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Based on Cardiopulmonary Exercise Testing to Construct and Validate Nomogram of Long-Term Prognosis Within 12 Months for NSCLC 基于心肺运动测试构建并验证 NSCLC 12 个月内长期预后的提名图
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13806
Xinyu Wang, Jin Li, Jingjie Zhou, Min Gao, Bin Wang, Yiman Tong, Yuhan Cao, Wei Chen

Objective

Construction nomogram was to effectively predict long-term prognosis in patients with non-small cell lung cancer (NSCLC).

Materials and Methods

The nomogram is developed by a retrospective study of 347 patients with NSCLC who underwent cardiopulmonary exercise testing (CPET) before surgery from May 2019 to February 2022. Cross-validation divided the data into a training cohort and validation cohort. The discrimination and accuracy ability of the nomogram were proofed by concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve, the area under the curve (AUC), and time-dependent ROC in validation cohort.

Results

Age, intraoperative blood loss, VO2 peak, and VE/VCO2 slope were included in the model of nomogram. The model demonstrated good discrimination and accuracy with C-index of 0.770 (95% CI: 0.712–0.822). AUC of 6 (AUC: 0.789, 95% CI: 0.726–0.851) and 12 months (AUC: 0.787, 95% CI: 0.724–0.850) were shown in ROC. Time-independent ROC maintains a good effect within 12 months.

Conclusion

We developed a nomogram based on CPET. This model has a good ability of discrimination and accuracy. It could help clinicians to make treatment decision in clinical decision.

目的:构建提名图以有效预测非小细胞肺癌(NSCLC)患者的长期预后:构建提名图以有效预测非小细胞肺癌(NSCLC)患者的长期预后:通过对2019年5月至2022年2月期间347名术前接受心肺运动测试(CPET)的NSCLC患者进行回顾性研究,建立了提名图。交叉验证将数据分为训练队列和验证队列。在验证队列中,通过一致性指数(C-index)、校准曲线、接收者操作特征曲线(ROC)、曲线下面积(AUC)和时间依赖性ROC来证明提名图的区分度和准确性:结果:年龄、术中失血量、VO2 峰值和 VE/VCO2 斜率均被纳入提名图模型。该模型具有良好的区分度和准确性,C 指数为 0.770(95% CI:0.712-0.822)。在 ROC 中显示了 6 个月(AUC:0.789,95% CI:0.726-0.851)和 12 个月(AUC:0.787,95% CI:0.724-0.850)的 AUC。与时间无关的 ROC 在 12 个月内保持良好的效果:我们建立了一个基于 CPET 的提名图。结论:我们开发了一种基于 CPET 的提名图,该模型具有良好的辨别能力和准确性。结论:我们建立了基于 CPET 的提名图,该模型具有良好的区分能力和准确性,可以帮助临床医生在临床决策中做出治疗决定。
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引用次数: 0
Evaluation of Efficacy and Safety in First-Line Treatment Methods for Extensive-Stage Small Cell Lung Cancer: A Comprehensive Comparative Study of Chemotherapy, Targeted Therapy Combined With Chemotherapy, and Immunotherapy Combined With Chemotherapy 评估广泛期小细胞肺癌一线治疗方法的有效性和安全性:化疗、靶向治疗联合化疗以及免疫治疗联合化疗的综合比较研究》(A comprehensive Comparative Study of Chemotherapy, Targeted Therapy Combined With Chemotherapy, and Immunotherapy Combined With Chemotherapy)。
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13819
Tiantian Zhang, Lu Tao, Yufo Chen, Shanshan Zhang, Yang Liu, Yumei Li, Rui Wang

Background

Small cell lung cancer (SCLC) is a highly aggressive tumor with limited effectiveness in its standard chemotherapy treatment. Targeted antiangiogenic therapy and immune checkpoint inhibitors (ICIs) have demonstrated potential as alternative treatments for extensive-stage SCLC (ES-SCLC). However, there is insufficient comparative evidence available to determine the optimal first-line treatment option between ICIs plus chemotherapy and targeted antiangiogenic therapy plus chemotherapy.

