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Interventional bronchoscopy in lung cancer treatment. 介入性支气管镜在肺癌治疗中的应用。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0201-2023
Ales Rozman, Elzbieta Magdalena Grabczak, Vineeth George, Mateja Marc Malovrh, Helder Novais Bastos, Anna Trojnar, Simon Graffen, Eric Daniel Tenda, Georgia Hardavella

Interventional bronchoscopy has seen significant advancements in recent decades, particularly in the context of lung cancer. This method has expanded not only diagnostic capabilities but also therapeutic options. In this article, we will outline various therapeutic approaches employed through either a rigid or flexible bronchoscope in multimodal lung cancer treatment. A pivotal focus lies in addressing central airway obstruction resulting from cancer. We will delve into the treatment of initial malignant changes in central airways and explore the rapidly evolving domain of early peripheral malignant lesions, increasingly discovered incidentally or through lung cancer screening programmes. A successful interventional bronchoscopic procedure not only alleviates severe symptoms but also enhances the patient's functional status, paving the way for subsequent multimodal treatments and thereby extending the possibilities for survival. Interventional bronchoscopy proves effective in treating initial cancerous changes in patients unsuitable for surgical or other aggressive treatments due to accompanying diseases. The key advantage of interventional bronchoscopy lies in its minimal invasiveness, effectiveness and favourable safety profile.

近几十年来,介入性支气管镜检查取得了重大进展,尤其是在肺癌方面。这种方法不仅提高了诊断能力,还扩展了治疗选择。本文将概述在肺癌多模式治疗中通过刚性或柔性支气管镜采用的各种治疗方法。治疗癌症引起的中央气道阻塞是一个关键重点。我们将深入探讨中央气道初期恶性病变的治疗方法,并探索快速发展的早期外周恶性病变领域,越来越多的早期外周恶性病变是偶然发现或通过肺癌筛查计划发现的。成功的介入性支气管镜手术不仅能缓解严重的症状,还能改善患者的功能状态,为后续的多模式治疗铺平道路,从而延长患者的生存期。事实证明,介入性支气管镜能有效治疗因伴随疾病而不适合接受手术或其他积极治疗的患者的初期癌变。介入性支气管镜的主要优势在于其微创性、有效性和良好的安全性。
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引用次数: 0
Lung cancer screening: where do we stand? 肺癌筛查:现状如何?
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0190-2023
Georgia Hardavella, Armin Frille, Katherina Bernadette Sreter, Florence Atrafi, Uraujh Yousaf-Khan, Ferhat Beyaz, Fotis Kyriakou, Elena Bellou, Monica L Mullin, Sam M Janes

Lung cancer screening (LCS) programmes have emerged over recent years around the world. LCS programmes present differences in delivery, inclusion criteria and resource allocation. On a national scale, only a few LCS programmes have been fully established, but more are anticipated to follow. Evidence has shown that, in combination with a low-dose chest computed tomography scan, smoking cessation should be offered as part of a LCS programme for improved patient outcomes. Promising tools in LCS include further refined risk prediction models, the use of biomarkers, artificial intelligence and radiomics. However, these tools require further study and clinical validation is required prior to routine implementation.

近年来,肺癌筛查(LCS)计划在世界各地兴起。肺癌筛查计划在实施、纳入标准和资源分配方面存在差异。在全国范围内,只有少数几个肺癌筛查项目已经完全建立,但预计会有更多的项目陆续建立。有证据表明,在低剂量胸部计算机断层扫描的同时,戒烟也应作为 LCS 计划的一部分,以改善患者的治疗效果。低剂量胸部计算机断层扫描中前景看好的工具包括进一步完善的风险预测模型、生物标记物的使用、人工智能和放射组学。不过,这些工具还需要进一步研究,并在常规实施前进行临床验证。
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引用次数: 0
A scoping review of lung cancer surgery with curative intent: workup, fitness assessment, clinical outcomes. 以治愈为目的的肺癌手术范围综述:准备工作、体能评估、临床结果。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0046-2024
Georgia Hardavella, Federica Carlea, Ioannis Karampinis, Alexandro Patirelis, Kalliopi Athanasiadi, Dimitrios Lioumpas, Joana Rei, Lucas Hoyos, Georgios Benakis, Edward Caruana, Eugenio Pompeo, Stefano Elia

Lung cancer surgery with curative intent has significantly developed over recent years, mainly focusing on minimally invasive approaches that do not compromise medical efficiency and ensure a decreased burden on the patient. It is directly linked with an efficient multidisciplinary team that will perform appropriate pre-operative assessment. Caution is required in complex patients with several comorbidities to ensure a meaningful and informed thoracic surgery referral leading to optimal patient outcomes.

