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Öztürk Ergür F, Öztürk A, Özdağ Ö, Tatcı E, Özmen Ö, Yılmaz A. When to Consider Invasive Lymph Node Staging in Non-Small-Cell Lung Cancer? A Novel Scoring System Utilising Metabolic Parameters in 18F-FDG PET/CT. Arch Bronconeumol 2024:S0300-2896(24)00184-4. [PMID: 38942660 DOI: 10.1016/j.arbres.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/05/2024] [Accepted: 05/12/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE The maximum standardised uptake value (SUVmax) is a widely utilised metric in positron emission tomography/computed tomography for clinically staging non-small-cell lung cancer (NSCLC), yet the reliability of SUVmax remains controversial. We herein aimed to assess the effectiveness of semi-quantitative parameters, encompassing size, SUVmax, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and heterogeneity factor (HF), in evaluating both primary tumours and lymph nodes (LNs) on positron emission tomography/computed tomography. A novel scoring system was devised to appraise the role of semi-quantitative parameters and visually evaluate LNs for nodal staging. MATERIALS AND METHODS Patients with pathological NSCLC, diagnosed between 2014 and 2019 and clinically staged I-III, were enrolled in the study. Patient demographics, including age, sex, tumour location, diameter, tumour-node-metastasis stage, as well as SUVmax, MTV, TLG and HF parameters of primary tumours and LNs, were documented. RESULTS The analysis comprised 319 patients and 963 LNs. Patients had a mean age of 61.62 years, with 91.5% being male. Adenocarcinoma exhibited a histological association with LN metastasis (P=0.043). The study findings revealed that tumour size, SUVmax, MTV, TLG and HF did not significantly affect the detection of LN metastasis. Conversely, non-squamous cell carcinoma, LNs exhibiting higher FDG levels than the liver, LN size, SUVmax, MTV and TLG were identified as risk factors (P<0.0001). The identified cut-off values were 1.05cm for LN size, 4.055 for SUVmax, 1.805cm3 for MTV and 5.485 for TLG. The scoring system incorporated these parameters, and visual assessment indicated that a score of ≥3 increased the risk of metastasis by 14.33 times. CONCLUSION We devised a novel scoring system and demonstrated that LNs with a score of ≥3 in patients with NSCLC have a high likelihood of metastasis. This innovative scoring system can serve as a valuable tool to mitigate excessive and extreme measures in the assessment of invasive pathological staging.
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Affiliation(s)
- Figen Öztürk Ergür
- Health Sciences University, Atatürk Sanatoryum Education and Research Hospital, Interventional Pulmonology, Ankara Turkey
| | - Ayperi Öztürk
- Health Sciences University, Atatürk Sanatoryum Education and Research Hospital, Interventional Pulmonology, Ankara Turkey.
| | - Özlem Özdağ
- Health Sciences University, Atatürk Sanatoryum Education and Research Hospital, Interventional Pulmonology, Ankara Turkey
| | - Ebru Tatcı
- Health Sciences University, Etlik City Hospital, Nuclear Medicine, Ankara Turkey
| | - Özlem Özmen
- Health Sciences University, Etlik City Hospital, Nuclear Medicine, Ankara Turkey
| | - Aydın Yılmaz
- Health Sciences University, Atatürk Sanatoryum Education and Research Hospital, Interventional Pulmonology, Ankara Turkey
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Tran PTC, Zhang Z, Chang Q, Jaratli H, Ahsan BU. A tumour with two-and-a-half faces-Primary lung adenosquamous carcinoma causing secondary squamous cell carcinoma in the colon. Cytopathology 2024; 35:404-407. [PMID: 38356462 DOI: 10.1111/cyt.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/17/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
Adenosquamous carcinoma in the lung was the source of colonic squamous cell carcinoma. Next‐generation sequencing confirmed the two tumours were the same, highlighting the importance of clinical suspicion and thorough workup, including genetic testing, in lung cancer cases.
