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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 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 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。
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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 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 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 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。
{"title":"A Meta-Analysis of Efficacy and Safety of Neoadjuvant Immunotherapy Plus Chemotherapy for Resectable Non-Small Cell Lung Cancer","authors":"Xinru Sun,&nbsp;Tianhua Kang,&nbsp;Baodong Liu,&nbsp;Yin Zhang,&nbsp;Guangming Huang","doi":"10.1111/crj.70019","DOIUrl":"10.1111/crj.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 <i>p</i> &lt; 0.05 was considered statistically significant. Twenty-two studies including a total of 1108 patients were eligible for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367566","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
Comparison of Efficacy and Safety of Different Guided Technologies Combined With Ultrathin Bronchoscopic Biopsy for Peripheral Pulmonary Lesions 不同导引技术结合超薄支气管镜活检治疗肺外周病变的有效性和安全性比较
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-09-27 DOI: 10.1111/crj.70012
Zhihan Zhang, Junbao Zhang, Xi Chen, Junfeng Yan, Cao Zeng, Ping Xu

Introduction

Various bronchoscopic guidance techniques have emerged to improve the diagnostic yield of peripheral pulmonary lesions (PPLs), especially when combined with ultra-thin bronchoscopy. However, uncertainties exists in the convenience, accuracy rate, and complications of these techniques. We compared the feasibility, accuracy rate, and complication rates of transbronchial biopsy of PPLs sampled by the standard thin-layer CT navigation combined with ultrathin bronchoscopy (CTNUTB), the Lungpro virtual navigation combined with ultrathin bronchoscopy (VNUTB), and electromagnetic navigation combined with ultrathin bronchoscopy (ENUTB).

Methods

Retrospectively identified were 256 patients sampled with transbronchial biopsy of PPLs. Eligible patients referred for CTNUTB, VNUTB, and ENUTB from January 2017 to December 2021 were included. We comprehensively compared the accuracy rate, feasibility, and complication rates for each method.

Results

There was no significant difference in the accuracy rate of CTNUTB, VNUTB, and ENUTB (p = 0.293). The operation time via Lungpro navigation was the shortest (14.4 min, p < 0.001). The planning time via CT planning was the shortest (7.36 min, p < 0.001). There was no difference in the incidence of complications such as hemorrhage, pneumonia, and pneumothorax (p = 0.123). Besides, ENUTB costs more than $2000, while CTNUTB and VNUTB cost only about $130–230.

Conclusion

CTNUTB is still the main bronchoscopy method we recommended, which has low cost, simple operation, and safety no less than the others. In contrast, ENUTB provides a higher accuracy rate for small diameter nodules (less than 2 cm), which has a high use value and is worth promoting in the future.

导言:为提高肺外周病变(PPL)的诊断率,出现了各种支气管镜引导技术,尤其是与超细支气管镜联合使用时。然而,这些技术的便利性、准确率和并发症都存在不确定性。我们比较了通过标准薄层 CT 导航结合超细支气管镜(CTNUTB)、Lungpro 虚拟导航结合超细支气管镜(VNUTB)和电磁导航结合超细支气管镜(ENUTB)对 PPL 取样进行经支气管活检的可行性、准确率和并发症发生率。 方法 回顾性地确定了 256 例经支气管活检的 PPL 患者。纳入了 2017 年 1 月至 2021 年 12 月期间转诊接受 CTNUTB、VNUTB 和 ENUTB 的合格患者。我们全面比较了每种方法的准确率、可行性和并发症发生率。 结果 CTNUTB、VNUTB 和 ENUTB 的准确率无明显差异(P = 0.293)。通过 Lungpro 导航的手术时间最短(14.4 分钟,p = 0.001)。通过 CT 规划的手术时间最短(7.36 分钟,p < 0.001)。出血、肺炎和气胸等并发症的发生率没有差异(P = 0.123)。此外,ENUTB 的费用超过 2000 美元,而 CTNUTB 和 VNUTB 的费用仅约 130-230 美元。 结论 CTNUTB 仍是我们推荐的主要支气管镜检查方法,其成本低、操作简单、安全性不亚于其他方法。相比之下,ENUTB 对小直径结节(小于 2 厘米)的准确率更高,具有很高的使用价值,值得在未来推广。
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引用次数: 0
Chest X-Ray Comparison Between Drug-Resistant and Drug-Sensitive Pulmonary Tuberculosis in Children 儿童耐药性肺结核与药物敏感性肺结核胸部 X 光片比较
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-09-25 DOI: 10.1111/crj.70010
Saffanah Az Zuhriyyah, Harry Galuh Nugraha, Djatnika Setiabudi, Prayudi Santoso, Heda Melinda Nataprawira