Objective

This study is aimed at analyzing clinical data from ES-SCLC patients treated at the First Affiliated Hospital of Bengbu Medical College between June 2021 and June 2023. The study compared the efficacy and safety of three first-line treatment regimens: standard chemotherapy, antiangiogenic therapy combined with chemotherapy, and immune combination therapy.

Methods

Patients who met the inclusion criteria were divided into three groups: chemotherapy, immune combination therapy, and antiangiogenic therapy combined with chemotherapy. The study collected data on clinical characteristics, treatment regimens, and adverse reactions. The analysis included objective response rate (ORR), duration of response (DoR), disease control rate (DCR), progression-free survival (PFS), and treatment safety.

Results

A total of 101 patients were included in the study, with 49 receiving chemotherapy alone, 19 receiving antiangiogenic therapy, and 33 receiving immune combination therapy. The ORRs were 78.9% for antiangiogenic therapy, 72.7% for immune combination therapy, and 42.9% for chemotherapy alone. The median PFS was 8.0 months for antiangiogenic therapy, 7.8 months for immune combination therapy, and 5.2 months for chemotherapy alone. Both combination therapy groups demonstrated superior efficacy compared to chemotherapy alone.

Conclusion

Targeted combined chemotherapy and immune combination chemotherapy showed superior efficacy as first-line treatments for ES-SCLC compared to chemotherapy alone, with manageable adverse reactions.

背景:小细胞肺癌(SCLC小细胞肺癌(SCLC)是一种高度侵袭性肿瘤,其标准化疗疗效有限。靶向抗血管生成疗法和免疫检查点抑制剂(ICIs)作为广泛期小细胞肺癌(ES-SCLC)的替代疗法已显示出潜力。然而,目前还没有足够的比较证据来确定ICIs加化疗与靶向抗血管生成疗法加化疗之间的最佳一线治疗方案:本研究旨在分析 2021 年 6 月至 2023 年 6 月期间在蚌埠医学院第一附属医院接受治疗的 ES-SCLC 患者的临床数据。研究比较了标准化疗、抗血管生成治疗联合化疗和免疫联合治疗三种一线治疗方案的疗效和安全性:符合纳入标准的患者被分为三组:化疗组、免疫联合疗法组和抗血管生成疗法联合化疗组。研究收集了临床特征、治疗方案和不良反应的数据。分析包括客观反应率(ORR)、反应持续时间(DoR)、疾病控制率(DCR)、无进展生存期(PFS)和治疗安全性:共有101名患者参与了研究,其中49人接受了单独化疗,19人接受了抗血管生成疗法,33人接受了免疫联合疗法。抗血管生成疗法的ORR为78.9%,免疫联合疗法的ORR为72.7%,单纯化疗的ORR为42.9%。抗血管生成疗法的中位 PFS 为 8.0 个月,免疫联合疗法为 7.8 个月,单独化疗为 5.2 个月。与单纯化疗相比,两组联合疗法均显示出更优越的疗效:结论:靶向联合化疗和免疫联合化疗作为ES-SCLC的一线治疗手段,疗效优于单纯化疗,且不良反应可控。
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引用次数: 0
Primary Lung Squamous Cell Carcinoma With Intestinal Metastasis: A Case Report and Literature Review 原发性肺鳞状细胞癌伴肠道转移:病例报告与文献综述
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13817
Jin Tao, Zhiqiang Wu, Rongfei Huang, Jun Li, Tiewei Xu, Yujie Gao, Weikun Jia, Hu Chen

Lung squamous cell carcinoma (LUSC) is characterized by a high rate of metastasis and recurrence, leading to a poor prognosis for affected patients. Intestinal metastasis of LUSC is a rare clinical occurrence. Treatment options for LUSC patients with intestinal metastasis are limited, and no standard therapy guidelines exist for managing these cases. In this review, we discuss the clinical features, diagnosis, and treatment of LUSC patients with intestinal metastasis and present a rare case of LUSC with intestinal metastasis. We describe a patient who presented with a severe cough and chest pain and diagnosed with LUSC and bone tumor. Initially, the primary LUSC and bone tumor were controlled with standard treatments. However, the primary LUSC reoccurred shortly after treatment, this time with intestinal metastasis, for which effective treatments are lacking. Our observation from the case suggests that LUSC metastasizing to intestinal tract is associated with a poorer prognosis.

