；奥希替尼二线/三线治疗进展后患者的ORR为30.77% vs. 6.67% vs. 13.33%）。免疫疗法+化疗组的中位生存期也明显长于其他组（所有患者的中位生存期分别为8.2个月 vs. 4.0个月 vs. 6.0个月，p = 0.0066）。虽然奥希替尼+贝伐珠单抗组的中位OS在数字上更长（所有患者中为37.0个月 vs. 37.0个月 vs. 47.6个月，p = 0.6357），但各组间的中位OS并无显著差异。与免疫疗法+化疗和化疗相比，奥希替尼+贝伐珠单抗的治疗相关不良事件（AEs）较轻，尤其是与胃肠道和骨髓抑制相关的不良事件。结论我们的研究提供了临床证据，证明耐药机制不明的奥希替尼进展后NSCLC患者可从免疫治疗+化疗中获益，与奥希替尼+贝伐单抗组或化疗组相比，免疫治疗+化疗组的ORR更高，PFS更长。奥希替尼+贝伐单抗治疗也是患者的一种可选方案，因为该组患者的OS在数量上更长、更安全。

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引用次数: 0

Oleic Acid Inhibits SDC4 and Promotes Ferroptosis in Lung Cancer Through GPX4/ACSL4 油酸通过 GPX4/ACSL4 抑制 SDC4 并促进肺癌中的铁凋亡

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-13 DOI: 10.1111/crj.70014

Jingfei Dong, Fei Qi, Huiqing Qie, Shibu Du, Li Li, Yan Zhang, Kaiyue Xu, Dehui Li, Yapei Xu

Introduction

As a common malignancy, lung cancer has a relatively poor prognosis and a low survival rate. In recent years, ferroptosis, as an emerging filed, has great promise in the potential treatment of cancer. Brucea javanica oil (BJO) is often used to treat various cancers. Oleic acid (OA) is the main ingredient of BJO. In this study, we investigated the role and molecular mechanism of OA in lung cancer treatment by promoting ferroptosis.

Methods

In this study, A549 cells and H1299 cells were used for in vitro experiments, and a CCK-8 test, scratch test, and MTT experiment were carried out. We examined reactive oxygen species (ROS), the JC-1 probe, glutathione (GSH) expression, lipid peroxidation, SDC4 mRNA levels, and ACSL4, SLC7A11, GPX4, and SDC4 protein levels.

Results

The results showed that OA could inhibit the proliferation and migration of A549 cells and H1299 cells, SDC4 was a potential therapeutic target of OA against lung cancer, and OA treatment significantly inhibited the expression of SDC4 in A549 cells and H1299 cells. OA induces ferroptosis in A549 cells and H1299 cells, decreases GSH levels, increases lipid peroxidation levels, and decreases SDC4 mRNA expression; in addition, OA upregulates ACSL4 expression and decreases SLC7A11, GPX4, and SDC4 expression.

Conclusion

This study confirmed that OA could inhibit SDC4 expression and promote the occurrence of ferroptosis in A549 cells and H1299 cells through the GPX4/ACSL4 pathway, providing an effective basis for the use of drugs targeting ferroptosis in lung cancer treatment.

导言肺癌是一种常见的恶性肿瘤，预后较差，生存率低。近年来，作为一种新兴的治疗方法，阿魏化疗在潜在的癌症治疗中大有可为。Brucea javanica 油（BJO）常用于治疗各种癌症。油酸（OA）是 BJO 的主要成分。在本研究中，我们探讨了 OA 通过促进铁突变在肺癌治疗中的作用和分子机制。方法本研究使用 A549 细胞和 H1299 细胞进行体外实验，并进行了 CCK-8 试验、划痕试验和 MTT 实验。我们检测了活性氧（ROS）、JC-1探针、谷胱甘肽（GSH）表达、脂质过氧化、SDC4 mRNA水平以及ACSL4、SLC7A11、GPX4和SDC4蛋白水平。结果表明，OA能抑制A549细胞和H1299细胞的增殖和迁移，SDC4是OA治疗肺癌的潜在靶点，OA治疗能显著抑制SDC4在A549细胞和H1299细胞中的表达。OA诱导A549细胞和H1299细胞的铁变态反应，降低GSH水平，增加脂质过氧化水平，降低SDC4 mRNA的表达；此外，OA上调ACSL4的表达，降低SLC7A11、GPX4和SDC4的表达。结论本研究证实 OA 可通过 GPX4/ACSL4 通路抑制 A549 细胞和 H1299 细胞中 SDC4 的表达并促进铁变态反应的发生，为肺癌治疗中使用靶向铁变态反应的药物提供了有效依据。

