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Sheu CC, Wang CC, Hsu JS, Chung WS, Hsu HY, Shi HY. Cost-Effectiveness of Low-Dose Computed Tomography Screenings for Lung Cancer in High-Risk Populations: A Markov Model. World J Oncol 2024; 15:550-561. [PMID: 38993243 PMCID: PMC11236381 DOI: 10.14740/wjon1882] [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: 04/09/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
Background Domestic and foreign studies on lung cancer have been oriented to the medical efficacy of low-dose computed tomography (LDCT), but there is a lack of studies on the costs, value and cost-effectiveness of the treatment. There is a scarcity of conclusive evidence regarding the cost-effectiveness of LDCT within the specific context of Taiwan. This study is designed to address this gap by conducting a comprehensive analysis of the cost-effectiveness of LDCT and chest X-ray (CXR) as screening methods for lung cancer. Methods Markov decision model simulation was used to estimate the cost-effectiveness of biennial screening with LDCT and CXR based on a health provider perspective. Inputs are based on probabilities, health status utility (quality-adjusted life years (QALYs)), costs of lung cancer screening, diagnosis, and treatment from the literatures, and expert opinion. A total of 1,000 simulations and five cycles of Markov bootstrapping simulations were performed to compare the incremental cost-utility ratio (ICUR) of these two screening strategies. Probability and one-way sensitivity analyses were also performed. Results The ICUR of early lung cancer screening compared LDCT to CXR is $-24,757.65/QALYs, and 100% of the probability agree to adopt it under a willingness-to-pay (WTP) threshold of the Taiwan gross domestic product (GDP) per capita ($35,513). The one-way sensitivity analysis also showed that ICUR depends heavily on recall rate. Based on the prevalence rate of 39.7 lung cancer cases per 100,000 people in 2020, it could be estimated that LDCT screening for high-risk populations could save $17,154,115. Conclusion LDCT can detect more early lung cancers, reduce mortality and is cost-saving than CXR in a long-term simulation of Taiwan's healthcare system. This study provides valuable insights for healthcare decision-makers and suggests analyzing cost-effectiveness for additional variables in future research.
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Affiliation(s)
- Chau-Chyun Sheu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan, Republic of China
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
| | - Chun-Chun Wang
- Medical Intensive Care Unit, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
| | - Jui-Sheng Hsu
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan, Republic of China
- Department of Radiology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
| | - Wei-Shiuan Chung
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan, Republic of China
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
| | - Hong-Yi Hsu
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan, Republic of China
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan, Republic of China
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan, Republic of China
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan, Republic of China
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Li YN, Su JL, Tan SH, Chen XL, Cheng TL, Jiang Z, Luo YZ, Zhang LM. Machine learning based on metabolomics unveils neutrophil extracellular trap-related metabolic signatures in non-small cell lung cancer patients undergoing chemoimmunotherapy. World J Clin Cases 2024; 12:4091-4107. [PMID: 39015934 PMCID: PMC11235537 DOI: 10.12998/wjcc.v12.i20.4091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/10/2024] [Accepted: 05/28/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) is the primary form of lung cancer, and the combination of chemotherapy with immunotherapy offers promising treatment options for patients suffering from this disease. However, the emergence of drug resistance significantly limits the effectiveness of these therapeutic strategies. Consequently, it is imperative to devise methods for accurately detecting and evaluating the efficacy of these treatments. AIM To identify the metabolic signatures associated with neutrophil extracellular traps (NETs) and chemoimmunotherapy efficacy in NSCLC patients. METHODS In total, 159 NSCLC patients undergoing first-line chemoimmunotherapy were enrolled. We first investigated the characteristics influencing clinical efficacy. Circulating levels of NETs and cytokines were measured by commercial kits. Liquid chromatography tandem mass spectrometry quantified plasma metabolites, and differential metabolites were identified. Least absolute shrinkage and selection operator, support vector machine-recursive feature elimination, and random forest algorithms were employed. By using plasma metabolic profiles and machine learning algorithms, predictive metabolic signatures were established. RESULTS First, the levels of circulating interleukin-8, neutrophil-to-lymphocyte ratio, and NETs were closely related to poor efficacy of first-line chemoimmunotherapy. Patients were classed into a low NET group or a high NET group. A total of 54 differential plasma metabolites were identified. These metabolites were primarily involved in arachidonic acid and purine metabolism. Three key metabolites were identified as crucial variables, including 8,9-epoxyeicosatrienoic acid, L-malate, and bis(monoacylglycerol)phosphate (18:1/16:0). Using metabolomic sequencing data and machine learning methods, key metabolic signatures were screened to predict NET level as well as chemoimmunotherapy efficacy. CONCLUSION The identified metabolic signatures may effectively distinguish NET levels and predict clinical benefit from chemoimmunotherapy in NSCLC patients.
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Affiliation(s)
- Yu-Ning Li
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan 411201, Hunan Province, China
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Jia-Lin Su
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan 411201, Hunan Province, China
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Shu-Hua Tan
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan 411201, Hunan Province, China
| | - Xing-Long Chen
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan 411201, Hunan Province, China
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Tian-Li Cheng
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Zhou Jiang
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Yong-Zhong Luo
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
| | - Le-Meng Zhang
- Department of Thoracic Medicine, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
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Nomenoğlu H, Fındık G, Çetin M, Aydoğdu K, Gülhan SŞE, Bıçakçıoğlu P. Efficiency of pulmonary nodule risk scoring systems in Turkish population. Updates Surg 2024:10.1007/s13304-024-01901-8. [PMID: 38944649 DOI: 10.1007/s13304-024-01901-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/21/2024] [Indexed: 07/01/2024]
Abstract
Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and evaluate their effectiveness and applicability for the Turkish population. Between 2014 and 2019, 351 patients who were operated on for pulmonary nodules were evaluated with the following data: age, gender, smoking history, family history of lung cancer, extrapulmonary malignancy and granulomatous disease, nodule diameter, attenuation character, side, localization, spiculation, nodule count, presence of pulmonary emphysema, FDG uptake in PET/CT of the nodule, and definitive pathology data. Malignancy risk scores were calculated using the equations of the Brock, Mayo, and Herder models. The results were evaluated statistically. The mean age of the 351 patients (236 men, 115 women) was 57.84 ± 10.87 (range 14-79) years, and 226 malignant and 125 benign nodules were observed. Significant correlations were found between malignancy and age (p < 0.001), nodule diameter (p < 0.001), gender (p < 0.009), speculation (p < 0.001), emphysema (p < 0.05), FDG uptake (p < 0.001). All three models were found effective in the differentiation (p < 0.001). The ideal threshold value was determined for the Brock (19.5%), Mayo (23.1%), and Herder (56%) models. All models were effective for nodules of > 10 mm, but none of them were for 0-10 mm. Brock was effective in ground-glass nodules (p = 0.02) and all models were effective for semi-solid and solid nodules. None of the groups could provide AUC values as high as those achieved in the original studies. This suggests the need to optimize models and malignancy risk thresholds for Turkish population.
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Affiliation(s)
- Hakan Nomenoğlu
- Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Göktürk Fındık
- Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Mehmet Çetin
- Department of Thoracic Surgery, Ministry of Health, Nigde Omer Halisdemir Training and Research Hospital, Nigde, Turkey.
| | - Koray Aydoğdu
- Department of Thoracic Surgery, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Selim Şakir Erkmen Gülhan
- Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Pınar Bıçakçıoğlu
- Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
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Huang M, Wang J, Zhou H, Lv Z, Li T, Liu M, Lv Y, Wu A, Xia J, Xu H, Chen W, Liu P. (-) - Epicatechin regulates LOC107986454 by targeting the miR-143-3p/EZH2 axis to enhance the radiosensitivity of non-small cell lung cancer. Am J Med Sci 2024:S0002-9629(24)01328-4. [PMID: 38944201 DOI: 10.1016/j.amjms.2024.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 04/10/2024] [Accepted: 06/24/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND AND OBJECTIVE Non-small cell lung cancer (NSCLC) is a pernicious tumor with high incidence and mortality rates. The incidence rate of NSCLC increases with age and poses a serious danger to human health. The aim of this study was to determine the mechanism by which (-)-epicatechin (EC) alleviates NSCLC. METHODS Twenty-four pairs of NSCLC tissues and cancer-adjacent tissues were collected, and A549 and H460 radiotherapy-resistant strains were generated by repeatedly irradiating A549 and H460 cells with dose-gradient X-rays. Radiotherapy-resistant H460 cells were successfully injected subcutaneously into the left dorsal side of nude mice at a dose of 1 × 105 to establish an NSCLC animal model. The levels of interrelated genes and proteins were detected by RT‒qPCR and Western blotting, and cell proliferation and apoptosis were evaluated by CCK‒8 assay, Transwell assay, flow cytometry, and TUNEL staining. RESULTS LOC107986454 was highly expressed in NSCLC patients, while miR-143-3p was expressed at low levels and was negatively correlated with LOC107986454. Functionally, EC promoted autophagy and apoptosis induced by radiotherapy, restrained cell proliferation and migration, and ultimately enhanced the radiosensitivity of NSCLC cells. A downstream mechanistic study showed that EC facilitated miR-143-3p expression by inhibiting LOC107986454 and then restraining the expression of EZH2, which ultimately facilitated autophagy and apoptosis in cancer cells, inhibited proliferation and migration, and enhanced the radiosensitivity of NSCLC cells. CONCLUSION EC can enhance the radiosensitivity of NSCLC cells by regulating the LOC107986454/miR-143-3p/EZH2 axis.
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Affiliation(s)
- Meifang Huang
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Junfeng Wang
- Department of Thoracic Surgery, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Huahua Zhou
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Zengbo Lv
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Tianqian Li
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Meiyan Liu
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Yaqing Lv
- Department of Clinical Pharmacy, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Anao Wu
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Jie Xia
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Hongying Xu
- Department of Oncology, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China
| | - Weiwen Chen
- Department of Endocrinology, Qujing Second People's Hospital of Yunnan Province, Qujing, Yunnan, 655000, China.
| | - Peiwan Liu
- Department of Hepatobiliary Surgery, The First People's Hospital of Qujing, The Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, 655000, China.
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Kim M, Park J, Seonghee Oh, Jeong BH, Byun Y, Shin SH, Im Y, Cho JH, Cho EH. Deep learning model integrating cfDNA methylation and fragment size profiles for lung cancer diagnosis. Sci Rep 2024; 14:14797. [PMID: 38926407 PMCID: PMC11208569 DOI: 10.1038/s41598-024-63411-2] [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: 01/24/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
Detecting aberrant cell-free DNA (cfDNA) methylation is a promising strategy for lung cancer diagnosis. In this study, our aim is to identify methylation markers to distinguish patients with lung cancer from healthy individuals. Additionally, we sought to develop a deep learning model incorporating cfDNA methylation and fragment size profiles. To achieve this, we utilized methylation data collected from The Cancer Genome Atlas and Gene Expression Omnibus databases. Then we generated methylated DNA immunoprecipitation sequencing and genome-wide Enzymatic Methyl-seq (EM-seq) form lung cancer tissue and plasma. Using these data, we selected 366 methylation markers. A targeted EM-seq panel was designed using the selected markers, and 142 lung cancer and 56 healthy samples were produced with the panel. Additionally, cfDNA samples from healthy individuals and lung cancer patients were diluted to evaluate sensitivity. Its lung cancer detection performance reached an accuracy of 81.5% and an area under the receiver operating characteristic curve of 0.87. In the serial dilution experiment, we achieved tumor fraction detection of 1% at 98% specificity and 0.1% at 80% specificity. In conclusion, we successfully developed and validated a combination of methylation panel and a deep learning model that can distinguish between patients with lung cancer and healthy individuals.
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Affiliation(s)
- Minjung Kim
- Genome Research Center, GC Genome, Yongin-si, Korea
| | - Juntae Park
- Genome Research Center, GC Genome, Yongin-si, Korea
| | - Seonghee Oh
- Genome Research Center, GC Genome, Yongin-si, Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yuree Byun
- Smart Healthcare Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Sun Hye Shin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yunjoo Im
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Hae Cho
- Genome Research Center, GC Genome, Yongin-si, Korea.
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Zong Z, Tang G, Guo Y, Kong F. Down-regulated expression of TIPE3 inhibits malignant progression of non-small cell lung cancer via Wnt signaling. Exp Cell Res 2024; 439:114093. [PMID: 38759744 DOI: 10.1016/j.yexcr.2024.114093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/12/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
Non-small cell lung cancer (NSCLC) accounts for approximately 80 % of all lung cancers with a low five-year survival rate. Therefore, the mechanistic pathways and biomarkers of NSCLC must be explored to elucidate its pathogenesis. In this study, we examined TIPE3 expression in NSCLC cells and investigated the molecular mechanisms underlying NSCLC regulation in vivo and in vitro. We collected tissue samples from patients with NSCLC to examine TIPE3 expression and its association with patient metastasis and prognosis. Furthermore, we evaluated the expression level of TIPE3 in NSCLC cells. Cell lines with the highest expression were selected for molecular mechanism experiments, and animal models were established for in vivo verification. The results showed that TIPE3 was significantly increased in patients with NSCLC, and this increased expression was associated with tumor metastasis and patient prognosis. TIPE3 knockdown inhibited proliferation, migration, invasion, EMT, angiogenesis, and tumorsphere formation in NSCLC cells. Moreover, it reduced the metabolic levels of tumor cells. However, overexpression of TIPE3 has the opposite effect. The in vivo results showed that TIPE3 knockdown reduced tumor volume, weight, and metastasis. Furthermore, the results showed that TIPE3 may inhibit malignant progression of NSCLC via the regulation of Wnt/β-catenin expression. These findings suggest that TIPE3 is significantly elevated in patients with NSCLC and that downregulation of TIPE3 can suppress the malignant progression of NSCLC, which could serve as a potential diagnostic and treatment strategy for NSCLC.
