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Shen J, Yang D, Zhou Y, Pei J, Wu Z, Wang X, Zhao K, Ding Y. Development of machine learning models for patients in the high intrahepatic cholangiocarcinoma incidence age group. BMC Geriatr 2024; 24:553. [PMID: 38918710 PMCID: PMC11197277 DOI: 10.1186/s12877-024-05154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis and is understudied. Based on the clinical features of patients with ICC, we constructed machine learning models to understand their importance on survival and to accurately determine patient prognosis, aiming to develop reference values to guide physicians in developing more effective treatment plans. METHODS This study used machine learning (ML) algorithms to build prediction models using ICC data on 1,751 patients from the SEER (Surveillance, Epidemiology, and End Results) database and 58 hospital cases. The models' performances were compared using receiver operating characteristic curve analysis, C-index, and Brier scores. RESULTS A total of eight variables were used to construct the ML models. Our analysis identified the random survival forest model as the best for prognostic prediction. In the training cohort, its C-index, Brier score, and Area Under the Curve values were 0.76, 0.124, and 0.882, respectively, and it also performed well in the test cohort. Kaplan-Meier survival analysis revealed that the model could effectively determine patient prognosis. CONCLUSIONS To our knowledge, this is the first study to develop ML prognostic models for ICC in the high-incidence age group. Of the ML models, the random survival forest model was best at prognosis prediction.
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Affiliation(s)
- Jie Shen
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Dashuai Yang
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Yu Zhou
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Junpeng Pei
- Dept of hepatobiliary surgery, 521 Hospital of Norinco Group, Xi'an, Shaanxi, 710061, China
| | - Zhongkai Wu
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Xin Wang
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Kailiang Zhao
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
| | - Youming Ding
- Dept of hepatobiliary surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
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Shen ZQ, Feng KP, Fang ZY, Xia T, Pan S, Ding C, Xu C, Ju S, Chen J, Li C, Zhao J. Influence of adjuvant chemotherapy on survival for patients with completely resected high-risk stage IB NSCLC. J Cardiothorac Surg 2024; 19:1. [PMID: 38166960 PMCID: PMC10763355 DOI: 10.1186/s13019-023-02457-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The use of adjuvant chemotherapy (ACT) in completely resected stage IB NSCLC is still controversial. This study aims to investigate the efficacy of ACT in pathological stage IB non-small cell lung cancer (NSCLC) with high risk factors. METHODS Patients with pT2aN0M0 stage IB NSCLC who underwent complete resection from 2013 to 2017 were retrospectively analyzed. Univariate and multivariable logistic regression analysis was used to assess potential independent risk factors associated with poor prognosis. To compare survival between patients who received ACT and those who did not. RESULTS In univariate and multivariate analyses, adenocarcinomas with predominantly micropapillary (MIP) and solid patterns (SOL), poorly differentiated squamous cell carcinoma (SCC), number of lymph nodes dissected less than 16 and tumor size larger than 36 mm were identified as high-risk factors for recurrence. In patients with high risk factors for recurrence, ACT resulted in significantly longer DFS (HR, 0.4689, 95%CI, 1.193-3.818; p = 0.0108) and OS (HR, 0.4696, 95%CI, 0.6578-6.895; p = 0.2073), although OS failed to reach statistically significance. After propensity score matching (PSM), 67 pairs of patients were 1:1 matched in the two groups and all baseline characteristics were well balanced. The results also demonstrated that ACT was associated with improved DFS (HR, 0.4776, 95%CI, 0.9779-4.484; p = 0.0440) while OS was not significantly different (92.5% vs. 91.0%; HR, 0.6167, 95%CI, 0.1688-2.038; p = 0.7458). In patients with low-risk factors for recurrence, DFS (HR, 0.4831, 95%CI, 0.03025-7.715; p = 0.6068) and OS (HR, 0.969, 95%CI, 0.08364-11.21; p = 0.9794) was not significantly different between those who received ACT and those who did not. CONCLUSION In patients with completely resected stage IB NSCLC, ACT can improve survival in patients with high risk for recurrence. Further large multicenter studies are needed to confirm these findings.
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Affiliation(s)
- Zi-Qing Shen
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Kun-Peng Feng
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Zi-Yao Fang
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Tian Xia
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Shu Pan
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Cheng Ding
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Chun Xu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Sheng Ju
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Jun Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
| | - Chang Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
| | - Jun Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
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Feng KP, Fu K, Xu C, Ding C, Zhu XY, Pan B, Jia XY, Zhao J, Li C. NSCLC patients with a changing T grade after operation may represent a special subset of tumor staging. J Cancer Res Clin Oncol 2023; 149:9991-9998. [PMID: 37258719 DOI: 10.1007/s00432-023-04925-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND There is consensus that postoperative adjuvant therapy is not recommended in patients with stage 1a non-small cell lung cancer (NSCLC). Meanwhile, it is still controversial whether postoperative adjuvant chemotherapy is recommended for NSCLC patients with T2aN0M0 (stage 1b). In some patients with stage 1b NSCLC without pleural invasion, tumor diameter was measured between 3 and 4 cm by preoperative imaging and less than 3 cm by postoperative pathology specimens. TNM staging in such patients is both radiologic stage 1b and pathologic stage 1a. Thoracic surgeons are often confused about whether such patients with NSCLC will require subsequent treatment and how the survival prognosis for this group of patients will be. METHODS All data of radiographic TNM stage 1b patients who underwent radical R0 resection at the department of thoracic surgery, the First Affiliated Hospital of Soochow University between January 2013 and July 2017 were retrieved, and 208 patients were finally included in the study. Clinical data, including imaging data, pathology data, were obtained by reviewing the patients' electronic medical records. Disease-free survival (DFS) and overall survival (OS) were obtained by telephone interview. Statistical analysis was performed using SPSS (SPSS 26.0 for windows, SPSS). RESULTS A total of 208 patients were included in this study, 61 patients with T-stage migration (observation group) and 147 patients without T-stage migration (control group). There were significant statistical differences between the two groups in terms of preoperative FEV1/FVC and tumor diameter (specimens, CT and 3-dimensional measurements). Logistic regression results showed that lower FEV1/FVC and smaller CT measurements would make the patient's T stage more likely to migrate. Bland-Altman plots showed that tumor length measured by imaging was significantly higher than that measured by pathological specimens. Taking DFS as the outcome, the survival curve of the observation group was significantly better than that of the control group. Similarly, there was a significant difference in OS between the two groups. CONCLUSIONS For NSCLC patients whose preoperative imaging evaluation was stage 1b (tumor diameter more than 3 cm, no main bronchus, pleura, no atelectasis), the presence of lung tissue with smaller tumor diameter and/or higher air content may indicate that the postoperative pathological staging may be changed to stage 1a (tumor diameter less than 3 cm). These patients had better survival prognosis than those who did not undergo TNM stage change and were diagnosed with stage 1b non-small cell lung cancer before and after surgery.