Introduction

Chest X-ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) that could help in the evaluation and management of TB cases in children.

Methods

Retrospective analysis with cross-sectional approach was conducted in children (<18 years old) diagnosed with pulmonary DR-TB and DS-TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi-square and Fisher's exact tests with significance levels set at p value <0.05.

Results

Sixty-nine children (DR-TB 31 children vs. DS-TB 38 children) were assessed. Of the 31 children with DR-TB, 65% were classified as multidrug-resistant TB (MDR-TB), followed by rifampicin-resistant TB (RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB). The most common CXR findings in DR-TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS-TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR-TB (p = 0.008).

Conclusions

Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR-TB. Pleural effusion is the most common in DS-TB. These findings have the potential to be considered in further examination of children with pulmonary DR-TB and DS-TB; hence, more extensive studies are needed to confirm these results.

导言 胸部 X 光(CXR)仍然是诊断肺结核(TB)的工具之一。然而,有关此类工具的研究很少,尤其是针对印度尼西亚儿童的研究。我们旨在调查和比较耐药肺结核(DR-TB)和药敏肺结核(DS-TB)患儿的胸部 X 光检查结果,以帮助评估和管理儿童肺结核病例。 方法 对 2018 年 1 月至 2021 年 12 月期间诊断为肺部 DR-TB 和 DS-TB 的儿童(<18 岁)进行横断面回顾性分析。记录数据来自万隆哈桑-萨迪金博士综合医院的儿科呼吸内科登记处和结核病信息系统。采用卡方检验(chi-square)和费雪精确检验(Fisher's exact)对儿童特征、CXR结果和结核病严重程度进行评估和比较,显著性水平设定为P值<0.05。 结果 共评估了 69 名儿童(DR-TB 31 名,DS-TB 38 名)。在31名DR-TB患儿中,65%被归类为耐多药结核病(MDR-TB),其次是耐利福平结核病(RR-TB)、前广泛耐药结核病(pre-XDR-TB)和广泛耐药结核病(XDR-TB)。在 DR-TB 中,最常见的 CXR 检查结果是合并症(68%)、纤维化(42%)和空洞(29%),而在 DS-TB 中则是胸腔积液(37%)。重症肺结核占 DR-TB 的 50%(P = 0.008)。 结论 合并、纤维化、空洞和重症肺结核在 DR-TB 中最为常见。胸腔积液在 DS-TB 中最为常见。在对肺部 DR-TB 和 DS-TB 儿童进行进一步检查时,有可能会考虑到这些结果;因此,需要进行更广泛的研究来证实这些结果。
{"title":"Chest X-Ray Comparison Between Drug-Resistant and Drug-Sensitive Pulmonary Tuberculosis in Children","authors":"Saffanah Az Zuhriyyah,&nbsp;Harry Galuh Nugraha,&nbsp;Djatnika Setiabudi,&nbsp;Prayudi Santoso,&nbsp;Heda Melinda Nataprawira","doi":"10.1111/crj.70010","DOIUrl":"https://doi.org/10.1111/crj.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Chest X-ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) that could help in the evaluation and management of TB cases in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis with cross-sectional approach was conducted in children (&lt;18 years old) diagnosed with pulmonary DR-TB and DS-TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi-square and Fisher's exact tests with significance levels set at <i>p</i> value &lt;0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-nine children (DR-TB 31 children vs. DS-TB 38 children) were assessed. Of the 31 children with DR-TB, 65% were classified as multidrug-resistant TB (MDR-TB), followed by rifampicin-resistant TB (RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB). The most common CXR findings in DR-TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS-TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR-TB (<i>p</i> = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR-TB. Pleural effusion is the most common in DS-TB. These findings have the potential to be considered in further examination of children with pulmonary DR-TB and DS-TB; hence, more extensive studies are needed to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316982","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
Detection of the Fatty Acid Metabolism-Linked Genes in Lung Adenocarcinoma as Biomarkers for Clinical Prognosis and Immunotherapeutic Targets 检测肺腺癌中的脂肪酸代谢相关基因,作为临床预后和免疫治疗靶点的生物标记物
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-09-25 DOI: 10.1111/crj.70013
Jingwei Shi, Rusong Yang, Xinyi Jiang, Kangle Zhu, Zhengcheng Liu