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Affiliation(s)
- Zhenfeng Zong
- Department of Thoracic Surgery, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China.
| | - Guojie Tang
- Department of Thoracic Surgery, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China
| | - Yu Guo
- Department of Respiratory Medicine, Hejian People's Hospital, Cangzhou, Hebei, 061000, China
| | - Fanyi Kong
- Department of Thoracic Surgery, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China
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Song L, Wu D, Wu J, Zhang J, Li W, Wang C. Investigating causal associations between pneumonia and lung cancer using a bidirectional mendelian randomization framework. BMC Cancer 2024; 24:721. [PMID: 38862880 PMCID: PMC11167773 DOI: 10.1186/s12885-024-12147-3] [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: 09/03/2023] [Accepted: 03/19/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Pneumonia and lung cancer are both major respiratory diseases, and observational studies have explored the association between their susceptibility. However, due to the presence of potential confounders and reverse causality, the comprehensive causal relationships between pneumonia and lung cancer require further exploration. METHODS Genome-wide association study (GWAS) summary-level data were obtained from the hitherto latest FinnGen database, COVID-19 Host Genetics Initiative resource, and International Lung Cancer Consortium. We implemented a bidirectional Mendelian randomization (MR) framework to evaluate the causal relationships between several specific types of pneumonia and lung cancer. The causal estimates were mainly calculated by inverse-variance weighted (IVW) approach. Additionally, sensitivity analyses were also conducted to validate the robustness of the causalty. RESULTS In the MR analyses, overall pneumonia demonstrated a suggestive but modest association with overall lung cancer risk (Odds ratio [OR]: 1.21, 95% confidence interval [CI]: 1.01 - 1.44, P = 0.037). The correlations between specific pneumonia types and overall lung cancer were not as significant, including bacterial pneumonia (OR: 1.07, 95% CI: 0.91 - 1.26, P = 0.386), viral pneumonia (OR: 1.00, 95% CI: 0.95 - 1.06, P = 0.891), asthma-related pneumonia (OR: 1.18, 95% CI: 0.92 - 1.52, P = 0.181), and COVID-19 (OR: 1.01, 95% CI: 0.78 - 1.30, P = 0.952). Reversely, with lung cancer as the exposure, we observed that overall lung cancer had statistically crucial associations with bacterial pneumonia (OR: 1.08, 95% CI: 1.03 - 1.13, P = 0.001) and viral pneumonia (OR: 1.09, 95% CI: 1.01 - 1.19, P = 0.037). Sensitivity analysis also confirmed the robustness of these findings. CONCLUSION This study has presented a systematic investigation into the causal relationships between pneumonia and lung cancer subtypes. Further prospective study is warranted to verify these findings.
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Affiliation(s)
- Lujia Song
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dongsheng Wu
- Department of Thoracic Surgery, Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiayang Wu
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiexi Zhang
- Chengdu Medical College, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Chengdi Wang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Ellis ET, Bauer MA, Beck JT, Bradford DS, Thompson J, Holt A, Kulik MC, Stahr SD, Hsu PC, Su LJ. Increased Utilization of Low-Dose CT for Lung Cancer Screening at an Arkansas Community Oncology Clinic. J Am Coll Radiol 2024; 21:858-866. [PMID: 37984767 PMCID: PMC11102528 DOI: 10.1016/j.jacr.2023.09.015] [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: 04/27/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Low-dose CT (LDCT) is underused in Arkansas for lung cancer screening, a rural state with a high incidence of lung cancer. The objective was to determine whether offering free LDCT increased the number of high-risk individuals screened in a rural catchment area. METHODS There were 5,402 patients enrolled in screening at Highlands Oncology, a community oncology clinic in Northwest Arkansas, from 2013 to 2020. Screenings were separated into time periods: period 1 (10 months for-fee), period 2 (10 months free with targeted advertisements and primary care outreach), and period 3 (62 months free with only primary care outreach). In all, 5,035 high-risk participants were eligible for analysis based on National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. Enrollment rates, incidence densities (IDs), Cox proportional hazard models, and Kaplan-Meier curves were performed to investigate differences between enrollment periods and high-risk groups. RESULTS Patient volume increased drastically once screenings were offered free of charge (period 1 = 4.6 versus period 2 = 66.0 and period 3 = 69.8 average patients per month). Incidence density per 1,000 person-years increased through each period (IDPeriod 1 = 17.2; IDPeriod 2 = 20.8; IDPeriod 3 = 25.5 cases). Cox models revealed significant differences in lung cancer risk between high-risk groups (P = .012) but not enrollment periods (P = .19). Kaplan-Meier lung cancer-free probabilities differed significantly between high-risk groups (log-rank P = .00068) but not enrollment periods (log-rank P = .18). CONCLUSIONS This study suggests that eligible patients are more receptive to free LDCT screening, despite most insurances not having a required copay for eligible patients.
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Affiliation(s)
- Edgar T Ellis
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Michael A Bauer
- Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | | | | | - Abby Holt
- ICF International Inc, Fairfax, Virginia
| | - Margarete C Kulik
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Tobacco-Related Disease Research Program, University of California Office of the President, Oakland, California
| | - Shelbie D Stahr
- Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ping-Ching Hsu
- Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - L Joseph Su
- Associate Dean for Academic Affairs, Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas.
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Li Q, Xiao T, Li J, Niu Y, Zhang G. The diagnosis and management of multiple ground-glass nodules in the lung. Eur J Med Res 2024; 29:305. [PMID: 38824558 PMCID: PMC11143686 DOI: 10.1186/s40001-024-01904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024] Open
Abstract
The prevalence of low-dose CT (LDCT) in lung cancer screening has gradually increased, and more and more lung ground glass nodules (GGNs) have been detected. So far, a consensus has been reached on the treatment of single pulmonary ground glass nodules, and there have been many guidelines that can be widely accepted. However, at present, more than half of the patients have more than one nodule when pulmonary ground glass nodules are found, which means that different treatment methods for nodules may have different effects on the prognosis or quality of life of patients. This article reviews the research progress in the diagnosis and treatment strategies of pulmonary multiple lesions manifested as GGNs.
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Affiliation(s)
- Quanqing Li
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Tianjiao Xiao
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jindong Li
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yan Niu
- Jilin University, Changchun, Jilin Province, China
| | - Guangxin Zhang
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun, Jilin Province, China.
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Teng X, Han K, Jin W, Ma L, Wei L, Min D, Chen L, Du Y. Development and validation of an early diagnosis model for bone metastasis in non-small cell lung cancer based on serological characteristics of the bone metastasis mechanism. EClinicalMedicine 2024; 72:102617. [PMID: 38707910 PMCID: PMC11066529 DOI: 10.1016/j.eclinm.2024.102617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
Background Bone metastasis significantly impact the prognosis of non-small cell lung cancer (NSCLC) patients, reducing their quality of life and shortening their survival. Currently, there are no effective tools for the diagnosis and risk assessment of early bone metastasis in NSCLC patients. This study employed machine learning to analyze serum indicators that are closely associated with bone metastasis, aiming to construct a model for the timely detection and prognostic evaluation of bone metastasis in NSCLC patients. Methods The derivation cohort consisted of 664 individuals with stage IV NSCLC, diagnosed between 2015 and 2018. The variables considered in this study included age, sex, and 18 specific serum indicators that have been linked to the occurrence of bone metastasis in NSCLC. Variable selection used multivariate logistic regression analysis and Lasso regression analysis. Six machine learning methods were utilized to develop a bone metastasis diagnostic model, assessed with Area Under the Curve (AUC), Decision Curve Analysis (DCA), sensitivity, specificity, and validation cohorts. External validation used 113 NSCLC patients from the Medical Alliance (2019-2020). Furthermore, a prospective validation study was conducted on a cohort of 316 patients (2019-2020) who were devoid of bone metastasis, and followed-up for at least two years to assess the predictive capabilities of this model. The model's prognostic value was evaluated using Kaplan-Meier survival curves. Findings Through variable selection, 11 serum indictors were identified as independent predictive factors for NSCLC bone metastasis. Six machine learning models were developed using age, sex, and these serum indicators. A random forest (RF) model demonstrated strong performance during the training and internal validation cohorts, achieving an AUC of 0.98 (95% CI 0.95-0.99) for internal validation. External validation further confirmed the RF model's effectiveness, yielding an AUC of 0.97 (95% CI 0.94-0.99). The calibration curves demonstrated a high level of concordance between the anticipated risk and the observed risk of the RF model. Prospective validation revealed that the RF model could predict the occurrence of bone metastasis approximately 10.27 ± 3.58 months in advance, according to the results of the SPECT. An online computing platform (https://bonemetastasis.shinyapps.io/shiny_cls_1model/) for this RF model is publicly available and free-to-use by doctors and patients. Interpretation This study innovatively employs age, gender, and 11 serological markers closely related to the mechanism of bone metastasis to construct an RF model, providing a reliable tool for the early screening and prognostic assessment of bone metastasis in NSCLC patients. However, as an exploratory study, the findings require further validation through large-scale, multicenter prospective studies. Funding This work is supported by the National Natural Science Foundation of China (NO.81974315); Shanghai Municipal Science and Technology Commission Medical Innovation Research Project (NO.20Y11903300); Shanghai Municipal Health Commission Health Industry Clinical Research Youth Program (NO.20204Y034).
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Affiliation(s)
- Xiaoyan Teng
- Department of Laboratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Kun Han
- Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Wei Jin
- Department of Laboratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Liru Ma
- Department of Laboratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Lirong Wei
- Department of Laboratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Daliu Min
- Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Libo Chen
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yuzhen Du
- Department of Laboratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
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Wang Y, Zhou C, Ying L, Lee E, Chan HP, Chughtai A, Hadjiiski LM, Kazerooni EA. Leveraging Serial Low-Dose CT Scans in Radiomics-based Reinforcement Learning to Improve Early Diagnosis of Lung Cancer at Baseline Screening. Radiol Cardiothorac Imaging 2024; 6:e230196. [PMID: 38752718 PMCID: PMC11211947 DOI: 10.1148/ryct.230196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 06/30/2024]
Abstract
Purpose To evaluate the feasibility of leveraging serial low-dose CT (LDCT) scans to develop a radiomics-based reinforcement learning (RRL) model for improving early diagnosis of lung cancer at baseline screening. Materials and Methods In this retrospective study, 1951 participants (female patients, 822; median age, 61 years [range, 55-74 years]) (male patients, 1129; median age, 62 years [range, 55-74 years]) were randomly selected from the National Lung Screening Trial between August 2002 and April 2004. An RRL model using serial LDCT scans (S-RRL) was trained and validated using data from 1404 participants (372 with lung cancer) containing 2525 available serial LDCT scans up to 3 years. A baseline RRL (B-RRL) model was trained with only LDCT scans acquired at baseline screening for comparison. The 547 held-out individuals (150 with lung cancer) were used as an independent test set for performance evaluation. The area under the receiver operating characteristic curve (AUC) and the net reclassification index (NRI) were used to assess the performances of the models in the classification of screen-detected nodules. Results Deployment to the held-out baseline scans showed that the S-RRL model achieved a significantly higher test AUC (0.88 [95% CI: 0.85, 0.91]) than both the Brock model (AUC, 0.84 [95% CI: 0.81, 0.88]; P = .02) and the B-RRL model (AUC, 0.86 [95% CI: 0.83, 0.90]; P = .02). Lung cancer risk stratification was significantly improved by the S-RRL model as compared with Lung CT Screening Reporting and Data System (NRI, 0.29; P < .001) and the Brock model (NRI, 0.12; P = .008). Conclusion The S-RRL model demonstrated the potential to improve early diagnosis and risk stratification for lung cancer at baseline screening as compared with the B-RRL model and clinical models. Keywords: Radiomics-based Reinforcement Learning, Lung Cancer Screening, Low-Dose CT, Machine Learning © RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Yifan Wang
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Chuan Zhou
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Lei Ying
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Elizabeth Lee
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Heang-Ping Chan
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Aamer Chughtai
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Lubomir M. Hadjiiski
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
| | - Ella A. Kazerooni
- From the Departments of Radiology (Y.W., C.Z., E.L., H.P.C., A.C.,
L.M.H., E.A.K.) and Internal Medicine (E.A.K.), The University of Michigan
Medical School, 1500 E Medical Center Dr, Medical Inn Building, Rm C479, Ann
Arbor, MI 48109-0904; Department of Electrical Engineering and Computer Science,
The University of Michigan, Ann Arbor, Mich (Y.W., L.Y.); and Department of
Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio (A.C.)
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Chen F, Li J, Li L, Tong L, Wang G, Zou X. Multidimensional biological characteristics of ground glass nodules. Front Oncol 2024; 14:1380527. [PMID: 38841161 PMCID: PMC11150621 DOI: 10.3389/fonc.2024.1380527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
The detection rate of ground glass nodules (GGNs) has increased in recent years because of their malignant potential but relatively indolent biological behavior; thus, correct GGN recognition and management has become a research focus. Many scholars have explored the underlying mechanism of the indolent progression of GGNs from several perspectives, such as pathological type, genomic mutational characteristics, and immune microenvironment. GGNs have different major mutated genes at different stages of development; EGFR mutation is the most common mutation in GGNs, and p53 mutation is the most abundant mutation in the invasive stage of GGNs. Pure GGNs have fewer genomic alterations and a simpler genomic profile and exhibit a gradually evolving genomic mutation profile as the pathology progresses. Compared to advanced lung adenocarcinoma, GGN lung adenocarcinoma has a higher immune cell percentage, is under immune surveillance, and has less immune escape. However, as the pathological progression and solid component increase, negative immune regulation and immune escape increase gradually, and a suppressive immune environment is established gradually. Currently, regular computer tomography monitoring and surgery are the main treatment strategies for persistent GGNs. Stereotactic body radiotherapy and radiofrequency ablation are two local therapeutic alternatives, and systemic therapy has been progressively studied for lung cancer with GGNs. In the present review, we discuss the characterization of the multidimensional molecular evolution of GGNs that could facilitate more precise differentiation of such highly heterogeneous lesions, laying a foundation for the development of more effective individualized treatment plans.