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Affiliation(s)
- Pierre T C Tran
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Ziying Zhang
- Department of Pathology, Henry Ford Health, Detroit, Michigan, USA
| | - Qing Chang
- Department of Pathology, Henry Ford Health, Detroit, Michigan, USA
| | - Hayan Jaratli
- Department of Pathology, Henry Ford Health, Detroit, Michigan, USA
| | - Beena U Ahsan
- Department of Pathology, Henry Ford Health, Detroit, Michigan, USA
- Department of Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
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3
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Wang Y, Guo H, Hou L, Wu Y, Li X, Zhao C, Cheng L, Xiong A. Comprehensive analysis of clinicopathological profiles in adenosquamous carcinoma of the lung. Am J Transl Res 2024; 16:126-135. [PMID: 38322563 PMCID: PMC10839401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVES Adenosquamous carcinoma (ASC), an uncommon subtype within non-small cell lung cancer (NSCLC), manifests distinctive traits of aggressiveness, embodying a fusion of both adenocarcinoma (AC) and squamous cell carcinoma (SCC) components. The clinicopathological characteristics of distinct subtypes of ASC remain unclear. METHODS This retrospective study included 226 patients diagnosed with lung ASC who consecutively underwent surgical resection at Shanghai Pulmonary Hospital, Tongji University, between January 2015 and March 2021. Data regarding the clinical features and pathological features were collected. RESULTS Out of this study cohort, 125 patients exhibited AC-predominant ASC, while 81 had SCC-predominant ASC. No significant differences were observed between the two subgroups in terms of age, gender, smoking history, primary site, and T, N classification. AC-Predominant ASC displayed a higher susceptibility to genetic alterations compared to SCC-Predominant ASC (P=0.02). Additionally, we showed that irrespective of the predominant pathological subtype in ASC, when lymph node metastasis occurred, the lymph node biopsies were more likely to exhibit AC, and a chi-square test confirmed that the primary predominant pathological subtype was not associated with the lymph node metastasis subtype. CONCLUSIONS In conclusion, we describe an overview of ASC in the Chinese population, and upon stratifying into predominant pathological subgroups, we observed a higher frequency of driver gene mutations in AC-predominant ASC. We found that the AC component in ASC has a higher propensity for lymph node metastasis. These findings may suggest the predominant role of the AC component within the context of ASC.
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Affiliation(s)
- Yuanyuan Wang
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Haoyue Guo
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Likun Hou
- Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Yuhan Wu
- Bengbu Medical College Graduate SchoolBengbu, Anhui, China
| | - Xuefei Li
- Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Chao Zhao
- Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Lei Cheng
- Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
| | - Anwen Xiong
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineShanghai, China
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Takagi H, Muto S, Enta A, Fukuhara M, Asano S, Shio Y, Suzuki H. A case of discordant histology and expression of programmed death ligand 1 between primary tumor and brain metastases in adenosquamous carcinoma of the lung. Thorac Cancer 2023; 14:2707-2711. [PMID: 37545057 PMCID: PMC10493479 DOI: 10.1111/1759-7714.15061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023] Open
Abstract
A patient presented with vomiting and gait disturbance. Investigation revealed a single cerebellar tumor and another tumor in the upper lobe of the left lung. Based on the severe vomiting and gait disturbance, we removed the cerebellar tumor first, achieving resolution of symptoms. The cerebellar tumor was pathologically diagnosed as metastatic lung adenocarcinoma. No other metastases were identified, including in the mediastinal lymph nodes. We therefore resected the primary lung tumor. On final pathological analysis, the tumor in the upper lobe of the left lung was diagnosed as adenosquamous carcinoma with no lymph node metastasis. PD-L1 expression was low in the primary lung adenosquamous carcinoma and high in the cerebellar metastasis. Furthermore, both tumors were KRASG12C -positive. Tumor PD-L1 expression is considered important for immune escape. In this case, adenocarcinoma cells in the primary adenosquamous carcinoma may have migrated to form a cerebellar metastasis. In advanced lung cancer, tumor growth may be observed in some lesions even when many other lesions are controlled by chemo- or immunotherapy. Biopsy to confirm histology and PD-L1 expression is worth considering, depending on the location of the metastases and the invasiveness of the biopsy procedure.