近年来,以根治为目的的肺癌手术有了长足的发展,主要集中在不影响医疗效率和确保减轻患者负担的微创方法上。这与高效的多学科团队直接相关,该团队将进行适当的术前评估。对于患有多种并发症的复杂患者,需要谨慎行事,以确保胸外科转诊有意义、有依据,从而使患者获得最佳治疗效果。
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引用次数: 0
Adjuvant immunotherapy and targeted therapy in early and locally advanced resectable lung cancer: expanding treatment tentacles? 早期和局部晚期可切除肺癌的辅助免疫疗法和靶向疗法:扩大治疗触角?
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0035-2024
Evaggelos Fergadis, Amadea Heitmann, Theodore Tsaras, Georgia Hardavella

Adjuvant platinum-based chemotherapy has been the main treatment following surgical resection with curative intent in early and locally advanced nonsmall cell lung cancer (NSCLC) albeit with a 5% improvement in 5-year survival rates. Recent advances in biomarkers pave the way for targeted treatments and immunotherapy in a broader spectrum of patients with subsequently improved clinical outcomes. Targeted treatments and immunotherapy have established their place in the adjuvant setting of resected NSCLC.

铂类辅助化疗一直是早期和局部晚期非小细胞肺癌(NSCLC)根治性手术切除后的主要治疗手段,尽管其 5 年生存率仅提高了 5%。生物标志物方面的最新进展为在更广泛的患者中开展靶向治疗和免疫疗法铺平了道路,从而改善了临床疗效。靶向治疗和免疫疗法已在切除的 NSCLC 的辅助治疗中占据了一席之地。
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引用次数: 0
Lung cancer: an update on the multidisciplinary approach from screening to palliative care. 肺癌:从筛查到姑息治疗的多学科方法的最新进展。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0117-2024
Georgia Hardavella, Joanna Chorostowska-Wynimko, Torsten Gerriet Blum

This issue of Breathe aims to provide a succinct overview of the current state of play in various aspects in thoracic oncology https://bit.ly/3XQexmp.

本期《呼吸》旨在简明扼要地概述胸部肿瘤学 https://bit.ly/3XQexmp 各个方面的现状。
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引用次数: 0
Two women with unexplained dyspnoea: removing the blame game from the lungs. 两名不明原因呼吸困难的妇女:从肺部消除指责游戏。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0029-2024
Eirini Vasarmidi, Irini Lambiri, Eirini Foteinaki, Vaia Stamatopoulou, Ioanna Mitrouska, Georgios Pitsidianakis, Alexandros Patrianakos, Anthoula Plevritaki, Stylianos Michelakis, Vasilis Amargianitakis, Georgios Prinianakis, Sophia Schiza, Nikolaos Tzanakis

Hypoxaemia due to right-to-left atrial shunt with normal pressures in the right heart cavities represents an underdiagnosed condition. A systematic approach to hypoxaemic respiratory failure based on pathophysiology can lead to an accurate diagnosis. https://bit.ly/4bTP8fJ.

在右心腔压力正常的情况下,由右至左心房分流引起的低氧血症是一种诊断不足的病症。以病理生理学为基础的低氧血症呼吸衰竭系统化方法可导致准确诊断。https://bit.ly/4bTP8fJ。
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引用次数: 0
The role of radiological imaging in the management of severe and difficult-to-treat asthma. 放射成像在严重和难治性哮喘治疗中的作用。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0033-2024
Joshua Aigbirior, Amer Almaghrabi, Monder Lafi, Adel H Mansur

Radiological imaging has proven to be a useful tool in the assessment of asthma, its comorbidities and potential complications. Characteristic chest radiograph and computed tomography scan findings can be seen in asthma and in other conditions that can coexist with or be misdiagnosed as asthma, including chronic rhinosinusitis, inducible laryngeal obstruction, excessive dynamic airway collapse, tracheobronchomalacia, concomitant COPD, bronchiectasis, allergic bronchopulmonary aspergillosis, eosinophilic granulomatosis with polyangiitis, and eosinophilic pneumonia. The identification of the characteristic radiological findings of these conditions is often essential in making the correct diagnosis and provision of appropriate management and treatment. Furthermore, radiological imaging modalities can be used to monitor response to therapy.