肺鳞状细胞癌(LUSC)的特点是转移率和复发率高,导致患者预后不良。肺鳞状细胞癌的肠道转移在临床上较为罕见。对于发生肠道转移的乳腺癌患者,治疗方案非常有限,目前也没有针对这些病例的标准治疗指南。在这篇综述中,我们讨论了伴有肠道转移的 LUSC 患者的临床特征、诊断和治疗,并介绍了一例罕见的伴有肠道转移的 LUSC 病例。我们描述了一名因剧烈咳嗽和胸痛而就诊的患者,他被诊断为 LUSC 和骨肿瘤。起初,原发性 LUSC 和骨肿瘤通过标准治疗得到了控制。然而,原发性 LUSC 在治疗后不久再次复发,这次是肠道转移,目前尚缺乏有效的治疗方法。我们从该病例中观察到,LUSC 转移到肠道的预后较差。
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引用次数: 0
Anti-Helicobacter pylori Infection Treatment and Pulmonary Hypersensitivity: Case Series and Review of the Literature 抗幽门螺杆菌感染治疗与肺部高敏感性:病例系列和文献综述。
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13816
Shan Xu, Xiaohong Wu, Enguo Chen, Kejing Ying

Background

Helicobacter pylori (H. pylori) infection is currently widespread throughout the world. Bismuth-containing quadruple therapy is widely used, but it has rarely been associated with interstitial lung disease.

Case Presentation

We described six cases with similar clinical symptoms and typical pulmonary interstitial imaging changes during anti-H. pylori therapy, usually on Days 7–12 following treatment. Anti-H. pylori infection treatment was discontinued when it was suspected to be the cause of the clinical symptoms, and all of the patients accepted observation therapy. All of them had a favorable outcome, the clinical symptoms returned to normal almost 1 week later, and the chest computed tomography (CT) scan images showed remarkable absorption 4 weeks later.

Conclusions

Drug interactions could be the cause, and the most likely drug was furazolidone. All of the patients recovered quickly after drug discontinuation, and low-dose steroid may help shorten the recovery time.

背景:幽门螺杆菌(H. pylori)感染目前在全世界广泛存在。含铋四联疗法被广泛使用,但很少与肺间质疾病相关:我们描述了六个病例,这些病例在接受幽门螺杆菌抗病毒治疗期间,通常在治疗后第 7-12 天出现类似的临床症状和典型的肺间质影像学改变。当怀疑幽门螺杆菌感染是导致临床症状的原因时,我们停止了抗幽门螺杆菌治疗,所有患者均接受了观察治疗。4周后,胸部计算机断层扫描(CT)图像显示吸收效果显著:结论:药物相互作用可能是诱因,最有可能的药物是呋喃唑酮。所有患者在停药后都很快康复,小剂量类固醇可能有助于缩短康复时间。
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引用次数: 0
Radiological Features of Primary Pulmonary Invasive Mucinous Adenocarcinoma Based on 312 Consecutive Patients 基于 312 例连续患者的原发性肺浸润性黏液腺癌放射学特征
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13820
Linlin Qi, Jia Jia, Guochao Zhang, Jianing Liu, Fenglan Li, Jiaqi Chen, Shulei Cui, Sainan Cheng, Liyan Xue, Qi Xue, Jianwei Wang

Background

The aim of this study is to investigate the radiological features of primary pulmonary invasive mucinous adenocarcinoma (IMA) in a relatively large population to help improve its further understanding and its accuracy of initial diagnosis.

Methods

This retrospective study included consecutive patients with pathologically confirmed primary pulmonary IMA from January 2019 to December 2021. According to tumor morphology, IMAs were divided into regular nodule/mass, irregular, and large consolidative types. According to tumor density, IMAs were divided into solid, halo, part-solid, pure ground-glass, and cystic types. ANOVA, chi-square, or Fisher exact tests were used to analyze the differences in radiological and clinicopathological characteristics of IMA according to morphological and density subtypes.

