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Li Y, Xu C, Yu Q. Risk factor analysis of bone metastasis in patients with non-small cell lung cancer. Am J Transl Res 2022; 14:6696-6702. [PMID: 36247263 PMCID: PMC9556442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Bone tissue is the most common metastatic location besides lung and liver. 30%~40% of patients with non-small cell lung cancer (NSCLC) will have bone metastasis (BM) in the development of the disease. This study aims to explore the relevant risk factors through multivariate analysis, in order to provide basis for the prevention of BM and bone related events of NSCLC. METHODS We analyzed 152 patients, with 67 in BM group and 85 in non-BM group. The general clinical data and laboratory indicators (mainly coagulation function) of patients were compared through univariate and multivarijate analysis. Finally, the independent risk factors of BM in patients with NSCLC were screened out. RESULTS The results of univariate analysis show that thrombosis, clinical stage, tumor-node-metastasis (TNM) stage, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-Dimer (D-D), platelet (PLT) and alkaline phosphatase (AKP) are the risk factors of BM in patients with NSCLC (p<0.05). Further multivariate logistic regression analysis suggests that the independent risk factors of BM in patients with NSCLC are clinical stage III-IV, TNM stage T1-T3, TNM stage N2-N3, FIB, APTT, D-D and AKP (P<0.05). CONCLUSION Clinical stage III-IV, TNM stage T1-T3, TNM stage N2-N3, FIB, APTT, D-D and AKP are the independent risk factors of BM in patients with NSCLC. Meanwhile, patients with these risk factors should be screened in time, which is of great significance to prevent bone related events and relieve pain.
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Affiliation(s)
- Yang Li
- Department of Thoracic Surgery, Long Hua Hospital, Shanghai University of Traditional Chinese MedicineShanghai, China
| | - Chongqing Xu
- Department of Thoracic Surgery, Long Hua Hospital, Shanghai University of Traditional Chinese MedicineShanghai, China
- Department of Orthopaedics, Long Hua Hospital, Shanghai University of Traditional Chinese MedicineShanghai, China
| | - Qiquan Yu
- Department of Thoracic Surgery, Long Hua Hospital, Shanghai University of Traditional Chinese MedicineShanghai, China
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Liao Y, Fan X, Wang X. Effects of different metastasis patterns, surgery and other factors on the prognosis of patients with stage IV non-small cell lung cancer: A Surveillance, Epidemiology, and End Results (SEER) linked database analysis. Oncol Lett 2019; 18:581-592. [PMID: 31289530 PMCID: PMC6546983 DOI: 10.3892/ol.2019.10373] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/10/2019] [Indexed: 12/26/2022] Open
Abstract
The surgical treatment of patients with advanced lung cancer remains controversial. The current study aimed to identify the factors affecting the prognosis of patients with stage IV non-small cell lung cancer (NSCLC) and to clarify the surgery guidelines. A total of 27,725 patients diagnosed with stage IV NSCLC were selected from the Surveillance, Epidemiology, and End Results program between 2010 and 2013. The sex, age, ethnicity, marital status, Tumor-Node-Metastasis stage, radiation therapy received and surgical status of each patient were recorded. Patients were followed up to November 2015. Survival rates were estimated by the Kaplan-Meier method. Single- and multi-factor analyses were performed using the log-rank test and multivariate Cox regression analysis respectively. In the isolated organ metastasis cohort, patients with liver metastasis alone had the worst prognosis, with a median overall survival (OS) of 4 months (liver metastasis vs. other organ metastases; P<0.001). Patients with lung metastasis only had the best prognosis, with a median OS of 8 months (lung metastasis vs. other organ metastases; P<0.001). Furthermore, patients with only one metastasis had the best prognosis, with a median OS of 6 months (single metastasis vs. multiple-organ metastases; P<0.001). The multivariate Cox regression analysis of the isolated-organ metastasis cohort and the multiple-organ metastases cohort revealed that patients who were ≤60 years, female, married, Asian, with N0 stage, had only bone metastasis, accepted wedge resection or lobectomy of the primary tumor, had surgical procedure to distant lymph node(s), and received beam radiation had an improved prognosis compared with the other patients. Age, sex, tumor type, ethnicity, N stage, number and type of metastatic lesions, surgical treatment of primary and metastatic lesions and radiation therapy are factors which influence the prognosis of patients with stage IV NSCLC. Furthermore, surgery may still benefit these patients.