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Affiliation(s)
- Furong Chen
- Department of Oncology, The First People’s Hospital of Shuangliu District/West China (Airport) Hospital, Sichuan University, Chengdu, China
| | - Jiangtao Li
- Department of Oncology, The First People’s Hospital of Shuangliu District/West China (Airport) Hospital, Sichuan University, Chengdu, China
| | - Lei Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China
- Department of State Key Laboratory of Respiratory Health and Multimobidity, West China Hospital, Sichuan University, Chengdu, China
| | - Lunbing Tong
- Department of Respiratory Medicine, Chengdu Seventh People’s Hospital/Affiliated Cancer Hospital of Chengdu Medical College, Chengdu, China
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China
- Department of State Key Laboratory of Respiratory Health and Multimobidity, West China Hospital, Sichuan University, Chengdu, China
| | - Xuelin Zou
- Department of Respiratory Medicine, Chengdu Seventh People’s Hospital/Affiliated Cancer Hospital of Chengdu Medical College, Chengdu, China
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Liu J, Qi L, Xu Q, Chen J, Cui S, Li F, Wang Y, Cheng S, Tan W, Zhou Z, Wang J. A Self-supervised Learning-Based Fine-Grained Classification Model for Distinguishing Malignant From Benign Subcentimeter Solid Pulmonary Nodules. Acad Radiol 2024:S1076-6332(24)00287-3. [PMID: 38777719 DOI: 10.1016/j.acra.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/02/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
RATIONALE AND OBJECTIVES Diagnosing subcentimeter solid pulmonary nodules (SSPNs) remains challenging in clinical practice. Deep learning may perform better than conventional methods in differentiating benign and malignant pulmonary nodules. This study aimed to develop and validate a model for differentiating malignant and benign SSPNs using CT images. MATERIALS AND METHODS This retrospective study included consecutive patients with SSPNs detected between January 2015 and October 2021 as an internal dataset. Malignancy was confirmed pathologically; benignity was confirmed pathologically or via follow-up evaluations. The SSPNs were segmented manually. A self-supervision pre-training-based fine-grained network was developed for predicting SSPN malignancy. The pre-trained model was established using data from the National Lung Screening Trial, Lung Nodule Analysis 2016, and a database of 5478 pulmonary nodules from the previous study, with subsequent fine-tuning using the internal dataset. The model's efficacy was investigated using an external cohort from another center, and its accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were determined. RESULTS Overall, 1276 patients (mean age, 56 ± 10 years; 497 males) with 1389 SSPNs (mean diameter, 7.5 ± 2.0 mm; 625 benign) were enrolled. The internal dataset was specifically enriched for malignancy. The model's performance in the internal testing set (316 SSPNs) was: AUC, 0.964 (95% confidence interval (95%CI): 0.942-0.986); accuracy, 0.934; sensitivity, 0.965; and specificity, 0.908. The model's performance in the external test set (202 SSPNs) was: AUC, 0.945 (95% CI: 0.910-0.979); accuracy, 0.911; sensitivity, 0.977; and specificity, 0.860. CONCLUSION This deep learning model was robust and exhibited good performance in predicting the malignancy of SSPNs, which could help optimize patient management.
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Affiliation(s)
- Jianing Liu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Linlin Qi
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Qian Xu
- Department of Computed Tomography and Magnetic Resonance, The Fourth Hospital of Hebei Medical University, Shijiazhuang, He Bei, China
| | - Jiaqi Chen
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Shulei Cui
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Fenglan Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Yawen Wang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Sainan Cheng
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Weixiong Tan
- Beijing Deepwise & League of PhD Technology Co. Ltd, Beijing, China
| | - Zhen Zhou
- Beijing Deepwise & League of PhD Technology Co. Ltd, Beijing, China
| | - Jianwei Wang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China.
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Wang M, Liu Z, Liu C, He W, Qin D, You M. DNAzyme-based ultrasensitive immunoassay: Recent advances and emerging trends. Biosens Bioelectron 2024; 251:116122. [PMID: 38382271 DOI: 10.1016/j.bios.2024.116122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
Immunoassay, as the most commonly used method for protein detection, is simple to operate and highly specific. Sensitivity improvement is always the thrust of immunoassays, especially for the detection of trace quantities. The emergence of artificial enzyme, i.e., DNAzyme, provides a novel approach to improve the detection sensitivity of immunoassay. Simultaneously, its advantages of simple synthesis and high stability enable low cost, broad applicability and long shelf life for immunoassay. In this review, we summarized the recent advances in DNAzyme-based immunoassay. First, we summarized the existing different DNAzymes based on their catalytic activities. Next, the common signal amplification strategies used for DNAzyme-based immunoassays were reviewed to cater to diverse detection requirements. Following, the wide applications in disease diagnosis, environmental monitoring and food safety were discussed. Finally, the current challenges and perspectives on the future development of DNAzyme-based immunoassays were also provided.
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Affiliation(s)
- Meng Wang
- Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing, 400065, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Zhe Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China; Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China
| | - Chang Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Wanghong He
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China; Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, 100050, PR China
| | - Dui Qin
- Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing, 400065, PR China.
| | - Minli You
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China.
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Meynen J, Adriaensens P, Criel M, Louis E, Vanhove K, Thomeer M, Mesotten L, Derveaux E. Plasma Metabolite Profiling in the Search for Early-Stage Biomarkers for Lung Cancer: Some Important Breakthroughs. Int J Mol Sci 2024; 25:4690. [PMID: 38731909 PMCID: PMC11083579 DOI: 10.3390/ijms25094690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. In order to improve its overall survival, early diagnosis is required. Since current screening methods still face some pitfalls, such as high false positive rates for low-dose computed tomography, researchers are still looking for early biomarkers to complement existing screening techniques in order to provide a safe, faster, and more accurate diagnosis. Biomarkers are biological molecules found in body fluids, such as plasma, that can be used to diagnose a condition or disease. Metabolomics has already been shown to be a powerful tool in the search for cancer biomarkers since cancer cells are characterized by impaired metabolism, resulting in an adapted plasma metabolite profile. The metabolite profile can be determined using nuclear magnetic resonance, or NMR. Although metabolomics and NMR metabolite profiling of blood plasma are still under investigation, there is already evidence for its potential for early-stage lung cancer diagnosis, therapy response, and follow-up monitoring. This review highlights some key breakthroughs in this research field, where the most significant biomarkers will be discussed in relation to their metabolic pathways and in light of the altered cancer metabolism.
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Affiliation(s)
- Jill Meynen
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
| | - Peter Adriaensens
- Applied and Analytical Chemistry, NMR Group, Institute for Materials Research (Imo-Imomec), Hasselt University, Agoralaan 1, B-3590 Diepenbeek, Belgium;
| | - Maarten Criel
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium;
| | - Evelyne Louis
- Department of Respiratory Medicine, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium;
| | - Karolien Vanhove
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Respiratory Medicine, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium;
- Department of Respiratory Medicine, Algemeen Ziekenhuis Vesalius, Hazelereik 51, B-3700 Tongeren, Belgium
| | - Michiel Thomeer
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium;
| | - Liesbet Mesotten
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Nuclear Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium
| | - Elien Derveaux
- Applied and Analytical Chemistry, NMR Group, Institute for Materials Research (Imo-Imomec), Hasselt University, Agoralaan 1, B-3590 Diepenbeek, Belgium;
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Yuan L, An L, Zhu Y, Duan C, Kong W, Jiang P, Yu QQ. Machine Learning in Diagnosis and Prognosis of Lung Cancer by PET-CT. Cancer Manag Res 2024; 16:361-375. [PMID: 38699652 PMCID: PMC11063459 DOI: 10.2147/cmar.s451871] [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: 11/29/2023] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
As a disease with high morbidity and high mortality, lung cancer has seriously harmed people's health. Therefore, early diagnosis and treatment are more important. PET/CT is usually used to obtain the early diagnosis, staging, and curative effect evaluation of tumors, especially lung cancer, due to the heterogeneity of tumors and the differences in artificial image interpretation and other reasons, it also fails to entirely reflect the real situation of tumors. Artificial intelligence (AI) has been applied to all aspects of life. Machine learning (ML) is one of the important ways to realize AI. With the help of the ML method used by PET/CT imaging technology, there are many studies in the diagnosis and treatment of lung cancer. This article summarizes the application progress of ML based on PET/CT in lung cancer, in order to better serve the clinical. In this study, we searched PubMed using machine learning, lung cancer, and PET/CT as keywords to find relevant articles in the past 5 years or more. We found that PET/CT-based ML approaches have achieved significant results in the detection, delineation, classification of pathology, molecular subtyping, staging, and response assessment with survival and prognosis of lung cancer, which can provide clinicians a powerful tool to support and assist in critical daily clinical decisions. However, ML has some shortcomings such as slightly poor repeatability and reliability.
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Affiliation(s)
- Lili Yuan
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Lin An
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Yandong Zhu
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Chongling Duan
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Weixiang Kong
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Pei Jiang
- Translational Pharmaceutical Laboratory, Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
| | - Qing-Qing Yu
- Jining NO.1 People’s Hospital, Shandong First Medical University, Jining, People’s Republic of China
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Cheng YF, Huang JY, Lin CH, Lin SH, Wang BY. The Prognostic Value of Positron Emission Tomography/Computed Tomography in Clinical Stage I Lung Cancer Patients: A Propensity-Match Analysis. J Clin Med 2024; 13:2416. [PMID: 38673689 PMCID: PMC11051513 DOI: 10.3390/jcm13082416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/10/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The application of positron emission tomography/computed tomography (PET/CT) helps provide accurate clinical staging for lung cancer patients. However, the effects and trends in early-stage lung cancer remain unclear. The aim of this study was to compare differences between clinical stage I lung cancer patients who received PET/CT for staging and those who did not. Methods: Data were obtained from the Taiwan Society of Cancer Registry. There were 6587 clinical stage I lung cancer patients between 2009 and 2014 analyzed in this study. We compared the characteristics of the PET/CT and no PET/CT groups. After propensity score matching, it resulted in both groups having 2649 patients. We measured the overall survival rates of all clinical stage I lung cancer patients and the overall survival rates of patients with PET/CT and without PET/CT. Results: The 1-, 3-, and 5-year survival rates of all clinical stage I lung cancer patients were 97.2%, 88.2%, and 79.0%, respectively. Patients with a larger tumor size tended to receive PET/CT for staging (stage Ib: 38.25% vs. 27.82%, p < 0.0001) and a larger resection (lobectomy: 74.62% vs. 66.61%, p < 0.0001). The 5-year survival rates were 79.8% in the PET/CT group and 78.2% in the no PET/CT group after propensity score matching (p = 0.6528). Conclusions: For clinical stage I lung cancer in Taiwan, patients with larger tumor sizes tend to have PET/CT for staging. Although PET/CT provided more precise clinical staging, these patients still received larger resections and had more pathological migration. However, there was no overall survival rate benefit after PET/CT.
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Affiliation(s)
- Ya-Fu Cheng
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Ching-Hsiung Lin
- Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-H.L.)
| | - Sheng-Hao Lin
- Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-H.L.)
| | - Bing-Yen Wang
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua 500, Taiwan;
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Soares BCC, Khine HEE, Sritularak B, Chanvorachote P, Alduina R, Sungthong R, Chaotham C. Cymensifin A: a promising pharmaceutical candidate to defeat lung cancer via cellular reactive oxygen species-mediated apoptosis. Front Pharmacol 2024; 15:1361085. [PMID: 38666017 PMCID: PMC11043475 DOI: 10.3389/fphar.2024.1361085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The upgrade of natural products for cancer treatment is essential since current anticancer drugs still pose severe side effects. Cymensifin A (Cym A) isolated from an orchid Cymbidium ensifolium has shown its potential to induce the death of several cancer cells; however, its underlying molecular mechanisms are hitherto unknown. Methods: Here, we conducted a set of in vitro preliminary tests to assess the cytotoxic effects of Cym A on non-small-cell lung cancer (NSCLC) cells (A549, H23, H292, and H460). A flow cytometry system and Western blot analyses were employed to unveil molecular mechanisms underlying cancer cell apoptosis caused by Cym A. Results: Cym A at 25-50 μM caused the death of all NSCLC cells tested, and its cytotoxicity was comparable to cisplatin, a currently used anticancer drug. The compound induced apoptosis of all NSCLC cells in a dose-dependent manner (5-50 μM), proven by flow cytometry, but H460 cells showed more resistance compared to other cells tested. Cym A-treated H460 cells demonstrated increased reactive oxygen species (ROS) and downregulated antioxidants (catalase, superoxide dismutase, and thioredoxin). The compound also upregulated the tumor suppressor P53 and the pro-apoptotic protein BAX but downregulated pro-survival proteins (BCL-2 and MCL-1) and deactivated survival signals (AKT and ERK) in H460 cells. Cym A was proven to trigger cellular ROS formation, but P53 and BAX were 2-fold more activated by Cym A compared to those treated with hydrogen peroxide. Our findings also supported that Cym A exerted its roles in the downregulation of nuclear factor erythroid 2-related factor 2 (a regulator of cellular antioxidant activity) and the increased levels of cleaved poly (ADP-ribose) polymerase (PARP) and cleaved caspase 3/7 during apoptosis. Conclusion: We propose that Cym A induces lung cancer cell death via ROS-mediated apoptosis, while the modulation of cellular ROS/antioxidant activity, the upregulation of P53 and BAX, the downregulation or deactivation of BCL-2, MCL-1, AKT, and ERK, and the increased cleavage of PARP and caspase 3/7, were the elucidated underlying molecular mechanisms of this phytochemical. The compound can be a promising candidate for future anticancer drug development.
