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Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol 2023; 20:624-639. [PMID: 37479810 DOI: 10.1038/s41571-023-00798-3] [Citation(s) in RCA: 93] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. However, lung cancer incidence and mortality rates differ substantially across the world, reflecting varying patterns of tobacco smoking, exposure to environmental risk factors and genetics. Tobacco smoking is the leading risk factor for lung cancer. Lung cancer incidence largely reflects trends in smoking patterns, which generally vary by sex and economic development. For this reason, tobacco control campaigns are a central part of global strategies designed to reduce lung cancer mortality. Environmental and occupational lung cancer risk factors, such as unprocessed biomass fuels, asbestos, arsenic and radon, can also contribute to lung cancer incidence in certain parts of the world. Over the past decade, large-cohort clinical studies have established that low-dose CT screening reduces lung cancer mortality, largely owing to increased diagnosis and treatment at earlier disease stages. These data have led to recommendations that individuals with a high risk of lung cancer undergo screening in several economically developed countries and increased implementation of screening worldwide. In this Review, we provide an overview of the global epidemiology of lung cancer. Lung cancer risk factors and global risk reduction efforts are also discussed. Finally, we summarize lung cancer screening policies and their implementation worldwide.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rajwanth R Veluswamy
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zhang X, Zhang G, Qiu X, Yin J, Tan W, Yin X, Yang H, Liao L, Wang H, Zhang Y. Radiomics under 2D regions, 3D regions, and peritumoral regions reveal tumor heterogeneity in non-small cell lung cancer: a multicenter study. LA RADIOLOGIA MEDICA 2023; 128:1079-1092. [PMID: 37486526 DOI: 10.1007/s11547-023-01676-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE Lung cancer has significant genetic and phenotypic heterogeneity, leading to poor prognosis. Radiomic features have emerged as promising predictors of the tumor phenotype. However, the role of underlying information surrounding the cancer remains unclear. MATERIALS AND METHODS We conducted a retrospective study of 508 patients with NSCLC from three institutions. Radiomics models were built using features from six tumor regions and seven classifiers to predict three prognostically significant tumor phenotypes. The models were evaluated and interpreted by the mean area under the receiver operating characteristic curve (AUC) under nested cross-validation and Shapley values. The best-performing predictive models corresponding to six tumor regions and three tumor phenotypes were identified for further comparative analysis. In addition, we designed five experiments with different voxel spacing to assess the sensitivity of the experimental results to the spatial resolution of the voxels. RESULTS Our results demonstrated that models based on 2D, 3D, and peritumoral region features yielded mean AUCs and 95% confidence intervals of 0.759 and [0.747-0.771] for lymphovascular invasion, 0.889 and [0.882-0.896] for pleural invasion, and 0.839 and [0.829-0.849] for T-staging in the testing cohort, which was significantly higher than all other models. Similar results were obtained for the model combining the three regional features at five voxel spacings. CONCLUSION Our study revealed the predictive role of the developed methods with multi-regional features for the preoperative assessment of prognostic factors in NSCLC. The analysis of different voxel spacing and model interpretability strengthens the experimental findings and contributes to understanding the biological significance of the radiological phenotype.
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Affiliation(s)
- Xingping Zhang
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, 510006, China
- Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, VIC, 3011, Australia
- Department of New Networks, Peng Cheng Laboratory, Shenzhen, 518000, China
| | - Guijuan Zhang
- Department of Respiratory and Critical Care, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Xingting Qiu
- Department of Radiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Jiao Yin
- Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, VIC, 3011, Australia
| | - Wenjun Tan
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, 110189, China
| | - Xiaoxia Yin
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, 510006, China
| | - Hong Yang
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, 510006, China
| | - Liefa Liao
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou, 341000, China
| | - Hua Wang
- Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, VIC, 3011, Australia.
| | - Yanchun Zhang
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, 510006, China.
- Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, VIC, 3011, Australia.
- Department of New Networks, Peng Cheng Laboratory, Shenzhen, 518000, China.
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Implementing lung cancer screening in Europe: taking a systems approach. JTO Clin Res Rep 2022; 3:100329. [PMID: 35601926 PMCID: PMC9121320 DOI: 10.1016/j.jtocrr.2022.100329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 12/05/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in Europe. Screening by means of low-dose computed tomography (LDCT) can shift detection to an earlier stage and reduce lung cancer mortality in high-risk individuals. However, to date, Poland, Croatia, Italy, and Romania are the only European countries to commit to large-scale implementation of targeted LDCT screening. Using a health systems approach, this article evaluates key factors needed to enable the successful implementation of screening programs across Europe. Recent literature on LDCT screening was reviewed for 10 countries (Belgium, Croatia, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, and United Kingdom) and complemented by 17 semistructured interviews with local experts. Research findings were mapped against a health systems framework adapted for lung cancer screening. The European policy landscape is highly variable, but potential barriers to implementation are similar across countries and consistent with those reported for other cancer screening programs. While consistent quality and safety of screening must be ensured across all screening centers, system factors are also important. These include appropriate data infrastructure, targeted recruitment methods that ensure equity in participation, sufficient capacity and workforce training, full integration of screening with multidisciplinary care pathways, and smoking cessation programs. Stigma and underlying perceptions of lung cancer as a self-inflicted condition are also important considerations. Building on decades of implementation research, governments now have a unique opportunity to establish effective, efficient, and equitable lung cancer screening programs adapted to their health systems, curbing the impact of lung cancer on their populations.