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引用次数: 0

Identification of the Prognostic Factors for Synchronous Multiple Primary Lung Cancer Treated With Staged Bilateral Surgery 分期双侧手术治疗同步多发性原发性肺癌预后因素的鉴定

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-13 DOI: 10.1111/crj.70017

Hui Zhang, Qiang Liu, Lian Chen, Liwei Song, Feng Mao, Wenyong Zhou, Jiantao Li, Zuodong Song, Wang Miao, Yang Shentu

Introduction

Staged bilateral surgery is widely used to treat synchronous multiple primary lung cancer (SMPLC); however, the prognostic factors for survival outcomes remain unclear. This study aimed to identify prognostic factors and construct a predictive model for overall survival (OS) and recurrence-free survival (RFS) in patients with SMPLC who underwent staged bilateral surgery.

Methods

The study included 256 patients diagnosed with SMPLC and treated with staged bilateral surgery at our hospital between January 2010 and July 2017. Multivariate Cox proportional-hazard regression was used to identify prognostic factors for OS and RFS. Additionally, a predictive model was constructed using time-dependent receiver operating characteristic curves.

Results

Among the 256 patients, 10 (3.95%) succumbed to the disease and 24 (9.41%) experienced recurrence. Smoking (hazard ratio [HR]: 5.128; 95% confidence interval [CI]: 1.442–18.233; p = 0.012) and most advanced pathological TNM (pTNM) stage (II + III) (HR: 12.938; 95% CI: 2.650–63.176; p = 0.002) were identified as significant predictors of poor OS. A prognostic model was developed for predicting OS, with a 5-year area under the curve (AUC) of 0.854. Furthermore, most advanced pTNM stage (II + III) was associated with poor RFS (HR: 5.964; 95% CI: 2.669–13.327; p < 0.001), and the predictive model exhibited a 5-year AUC of 0.718 for RFS.

Conclusion

This study revealed that smoking and most advanced pTNM stage were independent prognostic factors associated with poor OS in patients with bilateral SMPLC. Moreover, most advanced pTNM stage was also linked to unfavorable RFS. The developed predictive model demonstrated moderate prognostic performance for both OS and RFS.

导言：分期双侧手术被广泛用于治疗同步多发性原发性肺癌（SMPLC）；然而，生存结果的预后因素仍不明确。本研究旨在确定接受分期双侧手术的 SMPLC 患者的预后因素，并构建总生存期（OS）和无复发生存期（RFS）的预测模型。方法研究纳入了2010年1月至2017年7月期间在我院确诊并接受分期双侧手术治疗的256例SMPLC患者。采用多变量 Cox 比例危险回归确定 OS 和 RFS 的预后因素。此外，还利用时间依赖性接收者操作特征曲线构建了预测模型。结果在256名患者中，10人（3.95%）死于疾病，24人（9.41%）复发。吸烟（危险比 [HR]：5.128；95% 置信区间 [CI]：吸烟（危险比 [HR]：5.128；95% 置信区间 [CI]：1.442-18.233；P = 0.012）和最晚期病理 TNM (pTNM) 分期（II + III）（HR：12.938；95% CI：2.650-63.176；P = 0.002）被认为是不良 OS 的重要预测因素。建立了一个预测 OS 的预后模型，其 5 年曲线下面积 (AUC) 为 0.854。此外，最晚期 pTNM 分期（II + III）与 RFS 差相关（HR：5.964；95% CI：2.669-13.327；p <；0.001），预测模型的 5 年 RFS AUC 为 0.718。结论本研究显示，吸烟和最晚期 pTNM 分期是与双侧 SMPLC 患者不良 OS 相关的独立预后因素。此外，pTNM 最晚期也与 RFS 差有关。所建立的预测模型对OS和RFS的预后表现适中。