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Affiliation(s)
- Yi Liao
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xianming Fan
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xue Wang
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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Lin X, Dong W, Lai X, Feng W, Yu X, Gu Q, Wang C, Xiao W, Zheng X. The clinical value of circulating tumor DNA detection in advanced non-small cell lung cancer. Transl Cancer Res 2019; 8:170-179. [PMID: 35116746 PMCID: PMC8797680 DOI: 10.21037/tcr.2019.01.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/14/2019] [Indexed: 11/25/2022]
Abstract
Background Circulating tumor DNA (ctDNA) is a kind of cell-free DNA which comes from tumor cells and effectively reflects the molecular characteristics of tumors, which providing us a novel method to explore its clinical therapeutic value in advanced lung cancer. Methods A total of 36 patients with advanced non-small cell lung cancer (NSCLC) were enrolled in this study, including 28 cases of adenocarcinoma and 8 cases of squamous cell carcinoma. Next-generation sequencing based ctDNA detection, tissue DNA (tDNA) detection, corresponding survival analysis, and retrospective statistics were performed to explore the feasibility of clinical practice directed by molecular characteristics in NSCLC. Results Epidermal growth factor receptor mutation (EGFR mutation) took over the highest mutation frequency (36.11%) in 36 samples, and the subsequent genes were PIK3CA, BRAF, KRAS, NRAS, MAP2K1, and GNAQ; 11 patients were detected with multiple gene mutations, including 8 cases with double gene mutations, 1 case with three gene mutations, and 2 cases with four gene mutations, and the subsequent 12-month survival observation revealed that patients with less mutations also had a longer OS (10.37±0.74 vs. 7.08±1.43 months, P=0.034). Twenty-one patients with EGFR mutation and subsequently treated with EGFR-tyrosine kinase inhibitor (TKI) combined chemotherapy, had significantly longer PFS than those with EGFR wild type and treated with chemotherapy in next 5-year monitoring test (18.00±4.41 vs. 7.33±1.58 months, P=0.024). Conclusions Gene mutation in advanced lung cancer is complex, and ctDNA detection has important guiding significance in clinical treatment of advanced NSCLC.
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Affiliation(s)
- Xiao Lin
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Wentao Dong
- 1Gene Bio-tech Co., Ltd., Hangzhou 310051, China
| | - Xiaojing Lai
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Wei Feng
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Xiaofu Yu
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Qing Gu
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | | | - Wen Xiao
- 1Gene Bio-tech Co., Ltd., Hangzhou 310051, China
| | - Xiao Zheng
- Department of Thoracic Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
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Meng C, Tang C, Liang J. [Progress of Biomarkers in Diagnosis of Bone Metastases of Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:615-619. [PMID: 30172269 PMCID: PMC6105350 DOI: 10.3779/j.issn.1009-3419.2018.08.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
中晚期恶性肿瘤容易发生骨转移,随诊疗水平不断提升使其生存期得以延长,骨转移发生率亦随之增加。其中,肺癌是全世界癌症相关死亡的首要原因,晚期肺癌患者骨转移发生率为30%-40%。传统的肺癌骨转移诊断通常依据临床症状、X线、计算机断层扫描(computed tomography, CT)、核磁共振(magnetic resonance imaging, MRI)等影像学及病理,基于血液标记物检测作为骨转移筛查与疗效评估的探索性研究近年多有报道。本文综述了肺癌骨转移诊断标记物的研究进展。
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Affiliation(s)
- Chao Meng
- Department of Oncology, Peking University International Hospital, Beijing 102206, China
| | - Chuanhao Tang
- Department of Oncology, Peking University International Hospital, Beijing 102206, China