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Cai C, Liu Y, Li J, Wang L, Zhang K. Serum fingerprinting by slippery liquid-infused porous SERS for non-invasive lung cancer detection. Analyst 2022; 147:4426-4432. [DOI: 10.1039/d2an01325h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Direct and label-free analysis of clinical serum samples using slippery liquid-infused porous-enhanced Raman spectroscopy (SLIPSERS) enables the rapid non-invasive identification of lung cancer.
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Affiliation(s)
- Chenlei Cai
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Yujie Liu
- Shanghai Institute for Pediatric Research, Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jiayu Li
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Lei Wang
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Kun Zhang
- Shanghai Institute for Pediatric Research, Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Tan Z, Chen M, Wang Y, Peng F, Zhu X, Li X, Zhang L, Li Y, Liu Y. CHEK1: a hub gene related to poor prognosis for lung adenocarcinoma. Biomark Med 2021; 16:83-100. [PMID: 34882011 DOI: 10.2217/bmm-2021-0919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The study aims to pinpoint hub genes and investigate their functions in order to gain insightful understandings of lung adenocarcinoma (LUAD). Methods: Bioinformatic approaches were adopted to investigate genes in databases including Gene Expression Omnibus, WebGestalt, STRING and Cytoscape, GEPIA2, Oncomine, Human Protein Atlas, TIMER2.0, UALCAN, cBioPortal, TargetScanHuman, OncomiR, ENCORI, Kaplan-Meier plotter, UCSC Xena, European Molecular Biology Laboratory - European Bioinformatics Institute Single Cell Expression Atlas and CancerSEA. Results: Five hub genes were ascertained. CHEK1 was overexpressed in a range of cancers, including LUAD. Promoter methylation, amplification and miRNA regulation might trigger CHEK1 upregulation, signaling poor prognosis. CHEK1 with its coexpressed genes were enriched in the cell cycle pathway. Intratumor heterogeneity of CHEK1 expression could be observed. Cell clusters with CHEK1 expression were more prone to metastasis and epithelial-to-mesenchymal transition. Conclusion: CHEK1 might potentially act as a prognostic biomarker for LUAD.
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Affiliation(s)
- Zhibo Tan
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Min Chen
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Ying Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 113, Baohe Avenue, Longgang District, Shenzhen, Guangdong Province, 518116, China
| | - Feng Peng
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Xiaopeng Zhu
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Xin Li
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Lei Zhang
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Ying Li
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
| | - Yajie Liu
- Department of Radiation Oncology, Peking University Shenzhen Hospital, no. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China.,Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute, Shenzhen-Peking University-Hong Kong University of Science & Technology Medical Center, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, Guangdong Province, 518036, China
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Wang H, Xu J, Ding L. MicroRNA-21 was a promising biomarker for lung carcinoma diagnosis: An update meta-analysis. Thorac Cancer 2021; 13:316-321. [PMID: 34837469 PMCID: PMC8807252 DOI: 10.1111/1759-7714.14242] [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: 10/03/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the diagnostic performance of microRNA‐21 detected in serum or sputum as a biomarker for lung carcinoma identification through pooling the open published data. Methods Clinical diagnostic studies related to microRNA‐21 as a biomarker for lung carcinoma identification were electronically searched in the databases of Pubmed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and Google Scholar. The data of the included studies was extracted and made pooling of diagnostic sensitivity, specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic curve (ROC) (AUC) for microRNA‐21 expression in serum or sputum as a biomarker for lung carcinoma identification. The publication bias was evaluated by Deek's funnel plot. Results Seventeen diagnostic studies were finally included and made data pooling. For the included 17 studies, 4 investigated the microRNA‐21 expression in sputum and 13 studies in serum. The pooled diagnostic sensitivity and specificity were 0.73 (95% CI, 0.67–0.78) and 0.81 (95% CI, 0.75–0.85), respectively, under random effect model. The combined DOR was 9.65 (95% CI, 6.64–14.03) with the AUC of 0.84 (95% CI, 0.80–0.87). Given a pre‐test probability of 50%, the post‐test positive probability and post‐test negative probability were 79% and 25%, respectively, by using microRNA‐21 as a biomarker for lung carcinoma diagnosis. Deek's funnel was obviously asymmetry and indicated significant publication bias (p < 0.05). Conclusion MicroRNA‐21 in serum or sputum was a promising biomarker for lung cancer identification with relative high diagnostic sensitivity and specificity.
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Affiliation(s)
- Haiyan Wang
- Department of Respiratory, Hangzhou Third People's Hospital, Hangzhou, China
| | - Jia Xu
- Department of Respiratory, Hangzhou Third People's Hospital, Hangzhou, China
| | - Ling Ding
- Department of Respiratory, Hangzhou Third People's Hospital, Hangzhou, China
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