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引用次数: 0

Solitary Renal Metastases From Stage IA Primary Lung Adenocarcinoma With Co-Alteration of EGFR, RB1, and MAP3K1: A Case Report 表皮生长因子受体（EGFR）、RB1 和 MAP3K1 共同变异的 IA 期原发性肺腺癌的孤立肾转移：病例报告。

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-09 DOI: 10.1111/crj.70018

Zhu Qin, Chen Xin, He Zhenzhen, Xie Liang, Yi Wei, Li Shuben

We report a case of 59-year-old female with solitary bilateral renal metastases after surgery of stage IA primary lung adenocarcinoma who underwent next-generation sequencing (NGS) of both lesions. The patient received right upper lobectomy and lymph node dissection, which revealed primary invasive lung adenocarcinoma (pT1cN0M0, stage IA3). Two years following this, positron emission tomography–computed tomography (PET/CT) revealed multiple masses in both kidneys without other distant metastases, and ultrasonography-guided puncture biopsy indicated the presence of metastatic lung adenocarcinoma. The NGS of both the primary and metastatic lesions revealed the co-alteration of epidermal growth factor receptor (EGFR), RB transcriptional corepressor 1 (RB1), and mitogen-activated protein kinase kinase 1 (MAP3K1), which is potentially associated with the risk of renal metastasis in early postoperative non-small cell lung cancer.

我们报告了一例59岁女性患者，她在IA期原发性肺腺癌术后出现单发双侧肾转移，并对两个病灶进行了新一代测序（NGS）。患者接受了右上叶切除术和淋巴结清扫术，术后发现原发性浸润性肺腺癌（pT1cN0M0，IA3 期）。此后两年，正电子发射计算机断层扫描（PET/CT）发现双肾多发肿块，无其他远处转移，超声引导下穿刺活检显示存在转移性肺腺癌。对原发病灶和转移病灶进行的 NGS 检测发现，表皮生长因子受体（EGFR）、RB 转录核心抑制因子 1（RB1）和丝裂原活化蛋白激酶激酶 1（MAP3K1）发生了共同改变，这可能与非小细胞肺癌术后早期肾转移的风险有关。

引用次数: 0

Aetiology of Pleural Effusions in a Large Multicentre Cohort: Variation Between Outpatients and Inpatients 大型多中心队列中胸腔积液的病因：门诊病人与住院病人之间的差异。

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-09 DOI: 10.1111/crj.13795

Asfandyar Yousuf, Sophie Holland, Junyi Zhang, Cheryl Hardy, Madeline Charles-Rudwick, Fredrik Vivian, Poppy Denniston, Nithin Thoppuram, Andrei Kisseljov, Rakesh K. Panchal, Eleanor K. Mishra

Introduction

This multi-centre retrospective cohort study aimed to determine whether the cause of an undiagnosed pleural effusion differed depending on if a patient presented as an outpatient or inpatient.

Methods

A total of 1080 adult patients (556 inpatients and 524 outpatients) presenting primarily with an undiagnosed pleural effusion from 1 January 2021 to 31 December 2022 from four UK hospitals were included.

Results

We found malignant effusions were more common in outpatients compared to inpatients (48.3% vs. 36.0% p < 0.0001). Infection was common in inpatients but uncommon in outpatients (36.2% vs. 5.0% p < 0.0001). Other causes in all patients included heart and/or renal failure (13.1%) and non-specific pleuritis (5.6%). No diagnosis was possible in 11.8% of patients referred.

Conclusion

Investigative pathways should vary depending on whether patients present as an inpatient or outpatient.