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Affiliation(s)
- Kun-Peng Feng
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Fu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun Xu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Cheng Ding
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin-Yu Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bin Pan
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin-Yu Jia
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chang Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, 215000, China.
- Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
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L'Hostis A, Palgen JL, Perrillat-Mercerot A, Peyronnet E, Jacob E, Bosley J, Duruisseaux M, Toueg R, Lefèvre L, Kahoul R, Ceres N, Monteiro C. Knowledge-based mechanistic modeling accurately predicts disease progression with gefitinib in EGFR-mutant lung adenocarcinoma. NPJ Syst Biol Appl 2023; 9:37. [PMID: 37524705 PMCID: PMC10390488 DOI: 10.1038/s41540-023-00292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/21/2023] [Indexed: 08/02/2023] Open
Abstract
Lung adenocarcinoma (LUAD) is associated with a low survival rate at advanced stages. Although the development of targeted therapies has improved outcomes in LUAD patients with identified and specific genetic alterations, such as activating mutations on the epidermal growth factor receptor gene (EGFR), the emergence of tumor resistance eventually occurs in all patients and this is driving the development of new therapies. In this paper, we present the In Silico EGFR-mutant LUAD (ISELA) model that links LUAD patients' individual characteristics, including tumor genetic heterogeneity, to tumor size evolution and tumor progression over time under first generation EGFR tyrosine kinase inhibitor gefitinib. This translational mechanistic model gathers extensive knowledge on LUAD and was calibrated on multiple scales, including in vitro, human tumor xenograft mouse and human, reproducing more than 90% of the experimental data identified. Moreover, with 98.5% coverage and 99.4% negative logrank tests, the model accurately reproduced the time to progression from the Lux-Lung 7 clinical trial, which was unused in calibration, thus supporting the model high predictive value. This knowledge-based mechanistic model could be a valuable tool in the development of new therapies targeting EGFR-mutant LUAD as a foundation for the generation of synthetic control arms.
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Affiliation(s)
- Adèle L'Hostis
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - Jean-Louis Palgen
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | | | - Emmanuel Peyronnet
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - Evgueni Jacob
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - James Bosley
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - Michaël Duruisseaux
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, 69100, France
- Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, Lyon, France
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Raphaël Toueg
- Janssen-Cilag, France, 1, rue Camille Desmoulins - TSA 60009, Issy-Les-Moulineaux Cedex 9, Issy-Les-Moulineaux, 92787, France
| | - Lucile Lefèvre
- Janssen-Cilag, France, 1, rue Camille Desmoulins - TSA 60009, Issy-Les-Moulineaux Cedex 9, Issy-Les-Moulineaux, 92787, France
| | - Riad Kahoul
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - Nicoletta Ceres
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France
| | - Claudio Monteiro
- Novadiscovery SA, Pl. Giovanni da Verrazzano, Lyon, 69009, Rhône, France.
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Cheng T, Chen J, Ying P, Wei H, Shu H, Kang M, Zou J, Ling Q, Liao X, Wang Y, Shao Y. Clinical risk factors of carbohydrate antigen-125, cytokeratin fragment 19, and neuron-specific enolase in liver metastases from elderly lung cancer patients. Front Genet 2022; 13:1013253. [PMID: 36246602 PMCID: PMC9557119 DOI: 10.3389/fgene.2022.1013253] [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: 08/06/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Lung cancer is a common malignant tumor characterized by challenging detection and lack of specificity in clinical manifestations. To investigate the correlation of tumor markers in the serum with liver metastasis and prognosis of lung cancer.Methods: A total of 3,046 elderly lung cancer patients were retrospectively studied between September 1999 and July 2020. Divided into liver metastasis group and non-liver metastasis group. We compared a series of serum biomarkers between the two groups of elderly patients to predict the prognosis in patients with lung cancer by fluorescence in situ hybridization (FISH), advanced flow cytometry (FCM) and multi tumor marker protein chip, including tumor markers in the serum included alkaline phosphatase (ALP), serum calcium, hemoglobin (HB), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin fragment 19 (Cyfra21-1), carbohydrate antigen-125 (CA-125), carbohydrate antigen-153 (CA-153), carbohydrate antigen-199 (CA-199), and free prostate specific antigen (free PSA). We used binary logistic regression analysis to determine risk factors, and used receiver operating curve (ROC) analysis to evaluate the diagnostic value of liver metastases in elderly patients with lung cancer.Results: The proportion of lung cancer in the liver metastasis group was higher than that observed in the non-liver metastases group. The expression levels of CA-125, Cyfra21-1, and NSE in the liver metastasis group of lung cancer were significantly higher than those reported in the non-liver metastases group (p < 0.05). ROC curve analysis shows that the area under the curve of CA-125, Cyfra21-1, and NSE are 0.614, 0.616 and 0.608, respectively. The sensitivity and specificity of CA-125 were 45.70% and 76.20%, the sensitivity and specificity of Cyfra21-1 were 60.10% and 57.10%, and the sensitivity and specificity of NSE were 44.10% and 75.00%, respectively.Conclusion: High levels of CA-125, Cyfra21-1, and NSE in the serum may be associated with liver metastasis in elderly patients with lung cancer. CA-125 and NSE are factors influencing the prognosis of elderly patients with liver metastasis of lung cancer.