Results

We analyzed 312 patients. Pulmonary IMA tended to occur in the elderly, with a slightly higher number of women than men. IMA showed a predominance in the lower lobe and adjacent to pleura. IMA of regular nodule/mass, irregular, and large consolidative types accounted for 80.8% (252/312), 13.8% (43/312), and 5.4% (17/312), respectively. Solid, halo, part-solid, pure ground-glass, and cystic IMAs accounted for 55.8% (174/312), 28.2% (88/312), 11.2% (35/312), 1.3% (4/312), and 3.5% (11/312), respectively. The lobulated (76.9%), spiculated (63.5%), and air bronchogram (56.7%) signs were common in IMA. Dead branch sign (88.2%), angiogram sign (88.2%), and satellite nodules/skipping lesions (47.1%) were common in large-consolidative-type IMA. Kirsten rat sarcoma viral oncogene mutations were common (56.1%), whereas epidermal growth factor receptor mutations were relatively rare (2.3%).

Conclusions

Pulmonary IMA of regular nodule/mass type and solid type were the most common at the initial diagnosis. Detailed radiological features can aid in the differential diagnosis of IMA.

背景:本研究旨在调查相对较大人群中原发性肺浸润性黏液腺癌(IMA)的放射学特征,以帮助提高对其的进一步认识和初步诊断的准确性:这项回顾性研究纳入了2019年1月至2021年12月经病理确诊的原发性肺IMA连续患者。根据肿瘤形态,IMAs 被分为规则结节/肿块型、不规则型和巨大合并型。根据肿瘤密度,IMA分为实性、晕轮、部分实性、纯磨玻璃和囊性型。采用方差分析、卡方检验或费雪精确检验来分析不同形态和密度亚型的 IMA 在放射学和临床病理学特征上的差异:我们对 312 例患者进行了分析。肺部 IMA 多发于老年人,女性患者略多于男性。IMA主要发生在肺下叶和胸膜附近。规则结节/肿块型、不规则型和大块合并型的 IMA 分别占 80.8%(252/312)、13.8%(43/312)和 5.4%(17/312)。实性、晕轮、部分实性、纯磨玻璃和囊性 IMA 分别占 55.8%(174/312)、28.2%(88/312)、11.2%(35/312)、1.3%(4/312)和 3.5%(11/312)。分叶征(76.9%)、棘征(63.5%)和空气支气管征(56.7%)在 IMA 中很常见。死枝征(88.2%)、血管造影征(88.2%)和卫星结节/跳跃性病变(47.1%)在大实变型 IMA 中很常见。Kirsten 大鼠肉瘤病毒癌基因突变常见(56.1%),而表皮生长因子受体突变相对罕见(2.3%):结论:肺部IMA在初诊时最常见的是规则结节/肿块型和实变型。详细的放射学特征有助于 IMA 的鉴别诊断。
{"title":"Radiological Features of Primary Pulmonary Invasive Mucinous Adenocarcinoma Based on 312 Consecutive Patients","authors":"Linlin Qi,&nbsp;Jia Jia,&nbsp;Guochao Zhang,&nbsp;Jianing Liu,&nbsp;Fenglan Li,&nbsp;Jiaqi Chen,&nbsp;Shulei Cui,&nbsp;Sainan Cheng,&nbsp;Liyan Xue,&nbsp;Qi Xue,&nbsp;Jianwei Wang","doi":"10.1111/crj.13820","DOIUrl":"10.1111/crj.13820","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study is to investigate the radiological features of primary pulmonary invasive mucinous adenocarcinoma (IMA) in a relatively large population to help improve its further understanding and its accuracy of initial diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included consecutive patients with pathologically confirmed primary pulmonary IMA from January 2019 to December 2021. According to tumor morphology, IMAs were divided into regular nodule/mass, irregular, and large consolidative types. According to tumor density, IMAs were divided into solid, halo, part-solid, pure ground-glass, and cystic types. ANOVA, chi-square, or Fisher exact tests were used to analyze the differences in radiological and clinicopathological characteristics of IMA according to morphological and density subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analyzed 312 patients. Pulmonary IMA tended to occur in the elderly, with a slightly higher number of women than men. IMA showed a predominance in the lower lobe and adjacent to pleura. IMA of regular nodule/mass, irregular, and large consolidative types accounted for 80.8% (252/312), 13.8% (43/312), and 5.4% (17/312), respectively. Solid, halo, part-solid, pure ground-glass, and cystic IMAs accounted for 55.8% (174/312), 28.2% (88/312), 11.2% (35/312), 1.3% (4/312), and 3.5% (11/312), respectively. The lobulated (76.9%), spiculated (63.5%), and air bronchogram (56.7%) signs were common in IMA. Dead branch sign (88.2%), angiogram sign (88.2%), and satellite nodules/skipping lesions (47.1%) were common in large-consolidative-type IMA. Kirsten rat sarcoma viral oncogene mutations were common (56.1%), whereas epidermal growth factor receptor mutations were relatively rare (2.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pulmonary IMA of regular nodule/mass type and solid type were the most common at the initial diagnosis. Detailed radiological features can aid in the differential diagnosis of IMA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908393","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
Nomogram for Predicting Efficacy and Prognosis After Chemotherapy for Advanced NSCLC 预测晚期 NSCLC 化疗后疗效和预后的提名图
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-08 DOI: 10.1111/crj.13815
Jiaying Gao, Yandong Nan, Gang Liu, Shihong Zhao, Huanqing Xiong, Yifeng Wang, Faguang Jin