简介：这项多中心回顾性队列研究旨在确定未确诊胸腔积液的原因是否因患者是门诊患者还是住院患者而有所不同：这项多中心回顾性队列研究旨在确定未确诊胸腔积液的病因是否因患者是门诊患者还是住院患者而有所不同：研究纳入了英国四家医院2021年1月1日至2022年12月31日期间主要因未确诊胸腔积液就诊的1080名成年患者（556名住院患者和524名门诊患者）：结果：我们发现恶性渗出在门诊患者中比住院患者中更为常见（48.3% 对 36.0% p 结论：检查路径应根据患者是住院病人还是门诊病人而有所不同。

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引用次数: 0

Epidemiological Characteristics of Upper Respiratory Tract Pathogens in Children in Guangdong, China 中国广东省儿童上呼吸道病原体的流行病学特征。

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-05 DOI: 10.1111/crj.70011

Qianwen Zhao, Peifeng Ke, Liangshan Hu, Changhong Jiang, Rong Su, Weifeng Lv, Qixin Li, Lingxiao Jiang, Donglin Cao

Objective

Researches on the epidemiology of various respiratory pathogens at multiple testing points in the pediatric population are limited, and these are crucial for the prevention of respiratory tract infections in children.

Methods

We obtained 1788 upper respiratory tract swabs from children exhibiting symptoms of respiratory infection (notably fever with a body temperature exceeding 38.5°C) across five hospitals in Guangdong between November 2020 and June 2022. We used the multiplex probe amplification (MPA) PCR testing to identify 11 respiratory viruses and subsequently analyzed the prevalence characteristics of these pathogens among febrile children in hospitals.

Results

The overall detection rate of the pathogens was 58.1% (1039/1788). Human rhinovirus (HRV) exhibited the highest detection rate at 19.0% (339/1788), succeeded by human parainfluenza virus (HPIV), human adenovirus (HAdV), and respiratory syncytial virus (RSV). The positivity and coinfection rates were higher in children aged 5 years and below compared to those above 5 years. Moreover, a distinct pathogen spectrum was observed across different age groups. Hospitalized patients demonstrated a significantly higher positivity and coinfection rate compared to outpatients. During COVID-2019, RSV appeared a counter-seasonal trend.

Conclusion

Respiratory viral infections in children display distinct characteristics concerning age, hospitalization status, and seasonality. Children under the age of 5 and minor patients admitted to hospitals at least be tested for RSV, HRV, HPIV, and HAdV. The epidemiological patterns of RSV in the post-epidemic period require ongoing surveillance.

摘要对儿科人群中多个检测点的各种呼吸道病原体的流行病学研究有限，而这些研究对预防儿童呼吸道感染至关重要：2020年11月至2022年6月期间，我们在广东省5家医院采集了1788名有呼吸道感染症状（主要是发热，体温超过38.5°C）的儿童的上呼吸道拭子。我们采用多重探针扩增（MPA）PCR检测方法鉴定了11种呼吸道病毒，随后分析了这些病原体在医院发热儿童中的流行特征：结果：病原体的总体检出率为58.1%（1039/1788）。人鼻病毒（HRV）的检出率最高，为 19.0%（339/1788），其次是人副流感病毒（HPIV）、人腺病毒（HAdV）和呼吸道合胞病毒（RSV）。与 5 岁以上儿童相比，5 岁及以下儿童的阳性率和合并感染率更高。此外，不同年龄组的病原体谱各不相同。与门诊患者相比，住院患者的阳性率和合并感染率明显更高。在 COVID-2019 期间，RSV 出现了反季节趋势：儿童呼吸道病毒感染在年龄、住院情况和季节性方面表现出明显的特征。5岁以下儿童和住院的未成年患者至少要检测RSV、HRV、HPIV和HAdV。需要对流行后时期 RSV 的流行模式进行持续监测。

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引用次数: 0

A Meta-Analysis of Efficacy and Safety of Neoadjuvant Immunotherapy Plus Chemotherapy for Resectable Non-Small Cell Lung Cancer 新辅助免疫疗法加化疗治疗可切除非小细胞肺癌的疗效和安全性Meta分析。

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2024-10-02 DOI: 10.1111/crj.70019

Xinru Sun, Tianhua Kang, Baodong Liu, Yin Zhang, Guangming Huang

Introduction

Neoadjuvant immunotherapy plus chemotherapy has ushered in a new era for surgical treatment for patients with NSCLC. This study aimed to examine the efficacy and safety of neoadjuvant immunotherapy plus chemotherapy in NSCLC.