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Affiliation(s)
- Bruno Cesar Costa Soares
- Pharmaceutical Sciences and Technology Program, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Hnin Ei Ei Khine
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Boonchoo Sritularak
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Natural Products for Ageing and Chronic Diseases, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pithi Chanvorachote
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Cancer Cell and Molecular Biology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rosa Alduina
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Rungroch Sungthong
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Chatchai Chaotham
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Cancer Cell and Molecular Biology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
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Markowitz S, Ringen K, Dement JM, Straif K, Christine Oliver L, Algranti E, Nowak D, Ehrlich R, McDiarmid MA, Miller A. Occupational lung cancer screening: A Collegium Ramazzini statement. Am J Ind Med 2024; 67:289-303. [PMID: 38440821 DOI: 10.1002/ajim.23572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Steven Markowitz
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
| | - Knut Ringen
- CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - John M Dement
- Duke University School of Medicine, Division of Occupational & Environmental Medicine, Durham, North Carolina, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Chestnut Hill, Massachusetts, USA
| | - L Christine Oliver
- Dalla Lana School of Public Health, Division of Occupational and Environmental Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU Klinikum, LMU Munich, CPC Munich, Comprehensive Pneumology Center Munich, #DZL, Deutsches Zentrum für Lungenforschung, Munich, Germany
| | - Rodney Ehrlich
- Division of occupational Medicine, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Melissa A McDiarmid
- Division of Occupational & Environmental Medicine, University of Maryland School of Medicine, USA
| | - Albert Miller
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
- Department of Medicine, Mount Sinai School of Medicine, New York, New York State, USA
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20
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Sun H, Zhu R, Guo X, Zhao P, Zhang R, Zhao Z, Zhou H. Exosome miR-101-3p derived from bone marrow mesenchymal stem cells promotes radiotherapy sensitivity in non-small cell lung cancer by regulating DNA damage repair and autophagy levels through EZH2. Pathol Res Pract 2024; 256:155271. [PMID: 38574630 DOI: 10.1016/j.prp.2024.155271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/13/2023] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND OBJECTIVE The morbidity rate of non-small cell lung cancer (NSCLC) increases with age, highlighting that NSCLC is a serious threat to human health. The aim of this study was mainly to describe the role of exosomal miR-101-3p derived from bone marrow mesenchymal stem cells (BMSCs) in NSCLC. METHODS A549 or NCI-H1703 cells (1×105/mouse) were injected into nude mice to establish an NSCLC animal model. RTqPCR, Western blotting and comet assays were used to assess the changes in gene expression, proteins and DNA damage repair. RESULTS miR-101-3p and RAI2 were found to be expressed at low levels in NSCLC, while EZH2 was highly expressed. In terms of function, miR-101-3p downregulated EZH2. In addition, exosomal miR-101-3p derived from BMSCs promoted the expression of RAI2, inhibited DNA damage repair, and inhibited the activation of the PI3K/AKT/mTOR signaling pathway by inhibiting EZH2, thereby promoting autophagy and decreasing cell viability and finally enhancing the sensitivity of NSCLC to radiotherapy and inhibiting the malignant biological behavior of NSCLC. CONCLUSION Exosomal miR-101-3p derived from BMSCs can inhibit DNA damage repair, promote autophagy, enhance the radiosensitivity of NSCLC, and inhibit the progression of NSCLC by inhibiting EZH2.
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Affiliation(s)
- Hongwen Sun
- Department of Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Runying Zhu
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Xijing Guo
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Peizhu Zhao
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Rui Zhang
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Zhongquan Zhao
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Hua Zhou
- Department of Oncology Radiotherapy, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
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21
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Poghosyan H, Richman I, Sarkar S, Presley CJ. Lung cancer screening use among screening-eligible adults with disabilities. J Am Geriatr Soc 2024; 72:1155-1165. [PMID: 38357789 PMCID: PMC11018473 DOI: 10.1111/jgs.18795] [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: 05/31/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Lung cancer screening (LCS) use among adults with disabilities has not been well characterized. We estimated the prevalence of LCS use by disability types and counts and investigated the association between disability counts and LCS utilization among LCS-eligible adults. METHODS We used cross-sectional data from the 2019 Behavioral Risk Factor Surveillance System, Lung Cancer Screening Module. Based on the 2013 US Preventive Services Task Force criteria for LCS, the sample included 4407 LCS-eligible adults, aged 55-79 years, with current or former (quit smoking in the past 15 years) tobacco use history of at least 30 pack-years. Disability types included limitations in hearing, vision, cognition, mobility, self-care, and independent living. We also categorized respondents by number of disabilities (no disability, 1 disability, 2 disabilities, 3+ disabilities). We utilized descriptive statistics and multivariable logistic regression analyses to determine the association between disability counts and the receipt of LCS (yes/no) in the past 12 months. RESULTS In 2019, 16.4% of LCS-eligible adults were screened for lung cancer. Overall, 49.6% of participants had no disability, and 14.5% had >3 disabilities. Mobility was the most prevalent disability type (35.4%), followed by cognitive impairment (18.2%) and hearing (16.6%). LCS was more prevalent in adults with disability in self-care versus no disability in self-care (24.0% vs. 15.5%, p = 0.01), disability in independent living versus no disability in independent living (22.2% vs. 15.4%, p = 0.02), and cognitive impairment disability versus no cognitive impairment (22.1% vs. 15.3%, p = 0.03). The prevalence rates of LCS among groups of LCS-eligible adults with different disability counts were not significant (p = 0.17). CONCLUSIONS Despite the lack of clinical guidelines on LCS among individuals with disabilities, some individuals with disabilities are being screened for lung cancer. Future research should address this knowledge gap to determine clinical benefit versus harm of LCS among those with disabilities.
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Affiliation(s)
- Hermine Poghosyan
- Yale School of Nursing, New Haven, Connecticut, USA
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ilana Richman
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Carolyn J. Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
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22
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Allehebi A, Al-Omair A, Mahboub B, Koegelenberg CF, Mokhtar M, Madkour AM, Al-Asad K, Selek U, Al-Shamsi HO. Recommended approaches for screening and early detection of lung cancer in the Middle East and Africa (MEA) region: a consensus statement. J Thorac Dis 2024; 16:2142-2158. [PMID: 38617789 PMCID: PMC11009596 DOI: 10.21037/jtd-23-1568] [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: 10/09/2023] [Accepted: 01/19/2024] [Indexed: 04/16/2024]
Abstract
Background The prevalence of lung cancer in the Middle East and Africa (MEA) region has steadily increased in recent years and is generally associated with a poor prognosis due to the late detection of most of the cases. We explored the factors leading to delayed diagnoses, as well as the challenges and gaps in the early screening, detection, and referral framework for lung cancer in the MEA. Methods A steering committee meeting was convened in October 2022, attended by a panel of ten key external experts in the field of oncology from the Kingdom of Saudi Arabia, United Arab Emirates, South Africa, Egypt, Lebanon, Jordan, and Turkey, who critically and extensively analyzed the current unmet needs and challenges in the screening and early diagnosis of lung cancer in the region. Results As per the experts' opinion, lack of awareness about disease symptoms, misdiagnosis, limited screening initiatives, and late referral to specialists were the primary reasons for delayed diagnoses emphasizing the need for national-level lung cancer screening programs in the MEA region. Screening guidelines recommend low-dose computerized tomography (LDCT) for lung cancer screening in patients with a high risk of malignancy. However, high cost and lack of awareness among the public as well as healthcare providers prevented the judicious use of LDCT in the MEA region. Well-established screening and referral guidelines were available in only a few of the MEA countries and needed to be implemented in others to identify suspected cases early and provide timely intervention thus improving patient outcomes. Conclusions There is a great need for large-scale screening programs, preferably integrated with tobacco-control programs and awareness programs for physicians and patients, which may facilitate higher adherence to lung cancer screening and improve survival outcomes.
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Affiliation(s)
- Ahmed Allehebi
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Jeddah, Kingdom of Saudi Arabia
| | - Ameen Al-Omair
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Bassam Mahboub
- Department of Pulmonary Medicine, Dubai Health Authority Hospital, Dubai, United Arab Emirates
| | | | - Mohsen Mokhtar
- Al-Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Ugur Selek
- Koc University School of Medicine, Istanbul, Turkey
| | - Humaid O. Al-Shamsi
- Department of Oncology, Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi, United Arab Emirates
- Emirates Oncology Society, Dubai, United Arab Emirates
- Gulf Medical University, Ajman, United Arab Emirates
- Gulf Cancer Society, Alsafa, Kuwait
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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23
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Yang J, Yu J, Wang Y, Liao M, Ji Y, Li X, Wang X, Chen J, Qi B, Yang F. Development of hypertension models for lung cancer screening cohorts using clinical and thoracic aorta imaging factors. Sci Rep 2024; 14:6862. [PMID: 38514739 PMCID: PMC10957886 DOI: 10.1038/s41598-024-57396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
This study aims to develop and validate nomogram models utilizing clinical and thoracic aorta imaging factors to assess the risk of hypertension for lung cancer screening cohorts. We included 804 patients and collected baseline clinical data, biochemical indicators, coexisting conditions, and thoracic aorta factors. Patients were randomly divided into a training set (70%) and a validation set (30%). In the training set, variance, t-test/Mann-Whitney U-test and standard least absolute shrinkage and selection operator were used to select thoracic aorta imaging features for constructing the AIScore. Multivariate logistic backward stepwise regression was utilized to analyze the influencing factors of hypertension. Five prediction models (named AIMeasure model, BasicClinical model, TotalClinical model, AIBasicClinical model, AITotalClinical model) were constructed for practical clinical use, tailored to different data scenarios. Additionally, the performance of the models was evaluated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA). The areas under the ROC curve for the five models were 0.73, 0.77, 0.83, 0.78, 0.84 in the training set, and 0.77, 0.78, 0.81, 0.78, 0.82 in the validation set, respectively. Furthermore, the calibration curves and DCAs of both sets performed well on accuracy and clinical practicality. The nomogram models for hypertension risk prediction demonstrate good predictive capability and clinical utility. These models can serve as effective tools for assessing hypertension risk, enabling timely non-pharmacological interventions to preempt or delay the future onset of hypertension.
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Affiliation(s)
- Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Yu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaoling Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Man Liao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Ji
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Li
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Xuechun Wang
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Jun Chen
- Precision Healthcare Institute, GE Healthcare, Shanghai, China
| | - Benling Qi
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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24
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Zhang Y, Xiao L, LYu L, Zhang L. Construction of a predictive model for bone metastasis from first primary lung adenocarcinoma within 3 cm based on machine learning algorithm: a retrospective study. PeerJ 2024; 12:e17098. [PMID: 38495760 PMCID: PMC10944632 DOI: 10.7717/peerj.17098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Background Adenocarcinoma, the most prevalent histological subtype of non-small cell lung cancer, is associated with a significantly higher likelihood of bone metastasis compared to other subtypes. The presence of bone metastasis has a profound adverse impact on patient prognosis. However, to date, there is a lack of accurate bone metastasis prediction models. As a result, this study aims to employ machine learning algorithms for predicting the risk of bone metastasis in patients. Method We collected a dataset comprising 19,454 cases of solitary, primary lung adenocarcinoma with pulmonary nodules measuring less than 3 cm. These cases were diagnosed between 2010 and 2015 and were sourced from the Surveillance, Epidemiology, and End Results (SEER) database. Utilizing clinical feature indicators, we developed predictive models using seven machine learning algorithms, namely extreme gradient boosting (XGBoost), logistic regression (LR), light gradient boosting machine (LightGBM), Adaptive Boosting (AdaBoost), Gaussian Naive Bayes (GNB), multilayer perceptron (MLP) and support vector machine (SVM). Results The results demonstrated that XGBoost exhibited superior performance among the four algorithms (training set: AUC: 0.913; test set: AUC: 0.853). Furthermore, for convenient application, we created an online scoring system accessible at the following URL: https://www.xsmartanalysis.com/model/predict/?mid=731symbol=7Fr16wX56AR9Mk233917, which is based on the highest performing model. Conclusion XGBoost proves to be an effective algorithm for predicting the occurrence of bone metastasis in patients with solitary, primary lung adenocarcinoma featuring pulmonary nodules below 3 cm in size. Moreover, its robust clinical applicability enhances its potential utility.
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Affiliation(s)
- Yu Zhang
- Department of Thoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lixia Xiao
- Department of Thoracic Surgery, Feicheng Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Lan LYu
- Department of Plastic Surgery, Feicheng Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China
| | - Liwei Zhang
- Department of Thoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Kearney L, Bolton RE, Núñez ER, Boudreau JH, Sliwinski S, Herbst AN, Caverly TJ, Wiener RS. Tackling Guideline Non-concordance: Primary Care Barriers to Incorporating Life Expectancy into Lung Cancer Screening Decision-Making-A Qualitative Study. J Gen Intern Med 2024:10.1007/s11606-024-08705-x. [PMID: 38459413 DOI: 10.1007/s11606-024-08705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Primary care providers (PCPs) are often the first point of contact for discussing lung cancer screening (LCS) with patients. While guidelines recommend against screening people with limited life expectancy (LLE) who are less likely to benefit, these patients are regularly referred for LCS. OBJECTIVE We sought to understand barriers PCPs face to incorporating life expectancy into LCS decision-making for patients who otherwise meet eligibility criteria, and how a hypothetical point-of-care tool could support patient selection. DESIGN Qualitative study based on semi-structured telephone interviews. PARTICIPANTS Thirty-one PCPs who refer patients for LCS, from six Veterans Health Administration facilities. APPROACH We thematically analyzed interviews to understand how PCPs incorporated life expectancy into LCS decision-making and PCPs' receptivity to a point-of-care tool to support patient selection. Final themes were organized according to the Cabana et al. framework Why Don't Physicians Follow Clinical Practice Guidelines, capturing the influence of clinician knowledge, attitudes, and behavior on LCS appropriateness determinations. KEY RESULTS PCP referrals to LCS for patients with LLE were influenced by limited knowledge of the life expectancy threshold at which patients are less likely to benefit from LCS, discomfort estimating life expectancy, fear of missing cancer at the point of early detection, and prioritization of factors such as quality of life, patient values, clinician-patient relationship, and family support. PCPs were receptive to a decision support tool to inform and communicate LCS appropriateness decisions if easy to use and integrated into clinical workflows. CONCLUSIONS Our study suggests knowledge gaps and attitudes may drive decisions to offer screening despite LLE, a behavior counter to guideline recommendations. Integrating a LCS decision support tool that incorporates life expectancy within the electronic medical record and existing clinical workflows may be one acceptable solution to improve guideline concordance and increase confidence in selecting high benefit patients for LCS.
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Affiliation(s)
- Lauren Kearney
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA.