Purpose

One major issue is the therapeutic effect following chemotherapy for non–small cell lung cancer (NSCLC). Although numerous risk factors have been identified and novel therapies have been developed, improving patient overall survival (OS) remains a crucial postoperative issue. This study aimed to develop a nomogram for accurately predicting the OS of patients with Stage III–IV NSCLC treated with chemotherapy.

Methods

The Department of Respiration at Tangdu Hospital, Air Force Medical University, prospectively collected data on 321 patients between January 2018 and December 2023. A week before treatment, the platelet-to-lymphocyte ratio (PLR), the neutrophil-to-lymphocyte ratio (NLR), and seven autoantibodies were measured using Youden's index, which was obtained using the ROC curve. The formula was used to compute the values of PLR and NLR. After using multifactor Cox regression analysis to identify risk factors, a nomogram was produced regarding the therapeutic effect following chemotherapy. The performance of the nomogram was assessed using a bootstrapped-concordance index and calibration plots.

Result

It was determined that NLR, sex-determining region Y-box 2 (SOX2), adenosine triphosphate binding RNA deconjugase 4–5 (GBU4-5), and MAGE family member A1 (MAGEA1) were significantly associated factors that could be combined to accurately predict the therapeutic effect following chemotherapy. Utilizing these risk indicators, we were able to develop a nomogram that predicted the patients' survival at 1, 3, and 5 years. At 3 years, the area under the curve representing the expected survival probability was 0.762 (95% confidence interval 0.66–0.87). With a bootstrapped-concordance index of 0.762, the nomogram demonstrated good calibration.

Conclusions

Our nomogram proved to be a valuable instrument in accurately predicting the overall survival of patients.

目的:一个主要问题是非小细胞肺癌(NSCLC)化疗后的治疗效果。虽然已经发现了许多风险因素,并开发出了新型疗法,但提高患者的总生存率(OS)仍是术后的一个关键问题。本研究旨在开发一种提名图,用于准确预测接受化疗的III-IV期NSCLC患者的OS:空军军医大学唐都医院呼吸科前瞻性地收集了2018年1月至2023年12月期间321名患者的数据。治疗前一周,采用尤登指数(Youden's index)测定血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)以及七种自身抗体,利用ROC曲线得出。该公式用于计算 PLR 和 NLR 的值。在使用多因素考克斯回归分析确定风险因素后,生成了化疗后疗效的提名图。使用自引导一致性指数和校准图评估了提名图的性能:结果:NLR、性别决定区Y-盒2(SOX2)、三磷酸腺苷结合RNA解拮抗剂4-5(GBU4-5)和MAGE家族成员A1(MAGEA1)被确定为显著相关的因素,这些因素结合在一起可准确预测化疗后的疗效。利用这些风险指标,我们绘制出了预测患者 1 年、3 年和 5 年生存率的提名图。在 3 年时,代表预期生存概率的曲线下面积为 0.762(95% 置信区间为 0.66-0.87)。自引导一致性指数为 0.762,表明提名图具有良好的校准性:我们的提名图被证明是准确预测患者总生存期的重要工具。
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引用次数: 0
Circ_0028826 Promotes Growth and Metastasis of NSCLC via Acting as a Sponge of miR-758-3p to Derepress IDH2 Expression Circ_0028826 通过充当 miR-758-3p 的海绵来抑制 IDH2 的表达,从而促进 NSCLC 的生长和转移。
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-07 DOI: 10.1111/crj.13802
Lihong Guo, Xueqin Liu, Jie Zhang, Zhuixing Liu, Bohao Zhang, Yang Sun, Dandan Cui, Jinpeng Liu