Background

Lung cancer, on a global scale, leads to the most common cases of cancer mortalities. Novel therapeutic approaches are urgently needed to disrupt this lethal disease. The rapid development of tumor immunology combining breakthroughs involving fatty acid metabolism brings possibilities. Directing fatty acid metabolism is supposed to help discover potential prognostic biomarkers and treatment targets for lung cancer.

Methods

Through searching the GSE140797 dataset, we identified genes related to fatty acid metabolism as well as fatty acid metabolism-related differentially expressed genes (DEGs). We applied various methods to ascertain the independent prognostic value of the DEGs. The methods we utilized entail prognostic analysis, differential expression analysis, as well as univariate and multivariate Cox regression analyses. The lasso Cox regression model was utilized in examining how DEGs correlate with the immune score, immune checkpoint, ferroptosis, methylation, and OCLR score. The expression levels of ACAT1 and ACSL3 in tissues derived from normal lung and lung adenocarcinoma (LUAD) tissues were compared by qRT-PCR.

Results

In this study, ACSL3 and ACAT1 were identified as fatty acid metabolism-related genes utilizing independent prognostic value and as a result, the risk prognostic model was built using these factors. qRT-PCR results implied that ACSL3 and ACAT1 expressions were upregulated and downregulated, correspondingly in tumor tissues. Additional evaluations suggested that ACSL3 and ACAT1 were affirmed to be remarkably correlated with the immune score, methylation, immune checkpoint, OCLR score, and ferroptosis.

Conclusions

ACSL3 and ACAT1 were effective prognostic biomarkers and potential immunotherapeutic targets in LUAD.