Methods

Eligible studies were identified from PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov, and conference meeting abstracts. The endpoints included major pathological response (MPR), complete pathological response (pCR), surgical resection rate, R0 resection, treatment-related adverse events (TRAEs), severe adverse events (SAEs), surgical complications, treatment discontinuation, surgical delay, and treatment-related death. Stata 18 software was used for statistical analysis, and p < 0.05 was considered statistically significant. Twenty-two studies including a total of 1108 patients were eligible for this study.

Results

Among the patients who received neoadjuvant immunotherapy plus chemotherapy, the pooled MPR rate was 51% (95% CI [0.44–0.58]), and pCR rate was 34% (95% CI [0.28–0.40]). The pooled surgical resection rate was 85% (95% CI [0.81–0.89]), and the pooled R0 rate was 94% (95% CI [0.91–0.96]). The pooled rate of pathological tumor downstaging was 84% (95% CI [0.79–0.88]), and the pooled rate of pathological nodal downstaging was 38% (95% CI [0.23–0.57]). During the treatment of neoadjuvant immunotherapy plus chemotherapy with or without surgery, the pooled rate of TRAEs (any grade) was 84% (95% CI [0.73–0.91]), and the pooled rate of SAEs was 29% (95% CI [0.21–0.38]). Surgical complications pooled rate was 25% (95% CI [0.14–0.41]). The pooled rate of treatment discontinuation (11%, 95% CI [0.09–0.13]), surgical delay (3%, 95% CI [0.02–0.05]), and treatment-related death (2%, 95% CI [0.02–0.03]) were conducted.

Conclusion

Neoadjuvant immunotherapy plus chemotherapy provides a high pathological response, surgical resection rate, R0 resection rate, and pathological downstage rate and has a low risk of increasing the incidence of SAEs, surgical complications, treatment discontinuation, surgical delay, and treatment-related death. The validation of prospective and large sample studies is needed to confirm this conclusion.

简介新辅助免疫治疗加化疗为NSCLC患者的外科治疗开创了新纪元。本研究旨在探讨新辅助免疫疗法加化疗治疗 NSCLC 的有效性和安全性：从 PubMed、Embase、Web of Science、Cochrane Library、ClinicalTrials.gov 和会议摘要中筛选出符合条件的研究。研究终点包括主要病理反应（MPR）、完全病理反应（pCR）、手术切除率、R0切除率、治疗相关不良事件（TRAE）、严重不良事件（SAE）、手术并发症、治疗中断、手术延迟以及治疗相关死亡。统计分析使用Stata 18软件，P 结果：在接受新辅助免疫疗法加化疗的患者中，总的MPR率为51%（95% CI [0.44-0.58]），pCR率为34%（95% CI [0.28-0.40]）。汇总的手术切除率为85%（95% CI [0.81-0.89]），汇总的R0率为94%（95% CI [0.91-0.96]）。肿瘤病理降期的汇总率为84%（95% CI [0.79-0.88]），结节病理降期的汇总率为38%（95% CI [0.23-0.57]）。在新辅助免疫疗法加化疗加或不加手术的治疗过程中，TRAEs（任何级别）的汇总率为84%（95% CI [0.73-0.91]），SAEs的汇总率为29%（95% CI [0.21-0.38]）。手术并发症的总发生率为 25%（95% CI [0.14-0.41]）。治疗中断（11%，95% CI [0.09-0.13]）、手术延迟（3%，95% CI [0.02-0.05]）和治疗相关死亡（2%，95% CI [0.02-0.03]）的汇总率均为：结论：新辅助免疫治疗加化疗可获得较高的病理反应、手术切除率、R0切除率和病理降期率，且增加SAE、手术并发症、治疗中止、手术延迟和治疗相关死亡的风险较低。这一结论需要前瞻性大样本研究的验证。

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引用次数: 0