Background

Non–small cell lung cancer (NSCLC) is one of the cancers with the highest mortality and morbidity in the world. Circular RNAs (circRNAs) are newly identified players in carcinogenesis and development of various cancers. This study is aimed at exploring the functional effects and mechanism of circ_0028826 in the development of NSCLC.

Methods

Real-time quantitative PCR (RT-qPCR) was used to detect the expression levels of circ_0028826, IDH2 mRNA, and miR-758-3p. IDH2, Bcl2, Bax, and E-cadherin protein levels were detected using a western blot. Cell Counting Kit-8 (CCK-8), 5-ethynyl-2′-deoxyuridine (EdU), flow cytometry, wound healing, and transwell assays were used to assess the capacities of proliferation, apoptosis, migration, and invasion. Interaction between miR-758-3p and circ_0028826 or IDH2 was validated using a dual-luciferase reporter assay. The role of circ_0028826 in vivo was checked based on a xenograft tumor model.

Results

Circ_0028826 was elevated in NSCLC, and its absence inhibited NSCLC cell proliferation, migration, invasion, and induced apoptosis. In terms of mechanism, circ_0028826 increased IDH2 expression by targeting miR-758-3p. In addition, circ_0028826 knockdown also regulated IDH2 by targeting miR-758-3p to inhibit tumor growth in vivo.

Conclusion

Circ_0028826 promoted the development of NSCLC via regulation of the miR-758-3p/IDH2 axis, providing a new strategy for NSCLC treatment.

背景:非小细胞肺癌(NSCLC非小细胞肺癌(NSCLC)是世界上死亡率和发病率最高的癌症之一。环状 RNA(circRNA)是新发现的在各种癌症的发生和发展中起作用的因子。本研究旨在探讨 circ_0028826 在 NSCLC 发病过程中的功能作用和机制:方法:采用实时定量 PCR(RT-qPCR)技术检测 circ_0028826、IDH2 mRNA 和 miR-758-3p 的表达水平。用 Western 印迹法检测 IDH2、Bcl2、Bax 和 E-cadherin 蛋白水平。细胞计数试剂盒-8(CCK-8)、5-乙炔基-2'-脱氧尿苷(EdU)、流式细胞术、伤口愈合和透孔试验被用来评估细胞的增殖、凋亡、迁移和侵袭能力。使用双荧光素酶报告实验验证了 miR-758-3p 与 circ_0028826 或 IDH2 之间的相互作用。通过异种移植肿瘤模型检验了circ_0028826在体内的作用:结果:Circ_0028826在NSCLC中升高,其缺失可抑制NSCLC细胞的增殖、迁移和侵袭,并诱导细胞凋亡。在机制方面,circ_0028826通过靶向miR-758-3p增加了IDH2的表达。此外,circ_0028826敲除后还能通过靶向miR-758-3p调节IDH2,从而抑制体内肿瘤的生长:Circ_0028826通过调控miR-758-3p/IDH2轴促进了NSCLC的发展,为NSCLC的治疗提供了一种新策略。
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引用次数: 0
A Nomogram for Predicting Cancer-Specific Survival in Young Patients With Advanced Lung Cancer Based on Competing Risk Model 基于竞争风险模型预测年轻晚期肺癌患者癌症特异性生存期的提名图
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-07 DOI: 10.1111/crj.13800
Jiaxin Li, Bolin Pan, Qiying Huang, Chulan Zhan, Tong Lin, Yangzhi Qiu, Honglang Zhang, Xiaohong Xie, Xinqin Lin, Ming Liu, Liqiang Wang, Chengzhi Zhou

Background

Young lung cancer is a rare subgroup accounting for 5% of lung cancer. The aim of this study was to compare the causes of death (COD) among lung cancer patients of different age groups and construct a nomogram to predict cancer-specific survival (CSS) in young patients with advanced stage.