背景肺癌在全球范围内导致最常见的癌症死亡病例。目前迫切需要新的治疗方法来阻断这一致命疾病。肿瘤免疫学的快速发展与脂肪酸代谢方面的突破相结合,带来了各种可能性。引导脂肪酸代谢有助于发现肺癌的潜在预后生物标志物和治疗靶点。 方法 通过搜索 GSE140797 数据集,我们发现了与脂肪酸代谢相关的基因以及与脂肪酸代谢相关的差异表达基因(DEGs)。我们采用了多种方法来确定 DEGs 的独立预后价值。我们采用的方法包括预后分析、差异表达分析以及单变量和多变量 Cox 回归分析。在研究 DEGs 与免疫评分、免疫检查点、铁突变、甲基化和 OCLR 评分的相关性时,我们使用了 lasso Cox 回归模型。通过 qRT-PCR 技术比较了 ACAT1 和 ACSL3 在正常肺组织和肺腺癌(LUAD)组织中的表达水平。 结果 本研究发现,ACSL3 和 ACAT1 是具有独立预后价值的脂肪酸代谢相关基因,因此利用这些因子建立了风险预后模型。其他评估结果表明,ACSL3 和 ACAT1 与免疫评分、甲基化、免疫检查点、OCLR 评分和铁变态反应显著相关。 结论 ACSL3 和 ACAT1 是 LUAD 的有效预后生物标志物和潜在免疫治疗靶点。
{"title":"Detection of the Fatty Acid Metabolism-Linked Genes in Lung Adenocarcinoma as Biomarkers for Clinical Prognosis and Immunotherapeutic Targets","authors":"Jingwei Shi,&nbsp;Rusong Yang,&nbsp;Xinyi Jiang,&nbsp;Kangle Zhu,&nbsp;Zhengcheng Liu","doi":"10.1111/crj.70013","DOIUrl":"https://doi.org/10.1111/crj.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer, on a global scale, leads to the most common cases of cancer mortalities. Novel therapeutic approaches are urgently needed to disrupt this lethal disease. The rapid development of tumor immunology combining breakthroughs involving fatty acid metabolism brings possibilities. Directing fatty acid metabolism is supposed to help discover potential prognostic biomarkers and treatment targets for lung cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through searching the GSE140797 dataset, we identified genes related to fatty acid metabolism as well as fatty acid metabolism-related differentially expressed genes (DEGs). We applied various methods to ascertain the independent prognostic value of the DEGs. The methods we utilized entail prognostic analysis, differential expression analysis, as well as univariate and multivariate Cox regression analyses. The lasso Cox regression model was utilized in examining how DEGs correlate with the immune score, immune checkpoint, ferroptosis, methylation, and OCLR score. The expression levels of ACAT1 and ACSL3 in tissues derived from normal lung and lung adenocarcinoma (LUAD) tissues were compared by qRT-PCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, ACSL3 and ACAT1 were identified as fatty acid metabolism-related genes utilizing independent prognostic value and as a result, the risk prognostic model was built using these factors. qRT-PCR results implied that ACSL3 and ACAT1 expressions were upregulated and downregulated, correspondingly in tumor tissues. Additional evaluations suggested that ACSL3 and ACAT1 were affirmed to be remarkably correlated with the immune score, methylation, immune checkpoint, OCLR score, and ferroptosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ACSL3 and ACAT1 were effective prognostic biomarkers and potential immunotherapeutic targets in LUAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324454","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
Is It Time to (Re)define the N-Category for Metastatic Lymph Nodes in Non–Small Cell Lung Cancer? 是时候(重新)定义非小细胞肺癌转移淋巴结的 N 分类了吗?
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-09-25 DOI: 10.1111/crj.70016
Koen C. H. A. Verkoulen, Jean H. T. Daemen, Aimée J. P. M. Franssen, Juliette H. R. J. Degens, Karel W. E. Hulsewé, Yvonne L. J. Vissers, Erik R. de Loos