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Affiliation(s)
- Hironori Takagi
- Department of Chest SurgeryIwaki City Medical CenterIwakiJapan
- Department of Chest SurgeryFukushima Medical UniversityFukushimaJapan
| | - Satoshi Muto
- Department of Chest SurgeryFukushima Medical UniversityFukushimaJapan
| | - Akio Enta
- Department of Chest SurgeryIwaki City Medical CenterIwakiJapan
| | | | | | - Yutaka Shio
- Department of Chest SurgeryFukushima Medical UniversityFukushimaJapan
| | - Hiroyuki Suzuki
- Department of Chest SurgeryFukushima Medical UniversityFukushimaJapan
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Savasta F, Giana M, Libretti A, Genestroni S, Surico D, Remorgida V. Vaginal metastasis of lung cancer: A case report. Case Rep Womens Health 2023; 39:e00536. [PMID: 37663888 PMCID: PMC10468352 DOI: 10.1016/j.crwh.2023.e00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Lung adenosquamous carcinoma (ASC) is a rare biphasic malignant tumor with squamous cell carcinoma (SCC) and adenocarcinoma (AC) components. ASC is reported to be aggressive; the most common metastatic sites are the regional lymph nodes and surrounding areas. A 46-year-old woman was referred to the emergency department with a persistent dry cough. She underwent fibro-bronchoscopy and was diagnosed with an adenosquamous lung carcinoma. Other than pulmonary and lymphatic findings, a total-body computed tomography (CT) examination highlighted a hypodense formation, of about 9 mm, with a cystic appearance, at the level of the vaginal region. A biopsy performed in the posterior vaginal wall highlighted a vaginal wall flap with subepithelial localization of neoplasia, compatible with the pulmonary ASC. Oncologists took charge of the case and the patient commenced medical therapy with entrectinib. Four months later, she developed dyspnea, and high-resolution CT highlighted an increase in the pathological tissue causing bronchial occlusion. The patient underwent endobronchial stent placement and thereafter restarted therapy with entrectinib, previously stopped because of the new symptoms, and was closely monitored. Apparently only one case of vaginal metastasis from pulmonary tumor has been previously reported, and this is the first report of vaginal metastasis from ASC. Although extremely rare, the presence of such metastasis should be considered in women with suspected vaginal neoformations.
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Affiliation(s)
- Federica Savasta
- Department of Gynaecology and Obstetrics, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
| | - Michele Giana
- Department of Gynaecology and Obstetrics, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
| | - Alessandro Libretti
- Department of Gynaecology and Obstetrics, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
| | - Silvia Genestroni
- Department of Oncology, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
| | - Daniela Surico
- Department of Gynaecology and Obstetrics, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
| | - Valentino Remorgida
- Department of Gynaecology and Obstetrics, University of Piemonte Orientale, Ospedale Maggiore della Carità, corso Mazzini 19, Novara, Italy
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Tang J, Shu HY, Sun T, Zhang LJ, Kang M, Ying P, Ling Q, Zou J, Liao XL, Wang YX, Wei H, Shao Y. Potential factors of cytokeratin fragment 21-1 and cancer embryonic antigen for mediastinal lymph node metastasis in lung cancer. Front Genet 2022; 13:1009141. [PMID: 36176291 PMCID: PMC9513202 DOI: 10.3389/fgene.2022.1009141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