Methods

Lung cancer patients diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and stratified into the young (18–45 years) and old (> 45 years) groups to compare their COD. Young patients diagnosed with advanced stage (IVa and IVb) from 2010 to 2015 were reselected and divided into training and validation cohorts (7:3). Independent prognostic factors were identified through the Fine-Gray's test and further integrated to the competing risk model. The area under the receiver operating characteristic curve (AUC), consistency index (C-index), and calibration curve were applied for validation.

Results

The proportion of cancer-specific death (CSD) in young patients was higher than that in old patients with early-stage lung cancer (p < 0.001), while there was no difference in the advanced stage (p = 0.999). Through univariate and multivariate analysis, 10 variables were identified as independent prognostic factors for CSS. The AUC of the 1-, 3-, and 5-year prediction of CSS was 0.688, 0.706, and 0.791 in the training cohort and 0.747, 0.752, and 0.719 in the validation cohort. The calibration curves demonstrated great accuracy. The C-index of the competing risk model was 0.692 (95% CI: 0.636–0.747) in the young patient cohort.

Conclusion

Young lung cancer is a distinct entity with a different spectrum of competing risk events. The construction of our nomogram can provide new insights into the management of young patients with lung cancer.

背景:年轻肺癌是一个罕见的亚组,占肺癌的5%。本研究旨在比较不同年龄组肺癌患者的死亡原因(COD),并构建一个提名图来预测晚期年轻患者的癌症特异性生存率(CSS):从监测、流行病学和最终结果(SEER)数据库中提取了2004年至2015年间确诊的肺癌患者,并将其分为年轻组(18-45岁)和年长组(大于45岁),以比较他们的死因。重新选择了2010年至2015年诊断为晚期(IVa和IVb)的年轻患者,并将其分为训练组和验证组(7:3)。通过Fine-Gray检验确定了独立的预后因素,并进一步整合到竞争风险模型中。应用接收者操作特征曲线下面积(AUC)、一致性指数(C-index)和校准曲线进行验证:结果:年轻肺癌患者的癌症特异性死亡(CSD)比例高于老年早期肺癌患者(P 结论:年轻肺癌是一个独特的实体,其癌症特异性死亡比例高于老年早期肺癌患者:年轻肺癌是一个独特的实体,具有不同的竞争风险事件谱。我们构建的提名图可以为年轻肺癌患者的治疗提供新的见解。
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引用次数: 0
Primary Pulmonary Angiosarcoma Found Incidentally in a Complicated Patient: A Rare Case Report 并发症患者偶然发现的原发性肺血管肉瘤:罕见病例报告
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-06 DOI: 10.1111/crj.13818
Reza Basiri, Alireza Ziaei Moghaddam, Arezoo Rikhtegar, Amir Hossein Jafarian

Introduction

Primary pulmonary angiosarcoma (PPA) is a highly aggressive and rare malignancy originating from the endothelial cells of blood vessels in the lungs. PPA is an extremely rare subtype, with less than 30 cases reported to date. PPA is not only challenging to diagnose but also has a poor prognosis, often resulting in a high mortality rate within a year of diagnosis, regardless of the treatment approach.

Method

We present the case of a 33-year-old woman with no significant past medical history who presented with abdominal pain and was incidentally found to have a right hilar mass with pleural effusion and empyema. After undergoing surgery for a perforated gastric ulcer, her pulmonary lesions were further worked up. Despite an extensive diagnostic evaluation, including imaging, bronchoscopy, and thoracotomy, establishing a diagnosis was challenging. Ultimately, PPA was diagnosed on surgical lung biopsy, and the patient was started on pazopanib and paclitaxel chemotherapy but expired after 1 month due to multiple complications.

Conclusion

This case highlights the difficulty in diagnosing this rare tumor and its poor prognosis regardless of therapy. Greater awareness of PPA and more research are needed to improve early detection and treatment options for this deadly disease.