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.
| | - Rendelle E Bolton
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Eduardo R Núñez
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA
| | - Jacqueline H Boudreau
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Samantha Sliwinski
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Abigail N Herbst
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Tanner J Caverly
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC, USA
- University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Renda Soylemez Wiener
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC, USA
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Ren Y, Zhang Z, She Y, He Y, Li D, Shi Y, He C, Yang Y, Zhang W, Chen C. A Highly Sensitive and Specific Non-Invasive Test through Genome-Wide 5-Hydroxymethylation Mapping for Early Detection of Lung Cancer. SMALL METHODS 2024; 8:e2300747. [PMID: 37990399 DOI: 10.1002/smtd.202300747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/04/2023] [Indexed: 11/23/2023]
Abstract
Low-dose computed tomography screening can increase the detection for non-small-cell lung cancer (NSCLC). To improve the diagnostic accuracy of early-stage NSCLC detection, ultrasensitive methods are used to detect cell-free DNA (cfDNA) 5-hydroxymethylcytosine (5hmC) in plasma. Genome-wide 5hmC is profiled in 1990 cfDNA samples collected from patients with non-small cell lung cancer (NSCLC, n = 727), healthy controls (HEA, n = 1,092), as well as patients with small cell lung cancer (SCLC, n = 41), followed by sample randomization, differential analysis, feature selection, and modeling using a machine learning approach. Differentially modified features reflecting tissue origin. A weighted diagnostic model comprised of 105 features is developed to compute a detection score for each individual, which showed an area under the curve (AUC) range of 86.4%-93.1% in the internal and external validation sets for distinguishing lung cancer from HEA controls, significantly outperforming serum biomarkers (p < 0.001). The 5hmC-based model detected high-risk pulmonary nodules (AUC: 82%)and lung cancer of different subtypes with high accuracy as well. A highly sensitive and specific blood-based test is developed for detecting lung cancer. The 5hmC biomarkers in cfDNA offer a promising blood-based test for lung cancer.
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Affiliation(s)
- Yijiu Ren
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Zhou Zhang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Yunlang She
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Yayi He
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dongdong Li
- Shanghai Epican Genetech, Co., Ltd., Shanghai, China
| | - Yixiang Shi
- Bionova (Shanghai) Medical Technology Co., Ltd, Shanghai, China
| | - Chuan He
- Department of Chemistry, The University of Chicago, Chicago, IL, 60637, USA
- The Howard Hughes Medical Institute, The University of Chicago, Chicago, IL, 60637, USA
| | - Yang Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Wei Zhang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Chang Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
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Ringen K, Dement J, Cloeren M, Almashat S, Hines S, Grier W, Quinn P, Chen A, Haas S. Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow-up through 2021. Am J Ind Med 2024; 67:261-273. [PMID: 38273456 DOI: 10.1002/ajim.23567] [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: 10/09/2023] [Revised: 12/07/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). METHODS The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). RESULTS Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. CONCLUSIONS Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. The high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.
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Affiliation(s)
- Knut Ringen
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Sammy Almashat
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - William Grier
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Patricia Quinn
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - Anna Chen
- Zenith American Solutions, Tampa, Florida, USA
| | - Scott Haas
- Zenith American Solutions, Tampa, Florida, USA
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Zhang T, Mao Z, Li W, Ma M, Li G, Qiao X, Wang H. Knowledge, attitude, and practice of lung cancer screening and associated factors among high-risk population in Lanzhou, China: A cross-sectional study. Medicine (Baltimore) 2024; 103:e37431. [PMID: 38428855 PMCID: PMC10906634 DOI: 10.1097/md.0000000000037431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/08/2024] [Indexed: 03/03/2024] Open
Abstract
This study aimed to assess the knowledge, attitude, and practice (KAP) of high-risk populations toward lung cancer screening in Lanzhou, China. Using convenience sampling, this cross-sectional study enrolled outpatients at high-risk for lung cancer at Lanzhou University Second Hospital between November 2022 and March 2023. An anonymous, self-administered online questionnaire was distributed to each participant via the Sojump website (https://www.wjx.cn/), comprising 40 items to collect demographic information and evaluate KAP toward lung cancer screening. The analyses were descriptive. A total of 577 participants (average age of 61.8 ± 7.1 years; 306 males) were included in the study. The participants' scores for KAP were 4.9 ± 2.2, 27.4 ± 3.0, and 7.0 ± 2.1, respectively. Participants with occupational exposure had significantly lower knowledge score (3.3 ± 2.4 vs 5.2 ± 2.1, P < .001), and practice score (5.6 ± 2.4 vs 7.3 ± 1.9, P < .001) than those without occupational exposure. Participants with smoking or passive smoking history had significantly higher attitude scores (27.6 ± 2.9 vs 25.8 ± 3.2, P < .001) and practice scores (7.1 ± 2.0 vs 6.5 ± 2.5, P = .014) than those without smoking history. A total of 360 (62.4%) participants endorsed the doctors' counseling on lung cancer screening, and 355 (61.5%) participants were willing to have screening for lung cancer as doctors advised. The study revealed that 390 (67.6%) participants identified low-dose computed tomography as the appropriate method for lung cancer screening, while 356 (61.7%) participants believed that X-rays were a reliable screening method for lung cancer. However, 365 (63.3%) participants thought that the treatment outcomes for early and late-diagnosed lung cancer were the same. Additionally, 416 (72.10%) participants believed that annual lung cancer CT scanning is unnecessary. On the other hand, 339 (58.8%) participants expressed concerns about exposure to radiation from CT scans, while 349 (60.5%) participants were worried about the cost of lung cancer screening. Only 142 (24.6%) participants reported having undergone annual lung cancer screening. The high-risk population had limited knowledge and insufficient attitude and practice toward lung cancer screening in Lanzhou, China.
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Affiliation(s)
- Tianming Zhang
- Department of Respiratory Medicine, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Zhiqing Mao
- The Second Clinical Medical School, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Wenjun Li
- Department of Respiratory Medicine, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Minghui Ma
- The Second Clinical Medical School, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Guangyan Li
- The Second Clinical Medical School, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Xiaozhong Qiao
- The Second Clinical Medical School, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Hong Wang
- Department of Respiratory Medicine, Lanzhou University Second Hospital, Lanzhou 730030, China
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Ando W, Sogabe M, Ishikawa S, Uematsu T, Furuya H, Yokomori H, Kohgo Y, Otori K, Nakano T, Endo S, Tsubochi H, Okazaki I. Matrix metalloproteinase‑1 and microRNA‑486‑5p in urinary exosomes can be used to detect early lung cancer: A preliminary report. Oncol Lett 2024; 27:127. [PMID: 38333640 PMCID: PMC10851336 DOI: 10.3892/ol.2024.14261] [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: 03/01/2023] [Accepted: 12/21/2023] [Indexed: 02/10/2024] Open
Abstract
The present study describes a novel molecular-genetic method suitable for lung cancer (LC) screening in the work-place and at community health centers. Using urinary-isolated exosomes from 35 patients with LC and 40 healthy volunteers, the expression ratio of MMP-1/CD63, and the relative expression levels of both microRNA (miRNA)-21 and miRNA-486-5p were measured. MMP-1/CD63 expression ratio was significantly higher in patients with LC than in the healthy controls {1.342 [95% confidence interval (CI): 0.890-1.974] vs. 0.600 (0.490-0.900); P<0.0001}. The relative expression of miRNA-486-5p in male healthy controls was significantly different from that in female healthy controls, whereas there was no significant difference in miRNA-21. Receiver operating characteristic curve (ROC) analysis of MMP-1/CD63 showed 92.5% sensitivity and 54.3% specificity, whereas miRNA-486-5p showed 85% sensitivity and 70.8% specificity for men, and 70.0% sensitivity and 72.7% specificity for women. The logistic regression model used to evaluate the association of LC with the combination of MMP-1/CD63 and miRNA-486-5p revealed that the area under the ROC curve was 0.954 (95% CI: 0.908-1.000), and the model had 89% sensitivity and 88% specificity after adjusting for age, sex and smoking status. These data suggested that the combined analysis of MMP-1/CD63 and miRNA-486-5p in urinary exosomes may be used to detect patients with early-stage LC in the work-place and at community health centers, although confirmational studies are warranted.
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Affiliation(s)
- Wataru Ando
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Tokyo 108-8641, Japan
| | - Masaya Sogabe
- Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Saitama 330-0834, Japan
- Center for Respiratory Diseases, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
- Department of Chest Surgery, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
| | - Shigemi Ishikawa
- Center for Respiratory Diseases, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
- Department of Chest Surgery, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
| | - Takayuki Uematsu
- Biomedical Laboratory, Division of Biomedical Research, Kitasato University Medical Center, Kitamoto, Saitama 364-8501, Japan
| | - Hiroyuki Furuya
- Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
| | - Hiroaki Yokomori
- Department of Internal Medicine, Kitasato University Medical Center, Kitamoto, Saitama 364-8501, Japan
| | - Yutaka Kohgo
- Department of Internal Medicine, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
- Department of Preventive Medicine, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
| | - Katsuya Otori
- Research and Education Center for Clinical Pharmacy, Division of Clinical Pharmacy, Laboratory of Pharmacy Practice and Science 1, Kitasato University School of Pharmacy, Sagamihara, Kanagawa 252-0375, Japan
| | - Tomoyuki Nakano
- Center for Respiratory Diseases, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
- Department of Chest Surgery, International University of Health and Welfare Hospital, Nasu-Shiobara, Tochigi 329-2763, Japan
| | - Shunsuke Endo
- Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Saitama 330-0834, Japan
| | - Hiroyoshi Tsubochi
- Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan
| | - Isao Okazaki
- Department of Health and Welfare, Higashi Nippon International University, Iwaki, Fukushima 970-8023, Japan
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Bao T, Liu B, Li R, Li Z, Ji G, Wang Y, Yang H, Li W, Huang W, Huang Y, Tang H. LDCT screening results among eligible and ineligible screening candidates in preventive health check-ups population: a real world study in West China. Sci Rep 2024; 14:4848. [PMID: 38418532 PMCID: PMC10902338 DOI: 10.1038/s41598-024-55475-x] [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: 09/05/2023] [Accepted: 02/23/2024] [Indexed: 03/01/2024] Open
Abstract
To compare the LDCT screening results between eligible and ineligible screening candidates in preventive health check-ups population. Using a real-world LDCT screening results among people who took yearly health check-up in health management center of West China Hospital between 2006 and 2017. Objects were classified according to the China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version) eligibility criteria. Descriptive analysis were performed between eligible and ineligible screening candidates. The proportion of ineligible screening candidates was 64.13% (10,259), and among them there were 4005 (39.04%) subjects with positive screenings, 80 cases had a surgical lung biopsy. Pathology results from lung biopsy revealed 154 cancers (true-positive) and 26 benign results (false-positive), the surgical false-positive biopsy rate was 4.17%, and ineligible group (7.69%) was higher than eligible group (2.47%), P < 0.05. Further, in ineligible screening candidates, the proportion of current smokers was higher among males compared to females (53.85% vs. 4.88%, P < 0.05). Of the 69 lung cancer patients detected in ineligible screening candidates, lung adenocarcinoma accounts for a high proportion of lung cancers both in male (75.00%) and female (85.00%). The proportion of ineligible screening candidates and the surgical false-positive biopsy rate in ineligible candidates were both high in health check-ups population.
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Affiliation(s)
- Ting Bao
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- Translational Informatics Center, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610212, China
| | - Bingqing Liu
- West China School of Public Health, Department of Epidemiology and Health Statistics, Sichuan University, Chengdu, 610041, China
| | - Ruicen Li
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zhenzhen Li
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Guiyi Ji
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Youjuan Wang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hanwei Yang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Weimin Li
- Department of Pulmonary and Critical Care Medicine, Sichuan University West China Hospital, Chengdu, 610041, China
| | - Wenxia Huang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yan Huang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Huairong Tang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Han B, Qin Z, Chen P, Yuan L, Diao M. Lateral Dorsal Basal Lung Resection Based on Functional Preserving Sublobectomy Method: Single-Center Experience. Ann Thorac Cardiovasc Surg 2024; 30:n/a. [PMID: 37730311 PMCID: PMC10902666 DOI: 10.5761/atcs.oa.23-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
PURPOSE Functional preserving sublobectomy (FPSL), a novel balancing strategy for segmentectomy and wedge resection, allows rapid and accurate removal of invisible nodules without the use of any preoperative localization markers. This study aimed to share single-center experience of lateral dorsal basal lung resection based on FPSL, so as to provide new surgical options for thoracic surgeons. METHODS A retrospective analysis was performed on 13 patients who underwent thoracoscopic basal lung resection after FPSL at XX hospital from January 2021 to August 2022. RESULTS The operation was successfully performed in 13 patients by using FPSL, including 12 patients with malignant tumors. The mean operating time was 107.5 ± 25.6 min. The mean postoperative hospital stay was 3.7 ± 2.4 days. None of the patients needed extended excision, such as an entire basal or inferior lobectomy. CONCLUSION Our single-center experience showed that the FPSL method only dealt with the target vessels, which greatly reduced the technical difficulty of surgery. In addition, both arteries and veins could be used as target vessels, and in particular cases such as undeveloped interlobar fissure, the operation could still be completed successfully. Lateral dorsal basal lung resection based on FPSL may be a new surgical option for surgeons.