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Affiliation(s)
- Tao Cheng
- Department of Respiratory, Shangrao People’s Hospital of Nanchang University, Shangrao, Jiangxi, China
| | - Jun Chen
- 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
| | - 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
| | - Huiye Shu
- 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
| | - 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
| | - 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
| | - Xulin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yixin Wang
- School of Optometry and Vision Science, Cardiff University, Cardiff, United Kingdom
| | - 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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Guinde J, Bourdages-Pageau E, Ugalde PA, Fortin M. Central location and risk of imaging occult mediastinal lymph node involvement in cN0T2-4 non-small cell lung cancer. J Thorac Dis 2020; 12:7156-7163. [PMID: 33447404 PMCID: PMC7797819 DOI: 10.21037/jtd-20-1565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Appropriate pre-operative staging is a cornerstone in the treatment of non-small cell lung cancer (NSCLC). Central location and size greater than 3 cm are amongst indications for pre-operative invasive mediastinal staging but the quality of the evidence behind this recommendation is low. Methods We retrospectively reviewed all cases of cT2-4N0M0 NSCLCL after CT and TEP-CT which underwent surgical resection with lymph node dissection or had a positive invasive pre-operative mediastinal staging in our institution from 2014 to 2018. Results Three hundred and ten patients met inclusion criteria, 79 (25.5%) central and 231 (74.5%) peripheral tumors. Central tumor location was associated with a higher prevalence of pN2-3 disease (17.7% vs. 6.1%, P<0.001). In a multivariate analysis, central tumor location remained the only factor statistically associated with imaging occult mediastinal disease (OR 3.23, 95% CI: 1.45–7.18). NPV of PET-CT for occult mediastinal disease was 0.83 (95% CI: 0.72–0.90) in central and 0.94 (95% CI: 0.90–0.97) in peripheral tumor. Central location was also associated with a higher prevalence of occult N1 to N3 disease (43.0% vs. 15.2%, P<0.001). Conclusions This study suggests that invasive mediastinal staging is required in central cT2-4N0 NSCLC but can be questioned in peripheral one, especially in cT2N2 subgroup if the patient is a candidate for lobar resection.
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Affiliation(s)
- Julien Guinde
- Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Canada.,Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Marseille, France
| | - Etienne Bourdages-Pageau
- Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Canada
| | - Paula Antonia Ugalde
- Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Canada
| | - Marc Fortin
- Department of Pulmonology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, Canada
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Choi YJ, Kim T, Kim EY, Lee SH, Kwon DS, Chang YS. Prediction model for hyperprogressive disease in non-small cell lung cancer treated with immune checkpoint inhibitors. Thorac Cancer 2020; 11:2793-2803. [PMID: 32779394 PMCID: PMC7529559 DOI: 10.1111/1759-7714.13594] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hyperprogressive disease (HPD) is a paradoxical acceleration of tumor growth after immune checkpoint inhibitor (ICI) treatment. This study aimed to identify the risk factors and to present a predictive model for HPD in patients treated with ICIs. METHODS A total of 78 non-small cell lung cancer (NSCLC) cases, treated with at least two cycles of ICIs who underwent computed tomography (CT) for response assessment were recruited into the study from January 2016 to August 2019. HPD was defined by the following criteria: (i) time-to-treatment failure <2 months; (ii) a 50% increase in the sum of target lesion diameters; (iii) new development of at least two lesions in an already involved organ; (iv) appearance of a new organ lesion; and (v) a decrease in ECOG PS 2. RESULTS Of the 78 total patients, 15 (19.2%) had HPD. The risk factors of HPD were age; primary lesion size; and metastases in the contralateral lung, pleura, liver, and bone in multivariable logistic regression (odds ratio [OR]; 0.9038, 1.6619, 28.5913, 23.8264, 14.5711, and 20.1533, respectively, all P-values < 0.05). By using these risk factors, we developed a prediction model for HPD and the area under the receiver operating characteristic curve of the model was 0.9556 (95% confidence interval [CI]: 0.9133-0.9978). CONCLUSIONS HPD is relatively common and associated with a grave clinical outcome, requiring a careful monitoring in lung cancer patients treated with ICIs. Moreover, risk factors such as age, size of tumor and number of various metastatic lesions should be taken into consideration before ICI administration. KEY POINTS SIGNIFICANT FINDINGS OF THE STUDY: Age, primary lesion size, and number of metastases are risk factors of HPD. HPD is strongly associated with poor prognosis. HPD during ICI use needs comprehensive monitoring. WHAT THIS STUDY ADDS This is the first study to develop a prediction model. The area under the curve of the prediction model for HPD was 0.9556.
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Affiliation(s)
- Yong Jun Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Taehee Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Hoon Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Do Sun Kwon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Kao MW, Su YC, Liang PI, Wu YY, Hong TM. Low Galectin-3 Expression Level in Primary Tumors Is Associated with Metastasis in T1 Lung Adenocarcinoma. J Clin Med 2020; 9:jcm9061990. [PMID: 32630393 PMCID: PMC7355842 DOI: 10.3390/jcm9061990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Although nodal and distant metastasis is rare in T1 lung adenocarcinoma, it is related to poor clinical prognosis. Association between galectin-3 (Gal-3) expression level, and clinical outcome of T1 lung adenocarcinoma has not been clarified. METHODS From January 2009 to December 2014, 74 patients with surgically resected T1 lung adenocarcinoma were enrolled in this retrospective cohort study. Patient outcomes were followed up until December 2019. Gal-3 expression level in primary tumors was assessed immunohistochemically and evaluated based on the staining intensity and percentage. Patient characteristics and correlation between Gal-3 expression level and clinical outcomes were reviewed. RESULTS Low Gal-3 expression was associated with increased metastatic events (p = 0.03), especially distant metastasis (p = 0.007), and mortality rate (p = 0.04). Kaplan-Meier analysis revealed that high Gal-3 expression level was associated with favorable recurrence-free survival in T1 lung adenocarcinoma (log-rank p = 0.048) and T1a (≤ 2 cm, American Joint Committee on Cancer (AJCC) 7th edition) lung adenocarcinoma (log-rank p = 0.043). Gal-3 expression along with tumor size showed a larger area under curve (AUC) than tumor size alone for predicting metastatic events (AUC = 0.747 vs. 0.681) and recurrence (AUC = 0.813 vs. 0.766) in T1a lung adenocarcinoma in the receiver-operating characteristic curve. CONCLUSION Low Gal-3 expression level in primary tumors was remarkably associated with increased metastatic events and reduced recurrence-free survival in T1 lung adenocarcinoma. We suggest that Gal-3 expression level in addition to tumor size may potentially be stronger than tumor size alone in predicting metastasis in T1a lung adenocarcinoma patients.