Objective: Lung cancer is a common malignant tumor, characterized by being difficult to detect and lacking specific clinical manifestations. This study aimed to find out the risk factors of mediastinal lymph node metastasis and explore the correlation between serum tumor markers and mediastinal lymph node metastasis and lung cancer prognosis. Methods: A retrospective study of 3,042 lung cancer patients (330 patients with mediastinal lymph node metastasis and 2,712 patients without mediastinal lymph node metastasis) collected from the First Affiliated Hospital of Nanchang University from April 1999 to July 2020. The patients were divided into two groups, namely, mediastinal lymph node metastasis group and non-mediastinal lymph node metastasis group. Student’s t test, non-parametric rank sum test and chi-square test were used to describe whether there is a significant difference between the two groups. We compared the serum biomarkers of the two groups of patients, including exploring serum alkaline phosphatase (ALP), calcium hemoglobin (HB), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA125, CA-199, CA -153, cytokeratin fragment 19 (CYFRA 21-1), total prostate specific antigen (TPSA), neuron-specific enolase (NSE) levels and the incidence and prognosis of lung cancer mediastinal lymph node metastasis. Binary logistic regression analysis was used to determine its risk factors, and receiver operating curve (ROC) analysis was used to evaluate its diagnostic value for mediastinal lymph node metastasis. Results: Binary logistic regression analysis showed that carcinoembryonic antigen and CYFRA 21-1 were independent risk factors for mediastinal lymph node metastasis in patients with lung cancer (p < 0.001 and p = 0.002, respectively). The sensitivity and specificity of CEA for the diagnosis of mediastinal lymph node metastasis were 90.2 and 7.6%, respectively; CYFRA 21-1 were 0.6 and 99.0%, respectively. Conclusion: Serum CEA and CYFRA 21-1 have predictive value in the diagnosis of mediastinal lymph node metastasis in patients with lung cancer.
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Affiliation(s)
- Jing Tang
- Department of Oncology, The Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou, Hunan, China
| | - Hui-Ye Shu
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tie Sun
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Li-Juan Zhang
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Min Kang
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ping Ying
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qian Ling
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jie Zou
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xu-Lin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yi-Xin Wang
- School of Optometry and Vision Science, Cardiff University, Cardiff, United Kingdom
| | - Hong Wei
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yi Shao
- Department of Ophthalmology, Jiangxi Branch of National Clinical Research Center for Ocular Disease, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Yi Shao,
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Bai S, Wang Z, Wang M, Li J, Wei Y, Xu R, Du J. Tumor-Derived Exosomes Modulate Primary Site Tumor Metastasis. Front Cell Dev Biol 2022; 10:752818. [PMID: 35309949 PMCID: PMC8924426 DOI: 10.3389/fcell.2022.752818] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
Tumor-derived exosomes (TDEs) are actively produced and released by tumor cells and carry messages from tumor cells to healthy cells or abnormal cells, and they participate in tumor metastasis. In this review, we explore the underlying mechanism of action of TDEs in tumor metastasis. TDEs transport tumor-derived proteins and non-coding RNA to tumor cells and promote migration. Transport to normal cells, such as vascular endothelial cells and immune cells, promotes angiogenesis, inhibits immune cell activation, and improves chances of tumor implantation. Thus, TDEs contribute to tumor metastasis. We summarize the function of TDEs and their components in tumor metastasis and illuminate shortcomings for advancing research on TDEs in tumor metastasis.