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Affiliation(s)
- Bing Han
- Department of Cardio-Thoracic Surgery, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Zheng Qin
- Department of Cardio-Thoracic Surgery, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Peirui Chen
- Department of Cardio-Thoracic Surgery, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Liqiang Yuan
- Department of Cardio-Thoracic Surgery, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Mingqiang Diao
- Department of Cardio-Thoracic Surgery, People's Hospital of Deyang City, Deyang, Sichuan, China
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Li J, Wang Y, Liu Y, Liu Q, Shen H, Ren X, Du J. Survival analysis and clinicopathological features of patients with stage IA lung adenocarcinoma. Heliyon 2024; 10:e23205. [PMID: 38169765 PMCID: PMC10758825 DOI: 10.1016/j.heliyon.2023.e23205] [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: 07/25/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
Background With the development of medical technology and change of life habits, early-stage lung adenocarcinoma (LUAD) has become more common. This study aimed to systematically analyzed clinicopathological factors associated to the overall survival (OS) of patients with Stage IA LUAD. Methods A total of 5942 Stage IA LUAD patients were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier methods and log-rank tests were used to compare the differences in OS. A nomogram constructed based on the Cox regression was evaluated by Concordance index (C index), calibration curve, decision curve analysis (DCA) and area under curve (AUC). And 136 patients were recruited from Shandong Province Hospital for external validation. Results Cox analysis regression indicated that 12 factors, such as Diagnosis to Treatment Interval (DTI) and Income Level, were independent prognostic factors and were included to establish the nomogram. The C-index of our novel model was 0.702, 0.724 and 0.872 in the training, internal and external validation cohorts, respectively. The 3-year and 5-year survival AUCs and calibration curves showed excellent agreement in each cohort. Some new factors in the SEER database, including DTI and Income Level, were firstly confirmed as independent prognostic factors of Stage IA LUAD patients. The distribution of these factors in the T1a, T1b, and T1c subgroups differed and had different effects on survival. Conclusion We summarized 12 factors that affect prognosis and constructed a nomogram to predict OS of Stage IA LUAD patients who underwent operation. For the first time, new SEER database parameters, including DTI and Income Level, were proved to be survival-related.
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Affiliation(s)
- Jiahao Li
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Yadong Wang
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Yong Liu
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Qiang Liu
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Hongchang Shen
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Xiaoyang Ren
- Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Jiajun Du
- Institute of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, PR China
- Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, Jinan, PR China
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Núñez ER, Zhang S, Glickman ME, Qian SX, Boudreau JH, Lindenauer PK, Slatore CG, Miller DR, Caverly TJ, Wiener RS. What Goes into Patient Selection for Lung Cancer Screening? Factors Associated with Clinician Judgments of Suitability for Screening. Am J Respir Crit Care Med 2024; 209:197-205. [PMID: 37819144 PMCID: PMC10806423 DOI: 10.1164/rccm.202301-0155oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 10/11/2023] [Indexed: 10/13/2023] Open
Abstract
Rationale: Achieving the net benefit of lung cancer screening (LCS) depends on optimizing patient selection. Objective: To identify factors associated with clinician assessments that a patient was unlikely to benefit from LCS ("LCS-inappropriate") because of comorbidities or limited life expectancy. Methods: Retrospective analysis of patients assessed for LCS at 30 Veterans Health Administration facilities from January 1, 2015 to February 1, 2021. We conducted hierarchical mixed-effects logistic regression analyses to determine factors associated with clinicians' designations of LCS inappropriateness (primary outcome), accounting for 3-year predicted probability (i.e., competing risk) of non-lung cancer death. Measurements and Main Results: Among 38,487 LCS-eligible patients, 1,671 (4.3%) were deemed LCS-inappropriate by clinicians, whereas 4,383 (11.4%) had an estimated 3-year competing risk of non-lung cancer death greater than 20%. Patients with higher competing risks of non-lung cancer death were more likely to be deemed LCS-inappropriate (odds ratio [OR], 2.66; 95% confidence interval [CI], 2.32-3.05). Older patients (ages 75-80; OR, 1.45; 95% CI, 1.18-1.78) and those with interstitial lung disease (OR, 1.98; 95% CI, 1.51-2.59) were more likely to be deemed LCS-inappropriate than would be explained by competing risk of non-lung cancer death, whereas patients currently smoking (OR, 0.65; 95% CI, 0.58-0.73) were less likely to be deemed LCS-inappropriate, suggesting that clinicians over- or underweighted these factors. The probability of being deemed LCS-inappropriate varied from 0.4% to 74%, depending on the clinician making the assessment (median OR, 3.07; 95% CI, 2.89-3.25). Conclusion: Concerningly, the likelihood that a patient is deemed LCS-inappropriate is more strongly associated with the clinician making the assessment than with patient characteristics. Patient selection may be optimized by providing decision support to help clinicians assess net LCS benefit.
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Affiliation(s)
- Eduardo R. Núñez
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
- The Pulmonary Center, School of Medicine, Boston University, Boston, Massachusetts
- Department of Healthcare Delivery and Population Sciences, Chan Medical School-Baystate, University of Massachusetts, Springfield, Massachusetts
| | - Sanqian Zhang
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
- Department of Statistics, Harvard University, Cambridge, Massachusetts
| | - Mark E. Glickman
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
- Department of Statistics, Harvard University, Cambridge, Massachusetts
| | - Shirley X. Qian
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
| | - Jacqueline H. Boudreau
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
| | - Peter K. Lindenauer
- Department of Healthcare Delivery and Population Sciences, Chan Medical School-Baystate, University of Massachusetts, Springfield, Massachusetts
| | - Christopher G. Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland Oregon
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon
| | - Donald R. Miller
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
- Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
| | - Tanner J. Caverly
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and
- School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Renda Soylemez Wiener
- Center for Healthcare Organization and Implementation Research, VA Boston and Bedford Healthcare Systems, Boston, Massachusetts
- VA Bedford Healthcare System, Bedford, Massachusetts
- The Pulmonary Center, School of Medicine, Boston University, Boston, Massachusetts
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC
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Tong X, Wang S, Zhang J, Fan Y, Liu Y, Wei W. Automatic Osteoporosis Screening System Using Radiomics and Deep Learning from Low-Dose Chest CT Images. Bioengineering (Basel) 2024; 11:50. [PMID: 38247927 PMCID: PMC10813496 DOI: 10.3390/bioengineering11010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE Develop two fully automatic osteoporosis screening systems using deep learning (DL) and radiomics (Rad) techniques based on low-dose chest CT (LDCT) images and evaluate their diagnostic effectiveness. METHODS In total, 434 patients who underwent LDCT and bone mineral density (BMD) examination were retrospectively enrolled and divided into the development set (n = 333) and temporal validation set (n = 101). An automatic thoracic vertebra cancellous bone (TVCB) segmentation model was developed. The Dice similarity coefficient (DSC) was used to evaluate the segmentation performance. Furthermore, the three-class Rad and DL models were developed to distinguish osteoporosis, osteopenia, and normal bone mass. The diagnostic performance of these models was evaluated using the receiver operating characteristic (ROC) curve and decision curve analysis (DCA). RESULTS The automatic segmentation model achieved excellent segmentation performance, with a mean DSC of 0.96 ± 0.02 in the temporal validation set. The Rad model was used to identify osteoporosis, osteopenia, and normal BMD in the temporal validation set, with respective area under the receiver operating characteristic curve (AUC) values of 0.943, 0.801, and 0.932. The DL model achieved higher AUC values of 0.983, 0.906, and 0.969 for the same categories in the same validation set. The Delong test affirmed that both models performed similarly in BMD assessment. However, the accuracy of the DL model is 81.2%, which is better than the 73.3% accuracy of the Rad model in the temporal validation set. Additionally, DCA indicated that the DL model provided a greater net benefit compared to the Rad model across the majority of the reasonable threshold probabilities Conclusions: The automated segmentation framework we developed can accurately segment cancellous bone on low-dose chest CT images. These predictive models, which are based on deep learning and radiomics, provided comparable diagnostic performance in automatic BMD assessment. Nevertheless, it is important to highlight that the DL model demonstrates higher accuracy and precision than the Rad model.
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Affiliation(s)
| | | | | | | | | | - Wei Wei
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116014, China (S.W.); (Y.F.)
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Huang C, Tong H. Two-stage minimally invasive pulmonary resections with intraoperative localization technique for bilateral multiple primary lung cancers: A case report. Thorac Cancer 2024; 15:192-197. [PMID: 38018514 PMCID: PMC10788464 DOI: 10.1111/1759-7714.15183] [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: 10/15/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
Multiple primary lung cancers (MPLCs) are becoming more and more common and these patients can benefit from minimally invasive surgery. Here, we report a case of a patient diagnosed with synchronous MPLCs who underwent bilateral thoracoscopic pulmonary resections in a two-stage strategy, and achieved a good surgical outcome and high quality of life. A 66-year-old female was found to have one major ground-glass nodule (GGN) in the right upper lobe and eight minor GGNs in the left upper and lower lobes. The patient underwent right upper lobe resection and systematic mediastinal lymph node dissection via single-utility port thoracoscopic surgery in September 2018. Pathology was lepidic predominant adenocarcinoma pT1bN0M0, IA2. Regular high-resolution computed tomography examination during 36 months after right upper lobectomy showed gradually increasing diameter and solid component of multiple GGNs in left lung. The patient underwent thoracoscopic multiple pulmonary resections using an intraoperative localization technique in a hybrid operating room in October 2021 and all eight nodules in the left lung were resected. Two segmentectomies and four wedge resections were performed, and the pathological results of the eight nodules included four adenocarcinomas, three adenocarcinomas in situ, and one alveolar epithelial hyperplasia. The two operations were successful with no intra- or postoperative 90-day complications. During more than 20 months of follow-up after the second operation, the patient had well recovered pulmonary function and physical status with a Karnofsky performance status score of 90 and no local recurrence or metastasis. A two-stage surgical strategy for synchronous MPLCs is therefore feasible. The surgical strategy, timing of intervention, and extent of pulmonary resection should be individually designed according to the location and characteristics of each nodule. Intraoperative localization of small GGNs is very important to ensure that all nodules are completely and accurately resected during the operation.
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Affiliation(s)
- Chuan Huang
- Department of Thoracic Surgery, Beijing Hospital, National Center of GerontologyInstitute of Geriatric Medicine, Chinese Academy of Medical SciencesBeijingChina
| | - Hong‐Feng Tong
- Department of Thoracic Surgery, Beijing Hospital, National Center of GerontologyInstitute of Geriatric Medicine, Chinese Academy of Medical SciencesBeijingChina
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Cho MK, Cho YH. Factors influencing the intention for lung cancer screening in high-risk populations for lung cancer. Asia Pac J Oncol Nurs 2024; 11:100332. [PMID: 38192279 PMCID: PMC10772583 DOI: 10.1016/j.apjon.2023.100332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/29/2023] [Indexed: 01/10/2024] Open
Abstract
Objective Utilizing low-dose computed tomography for lung cancer screening has proven effective in reducing lung cancer mortality among high-risk individuals. This study aimed to investigate the health beliefs, knowledge of lung cancer, and cancer prevention behaviors in adults at high risk for lung cancer, with the goal of identifying predictors influencing their intention to undergo lung cancer screening. Methods The study utilized a descriptive cross-sectional design. Online questionnaires, including assessments of lung cancer screening health beliefs, knowledge of lung cancer, cancer prevention behaviors, intention to undergo lung cancer screening, and participant characteristics, were distributed to 186 individuals at high risk of lung cancer through a survey link. The data collection period spanned from April 26 to May 3, 2023. Analytical procedures encompassed descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlations, and hierarchical multiple regression. Results The mean score for the intention to undergo lung cancer screening in our study was 3.66 out of 5. The regression model explaining the intention to undergo lung cancer screening accounted for 34.7% of the variance. Significant factors identified included stress level (β = 0.20, P = 0.002), perceived risk (β = 0.13, P = 0.040), self-efficacy (β = 0.35, P < 0.001), and engagement in cancer prevention behavior (β = 0.26, P < 0.001). Conclusions Healthcare providers should implement psychological interventions and provide education about cancer screening for high-risk individuals, aiming to enhance their perceived risk and self-efficacy, thus promoting a higher likelihood of undergoing screening.
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Affiliation(s)
- Mi-Kyoung Cho
- Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Yoon Hee Cho
- Department of Nursing, College of Nursing, Dankook University, Cheonan, Republic of Korea
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Wu W, Zhang L, Wang C, Xu Z, Feng C, Zhang Z, Qin D, Zhang C, Lin F. The prognostic value of the preoperative albumin/globulin and monocyte ratio in resected early-stage non-small cell lung cancer. Asian J Surg 2024; 47:118-123. [PMID: 37419798 DOI: 10.1016/j.asjsur.2023.06.068] [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: 01/06/2023] [Accepted: 06/15/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVE This study investigated the prognostic value of the preoperative albumin/globulin to monocyte ratio (AGMR) in patients with resected non-small cell lung cancer (NSCLC). METHODS The study retrospectively enrolled patients with resected NSCLC from the Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University from January 2016 to December 2017. Baseline demographic and clinicopathological data were collected. The preoperative AGMR was calculated. Propensity score matching (PSM) analysis was applied. The receiver operating characteristic curve was used to determine the optimal AGMR cut-off value. The Kaplan-Meier method was used to calculate the overall survival (OS) and disease-free survival (DFS). The Cox proportional hazards regression model was used to evaluate the prognostic value of the AGMR. RESULTS A total of 305 NSCLC patients were included. The optimal AGMR value was 2.80. Before PSM. The high AGMR (>2.80) group had a significantly longer OS (41.34 + 11.32 vs. 32.03 + 17.01 months; P < 0.01) and DFS (39.00 + 14.49 vs. 28.78 + 19.13 months; P < 0.01) compared with the low AGMR (≤2.80) group. Multivariate analyses showed that AGMR (P < 0.01) in addition to sex (P < 0.05), body mass index (P < 0.01), history of respiratory diseases (P < 0.01), lymph node metastasis (P < 0.01), and tumor size (P < 0.01) were associated with OS and DFS. After PSM, AGMR remained as an independent prognostic factor for OS (hazard ratio [HR] 2.572, 95% confidence interval [CI]: 1.470-4.502; P = 0.001) and DFS (HR 2.110, 95% CI: 1.228-3.626; P = 0.007). CONCLUSION The preoperative AGMR is a potential prognostic indicator for OS and DFS in resected early-stage NSCLC.
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Affiliation(s)
- Wenqi Wu
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Lening Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Chen Wang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Zhenan Xu
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Chong Feng
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Zhe Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Dongliang Qin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Chen Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Fengwu Lin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China.