| | - Jun Liang
- Department of Oncology, Peking University International Hospital, Beijing 102206, China
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Zhang G, Cheng R, Zhang Z, Jiang T, Ren S, Ma Z, Zhao S, Zhou C, Zhang J. Bisphosphonates enhance antitumor effect of EGFR-TKIs in patients with advanced EGFR mutant NSCLC and bone metastases. Sci Rep 2017; 7:42979. [PMID: 28211502 PMCID: PMC5314405 DOI: 10.1038/srep42979] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/17/2017] [Indexed: 12/13/2022] Open
Abstract
Whether bisphosphonates could enhance the effect of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) patients with EGFR mutation and bone metastases (BM) remains unknown. EGFR mutation status were collected from 1560 patients with NSCLC and BM. 356 NSCLC patients with EGFR mutation and BM were identified. Among them, 91 patients received EGFR-TKIs alone and 105 patients received EGFR-TKIs plus bisphosphonates as first-line therapy. Comparing to TKIs alone, EGFR-TKIs plus bisphosphonates had a statistically significant longer progression-free survival (PFS: 11.6 vs. 9.3 months; HR = 0.68, P = 0.009), while a similar overall survival (OS: 20.5 vs. 19.5 months; HR = 0.95, P = 0.743) in patients with EGFR-mutant NSCLC and BM. The incidence of skeletal-related events in combined group was numerically lower than that in EGFR-TKIs alone group (29.7% vs. 39.4%, P = 0.147). In multivariate analysis, EGFR mutation was found to be a significant independent prognostic factor for OS in NSCLC patients with BM (HR = 0.710, P = 0.021). In conclusion, EGFR mutation was the significant independent prognostic factor for OS and the addition of bisphosphonates to EGFR-TKIs could enhance the antitumor effect of EGFR-TKIs in patients with EGFR-mutant NSCLC and BM.
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Affiliation(s)
- Guowei Zhang
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450003, China
| | - Ruirui Cheng
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
| | - Zengli Zhang
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
- Department of Respiratory, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Tao Jiang
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
| | - Zhiyong Ma
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450003, China
| | - Sha Zhao
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
| | - Jun Zhang
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Department of Internal Medicine, Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Zhang S, Huang W, Liu X, Li J. [Complete Single-Utility-Port Thoracoscopic Resection of Lung Cancer
with Single-Rib Metastasis]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2016; 19:220-3. [PMID: 27118650 PMCID: PMC5999816 DOI: 10.3779/j.issn.1009-3419.2016.04.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
背景与目的 随着全胸腔镜手术经验的增加,其适应症也在向复杂的术式延伸。本研究旨在探讨单操作孔全胸腔镜下同期行肺叶联合肋骨切除术的可行性。 方法 结合我科为1例肺癌单发肋骨转移的患者进行了“单操作孔全胸腔镜下肺叶及部分肋骨切除术”进行病例分享并复习有关文献。 结果 肿瘤分期为T1N1M1。患者术后恢复良好并于术后第4天出院。最近一次随访于术后18个月,患者无病生存良好。 结论 筛选后的肺癌伴肋骨转移病例,适合行单操作孔全胸腔镜手术切除。
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Affiliation(s)
- Shijie Zhang
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Weiming Huang
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Xiangzheng Liu
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - Jian Li
- Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