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Affiliation(s)
- Suwen Bai
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China.,School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Zunyun Wang
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Minghua Wang
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China
| | - Junai Li
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China
| | - Yuan Wei
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China
| | - Ruihuan Xu
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China
| | - Juan Du
- Longgang District People´s Hospital of Shenzhen, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen, China
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Tang J, Ge QM, Huang R, Shu HY, Su T, Wu JL, Pan YC, Liang RB, Zhang LJ, Shao Y, Yu Y. Clinical Significance of CYFRA21-1, AFP, CA-153, CEA, and CA-199 in the Diagnosis of Lung Cancer Ocular Metastasis in Hypertension Population. Front Cardiovasc Med 2021; 8:670594. [PMID: 34595214 PMCID: PMC8476747 DOI: 10.3389/fcvm.2021.670594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose: To detect lung metastases, we conducted a retrospective study to improve patient prognosis. Methods: Hypertension patients with ocular metastases (OM group; n = 58) and without metastases (NM group; n = 1,217) were selected from individuals with lung cancer admitted to our hospital from April 2005 to October 2019. The clinical characteristics were compared by Student's t-test and chi-square test. Independent risk factors were identified by binary logistic regression, and their diagnostic value evaluated by receiver operating characteristic curve analysis. Results: Age and sex did not differ significantly between OM and NM groups; There were significant differences in pathological type and treatment. Adenocarcinoma was the main pathological type in the OM group (67.24%), while squamous cell carcinoma was the largest proportion (46.43%) in the NM group, followed by adenocarcinoma (34.10%). The OM group were treated with chemotherapy (55.17%), while the NM group received both chemotherapy (39.93%) and surgical treatment (37.06%). Significant differences were detected in the concentrations of cancer antigen (CA)−125, CA-199, CA-153, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cytokeratin fraction 21-1 (CYFRA21-1), total prostate-specific antigen, alkaline phosphatase, and hemoglobin (Student's t-test). Binary logistic regression analysis indicated that CA-199, CA-153, AFP, CEA, and CYRFA21-1 were independent risk factors for lung cancer metastasis. AFP (98.3%) and CEA (89.3%) exhibited the highest sensitivity and specificity, respectively, while CYRFA21-1 had the highest area under the ROC curve value (0.875), with sensitivity and specificity values of 77.6 and 87.0%, respectively. Hence, CYFRA21-1 had the best diagnostic value.
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Affiliation(s)
- Jing Tang
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Oncology, The Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou, China
| | - Qian-Min Ge
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Rong Huang
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hui-Ye Shu
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Su
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Eye Institute of Xiamen University, Xiamen, China.,Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States
| | - Jie-Li Wu
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Eye Institute of Xiamen University, Xiamen, China
| | - Yi-Cong Pan
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Rong-Bin Liang
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Juan Zhang
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Shao
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yao Yu
- Department of Endocrinology and Ophthalmology, Jiangxi Center of National Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Wang Z, Wu Y, Wang L, Gong L, Han C, Liang N, Li S. Predicting occult lymph node metastasis by nomogram in patients with lung adenocarcinoma ≤2 cm. Future Oncol 2021; 17:2005-2013. [PMID: 33784826 DOI: 10.2217/fon-2020-0905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Previous researches had not proposed any prediction models for occult lymph node metastasis (OLNM). Considering the occurrence of OLNM and the importance of OLNM management, we aimed to develop a nomogram to predict OLNM of patients with lung adenocarcinoma ≤2 cm. Methods: Characteristics of patients with lung adenocarcinoma of ≤2 cm diameter at the Peking Union Medical College Hospital were retrospectively reviewed. Univariate and multivariate logistic regressions were performed. A nomogram model was developed. The concordance index (C-index) and calibration and decision curves were used to evaluate the predictive ability. Results: A total of 473 patients were enrolled, with an OLNM incidence of 7.4%. Four factors were selected as risk factors. The model had a C-index of 0.932. Calibration and decision curves were determined. Conclusion: Patients with pure ground-glass opacity (pGGO) or noninvasive adenocarcinoma have significantly lower risk of OLNM. SUVmax, CEA, micropapillary and solid component were identified as independent risk factors. The nomogram model was effective in predicting OLNM preoperatively.