放射成像已被证明是评估哮喘及其并发症和潜在并发症的有用工具。在哮喘和其他可与哮喘并存或被误诊为哮喘的疾病中,包括慢性鼻窦炎、诱发性喉阻塞、过度动态气道塌陷、气管支气管哮喘、并发慢性阻塞性肺疾病等,都可见到特征性的胸片和计算机断层扫描结果、过度动态气道塌陷、气管支气管畸形、合并慢性阻塞性肺病、支气管扩张、过敏性支气管肺曲霉病、嗜酸粒细胞性肉芽肿伴多血管炎和嗜酸粒细胞性肺炎。确定这些疾病的特征性放射学检查结果往往对做出正确诊断和提供适当的管理和治疗至关重要。此外,放射成像模式还可用于监测治疗反应。
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引用次数: 0
Erratum: "Rolling out new anti-tuberculosis drugs without diagnostic capacity". T. Ness, L.H. Van, I. Petermane, R. Duarte, C. Lange, D. Menzies and D.M. Cirillo on behalf of the UNITE4TB Consortium. Breathe 2023; 19: 230084. 勘误:"在没有诊断能力的情况下推广抗结核新药"。T. Ness、L.H. Van、I. Petermane、R. Duarte、C. Lange、D. Menzies 和 D.M. Cirillo 代表 UNITE4TB 联盟。呼吸 2023; 19: 230084.
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.5084-2023

[This corrects the article DOI: 10.1183/20734735.0084-2023.].

[This corrects the article DOI: 10.1183/20734735.0084-2023.].
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引用次数: 0
Erratum: "Treatment-shortening regimens for tuberculosis: updates and future priorities". F. Saluzzo, V.A. Adepoju, R. Duarte, C. Lange and P.P.J. Phillips on behalf of the UNITE4TB Consortium12. Breathe 2023; 19: 230028. 勘误:"结核病缩短疗程疗法:最新情况和未来优先事项"。F. Saluzzo、V.A. Adepoju、R. Duarte、C. Lange 和 P.P.J. Phillips 代表 UNITE4TB 联合会12。呼吸 2023;19:230028。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.5028-2023

[This corrects the article DOI: 10.1183/20734735.0028-2023.].

[This corrects the article DOI: 10.1183/20734735.0028-2023.].
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引用次数: 0
Unravelling the diagnostic pathology and molecular biomarkers in lung cancer. 揭示肺癌的病理诊断和分子生物标记物。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0192-2023
Andriani Charpidou, Georgia Hardavella, Efimia Boutsikou, Emmanouil Panagiotou, Gökçen Ömeroğlu Simsek, Koen Verbeke, Daniela Xhemalaj, Joanna Domagała-Kulawik

The progress in lung cancer treatment is closely interlinked with the progress in diagnostic methods. There are four steps before commencing lung cancer treatment: estimation of the patient's performance status, assessment of disease stage (tumour, node, metastasis), recognition of histological subtype, and detection of biomarkers. The resection rate in lung cancer is <30% and >70% of patients need systemic therapy, which is individually adjusted. Accurate histological diagnosis is very important and it is the basis of further molecular diagnosis. In many cases only small biopsy samples are available and the rules for their assessment are defined in this review. The use of immunochemistry with at least thyroid transcription factor 1 (TTF1) and p40 is decisive in distinction between lung adenocarcinoma and squamous cell carcinoma. Molecular diagnosis and detection of known driver mutations is necessary for introducing targeted therapy and use of multiplex gene panel assays using next-generation sequencing is recommended. Immunotherapy with checkpoint inhibitors is the second promising method of systemic therapy with best results in tumours with high programmed death-ligand 1 (PD-L1) expression on cancer cells. Finally, the determination of a full tumour pattern will be possible using artificial intelligence in the near future.

肺癌治疗的进步与诊断方法的进步密切相关。开始肺癌治疗前有四个步骤:估计患者的表现状态、评估疾病分期(肿瘤、结节、转移)、识别组织学亚型和检测生物标志物。肺癌的切除率为 70%,患者需要接受系统治疗,治疗方案会根据个体情况进行调整。准确的组织学诊断非常重要,是进一步分子诊断的基础。在许多情况下,只能获得少量活检样本,本综述将对活检样本的评估规则进行定义。至少使用甲状腺转录因子 1(TTF1)和 p40 的免疫化学方法对区分肺腺癌和鳞状细胞癌具有决定性意义。分子诊断和已知驱动基因突变的检测是引入靶向治疗的必要条件,建议使用下一代测序技术进行多重基因面板检测。使用检查点抑制剂进行免疫治疗是第二种有前景的全身治疗方法,对于癌细胞中程序性死亡配体1(PD-L1)高表达的肿瘤效果最佳。最后,在不久的将来,利用人工智能确定完整的肿瘤模式将成为可能。
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