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Affiliation(s)
- Ming-Wei Kao
- Division of Thoracic Surgery, Department of Surgery, E-Da Hospital, and College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Yue-Chiu Su
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (Y.-C.S.); (P.-I.L.)
| | - Peir-In Liang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (Y.-C.S.); (P.-I.L.)
| | - Yi-Ying Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Tse-Ming Hong
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 4259)
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Chen CY, Wu BR, Chen CH, Cheng WC, Chen WC, Liao WC, Chen CY, Hsia TC, Tu CY. Prognostic Value of Tumor Size in Resected Stage IIIA-N2 Non-Small-Cell Lung Cancer. J Clin Med 2020; 9:jcm9051307. [PMID: 32370082 PMCID: PMC7290400 DOI: 10.3390/jcm9051307] [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: 03/24/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022] Open
Abstract
The eighth edition of the American Joint Committee on Cancer (AJCC) staging system for lung cancer was introduced in 2017 and included major revisions, especially of stage III. For the subgroup stage IIIA-N2 non-small-cell lung cancer (NSCLC), surgical resection remains controversial due to heterogeneous disease entity. The aim of this study was to evaluate the clinicopathologic features and prognostic factors of patients with completely resected stage IIIA-N2 NSCLC. We retrospectively evaluated 77 consecutive patients with pathologic stage IIIA-N2 NSCLC (AJCC eighth edition) who underwent surgical resection with curative intent in China Medical University Hospital between 2006 and 2014. Survival analysis was conducted, using the Kaplan–Meier method. Prognostic factors predicting overall survival (OS) and disease-free survival (DFS) were analyzed, using log-rank tests and multivariate Cox proportional hazards models. Of the 77 patients with pathologic stage IIIA-N2 NSCLC examined, 35 (45.5%) were diagnosed before surgery and 42 (54.5%) were diagnosed unexpectedly during surgery. The mean age of patients was 59 years, and the mean length of follow-up was 38.1 months. The overall one-, three-, and five-year OS rates were 91.9%, 61.3%, and 33.5%, respectively. Multivariate analysis showed that tumor size <3 cm (hazards ratio (HR): 0.373, p = 0.003) and video-assisted thoracoscopic surgery (VATS) approach (HR: 0.383, p = 0.014) were significant predictors for improved OS. For patients with surgically treated, pathologic stage IIIA-N2 NSCLC, tumor size <3 cm and the VATS approach seemed to be associated with better prognosis.
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Affiliation(s)
- Chih-Yu Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Bing-Ru Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Chia-Hung Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Wen-Chien Cheng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Wei-Chun Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- Department of Respiratory Therapy, China Medical University, Taichung 40402, Taiwan
- Hyperbaric oxygen therapy center, China Medical University Hospital, Taichung 40447, Taiwan
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
- Hyperbaric oxygen therapy center, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence: ; Tel.: +886-4-2205-2121 (ext. 4661)
| | - Chih-Yi Chen
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- Department of Respiratory Therapy, China Medical University, Taichung 40402, Taiwan
- Hyperbaric oxygen therapy center, China Medical University Hospital, Taichung 40447, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (C.-Y.C.); (B.-R.W.); (C.-H.C.); (W.-C.C.); (W.-C.C.); (T.-C.H.); (C.-Y.T.)
- School of Medicine, China Medical University, Taichung 40402, Taiwan
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10
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Shan Q, Fan Y, Guo J, Han X, Wang H, Wang Z. Relationship between tumor size and metastatic site in patients with stage IV non-small cell lung cancer: A large SEER-based study. PeerJ 2019; 7:e7822. [PMID: 31616594 PMCID: PMC6790223 DOI: 10.7717/peerj.7822] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/03/2019] [Indexed: 12/23/2022] Open
Abstract
Objective To analyze the relationship between tumor size and metastatic site in stage IV NSCLC patients. Methods A total of 40,196 stage IV NSCLC patients from 2010 to 2015 were screened by SEER database. Chi-square test was used to compare the characteristics of clinical variables. At the same time, multivariate Logistic regression analysis was used to evaluate the relationship between tumor size and organ metastasis. Results Regardless of tumor size, the proportion of bone metastasis and lung metastasis was higher and similar in patients with squamous cell carcinoma, while in patients with adenocarcinoma, bone metastasis accounted for the highest proportion. We found that whether the metastatic site was bone, brain, liver or lung, the proportion of patients with a tumor size of 3–7 cm was the highest. Multivariate regression analysis demonstrated that patients with a tumor size of 3–7 cm and a tumor size ≥7 cm were more likely to develop brain metastasis and lung metastasis compared with patients with a tumor size ≤3 cm (all P < 0.001), which meant the larger the tumor, the greater the risk of brain or lung metastasis. At the same time, the results indicated that patients with a tumor size of 3–7 cm had a tendency to develop liver metastasis (P = 0.004), while the statistical significance was not found for patients with a tumor size ≥7 cm (P = 0.524). The results also revealed that patients with a tumor size of 3–7cm had no significant difference to develop bone metastasis (P = 0.116), while the statistical significance was found for patients with a tumor size ≥7 cm (P < 0.001). Conclusions There was statistical significance between tumor size and metastatic site in patients with stage IV NSCLC. For brain or lung metastasis, the larger the tumor, the higher the risk of brain or lung metastasis. For liver metastasis, patients with a tumor size of 3–7 cm were more prone to develop liver metastasis. For bone metastasis, patients with a tumor size ≥7 cm were more likely to have bone metastasis.
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Affiliation(s)
- Qinge Shan
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.,Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yanling Fan
- Department of Haematology and Oncology, Jinxiang People's Hospital, Jinxiang Hospital Affiliated with Jining Medical University, Jining, Shandong, China
| | - Jun Guo
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiao Han
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Haiyong Wang
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Zhehai Wang
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
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11
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Kim I, Eom JS, Kim AR, Lee CH, Lee G, Jo EJ, Kim MH, Mok JH, Lee K, Kim KU, Park HK, Lee MK. Molecular analysis of small tissue samples obtained via transbronchial lung biopsy using radial probe endobronchial ultrasound. PLoS One 2019; 14:e0212672. [PMID: 30807604 PMCID: PMC6391011 DOI: 10.1371/journal.pone.0212672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 02/07/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Radial probe endobronchial ultrasound using a guide sheath (EBUS-GS) is used to diagnose peripheral lung cancer. The aim was to identify the accuracy of molecular analysis that were performed with EBUS-GS specimens in patients with non-small cell lung cancer (NSCLC). METHOD From December 2015 to September 2017, we retrospectively studied 91 patients with peripheral NSCLC who underwent surgery after EBUS-GS. Epidermal growth factor receptor (EGFR) mutational and anaplastic lymphoma kinase (ALK) translocation status obtained from surgical specimens served as the references. RESULTS Compared to the reference data, EGFR mutational testing of EBUS-GS specimens was in 97% agreement, and the κ coefficient was 0.931 (P< 0.001). In addition, on ALK translocation testing, the results of all 91 patients were in agreement with the reference data (concordance rate of 100%, κ coefficient 1.000; P< 0.001). CONCLUSION We found that EBUS-GS could be used for molecular diagnosis, such as EGFR mutational and ALK translocation status, in patients with peripheral NSCLC.