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Affiliation(s)
- Zhile Wang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.,Peking Union Medical College, Eight-Year MD Program, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yijun Wu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.,Peking Union Medical College, Eight-Year MD Program, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Li Wang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.,Peking Union Medical College, Eight-Year MD Program, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Liang Gong
- Peking Union Medical College, Eight-Year MD Program, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chang Han
- Peking Union Medical College, Eight-Year MD Program, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Naixin Liang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
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Tumor volume is more reliable to predict nodal metastasis in non-small cell lung cancer of 3.0 cm or less in the greatest tumor diameter. World J Surg Oncol 2020; 18:168. [PMID: 32669129 PMCID: PMC7364500 DOI: 10.1186/s12957-020-01946-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023] Open
Abstract
Background In this study, we sought to evaluate the correlation between TV, GTD, and lymph node metastases in NSCLC patients with tumors of GTD ≤ 3.0 cm. Methods We retrospectively analyzed the characteristics of clinicopathologic variables for lymph node involvement in 285 NSCLC patients with tumors of GTD ≤ 3.0 cm who accepted curative surgical resection. The TVs were semi-automatically measured by a software, and optimal cutoff points were obtained using the X-tile software. The relationship between GTD and TV were described using non-linear regression. The correlation between GTD, TV, and N stages was analyzed using the Pearson correlation coefficient. The one-way ANOVA was used to compare the GTD and TV of different lymph node stage groups. Results The relationship between GTD and TV accorded with the exponential growth model: y = 0.113e1.455x (y = TV, x = GTD). TV for patients with node metastases (4.78 cm3) was significantly greater than those without metastases (3.57 cm3) (P < 0.001). However, there were no obvious GTD differences in cases with or without lymph node metastases (P = 0.054). We divided all cases into three TV groups using the two cutoff values (0.9 cm3 and 3.9 cm3), and there was an obvious difference in the lymphatic involvement rate between the groups (P < 0.001). The tendency to metastasize was greater with higher TV especially when the TV was > 0.9–14.2 cm3 (P = 0.010). Conclusions For NSCLC tumors with GTD ≤ 3.0 cm, TV is a more sensitive marker than GTD in predicting the positive lymph node metastases. The likelihood for metastasis increases with an increasing TV especially when GTD is > 2.0–3.0 cm.
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Luo T, Chen Q, Zeng J. Analysis of lymph node metastasis in 200 patients with non-small cell lung cancer. Transl Cancer Res 2020; 9:1577-1583. [PMID: 35117505 PMCID: PMC8798765 DOI: 10.21037/tcr.2020.01.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/07/2020] [Indexed: 11/22/2022]
Abstract
Background Lymph node metastasis occurs although clinical stage IA is a relatively early stage for patients with non-small cell lung cancer (NSCLC). This study aimed to explore the influencing factors of lymph node metastasis. Methods A total of 200 patients diagnosed with clinical stage IA NSCLC preoperatively from July 2014 to July 2016 were examined. Every patient underwent lobectomy and systematic lymph node dissection. Their clinicopathological characteristics and status of lymph node metastasis are analyzed. Results The rates of both N1 and N2 lymph node metastasis increase with the increase in the tumor diameter. The N1 lymph node metastasis rate is 0%, 2.82%, and 9.52%, while the N2 lymph node metastasis rate is 0%, 4.23%, and 25.40% for pure ground-glass nodules, mixed ground-glass nodules (solid component <50%), and mixed ground-glass nodules (solid component >50%), respectively. The difference is statistically significant (P=0.000). Patients with squamous cell carcinoma have a relatively higher N1 lymph node metastasis rate comparing with patients with adenocarcinoma (P<0.05). Tumors locate in the inner half lobe (close to hilus) are prone to metastasize to lymph nodes (P=0.018). Multiple regression analysis shows that tumor diameter, solid component rate, and tumor location are relevant factors for lymph node metastasis. Conclusions In patients with NSCLC, who have tumors smaller than 1 cm, pure ground-glass nodules, or tumors locate in the lateral half lobe, lymph node metastasis is rare and selective lymphadenectomy is considerable.