<p>In a recent issue of <i>The Clinical Respiratory Journal</i>, Guo et al. published a study that evaluated the correlation between the rate and number of resected metastatic lymph nodes and survival in patients undergoing an anatomical resection for non–small cell lung cancer (NSCLC) [<span>1</span>]. To date, nodal staging is key in the work-up and treatment guidance for NSCLC as it is an important determinant of survival [<span>2, 3</span>]. As opposed to some other cancer types, nodal staging for lung cancer is based on the anatomic location of the respective regional and mediastinal lymph node stations rather than the number of metastasis [<span>4-6</span>]. Hence, the ongoing debate concerning the potential prognostic value of the number and rate of lymph node metastases in NSCLC continues. Over the last decade, numerous studies have aimed to address this issue [<span>7-10</span>]. However, they are generally limited by their retrospective design and inherent bias, as well as methodological disparity [<span>11</span>]. How does the current report add to the evidence collected for over more than a decade?</p><p>Guo et al. carried out the first population-based study concerning this subject. They revealed that both the number and rate of positive lymph nodes after lymphadenectomy concomitant to an anatomical lung parenchyma resection are a predictor for overall survival, independent of the anatomical location of the nodal station that is affected, being either N1 or N2. These results are in line with prior retrospective studies and a recently published meta-analysis [<span>8, 10, 12</span>]. However, the number and rate of metastatic lymph nodes was only examined in postoperative patients that underwent lymphadenectomy, in whom the lymph nodes were completely dissected (defined as examination of more than 15 dissected lymph nodes) instead of biopsied stations. Thus, these results are only applicable as a prognostic tool and in treatment decision-making processes for postoperative patients. To be of an even greater importance for treatment plan composition, for example, one should repeat this study for preoperative clinical lymph node staging (cTNM) using minimally invasive staging techniques like endosonographic lymph node staging (EUS/EBUS) or surgical video-assisted mediastinoscopy (VAM) or video-assisted mediastinoscopic lymphadenectomy (VAMLA). However, a recent publication showed in a noninferiority study that VAMLA might not be of added value in patients that underwent systemic EUS/EBUS [<span>13</span>]. Additionally, VAM/VAMLA or EUS is mainly used to assess N2 nodes. Hence, the vast majority of metastatic N1 nodes cannot be evaluated through these techniques. These drawbacks illustrate the challenges of the current TNM classification, and lymph node staging, especially for clinical lymph node staging. The sensitivity of preoperative lymph node staging modalities like (PET)-CT scan and EUS/EBUS ranges from 20% to 70%, resulting in a
欧洲和美国的术前淋巴结分期指南存在差异。修订后的欧洲胸外科医师协会纵隔分期指南建议至少清扫 4L-R 和 7 号淋巴结[20],而美国胸科医师学会指南则建议至少清扫 2L-R、4L-R 和 7 号淋巴结[21]。包括荷兰指南在内的一些国家指南甚至没有明确指出应切除的具体部位[22]。Guo 等人建议至少清扫 16 个检查淋巴结,并排除了 16 个检查淋巴结的患者。但另一项研究建议切除 10 个淋巴结,而不是 Guo 等人提出的 16 个[7]。另一项研究发现,在解剖性肺切除术中,如果切除的淋巴结越多,生存率越高[23]。相反,根据一项荟萃分析[24],迄今为止,淋巴结清扫比取样更有利于提高总生存率。因此,这些研究报告中关于解剖肺切除术中淋巴结检查的差异导致了术中淋巴结清扫的混乱。日常实践也凸显了这种不一致;从荷兰全国肺癌审计中可以推断出,只有少数患者的术中淋巴结取样是根据指南进行的[25]。要实现这种重新定义,就必须在淋巴结分期方面制定更少异质性、更精确的国际指南,并尽可能遵守和报告这些指南。改变 TNM 分期可能与临床相关,并有助于未来的研究工作。在第 9 版 TNM 分类系统中,国际肺癌研究协会提出了不同的概念,如前面提到的结节区概念以及淋巴结转移的数量和确切位置[11]。这些概念的整合可能会成为更适合患者的治疗方法,从而获得更好的生存结果。无论 TNM 分类的 N 描述符是否会改变,提高现行指南的标准化程度并遵守这些指南,都将是朝着改进结节分期和适合患者的治疗模式方向迈出的良好的第一步。由于这是一篇特邀社论,没有使用任何人类或动物数据,因此本稿件草案不适用伦理审批或患者/动物同意书。作者对工作的所有方面负责,确保与工作任何部分的准确性或完整性有关的问题得到妥善调查和解决。作者无利益冲突需要声明,他们都为本手稿的撰写做出了贡献。