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Affiliation(s)
- Insu Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ah Rong Kim
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hun Lee
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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12
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Łochowski M, Łochowska B, Rębowski M, Brzeziński D, Cieślik-Wolski B, Kozak J. Five-year survival analysis and prognostic factors in patients operated on for non-small cell lung cancer with N2 disease. J Thorac Dis 2018; 10:3180-3186. [PMID: 30069313 DOI: 10.21037/jtd.2018.05.173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background The aim of the study is to analyse 5-year survival and prognostic factors in patients operated due to lung cancer with postoperatively confirmed metastases to N2 group nodes. Methods In the years 2007-2015, 1,148 patients with lung cancer were treated surgically. A postoperative histopathological study confirmed N2 feature in 150 patients. One hundred and ten patients, in whom a 5-year survival analysis was possible to perform, were included in such analysis. The patients underwent the following procedures: pneumonectomy, 31 patients; lobectomy, 61; bilobectomy, 10; and wedge resection, 8. All patients were subjected to supplementary treatment after the surgery. Results Five-year survival was achieved in 23 patients (21%). The patients' survival did not depend on the type of surgery, type of tumour, its location or presence of metastases in N1 nodes (P=0.82, P=0.51, P=0.36 and P=0.23, respectively). A statistically significant correlation was observed (P=0.01) between the 5-year survival of a patient and the occurrence of metastases only in one group of lymph nodes of the N2 feature (22 patients, 20%). Involvement of three or more mediastinal nodal groups resulted in survival shorter than 5-year. Conclusions (I) In patients with the N2 feature, the type of performed surgery, type of tumour and the occurrence of metastases in the lymph nodes of the lung hilum do not affect 5-year survival; (II) involvement of only one nodal group allows to achieve 5-year survival in 20% of patients; (III) involvement of three and more nodal groups with the N2 feature results in decreased 5-year survival.
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Affiliation(s)
- Mariusz Łochowski
- Department of Thoracic Surgery, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
| | - Barbara Łochowska
- Department of Chemotherapy, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
| | - Marek Rębowski
- Department of Thoracic Surgery, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
| | - Daniel Brzeziński
- Department of Thoracic Surgery, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
| | - Bartosz Cieślik-Wolski
- Department of Thoracic Surgery, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
| | - Józef Kozak
- Department of Thoracic Surgery, Memorial Copernicus Hospital, Medical University of Lodz, Lodz, Poland
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13
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Yang L, Wang S, Gerber DE, Zhou Y, Xu F, Liu J, Liang H, Xiao G, Zhou Q, Gazdar A, Xie Y. Main bronchus location is a predictor for metastasis and prognosis in lung adenocarcinoma: A large cohort analysis. Lung Cancer 2018; 120:22-26. [PMID: 29748011 DOI: 10.1016/j.lungcan.2018.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/16/2018] [Accepted: 03/10/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES In the literature, inconsistent associations between the primary locations of lung adenocarcinomas (ADCs) with patient prognosis have been reported, due to varying definitions for central and peripheral locations. In this study, we investigated the clinical characteristics and prognoses of ADCs located in the main bronchus. METHODS A total of 397,189 lung ADCs registered from 2004 to 2013 in the National Cancer Database (NCDB) were extracted and divided into main bronchus-located ADCs (2.5%, N = 10,111) and non-main bronchus ADCs (97.5%, N = 387,078). The ADCs located in the main bronchus and those not in the main bronchus were compared in terms of patient prognosis, lymph node involvement, distant metastases and other clinical features, including rate of curative-intent resection, histologic grade, and stage. RESULTS ADCs located in the main bronchus had significantly worse patient survival than those in the non-main bronchus, both for all patients (HR = 1.82, 95% CI 1.78-1.86) and for those undergoing curative-intent resection (HR = 2.49, 95% CI 2.23-2.78). Furthermore, ADCs located in the main bronchus had a significantly higher rate of lymph node involvement and distant metastasis than those not in the main bronchus, when stratified by tumor size (trend test, p < e-16). Multivariate analysis of overall survival showed that main bronchus location is a prognostic factor (HR = 1.15, 95% CI 1.08-1.23) independent of other clinical factors. CONCLUSIONS Main bronchus location is an independent predictor for metastasis and worse outcomes irrespective of stage and treatment. Tumor primary location might be considered in prognostication and treatment planning.
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Affiliation(s)
- Lin Yang
- Department of Pathology, National Cancer Center, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, China; Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Shidan Wang
- Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - David E Gerber
- Division of Hematology Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Yunyun Zhou
- Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Department of Data Science, University of Mississippi Medical Center, MS, 39216, USA
| | - Feng Xu
- Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jiewei Liu
- Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Hao Liang
- Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Guanghua Xiao
- Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA; Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Qinghua Zhou
- Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Adi Gazdar
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA; Department of Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, TX, 75390, USA
| | - Yang Xie
- Quantitative Biomedical Research Center, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA; Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, 75390, USA.