简介原发性肺血管肉瘤(PPA)是一种源自肺部血管内皮细胞的高度侵袭性罕见恶性肿瘤。PPA 是一种极为罕见的亚型,迄今报道的病例不到 30 例。PPA 不仅诊断困难,而且预后较差,无论采用何种治疗方法,通常在确诊后一年内死亡率较高:我们介绍了一例 33 岁女性的病例,她既往无重大病史,因腹痛就诊,偶然发现右侧腹股沟肿块,伴有胸腔积液和肺水肿。在接受胃溃疡穿孔手术后,她的肺部病变得到了进一步检查。尽管进行了广泛的诊断评估,包括影像学检查、支气管镜检查和胸腔切开术,但确诊仍很困难。最终,手术肺活检确诊为 PPA,患者开始接受帕唑帕尼和紫杉醇化疗,但 1 个月后因多种并发症去世:本病例凸显了诊断这种罕见肿瘤的难度,以及无论采用何种治疗方法,其预后都很差。我们需要提高对PPA的认识并开展更多研究,以改善这种致命疾病的早期发现和治疗方案。
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引用次数: 0
Unplanned Perioperative Reoperation Following Pulmonary Resection in Lung Cancer Patients: A Report of a Single-Center Experience 肺癌患者肺切除术后非计划围手术期再次手术:单中心经验报告
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-06 DOI: 10.1111/crj.13810
Hongxiang Feng, Yue Zhao, Chaoyang Liang, Yuhui Shi, Deruo Liu, Jin Zhang, Zhenrong Zhang

Background

Pulmonary resection is an important part of comprehensive treatment of lung cancer. Despite the progress in recent thoracic surgery, reoperation is occasionally inevitable for managing severe perioperative complications. This study aimed to investigate the incidence and causes of perioperative reoperation in lung cancer patients.

Methods

We retrospectively collected patients who underwent reoperation following pulmonary resection from January 2010 to February 2021 in China-Japan Friendship Hospital.

Results

Among the 5032 lung cancer patients who received primary pulmonary resection in our institute, 37 patients underwent perioperative reoperation with the rate being 0.74%. Lobectomy was the most frequently executed procedure (56.8%). The mean duration of the primary surgery was 143.6 ± 65.1 min. About half of the cases received secondary surgery within 24 h of the primary surgery, whereas only one case underwent secondary surgery 30 days after the primary surgery (due to chylous leakage). The major causes of the reoperation were bleeding (73.0%), chylous leakage (13.5%), lobar torsion (5.4%), air leakage (2.7%), atelectasis (2.9%), and cardiac herniation (2.7%).

Conclusion

The most prevalent reasons for unplanned reoperation following pulmonary resection in lung cancer patients include bleeding, chylous leakage, and lobar torsion. The strict control of the surgical indications and standardization of surgical procedures are fundamental to reduce unplanned secondary operations after pulmonary resections. Timely identification of the need to secondary surgery is also important to ensure patients' safety.

背景:肺切除术是肺癌综合治疗的重要组成部分。尽管近年来胸外科手术取得了很大进展,但为了处理严重的围手术期并发症,再次手术有时仍不可避免。本研究旨在调查肺癌患者围手术期再次手术的发生率和原因:我们回顾性收集了 2010 年 1 月至 2021 年 2 月期间在中日友好医院接受肺切除术后再次手术的患者:结果:在我院接受原发性肺切除术的5032例肺癌患者中,有37例患者进行了围手术期再手术,再手术率为0.74%。肺叶切除术是最常见的手术(56.8%)。初次手术的平均时间为(143.6 ± 65.1)分钟。约半数病例在初次手术后24小时内接受了二次手术,只有一例在初次手术后30天接受了二次手术(由于乳糜漏)。再次手术的主要原因是出血(73.0%)、乳糜漏(13.5%)、肺叶扭转(5.4%)、漏气(2.7%)、肺不张(2.9%)和心脏疝(2.7%):结论:肺癌患者肺切除术后最常见的非计划再手术原因包括出血、乳糜漏和肺叶扭转。严格控制手术适应症和规范手术流程是减少肺切除术后意外二次手术的根本。及时发现是否需要二次手术对于确保患者的安全也很重要。
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引用次数: 0
期刊
Clinical Respiratory Journal
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