{"title":"Is It Time to (Re)define the N-Category for Metastatic Lymph Nodes in Non–Small Cell Lung Cancer?","authors":"Koen C. H. A. Verkoulen,&nbsp;Jean H. T. Daemen,&nbsp;Aimée J. P. M. Franssen,&nbsp;Juliette H. R. J. Degens,&nbsp;Karel W. E. Hulsewé,&nbsp;Yvonne L. J. Vissers,&nbsp;Erik R. de Loos","doi":"10.1111/crj.70016","DOIUrl":"https://doi.org/10.1111/crj.70016","url":null,"abstract":"&lt;p&gt;In a recent issue of &lt;i&gt;The Clinical Respiratory Journal&lt;/i&gt;, Guo et al. published a study that evaluated the correlation between the rate and number of resected metastatic lymph nodes and survival in patients undergoing an anatomical resection for non–small cell lung cancer (NSCLC) [&lt;span&gt;1&lt;/span&gt;]. To date, nodal staging is key in the work-up and treatment guidance for NSCLC as it is an important determinant of survival [&lt;span&gt;2, 3&lt;/span&gt;]. As opposed to some other cancer types, nodal staging for lung cancer is based on the anatomic location of the respective regional and mediastinal lymph node stations rather than the number of metastasis [&lt;span&gt;4-6&lt;/span&gt;]. Hence, the ongoing debate concerning the potential prognostic value of the number and rate of lymph node metastases in NSCLC continues. Over the last decade, numerous studies have aimed to address this issue [&lt;span&gt;7-10&lt;/span&gt;]. However, they are generally limited by their retrospective design and inherent bias, as well as methodological disparity [&lt;span&gt;11&lt;/span&gt;]. How does the current report add to the evidence collected for over more than a decade?&lt;/p&gt;&lt;p&gt;Guo et al. carried out the first population-based study concerning this subject. They revealed that both the number and rate of positive lymph nodes after lymphadenectomy concomitant to an anatomical lung parenchyma resection are a predictor for overall survival, independent of the anatomical location of the nodal station that is affected, being either N1 or N2. These results are in line with prior retrospective studies and a recently published meta-analysis [&lt;span&gt;8, 10, 12&lt;/span&gt;]. However, the number and rate of metastatic lymph nodes was only examined in postoperative patients that underwent lymphadenectomy, in whom the lymph nodes were completely dissected (defined as examination of more than 15 dissected lymph nodes) instead of biopsied stations. Thus, these results are only applicable as a prognostic tool and in treatment decision-making processes for postoperative patients. To be of an even greater importance for treatment plan composition, for example, one should repeat this study for preoperative clinical lymph node staging (cTNM) using minimally invasive staging techniques like endosonographic lymph node staging (EUS/EBUS) or surgical video-assisted mediastinoscopy (VAM) or video-assisted mediastinoscopic lymphadenectomy (VAMLA). However, a recent publication showed in a noninferiority study that VAMLA might not be of added value in patients that underwent systemic EUS/EBUS [&lt;span&gt;13&lt;/span&gt;]. Additionally, VAM/VAMLA or EUS is mainly used to assess N2 nodes. Hence, the vast majority of metastatic N1 nodes cannot be evaluated through these techniques. These drawbacks illustrate the challenges of the current TNM classification, and lymph node staging, especially for clinical lymph node staging. The sensitivity of preoperative lymph node staging modalities like (PET)-CT scan and EUS/EBUS ranges from 20% to 70%, resulting in a ","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324464","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
Comparison Between Endobronchial-Guided Transbronchial Biopsy and Computed Tomography–Guided Transthoracic Lung Biopsy for the Diagnosis of Central Pulmonary Lesions 支气管内引导经支气管活检与计算机断层扫描引导经胸肺活检在诊断肺中心病变方面的比较
IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2024-09-24 DOI: 10.1111/crj.70015
Cheng Zhang, Senlin Zhu, Yanliang Yuan, Shenhui Dai