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14
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Warkentin MT, Tammemägi MC, Freedman MT, Ragard LR, Hocking WG, Kvale PA, Brenner DR, Hu P, Riley TL, Commins J, Church TR, Berg CD. Factors Associated With Small Aggressive Non-Small Cell Lung Cancers in the National Lung Screening Trial: A Validation Study. JNCI Cancer Spectr 2018; 2:pkx010. [PMID: 31360836 PMCID: PMC6649725 DOI: 10.1093/jncics/pkx010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/17/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022] Open
Abstract
Background A small proportion of non-small cell lung cancers (NSCLCs) have been observed to spread to distant lymph nodes (N3) or metastasize (M1) or both, while the primary tumor is small (≤3 cm, T1). These small aggressive NSCLCs (SA-NSLSC) are important as they are clinically significant, may identify unique biologic pathways, and warrant aggressive follow-up and treatment. This study identifies factors associated with SA-NSCLC and attempts to validate a previous finding that women with a family history of lung cancer are at particularly elevated risk of SA-NSCLC. Methods This study used a case-case design within the National Cancer Institute's National Lung Screening Trial (NLST) cohort. Case patients and "control" patients were selected based on TNM staging parameters. Case patients (n = 64) had T1 NSCLCs that were N3 or M1 or both, while "control" patients (n = 206) had T2 or T3, N0 to N2, and M0 NSCLCs. Univariate and multivariable logistic regression were used to identify factors associated with SA-NSCLC. Results In bootstrap bias-corrected multivariable logistic regression models, small aggressive adenocarcinomas were associated with a positive history of emphysema (odds ratio [OR] = 5.15, 95% confidence interval [CI] = 1.63 to 23.00) and the interaction of female sex and a positive family history of lung cancer (OR = 6.55, 95% CI = 1.06 to 50.80). Conclusions Emphysema may play a role in early lung cancer progression. Females with a family history of lung cancer are at increased risk of having small aggressive lung adenocarcinomas. These results validate previous findings and encourage research on the role of female hormones interacting with family history and genetic factors in lung carcinogenesis and progression.
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Affiliation(s)
- Matthew T Warkentin
- Department of Health Sciences, Brock University, St. Catharine's, Ontario, Canada.,Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Martin C Tammemägi
- Department of Health Sciences, Brock University, St. Catharine's, Ontario, Canada
| | - Matthew T Freedman
- Cancer Prevention and Control, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | | | - William G Hocking
- Department of Clinical Oncology, Marshfield Clinic Health System, Marshfield, WI
| | - Paul A Kvale
- Division of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, MI
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Community Health Sciences and Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ping Hu
- Biometry Research Group, National Cancer Institute, Bethesda, MD
| | | | - John Commins
- Information Management Services, Inc., Rockville, MD
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Christine D Berg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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15
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O'Connell OJ, Almeida FA, Simoff MJ, Yarmus L, Lazarus R, Young B, Chen Y, Semaan R, Saettele TM, Cicenia J, Bedi H, Kliment C, Li L, Sethi S, Diaz-Mendoza J, Feller-Kopman D, Song J, Gildea T, Lee H, Grosu HB, Machuzak M, Rodriguez-Vial M, Eapen GA, Jimenez CA, Casal RF, Ost DE. A Prediction Model to Help with the Assessment of Adenopathy in Lung Cancer: HAL. Am J Respir Crit Care Med 2017; 195:1651-1660. [PMID: 28002683 DOI: 10.1164/rccm.201607-1397oc] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Estimating the probability of finding N2 or N3 (prN2/3) malignant nodal disease on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with non-small cell lung cancer (NSCLC) can facilitate the selection of subsequent management strategies. OBJECTIVES To develop a clinical prediction model for estimating the prN2/3. METHODS We used the AQuIRE (American College of Chest Physicians Quality Improvement Registry, Evaluation, and Education) registry to identify patients with NSCLC with clinical radiographic stage T1-3, N0-3, M0 disease that had EBUS-TBNA for staging. The dependent variable was the presence of N2 or N3 disease (vs. N0 or N1) as assessed by EBUS-TBNA. Univariate followed by multivariable logistic regression analysis was used to develop a parsimonious clinical prediction model to estimate prN2/3. External validation was performed using data from three other hospitals. MEASUREMENTS AND MAIN RESULTS The model derivation cohort (n = 633) had a 25% prevalence of malignant N2 or N3 disease. Younger age, central location, adenocarcinoma histology, and higher positron emission tomography-computed tomography N stage were associated with a higher prN2/3. Area under the receiver operating characteristic curve was 0.85 (95% confidence interval, 0.82-0.89), model fit was acceptable (Hosmer-Lemeshow, P = 0.62; Brier score, 0.125). We externally validated the model in 722 patients. Area under the receiver operating characteristic curve was 0.88 (95% confidence interval, 0.85-0.90). Calibration using the general calibration model method resulted in acceptable goodness of fit (Hosmer-Lemeshow test, P = 0.54; Brier score, 0.132). CONCLUSIONS Our prediction rule can be used to estimate prN2/3 in patients with NSCLC. The model has the potential to facilitate clinical decision making in the staging of NSCLC.
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Affiliation(s)
| | | | - Michael J Simoff
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Lonny Yarmus
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Benjamin Young
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Yu Chen
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Roy Semaan
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | | | - Joseph Cicenia
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Harmeet Bedi
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Corrine Kliment
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Liang Li
- 5 Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Sonali Sethi
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Javier Diaz-Mendoza
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - David Feller-Kopman
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Juhee Song
- 5 Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Thomas Gildea
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Hans Lee
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Michael Machuzak
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
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16
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Yao G. Value of window technique in diagnosis of the ground glass opacities in patients with non-small cell pulmonary cancer. Oncol Lett 2016; 12:3933-3935. [PMID: 27895751 PMCID: PMC5104212 DOI: 10.3892/ol.2016.5133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/12/2016] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to examine the value of window technique in qualitative diagnosis of the ground glass opacities (GGO) in patients with non-small cell pulmonary cancer. A total of 124 clinically suspected pulmonary cancer patients were analyzed retrospectively. The lesions were affirmed by puncture biopsy, and were GGO on pulmonary window while were invisible on mediastinal window. Sixty-four multi-detector spiral computed tomography with the window width and window level of 1,500 Hounsfield units (HU) and −450 HU on pulmonary window, while the window width and window level of 400 and 40 HU on mediastinal window, was used in the study. The window adjustment technique was used to analyze the window width and window level of lesion on pulmonary window and mediastinal window, for searching invisible threshold on 3-megapixel medical displays. The diagnostic accuracy and the cut-off value were compared on receiver operating characteristic (ROC) curve. The results showed that the window width and window level on pulmonary window and mediastinal window of malignant lesions were significantly less than those of benign ones (P<0.05). The cut-off value on pulmonary window was the window width and window level of 1,300 and −220 HU, the area under the ROC was 0.830 [sensitivity was 72.5%, specificity was 84.3%; 95% confidence interval (CI), 0.712–0.945]. The cut-off value on mediastinal window was the window width and window level of 360 and 30 HU, and the area under the ROC was 0.623 (was 62.0%, specificity was 55.7%; 95% CI, 0.541–0.745). In conclusion, the window technique has high sensitivity and accuracy in qualitative diagnosis of the GGO.