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Liang S, Cao X, Wang Y, Leng P, Wen X, Xie G, Luo H, Yu R. Metabolomics Analysis and Diagnosis of Lung Cancer: Insights from Diverse Sample Types. Int J Med Sci 2024; 21:234-252. [PMID: 38169594 PMCID: PMC10758149 DOI: 10.7150/ijms.85704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/14/2023] [Indexed: 01/05/2024] Open
Abstract
Lung cancer is a highly fatal disease that poses a significant global health burden. The absence of characteristic clinical symptoms frequently results in the diagnosis of most patients at advanced stages of lung cancer. Although low-dose computed tomography (LDCT) screening has become increasingly prevalent in clinical practice, its high rate of false positives continues to present a significant challenge. In addition to LDCT screening, tumor biomarker detection represents a critical approach for early diagnosis of lung cancer; unfortunately, no tumor marker with optimal sensitivity and specificity is currently available. Metabolomics has recently emerged as a promising field for developing novel tumor biomarkers. In this paper, we introduce metabolic pathways, instrument platforms, and a wide variety of sample types for lung cancer metabolomics. Specifically, we explore the strengths, limitations, and distinguishing features of various sample types employed in lung cancer metabolomics research. Additionally, we present the latest advances in lung cancer metabolomics research that utilize diverse sample types. We summarize and enumerate research studies that have investigated lung cancer metabolomics using different metabolomic sample types. Finally, we provide a perspective on the future of metabolomics research in lung cancer. Our discussion of the potential of metabolomics in developing new tumor biomarkers may inspire further study and innovation in this dynamic field.
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Affiliation(s)
- Simin Liang
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xiujun Cao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yingshuang Wang
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Ping Leng
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xiaoxia Wen
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Guojing Xie
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Huaichao Luo
- Department of Clinical Laboratory, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, China
| | - Rong Yu
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
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Hu P, Song X, Fan X, Zhu Y, Fu X, Fu S. "Low-age, low-frequency" lung cancer screening strategies maybe adaptable to the situation in China. BMC Surg 2023; 23:367. [PMID: 38066463 PMCID: PMC10704619 DOI: 10.1186/s12893-023-02279-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The object was to compare changes in patients undergoing lung surgery before and after COVID-19 outbreak, and to explore the impact of COVID-19 on lung surgery and its coping strategies. METHOD A retrospective review of patients undergoing thoracic surgery at a single institution was conducted. Group A included patients treated between January 23, 2019, and January 23, 2020, while Group B included patients treated between June 1, 2020, and June 1, 2021, at our center. We compared the reasons of seeking medical treatment, the general characteristics of patients, imaging features, pathological features, surgical methods and postoperative recovery. RESULT Compared to Group A, the number of patients with pulmonary nodules screened by routine check-up increased in Group B (57.6% vs 46.9%, p < 0.05). Female patient increased (55.2%vs 44.7%). Patient without smoking history or with family history of lung cancer increased (70.7% vs 60.7%) (10.1%vs 7.8%). Early stage lung cancer increased. Lobectomy decreased (53.4% vs 64.1%). Segmental resection increased (33.3% vs 12.7%). Patients without postoperative comorbidities increased (96.1%vs 85.7%). In the case of patients with Ground Glass Opacity(GGO), their age was comparatively lower (52 ± 9.9 vs. 55 ± 10.7), the female patients increased, patient without smoking history, tumor history, family history of tumor increased, small GGO increased. Lobectomy decreased (35.2% vs 49.7%). Segmental resection increased (49.6% vs 21.2%). Patients without postoperative comorbidities increased (96.5% vs 87.4%). CONCLUSION Since COVID-19 outbreak, more young, non-smoking, female lung cancers, more Ground Glass Opacity, none high risk patients have been detected through screening, suggesting that our current screening criteria for lung cancer may need to be revised. Higher requirements, including the selection of the timing of nodular surgery, surgical methods were put forward for thoracic surgeons' skills.
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Affiliation(s)
- Peixuan Hu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
- The Second Clinical School, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xiaozhen Song
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
- The Second Clinical School, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xiaowu Fan
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yunpeng Zhu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Shengling Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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Han X, Wang X, Li Z, Dou W, Shi H, Liu Y, Sun K. Risk prediction of intraoperative pain in percutaneous microwave ablation of lung tumors under CT guidance. Eur Radiol 2023; 33:8693-8702. [PMID: 37382619 DOI: 10.1007/s00330-023-09874-9] [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: 08/19/2022] [Revised: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To evaluate the effect of intraoperative pain in microwave ablation of lung tumors (MWALT) on local efficacy and establish the pain risk prediction model. METHODS It was a retrospectively study. Consecutive patients with MWALT from September 2017 to December 2020 were divided into mild and severe pain groups. Local efficacy was evaluated by comparing technical success, technical effectiveness, and local progression-free survival (LPFS) in two groups. All cases were randomly allocated into training and validation cohorts at a ratio of 7:3. A nomogram model was established using predictors identified by logistics regression in training dataset. The calibration curves, C-statistic, and decision curve analysis (DCA) were used to evaluate the accuracy, ability, and clinical value of the nomogram. RESULTS A total of 263 patients (mild pain group: n = 126; severe pain group: n = 137) were included in the study. Technical success rate and technical effectiveness rate were 100% and 99.2% in the mild pain group and 98.5% and 97.8% in the severe pain group. LPFS rates at 12 and 24 months were 97.6% and 87.6% in the mild pain group and 91.9% and 79.3% in the severe pain group (p = 0.034; HR: 1.90). The nomogram was established based on three predictors: depth of nodule, puncture depth, and multi-antenna. The prediction ability and accuracy were verified by C-statistic and calibration curve. DCA curve suggested the proposed prediction model was clinically useful. CONCLUSIONS Severe intraoperative pain in MWALT reduced the local efficacy. An established prediction model could accurately predict severe pain and assist physicians in choosing a suitable anesthesia type. CLINICAL RELEVANCE STATEMENT This study firstly provides a prediction model for the risk of severe intraoperative pain in MWALT. Physicians can choose a suitable anesthesia type based on pain risk, in order to improve patients' tolerance as well as local efficacy of MWALT. KEY POINTS • The severe intraoperative pain in MWALT reduced the local efficacy. • Predictors of severe intraoperative pain in MWALT were the depth of nodule, puncture depth, and multi-antenna. • The prediction model established in this study can accurately predict the risk of severe pain in MWALT and assist physicians in choosing a suitable anesthesia type.
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Affiliation(s)
- Xujian Han
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhenjia Li
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China.
| | - Weitao Dou
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Honglu Shi
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Yuanqing Liu
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Kui Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
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Liu D, Zhang R, Yu X, Liao L, Shi S, Chen L. Comparison of two methods for CT-guided pulmonary nodule location before thoracoscopic surgery. Wideochir Inne Tech Maloinwazyjne 2023; 18:680-689. [PMID: 38239574 PMCID: PMC10793156 DOI: 10.5114/wiitm.2023.133073] [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: 08/21/2023] [Accepted: 10/18/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Preoperative computed tomography (CT)-guided localization can shorten the time of video-assisted thoracoscopic surgery (VATS) and accurately aid in pulmonary nodule removal. Aim To discuss the application value and safety of 2 kinds of breast localization needles and anchor localization needles in clinical practice for pulmonary nodules under CT guidance before VATS. Material and methods We retrospectively studied 215 patients with 247 pulmonary nodules, who underwent CT-guided pulmonary nodule location before VATS. The 2 kinds of localization needles were randomly used, and we collected and analysed the clinical data. Results We used breast and anchor localization needles in 27.9% and 72.1% of cases, respectively. Differences were observed in puncture localization time, detachment rate, and visual analogue scale (VAS). The detachment rate (0%) and positioning time (median: 12 min) were less in the anchor than in the breast localization needle group (8.7% and median: 13 min, respectively). The median VAS was approximately 2 and 5 in the anchor and breast localization needle groups, respectively. Surgical pathology revealed that 155 (62.8%) pulmonary nodules were malignant while 92 (37.2%) were benign. The primary distinction in surgical procedures is the higher proportion of segmental resections in the middle and inner band group (19.3%) compared to the periphery band group (4.2%). Conclusions Unlike breast localization needles, anchor localization needles can reduce pain and discomfort after positioning, and they are not easy to decouple. These 2 needles are safe for CT-guided localization, which can shorten the time of VATS and accurately aid in pulmonary nodule removal.
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Affiliation(s)
- Dehao Liu
- Department of Radiology, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China
| | - Rongzhou Zhang
- Department of Radiology, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China
| | - Xiuyi Yu
- Department of Thoracic surgery, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China
| | - Liangzhong Liao
- Department of Radiology, Xiamen Hospital of Traditional Chinese Medicine, HuLi, Xiamen, Fujian, China
| | - Sien Shi
- Department of Thoracic surgery, The First Affiliated Hospital of Xiamen University, SiMing, Xiamen, Fujian, China
| | - Lichun Chen
- Department of Radiology, Xiamen Hospital of Traditional Chinese Medicine, HuLi, Xiamen, Fujian, China
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Fang J, Wang J, Li A, Yan Y, Liu H, Li J, Yang H, Hou Y, Yang X, Yang M, Liu J. Parameterized Gompertz-Guided Morphological AutoEncoder for Predicting Pulmonary Nodule Growth. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:3602-3613. [PMID: 37471191 DOI: 10.1109/tmi.2023.3297209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The growth rate of pulmonary nodules is a critical clue to the cancerous diagnosis. It is essential to monitor their dynamic progressions during pulmonary nodule management. To facilitate the prosperity of research on nodule growth prediction, we organized and published a temporal dataset called NLSTt with consecutive computed tomography (CT) scans. Based on the self-built dataset, we develop a visual learner to predict the growth for the following CT scan qualitatively and further propose a model to predict the growth rate of pulmonary nodules quantitatively, so that better diagnosis can be achieved with the help of our predicted results. To this end, in this work, we propose a parameterized Gempertz-guided morphological autoencoder (GM-AE) to generate any future-time-span high-quality visual appearances of pulmonary nodules from the baseline CT scan. Specifically, we parameterize a popular mathematical model for tumor growth kinetics, Gompertz, to predict future masses and volumes of pulmonary nodules. Then, we exploit the expected growth rate on the mass and volume to guide decoders generating future shape and texture of pulmonary nodules. We introduce two branches in an autoencoder to encourage shape-aware and textural-aware representation learning and integrate the generated shape into the textural-aware branch to simulate the future morphology of pulmonary nodules. We conduct extensive experiments on the self-built NLSTt dataset to demonstrate the superiority of our GM-AE to its competitive counterparts. Experiment results also reveal the learnable Gompertz function enjoys promising descriptive power in accounting for inter-subject variability of the growth rate for pulmonary nodules. Besides, we evaluate our GM-AE model on an in-house dataset to validate its generalizability and practicality. We make its code publicly available along with the published NLSTt dataset.
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Qian C, Zou X, Li W, Li Y, Yu W. The outpost against cancer: universal cancer only markers. Cancer Biol Med 2023; 20:j.issn.2095-3941.2023.0313. [PMID: 38018033 PMCID: PMC10690883 DOI: 10.20892/j.issn.2095-3941.2023.0313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/12/2023] [Indexed: 11/30/2023] Open
Abstract
Cancer is the leading cause of death worldwide. Early detection of cancer can lower the mortality of all types of cancer; however, effective early-detection biomarkers are lacking for most types of cancers. DNA methylation has always been a major target of interest because DNA methylation usually occurs before other detectable genetic changes. While investigating the common features of cancer using a novel guide positioning sequencing for DNA methylation, a series of universal cancer only markers (UCOMs) have emerged as strong candidates for effective and accurate early detection of cancer. While the clinical value of current cancer biomarkers is diminished by low sensitivity and/or low specificity, the unique characteristics of UCOMs ensure clinically meaningful results. Validation of the clinical potential of UCOMs in lung, cervical, endometrial, and urothelial cancers further supports the application of UCOMs in multiple cancer types and various clinical scenarios. In fact, the applications of UCOMs are currently under active investigation with further evaluation in the early detection of cancer, auxiliary diagnosis, treatment efficacy, and recurrence monitoring. The molecular mechanisms by which UCOMs detect cancers are the next important topics to be investigated. The application of UCOMs in real-world scenarios also requires implementation and refinement.
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Affiliation(s)
- Chengchen Qian
- Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai 200233, China
| | - Xiaolong Zou
- Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Wei Li
- Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai 200233, China
- Shandong Epiprobe Medical Laboratory Co., Ltd, Heze 274108, China
| | - Yinshan Li
- People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan 750002, China
| | - Wenqiang Yu
- Shanghai Public Health Clinical Center & Department of General Surgery, Huashan Hospital & Cancer Metastasis Institute & Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Pua BB, O'Neill BC, Ortiz AK, Wu A, D'Angelo D, Cahill M, Groner LK. Results from Lung Cancer Screening Outreach Utilizing a Mobile CT Scanner in an Urban Area. J Am Coll Radiol 2023:S1546-1440(23)00936-5. [PMID: 37984766 DOI: 10.1016/j.jacr.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/20/2023] [Accepted: 10/12/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Lung cancer screening using low-dose (LD) CT reduces lung cancer-specific and all-cause mortality in high-risk individuals, although significant barriers to screening remain. We assessed the outreach of a mobile lung cancer screening program to increase screening accessibility and early detection of lung cancer. METHODS We placed a mobile CT unit in a high-traffic area in New York City and offered free screening to all eligible patients. Characteristics of the mobile screening cohort were compared with those of our hospital-based screening cohort. RESULTS Between December 9, 2019, and January 30, 2020, a total of 216 patients underwent mobile LDCT screening. Compared with the hospital-based screening cohort, mobile screening participants were significantly more likely to be younger, be uninsured, and have lower smoking intensity and were less likely to meet 2013 US Preventive Services Task Force guidelines (but would meet their 2021 guidelines) and self-identify as White race and Hispanic ethnicity. Asian New Yorkers were substantially underrepresented in both hospital and mobile screening cohorts, compared with their level of representation in New York City. Two patients were diagnosed with lung cancer and were treated. Potentially clinically significant non-lung cancer findings were identified in 28.2%, most commonly moderate-severe coronary artery calcification and emphysema. CONCLUSIONS Mobile LDCT screening is useful and effective in detecting lung cancer and other significant findings and may engage a distinct high-risk patient demographic. Disproportionately low screening rates among certain high-risk populations highlight the imperative of implementing strategies aimed at understanding health behaviors and access barriers for diverse populations. Effective care-navigation services, facilitating high-quality care for all patients, are critical.