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Zhao QT, Yang ZX, Yang L, Xing D, Wei JC, Li WY. Diagnostic value of bone-specific alkaline phosphatase in lung carcinoma patients with bone metastases: a meta-analysis. Int J Clin Exp Med 2015; 8:17271-17280. [PMID: 26770319 PMCID: PMC4694219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/09/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED Aim and Backgrounds: The accurate diagnosis of lung carcinoma patients with bone metastases is crucial for therapy and the prevention of complications. We performed a systematic review and meta-analysis to evaluate the diagnostic value of serum bone-specific alkaline phosphatase (BALP) in lung carcinoma patients with bone metastases. METHODS Such databases as PubMed, Embase, Cochrane Library, Web of Science, Ovid, BioMed Central, Biosis previews and four Chinese databases (Chinese Biomedical Literature Database-disc (CBM), Chinese National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP) and Wan Fang DATA) were retrieved on computer, and the relevant journals were also manually searched to collect the trials on BALP in diagnosis of lung carcinoma patients with bone metastases. The meta-analysis was conducted by using Meta-Disc 1.4 software. RESULTS A total of 8 studies were included, and there were 848 lung carcinoma patients diagnosed by gold standard, patients were divided into two groups: 419 cases with bone metastases and 429 cases without bone metastases. The meta-analysis showed that, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) was 0.48 [95% CI (0.43 to 0.53)], 0.86 [95% CI (0.82 to 0.89)], 3.14 [95% CI (2.47 to 3.99)], 0.62 [95% CI (0.56 to 0.68)], 6.66 [95% CI (4.62 to 9.60)] respectively. And the AUC of SROC was 0.78, (Q*=0.72). CONCLUSION BALP has greater diagnostic value in detecting lung carcinoma patients with bone metastases. However, further large scale studies are required to confirm the predictive value.
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Affiliation(s)
- Qing-Tao Zhao
- Department of Thoracic Surgery, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Zhao-Xu Yang
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Lei Yang
- Department of Pediatrics, Bethune International Peace Hospital of Chinese PLAShijiazhuang 050082, Hebei, P. R. China
| | - Dong Xing
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Jing-Chao Wei
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Wen-Yi Li
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
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Guo Q, Wu M, An T, Zhao J, Duan J, Wang Z, Wang S, Wang J. [Characteristics and treatment of bone metastases in 322 cases non-small cell lung cancer: a retrospective study]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:656-62. [PMID: 25248706 PMCID: PMC6000505 DOI: 10.3779/j.issn.1009-3419.2014.09.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
背景与目的 骨是非小细胞肺癌最常见转移部位之一,可引起疼痛病理性骨折等,严重影响患者生活质量。本研究探讨非小细胞肺癌骨转移的临床特点及预后因素。 方法 回顾性分析我科近5年收治的600例非小细胞肺癌患者,单光子计算机断层扫描(emission computed tomography, ECT)作为筛查方法,计算机断层扫描(computed tomography, CT)/磁共振成像(magnetic resonance imaging, MRI)/X线或病理学诊断作为骨转移的确诊方法。 结果 肺腺癌发生骨转移的比率最高,脊柱、骨盆、股骨等为骨转移高发部位。ECT显示3个浓聚灶及以上者,行CT/MRI/X线可以证实骨转移,确诊骨转移的几率远远高于ECT显示1个-2个浓聚灶的患者[80.6%(203/252)vs 50.79%(32/63), P < 0.001]。出现骨转移后未发生骨相关事件(skeletal related events, SRE)的患者生存期长于发生SRE者,1年生存率和中位生存期分别为44.75%、14.74个月 vs 36.17%、12.25个月(P=0.022)。经Cox多因素分析,病理组织学诊断为非腺癌、骨转移病灶数少于3个,单纯骨转移为有益于生存期的预后因素。 结论 ECT异常浓聚灶的数目与骨转移影像学的确诊有关。病理组织学非腺癌、骨转移病灶数少于3个、单纯骨转移是非小细胞肺癌骨转移的独立预后因素。
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Affiliation(s)
- Qingzhi Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Meina Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Tongtong An
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Jun Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Jianchun Duan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Zhijie Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Shuhang Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Jie Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
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