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Affiliation(s)
- Gang Yao
- Department of Radiology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277100, P.R. China
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17
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Wang T, Ma S, Yan T, Song J, Wang K, He W, Bai J. [Clinical Study of Surgical Treatment of Non-small Cell Lung Cancer
10 mm or Less in Diameter Under Video-assisted Thoracoscopy]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2016; 19:216-9. [PMID: 27118649 PMCID: PMC5999813 DOI: 10.3779/j.issn.1009-3419.2016.04.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
背景与目的 早期原发性非小细胞肺癌(non-small cell lung cancer, NSCLC)的手术切除及淋巴结切除的合理方式存在较大争议,本研究旨在探讨直径≤10 mm的原发NSCLC的微创切除及淋巴结切除的手术方式。 方法 对2013年7月-2016年3月在我院接受电视胸腔镜手术(video-assisted thoracic surgery, VATS)治疗并有明确病理诊断为NSCLC的共46例患者的临床资料进行回顾性分析。所有患者术前行薄层计算机断层扫描(computed tomography, CT),实性结节5例,混合性磨玻璃结节(mixed ground-glass opacity, mGGO)23例,纯磨玻璃结节(pure ground-glass opacity, pGGO)18例。根据患者具体情况采用不同术式,包括VATS肺叶切除和系统性淋巴结清扫,VATS肺楔形切除和选择性淋巴结切除,VATS肺段切除和选择性淋巴结切除,或仅采用VATS肺楔形切除。其中7例术前行CT引导下Hook-wire定位。 结果 VATS肺叶切除和系统性淋巴结清扫23例(mGGOs 15例,pGGOs 4例,实性结节4例),只有1例实性腺癌结节出现N2淋巴结转移,VATS肺楔形切除和选择性淋巴结切除5例(mGGOs 2例,pGGOs 3例)和VATS肺段切除和选择性淋巴结切除4例(mGGOs 2例,pGGOs 2例)均无淋巴结转移,仅采用VATS肺楔形切除14例(mGGOs 4例,pGGOs 9例,实性结节1例)。7例Hook-wire定位均成功。围手术期无重大并发症,随访1个月-26个月,平均(13.7±8.7)个月,无复发及转移。 结论 直径≤10 mm以mGGO和pGGO为表现的原发性NSCLC淋巴结转移率低,术中可以不进行淋巴结的清扫,实性结节应选择性淋巴结切除或系统性淋巴结清扫。高龄和心肺功能差的患者可以选择楔形切除或肺段切除。术前运用Hook-wire定位安全有效,可为VATS提供便利。
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Affiliation(s)
- Tong Wang
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Shaohua Ma
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Tiansheng Yan
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Jintao Song
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Keyi Wang
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Wei He
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
| | - Jie Bai
- Department of Thoracic Surgery, the Third Hospital of Peking University, Beijing 100191, China
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Tumour stage and implementation of standardised cancer patient pathways: a comparative cohort study. Br J Gen Pract 2016; 66:e434-43. [PMID: 27025558 DOI: 10.3399/bjgp16x684805] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/04/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Some European countries have introduced standardised cancer patient pathways (CPPs), including urgent referrals, with the aim of diagnosing cancer at an earlier stage. This is despite a lack of evidence, particularly in patients with symptomatic cancer diagnosed via general practice. AIM To compare tumour stages in patients with incident cancer diagnosed via general practice before, during, and after CPP implementation in Denmark in 2008-2009. DESIGN AND SETTING A comparative cohort study of data from GPs and registries on patients with incident cancer listed with a GP before (n = 1420), during (n = 5272), and after (n = 2988) CPP implementation. METHOD χ(2) test was used to compare stage distributions and logistic regression to estimate odds ratios (OR) of having local cancer after versus before CPP implementation. RESULTS Distribution of tumour stages did not differ statistically significantly across time (P = 0.494) or between CPP use (P = 0.202). For all cancers combined, the OR of having local cancer after CPP implementation was 0.88 (95% confidence interval [CI] = 0.73 to 1.06) compared with before. For CPP-referred patients, the OR of having local cancer was 0.77 (95% CI = 0.62 to 0.94) compared with all patients before CPP implementation; the corresponding OR for non-CPP-referred patients was 0.96 (95% CI = 0.80 to 1.14). CONCLUSION No clear tendencies were observed confirming earlier detection of cancer after rather than before CPP implementation. CPP-referred patients had lower odds of having local cancer after CPP implementation than all patients before CPP implementation; this could be because the GPs refer patients who are 'more ill' as urgent referrals.
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Jiang L, Jiang S, Lin Y, Yang H, Xie Z, Lin Y, Long H. Nomogram to Predict Occult N2 Lymph Nodes Metastases in Patients With Squamous Nonsmall Cell Lung Cancer. Medicine (Baltimore) 2015; 94:e2054. [PMID: 26579815 PMCID: PMC4652824 DOI: 10.1097/md.0000000000002054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
For nonsmall cell lung cancer (NSCLC) patients without distant metastases, occult involvement of N2 lymph nodes would be of the utmost importance in determining both treatment and survival. The key to optimal treatment strategies relied on accurate diagnosis, in particular accurate clinical tumor staging. Patients with clinical N0 or N1 staging preoperatively had a sizeable risk to have occult N2 lymph nodes metastases.From November 2004 to March 2007, the entire database in a tertiary hospital of all patients with a pathologic diagnosis of squamous NSCLC underwent anatomical pulmonary resection and systematic mediastinal lymph node dissection were retrospectively collected and reviewed. A nomogram was developed on the basis of a multivariable logistic regression model with a combination of all potential variables. In order to surmount the potential of overestimating predictive performance, both bootstrapping for internal validation and an independent external validation set were employed.A nomogram incorporating the significant risk factors was created to predict the probability of occult N2 lymph nodes metastases. The calibration plot for the probability of occult N2 lymph nodes metastases showed an optimal agreement between the predicted probabilities by nomogram and actual observed probabilities. An objective and accurate nomogram predictive model for occult N2 lymph nodes metastases was drawn up and validated internally and externally in patients with squamous NSCLC.The nomogram model, as a robust tool in predicting occult N2 lymph nodes involvement, could be involved in a cost-effective application of specific diagnostic and therapeutic strategies.