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Affiliation(s)
- Bradley B Pua
- Division of Interventional Radiology, Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York; Associate Professor of Radiology; Associate Professor of Radiology in Cardiothoracic Surgery; Division Chief, Interventional Radiology; Director, Lung Cancer Screening Program/Radiology Consultation Service.
| | - Brooke C O'Neill
- Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York
| | - Ana K Ortiz
- Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York
| | - Alan Wu
- Division of Biostatistics, Department of Population Health Sciences, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York
| | - Debra D'Angelo
- Division of Biostatistics, Department of Population Health Sciences, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York
| | - Meghan Cahill
- Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York
| | - Lauren K Groner
- Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York; Assistant Professor of Radiology, Division of Cardiothoracic Imaging
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Zhang M, He X, Wu J, Xie F. Differences between physician and patient preferences for cancer treatments: a systematic review. BMC Cancer 2023; 23:1126. [PMID: 37980466 PMCID: PMC10657542 DOI: 10.1186/s12885-023-11598-4] [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: 07/26/2023] [Accepted: 11/01/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Shared decision-making is useful to facilitate cancer treatment decisions. However, it is difficult to make treatment decisions when physician and patient preferences are different. This review aimed to summarize and compare the preferences for cancer treatments between physicians and patients. METHODS A systematic literature search was conducted on PubMed, Embase, PsycINFO, CINAHL and Scopus. Studies elicited and compared preferences for cancer treatments between physicians and patients were included. Information about the study design and preference measuring attributes or questions were extracted. The available relative rank of every attribute in discrete choice experiment (DCE) studies and answers to preference measuring questions in non-DCE studies were summarized followed by a narrative synthesis to reflect the preference differences. RESULTS Of 12,959 studies identified, 8290 were included in the title and abstract screening and 48 were included in the full text screening. Included 37 studies measured the preferences from six treatment-related aspects: health benefit, adverse effects, treatment process, cost, impact on quality of life, and provider qualification. The trade-off between health benefit and adverse effects was the main focus of the included studies. DCE studies showed patients gave a higher rank on health benefit and treatment process, while physicians gave a higher rank on adverse effects. Non-DCE studies suggested that patients were willing to take a higher risk of adverse effects or lower health benefit than physicians when accepting a treatment. CONCLUSIONS Physicians and patients had important preference differences for cancer treatment. More sufficient communication is needed in cancer treatment decision-making.
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Affiliation(s)
- Mengqian Zhang
- School of Pharmaceutical Science and Technology, Tianjin University, No 92 Weijin Road, Nankai District, Tianjin, CO, 300072, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, No 92 Weijin Road, Nankai District, Tianjin, CO, 300072, China.
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, No 92 Weijin Road, Nankai District, Tianjin, CO, 300072, China.
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
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Wang S, Cheng Z, Cui Y, Xu S, Luan Q, Jing S, Du B, Li X, Li Y. PTPRH promotes the progression of non-small cell lung cancer via glycolysis mediated by the PI3K/AKT/mTOR signaling pathway. J Transl Med 2023; 21:819. [PMID: 37974250 PMCID: PMC10652596 DOI: 10.1186/s12967-023-04703-5] [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: 08/22/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The protein tyrosine phosphatase H receptor (PTPRH) is known to regulate the occurrence and development of pancreatic and colorectal cancer. However, its association with glycolysis in non-small cell lung cancer (NSCLC) is still unclear. In this study, we aimed to investigate the relationship between PTPRH expression and glucose metabolism and the underlying mechanism of action. METHODS The expression of PTPRH in NSCLC cells was evaluated by IHC staining, qRT‒PCR and Western blotting. The effect of PTPRH on cell biological behavior was evaluated by colony assays, EdU experiments, Transwell assays, wound healing assays and flow cytometry. Changes in F-18-fluorodeoxyglucose (18F-FDG) uptake and glucose metabolite levels after altering PTPRH expression were detected via a gamma counter and lactic acid tests. The expression of glycolysis-related proteins in NSCLC cells was detected by Western blotting after altering PTPRH expression. RESULTS The results showed that PTPRH was highly expressed in clinical patient tissue samples and closely related to tumor diameter and clinical stage. In addition, PTPRH expression was associated with glycometabolism indexes on 18F-FDG positron emission tomography/computed tomography (PET/CT) imaging, the expression level of Ki67 and the expression levels of glycolysis-related proteins. PTPRH altered cell behavior, inhibited apoptosis, and promoted 18F-FDG uptake, lactate production, and the expression of glycolysis-related proteins. In addition, PTPRH modulated the glycometabolism of NSCLC cells via the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway, as assessed using LY294002 and 740Y-P (an inhibitor and agonist of PI3K, respectively). The same results were validated in vivo using a xenograft tumor model in nude mice. Protein expression levels of PTPRH, glycolysis-related proteins, p-PI3K/PI3K and p-AKT/AKT were measured by IHC staining using a subcutaneous xenograft model in nude mice. CONCLUSIONS In summary, we report that PTPRH promotes glycolysis, proliferation, migration, and invasion via the PI3K/AKT/mTOR signaling pathway in NSCLC and ultimately promotes tumor progression, which can be regulated by LY294002 and 740Y-P. These results suggest that PTPRH is a potential therapeutic target for NSCLC.
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Affiliation(s)
- Shu Wang
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zhiming Cheng
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yan Cui
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Shuoyan Xu
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Qiu Luan
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Shan Jing
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Bulin Du
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xuena Li
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yaming Li
- Department of Nuclear Medicine, The First Hospital of China Medical University, No. 155, Nanjing Northern Street, Shenyang, 110001, Liaoning, People's Republic of China.
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Xiu J, Wang X, Xu W, Wang S, Hu Y, Ding R, Hua Y, Liu D. Diagnostic value of peripheral blood eosinophils for benign and malignant pulmonary nodule. Medicine (Baltimore) 2023; 102:e35936. [PMID: 37932999 PMCID: PMC10627640 DOI: 10.1097/md.0000000000035936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/12/2023] [Indexed: 11/08/2023] Open
Abstract
This retrospective study aims to assess the diagnostic utility of peripheral blood eosinophil counts in distinguishing between benign and malignant pulmonary nodules (PNs) prior to surgical intervention. We involved patients presenting with PNs measuring ≤30 mm as the primary CT imaging finding prior to surgical procedures at the General Hospital of Northern Theater Command in Shenyang, China, during the period spanning 2021 to 2022. Multivariable logistic regression analysis and receiver operator characteristic curve analysis, along with area under the curve (AUC) calculations, were used to determine the diagnostic value of eosinophil. A total of 361 patients with PN were included, consisting of 135 with benign PN and 226 with malignant PN. Multivariable logistic regression analysis showed that eosinophil percentage (OR = 1.909, 95% CI: 1.323-2.844, P < .001), absolute eosinophil value (OR = 0.001, 95% CI: 0.000-0.452, P = .033), tumor diameter (OR = 0.918, 95% CI: 0.877-0.959, P < .001), nodule type (OR = 0.227, 95% CI: 0.125-0.400, P < .001), sex (OR = 2.577, 95% CI: 1.554-4.329, P < .001), and age (OR = 0.967, 95% CI: 0.945-0.989, P = .004) were independently associated with malignant PN. The diagnostic value of regression model (AUC [95% CI]: 0.775 [0.725-0.825]; sensitivity: 74.3%; specificity: 71.1%) was superior to eosinophil percentage (AUC [95% CI]: 0.616 [0.556-0.677]; specificity: 66.8%; specificity: 51.1%) (Delong test: P < .001). Peripheral blood eosinophil percentage might be useful for early malignant PN diagnosis, and combining that with other characteristics might improve the diagnostic performance.
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Affiliation(s)
- Jiawei Xiu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, China Medical University, Shenyang, China
| | - Xilong Wang
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Wei Xu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Shiqi Wang
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Yuhang Hu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Renquan Ding
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Yujuan Hua
- Department of Anesthesiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Dazhi Liu
- Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China
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Huang Y, Bao T, Zhang T, Ji G, Wang Y, Ling Z, Li W. Machine Learning Study of SNPs in Noncoding Regions to Predict Non-small Cell Lung Cancer Susceptibility. Clin Oncol (R Coll Radiol) 2023; 35:701-712. [PMID: 37689528 DOI: 10.1016/j.clon.2023.08.010] [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: 01/10/2023] [Revised: 07/23/2023] [Accepted: 08/30/2023] [Indexed: 09/11/2023]
Abstract
Non-small cell lung cancer (NSCLC) is the most common pathological subtype of lung cancer. Both environmental and genetic factors have been reported to impact the lung cancer susceptibility. We conducted a genome-wide association study (GWAS) of 287 NSCLC patients and 467 healthy controls in a Chinese population using the Illumina Genome-Wide Asian Screening Array Chip on 712,095 SNPs (single nucleotide polymorphisms). Using logistic regression modeling, GWAS identified 17 new noncoding region SNP loci associated with the NSCLC risk, and the top three (rs80040741, rs9568547, rs6010259) were under a stringent p-value (<3.02e-6). Notably, rs80040741 and rs6010259 were annotated from the intron regions of MUC3A and MLC1, respectively. Together with another five SNPs previously reported in Chinese NSCLC patients and another four covariates (e.g., smoking status, age, low dose CT screening, sex), a predictive model by machine learning methods can separate the NSCLC from healthy controls with an accuracy of 86%. This is the first time to apply machine learning method in predicting the NSCLC susceptibility using both genetic and clinical characteristics. Our findings will provide a promising method in NSCLC early diagnosis and improve our understanding of applying machine learning methods in precision medicine.
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Affiliation(s)
- Y Huang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - T Bao
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - T Zhang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - G Ji
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Y Wang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Z Ling
- Chengdu Genepre Technology Co., LTD, Chengdu, Sichuan, China
| | - W Li
- Institute of Respiratory Healthy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Department of Respiratory and Critical Care Medicine, Institute of Respiratory Healthy, Precision Medicine Key Laboratory of Sichuan Province, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu, Sichuan 610041, China; State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu, Sichuan 610041, West China Hospital, China.
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Abstract
Lung cancer represents a large burden on society with a staggering incidence and mortality rate that has steadily increased until recently. The impetus to design an effective screening program for the deadliest cancer in the United States and worldwide began in 1950. It has taken more than 50 years of numerous clinical trials and continued persistence to arrive at the development of modern-day screening program. As the program continues to grow, it is important for clinicians to understand its evolution, track outcomes, and continually assess the impact and bias of screening on the medical, social, and economic systems.
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Affiliation(s)
- Hai V N Salfity
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati School of Medicine, 231 Albert Sabin Way Suite 2472, Cincinnati, OH 45267, USA.
| | - Betty C Tong
- Division of Thoracic Surgery, Department of Surgery, Duke University School of Medicine, Box 3531 DUMC, Durham, NC 27710, USA
| | - Madison R Kocher
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University School of Medicine, Box 3808 DUMC, Durham, NC 27710, USA
| | - Tina D Tailor
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University School of Medicine, Box 3808 DUMC, Durham, NC 27710, USA
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Nguyen TC, Nguyen TP, Cao T, Dao TTP, Ho TN, Nguyen TV, Tran MT. MANet: Multi-branch attention auxiliary learning for lung nodule detection and segmentation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 241:107748. [PMID: 37598474 DOI: 10.1016/j.cmpb.2023.107748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND AND OBJECTIVE Pulmonary nodule detection and segmentation are currently two primary tasks in analyzing chest computed tomography (Chest CT) in order to detect signs of lung cancer, thereby providing early treatment measures to reduce mortality. Even though there are many proposed methods to reduce false positives for obtaining effective detection results, distinguishing between the pulmonary nodule and background region remains challenging because their biological characteristics are similar and varied in size. The purpose of our work is to propose a method for automatic nodule detection and segmentation in Chest CT by enhancing the feature information of pulmonary nodules. METHODS We propose a new UNet-based backbone with multi-branch attention auxiliary learning mechanism, which contains three novel modules, namely, Projection module, Fast Cascading Context module, and Boundary Enhancement module, to further enhance the nodule feature representation. Based on that, we build MANet, a lung nodule localization network that simultaneously detects and segments precise nodule positions. Furthermore, our MANet contains a Proposal Refinement step which refines initially generated proposals to effectively reduce false positives and thereby produce the segmentation quality. RESULTS Comprehensive experiments on the combination of two benchmarks LUNA16 and LIDC-IDRI show that our proposed model outperforms state-of-the-art methods in the tasks of nodule detection and segmentation tasks in terms of FROC, IoU, and DSC metrics. Our method reports an average FROC score of 88.11% in lung nodule detection. For the lung nodule segmentation, the results reach an average IoU score of 71.29% and a DSC score of 82.74%. The ablation study also shows the effectiveness of the new modules which can be integrated into other UNet-based models. CONCLUSIONS The experiments demonstrated our method with multi-branch attention auxiliary learning ability are a promising approach for detecting and segmenting the pulmonary nodule instances compared to the original UNet design.
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Affiliation(s)
- Tan-Cong Nguyen
- University of Science - VNUHCM, Ho Chi Minh City, Viet Nam; University of Social Sciences and Humanities - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam
| | - Tien-Phat Nguyen
- University of Science - VNUHCM, Ho Chi Minh City, Viet Nam; John von Neumann Institute - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam
| | - Tri Cao
- University of Science - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam
| | - Thao Thi Phuong Dao
- University of Science - VNUHCM, Ho Chi Minh City, Viet Nam; John von Neumann Institute - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam; Thong Nhat Hospital, Ho Chi Minh City, Viet Nam
| | - Thi-Ngoc Ho
- University of Social Sciences and Humanities - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam
| | - Tam V Nguyen
- University of Dayton, Dayton, OH, United States.
| | - Minh-Triet Tran
- University of Science - VNUHCM, Ho Chi Minh City, Viet Nam; John von Neumann Institute - VNUHCM, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam
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