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Affiliation(s)
- Taobo Luo
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Hangzhou 310022, China.,Cancer Hospital of University of Chinese Academy of Sciences, Hangzhou 310022, China.,Zhejiang Cancer Hospital, Department of Thoracic Surgery, Hangzhou 310022, China
| | - Qixun Chen
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Hangzhou 310022, China.,Cancer Hospital of University of Chinese Academy of Sciences, Hangzhou 310022, China.,Zhejiang Cancer Hospital, Department of Thoracic Surgery, Hangzhou 310022, China
| | - Jian Zeng
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Hangzhou 310022, China.,Cancer Hospital of University of Chinese Academy of Sciences, Hangzhou 310022, China.,Zhejiang Cancer Hospital, Department of Thoracic Surgery, Hangzhou 310022, China
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Matayeva E, Henson T, Alaverdian A. A 38-Year-Old Man With An Ataxic Gait, Night Sweats, and Weight Loss. Chest 2019; 156:e133-e136. [PMID: 31812212 DOI: 10.1016/j.chest.2019.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/01/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022] Open
Abstract
CASE PRESENTATION A 38-year-old Jamaican man with no medical history presented with worsening right-sided weakness. He developed an ascending hemiparesis that began in the right lower extremity 3 months ago and progressed to the right upper extremity this past month. Over the past 3 months, the patient has had unintentional weight loss and an ataxic gait, and for the past month he has had night sweats. He denied headache, vision changes, numbness, tingling, cough, or chest pain. Social history was significant for 20 smoking pack-years and daily use of marijuana.
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Abstract
Adenosquamous carcinoma of the lung (ASC), a relatively rare subtype of non-small-cell lung cancer, is defined as a malignancy containing components of lung adenocarcinoma (ADC) and lung squamous cell carcinoma (SCC). Although ASC has biological characteristics of ADC and SCC, it is not by any means a simple hybrid of two components above. It is extremely difficult to diagnose preoperatively; pathology of surgically resected gross specimen is the most effective means for adequate diagnosis of ASC. Platinum-based postoperative adjuvant chemotherapy for at least four cycles can significantly improve the survival in stage III patients with ASC. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as erlotinib and gefitinib can be the effective therapeutic strategies for advanced EGFR-mutant ASC. The studies of crizotinib in the treatment of patients with ASC are very limited. Immune checkpoint blockade therapy may be a potential treatment choice for ASC patients.
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Affiliation(s)
- Chenghui Li
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang province, People's Republic of China.,Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China,
| | - Hongyang Lu
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China, .,Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Hangzhou, People's Republic of China,
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Abstract
RATIONALE Gastrointestinal multiple metastases of lung cancer are extremely rare. The majority of gastrointestinal metastasis cases are diagnosed at a late stage and the prognosis is extremely poor. This report describes the clinical characteristics and outcomes of a patient with gastrointestinal multiple metastases from squamous-cell lung cancer, with special emphasis on the diagnosis and treatment of metastatic lung cancer. PATIENT CONCERNS A 61-year-old man who presented with progressive abdominal distention was admitted to our hospital. Radiological examinations showed changes of post-primary pulmonary tuberculosis and mechanical obstruction of the small bowl. Histopathological findings of gastroscopic examination and biopsy specimens showed a diagnosis of squamous-cell carcinoma in the body of the stomach. DIAGNOSES Postoperative histopathology confirmed a gastrointestinal multiple squamous-cell carcinoma in stomach and small bowl. Finally, squamous-cell lung cancer was confirmed by lung biopsy. INTERVENTIONS During his hospitalization urgent surgery was performed because of acute abdomen. The patient underwent a laparotomy with curative gastrectomy for gastric cancer and small bowel partial resection. The patient was recommended with combination chemotherapy of carboplatin and paclitaxel for 3 cycles. OUTCOMES Six months later after operation, the patient succumbed to respiratory failure. LESSONS We searched the related literature of gastrointestinal metastases from lung cancer and the clinical presentation, site of metastasis, diagnosis, treatment, and survival time in these cases were reviewed. The present study may increase the awareness of early diagnosis and appropriate treatment of metastatic lung cancer of gastrointestinal tract.
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Affiliation(s)
- Xinyu Li
- Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University
- Experimental Surgery Division at University of Munich (LMU), Munich, Germany
| | - Songhe Li
- Department of Ophthalmology, the 1st Hospital of Jilin University, Changchun, China
| | - Zhiming Ma
- Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University
| | - Shutao Zhao
- Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University
| | - Xudong Wang
- Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University
| | - Dacheng Wen
- Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University
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