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Affiliation(s)
- Long Jiang
- From the Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China (LJ, SJ, YL, HY, ZX, YL, HL); Lung Cancer Institute of Sun Yat-sen University, Guangzhou, China (LJ, YL, HY, ZX, YL, HL); Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China (LJ, YL, HY, ZX, YL, HL); and University of California, San Francisco, San Francisco, CA (LJ)
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Mao H, Labh K, Han F, Jiang S, Yang Y, Sun X. Diagnosis of the invasiveness of lung adenocarcinoma manifesting as ground glass opacities on high-resolution computed tomography. Thorac Cancer 2015; 7:129-35. [PMID: 26816547 PMCID: PMC4718115 DOI: 10.1111/1759-7714.12269] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/29/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To explore the diagnostic method in assessing the malignancy of pulmonary adenocarcinoma characterized by ground glass opacities (GGO) on computed tomography (CT). METHODS Preoperative CT data for preinvasive and invasive lung adenocarcinomas were analyzed retrospectively. GGO lesions that were detected on lung windows but absent using the mediastinal window were subject to adjustment of the window width, which was reduced with the fixed interval of 100 HU until the lesions were no longer evident, with a fixed mediastinal window level of 40 HU. The shape, smoking habits, size of the lesion on the lung window, and window width at which lesions disappeared were compared and receiver operating characteristic curves were used to determine the optimal cut-off of the lesion size and window width to differentiate between these invasive and preinvasive lesions. RESULTS Of the 209 lung adenocarcinomas, 102 were preinvasive (25 atypical adenomatous hyperplasia and 77 adenocarcinoma in situ), while 107 were invasive (78 minimally invasive adenocarcinoma and 29 invasive adenocarcinoma). The shape, lesion size, and window width at which lesions were no longer evident differed significantly between the two groups (P < 0.05). The size of 8.9 mm and a window width of 1250 HU were the optimal cut-off to differentiate between preinvasive and invasive lesions. CONCLUSION The shape, size of the lesion, and window width on high-resolution CT may be useful in assessing the invasiveness of lung adenocarcinoma that manifests as GGO. Irregular lesions that disappear at window width <1250 HU, with a diameter of > 8.9 mm are more likely to be invasive.
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Affiliation(s)
- Haixia Mao
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
| | - Kanchan Labh
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
| | - Fushi Han
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
| | - Sen Jiang
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
| | - Yang Yang
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
| | - Xiwen Sun
- Department of Radiology Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China
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Development and Validation of a Clinical Prediction Model for N2 Lymph Node Metastasis in Non-Small Cell Lung Cancer. Ann Thorac Surg 2013; 96:1761-8. [DOI: 10.1016/j.athoracsur.2013.06.038] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/29/2013] [Accepted: 06/07/2013] [Indexed: 11/19/2022]
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22
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Melkamu T, Qian X, Upadhyaya P, O'Sullivan MG, Kassie F. Lipopolysaccharide enhances mouse lung tumorigenesis: a model for inflammation-driven lung cancer. Vet Pathol 2013; 50:895-902. [PMID: 23381924 DOI: 10.1177/0300985813476061] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The association between pulmonary inflammation and lung cancer is well established. However, currently there are no appropriate models that recapitulate inflammation-related lung cancer in humans. In the present study, we examined, in 2 tumor bioassays, enhancement by bacterial lipopolysaccharide (LPS) of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced lung tumorigenesis in A/J mice. Mice that were treated with NNK alone developed 29.6 ± 9.8 and 36.2 ± 4.1 lung tumors per mouse in experiments 1 and 2, respectively. Chronic intranasal instillation of LPS to NNK-treated mice increased the multiplicity of lung tumors to 47.3 ± 16.1 and 51.2 ± 4.8 lung tumors per mouse in experiments 1 and 2, corresponding to a significant increase by 60% and 41%, respectively. Moreover, administration of LPS to NNK-pretreated mice significantly increased the multiplicity of larger tumors and histopathologically more advanced lesions (adenoma with dysplasia and adenocarcinoma), macrophage recruitment to the peritumoral area, and expression of inflammation-, cell proliferation-, and survival-related proteins. Overall, our findings demonstrated the promise of the NNK-LPS-A/J mice model to better understand inflammation-driven lung cancer, dissect the molecular pathways involved, and identify more effective preventive and therapeutic agents against lung cancer.
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Affiliation(s)
- T Melkamu
- Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806, 420 Delaware Street SE, Minneapolis, MN 55455.
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Su M, Li L. [Correlation between regional node metastasis and imageological characteristics in non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2012; 15:730-4. [PMID: 23249719 PMCID: PMC6000044 DOI: 10.3779/j.issn.1009-3419.2012.12.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
非小细胞肺癌(non-small cell lung cancer, NSCLC)局部淋巴结(N)分期是影响患者治疗方案选择的关键因素之一。目前临床所使用的无创和有创性N分期方法均有其局限性。研究发现NSCLC的某些影像学特点可预测淋巴结转移的危险性,包括大小、CT密度和氟代脱氧葡萄糖(fluorodeoxyglucose, FDG)标准化摄取值(standardized uptake value, SUV)等。期待系统性多因素分析,以发现影响肺癌淋巴结转移的关键因素。
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Affiliation(s)
- Minggang Su
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
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Verma MK, Miki Y, Abe K, Nagasaki S, Niikawa H, Suzuki S, Kondo T, Sasano H. Co-expression of estrogen receptor beta and aromatase in Japanese lung cancer patients: Gender-dependent clinical outcome. Life Sci 2012; 91:800-8. [DOI: 10.1016/j.lfs.2012.08.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 08/10/2012] [Accepted: 08/25/2012] [Indexed: 11/25/2022]
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Goldwasser DL, Kimmel M. Small median tumor diameter at cure threshold (<20 mm) among aggressive non-small cell lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation framework. Int J Cancer 2012; 132:189-97. [DOI: 10.1002/ijc.27599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 03/27/2012] [Indexed: 11/06/2022]
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