Background

Lung cancer is one of the most common malignant tumors at present. This study aimed to compare the diagnostic accuracy, complication rates, and predictive values of computed tomography (CT)–guided percutaneous transthoracic needle biopsy (PTNB) and electronic bronchoscopy–guided transbronchial lung biopsy (TBLB) for patients with central pulmonary lesions (CPLs) with a diameter ≥ 3 cm.

Methods

We retrospectively included 110 patients with CPLs with a diameter ≥ 3 cm who underwent preoperative PTNB and TBLB examinations and ultimately underwent surgery to remove CPLs and obtained pathological results. Detailed information was collected in order to compare whether there was a difference between two groups. Data were processed using SPSS software (Version 26.0; IBM Corp). Data were compared by t-test or chi-square test. p < 0.05 was considered statistically significant.

Results

All patients underwent surgical treatment at the department of thoracic surgery and obtained a final pathological diagnosis. The rate of positive predictive value (PPV) was comparable between the two methods, and the negative predictive value (NPV) was significantly higher in the PTNB group compared with the TBLB group (p < 0.05). In addition, PTNB was more sensitive and accurate than TBLB (p < 0.05). However, the PTNB group had a higher probability of complications, and TBLB was a relatively safer examination method.

Conclusion

PTNB demonstrated a higher accuracy and sensitivity than TBLB in the treatment of CPLs with a diameter ≥ 3 cm, but the complication rates of PTNB are relatively high. These methods exhibited different diagnostic accuracies and therefore should be selected based on different medical conditions.

背景:肺癌是目前最常见的恶性肿瘤之一:肺癌是目前最常见的恶性肿瘤之一。本研究旨在比较计算机断层扫描(CT)引导下经皮经胸针活检(PTNB)和电子支气管镜引导下经支气管肺活检(TBLB)对直径≥3 厘米的肺中心病变(CPLs)患者的诊断准确性、并发症发生率和预测值:我们回顾性地纳入了 110 例直径≥ 3 cm 的 CPL 患者,这些患者在术前接受了 PTNB 和 TBLB 检查,最终接受了手术切除 CPL 并获得了病理结果。收集详细信息是为了比较两组之间是否存在差异。数据使用 SPSS 软件(26.0 版;IBM 公司)处理。数据比较采用 t 检验或卡方检验:所有患者均在胸外科接受手术治疗,并获得最终病理诊断。两种方法的阳性预测值(PPV)率相当,与 TBLB 组相比,PTNB 组的阴性预测值(NPV)明显更高(P 结论:PTNB 显示出更高的准确性和阴性预测值:在治疗直径≥ 3 厘米的 CPL 时,PTNB 的准确性和灵敏度均高于 TBLB,但 PTNB 的并发症发生率相对较高。这些方法表现出不同的诊断准确性,因此应根据不同的病情进行选择。
{"title":"Comparison Between Endobronchial-Guided Transbronchial Biopsy and Computed Tomography–Guided Transthoracic Lung Biopsy for the Diagnosis of Central Pulmonary Lesions","authors":"Cheng Zhang,&nbsp;Senlin Zhu,&nbsp;Yanliang Yuan,&nbsp;Shenhui Dai","doi":"10.1111/crj.70015","DOIUrl":"10.1111/crj.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer is one of the most common malignant tumors at present. This study aimed to compare the diagnostic accuracy, complication rates, and predictive values of computed tomography (CT)–guided percutaneous transthoracic needle biopsy (PTNB) and electronic bronchoscopy–guided transbronchial lung biopsy (TBLB) for patients with central pulmonary lesions (CPLs) with a diameter ≥ 3 cm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively included 110 patients with CPLs with a diameter ≥ 3 cm who underwent preoperative PTNB and TBLB examinations and ultimately underwent surgery to remove CPLs and obtained pathological results. Detailed information was collected in order to compare whether there was a difference between two groups. Data were processed using SPSS software (Version 26.0; IBM Corp). Data were compared by <i>t</i>-test or chi-square test. <i>p</i> &lt; 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients underwent surgical treatment at the department of thoracic surgery and obtained a final pathological diagnosis. The rate of positive predictive value (PPV) was comparable between the two methods, and the negative predictive value (NPV) was significantly higher in the PTNB group compared with the TBLB group (<i>p</i> &lt; 0.05). In addition, PTNB was more sensitive and accurate than TBLB (<i>p</i> &lt; 0.05). However, the PTNB group had a higher probability of complications, and TBLB was a relatively safer examination method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PTNB demonstrated a higher accuracy and sensitivity than TBLB in the treatment of CPLs with a diameter ≥ 3 cm, but the complication rates of PTNB are relatively high. These methods exhibited different diagnostic accuracies and therefore should be selected based on different medical conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309178","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
期刊
Clinical Respiratory Journal
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